Tzu Chi Medical Journal最新文献

{"title":"Extrahepatic manifestations of metabolic dysfunction-associated steatotic liver disease: An updated clinical overview.","authors":"Chia-Hsun Tsai, Tsung-Hsing Hung, Tuck-Siu Wong, Chung-Yi Lin, Chia-Lu Hsu, Ping-Hung Ko, Yi-Chun Chou, Hsing-Feng Li, Sou-Hsin Chien, Ching-Sheng Hsu","doi":"10.4103/tcmj.tcmj_158_25","DOIUrl":"10.4103/tcmj.tcmj_158_25","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease worldwide and is closely linked to obesity, insulin resistance, type 2 diabetes, and dyslipidemia. It ranges from simple steatosis to steatohepatitis (metabolic dysfunction-associated steatohepatitis), which can progress to fibrosis, cirrhosis, or liver cancer. Beyond liver-related issues, MASLD is a systemic disease strongly associated with extrahepatic complications such as cardiovascular disease (CVD), chronic kidney disease (CKD), cancers, endocrine disorders, musculoskeletal problems, and sleep apnea. CVD and cancer are the leading causes of death in MASLD patients, with liver-related mortality ranking third. Fibrosis severity is the key predictor of overall and cause-specific mortality. MASLD significantly increases the risk and progression of type 2 diabetes, CVD, and CKD. It is also linked to increased risks of extrahepatic cancers, particularly colorectal, pancreatic, and breast cancers. Endocrine conditions such as hypothyroidism and polycystic ovary syndrome and musculoskeletal disorders, including sarcopenia and osteoporosis, frequently co-occur with MASLD. Obstructive sleep apnea independently contributes to the severity of liver disease and shares overlapping metabolic pathways. Surgical and transplant outcomes are worse in patients with MASLD due to impaired liver regeneration and increased postoperative risks. The recent approval of resmetirom offers a new therapeutic option, whereas lifestyle changes remain the cornerstone of management. Given the multisystemic impact of MASLD, a patient-centered approach is essential for effective treatment and improved long-term results. In this article, we provide an overview of key extrahepatic conditions commonly associated with MASLD and their clinical significance.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 4","pages":"378-385"},"PeriodicalIF":1.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The updated network meta-analysis of the therapeutic efficacies of lung cancer: A systematic review and meta-analysis.","authors":"Chuan-Hsin Chang, Chih-Cheng Chien, Yue-Cune Chang","doi":"10.4103/tcmj.tcmj_264_24","DOIUrl":"10.4103/tcmj.tcmj_264_24","url":null,"abstract":"<p><strong>Objectives: </strong>Lung cancer is one of the most common malignancies worldwide. We aim to investigate the most effective treatments for advanced/nonadvanced stages of lung cancer patients.</p><p><strong>Materials and methods: </strong>We searched electronic databases to investigate the treatment efficacies of lung cancer. The network meta-analysis was used to identify the top five most effective therapeutic strategies. A total of 157 studies were collected with a cumulative total of 164,678 participants.</p><p><strong>Results: </strong>The results showed that the best top five treatments: (1) for advanced lung cancer in response rate, were Chemo + Chemotherapy + Targeted Therapy, Cell therapy + Immunotherapy, Targeted Therapy + Radiotherapy, Chemoradiotherapy + Immunotherapy, and Chemotherapy + Chemoradiotherapy with cumulative probabilities 50.5, 49.6, 47.7, 46.0, and 45.6%; (2) for advanced lung cancer in progression-free survival (PFS) rate, were Targeted + Radiotherapy, Targeted + Others Therapy, Targeted + Targeted Therapy, Immu + Immu + Chemo Therapy, and Chemoradiotherapy with cumulative probabilities 99.5, 82.8, 44.9, 36.5, and 33.6%; (3) for nonadvanced lung cancer in response rate, were Chemoradiotherapy + Immu, Chemoradiotherapy + Targeted therapy, Chemoradiotherapy + Others, Chemotherapy + Surgery, and Radiotherapy + Others with cumulative probabilities 79.1, 74.9, 66.9, 60.4, and 54.2%; (4) for non-advanced lung cancer in PFS rate, were Chemo + Surgery, Chemoradiotherapy + Targeted, Surgery, Surgery + Radiotherapy, and Chemoradiotherapy + Others with cumulative probabilities 88.3, 86.1, 78.3, 73.1, and 50.8%.</p><p><strong>Conclusion: </strong>We present the latest and most effective therapeutic strategies for patients with advanced or nonadvanced stages of lung cancer.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 3","pages":"339-347"},"PeriodicalIF":1.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exosomal long noncoding RNAs and microRNAs in colorectal cancer.","authors":"Yun Yen, Tang-Yuan Chu, Ruo-Chia Tseng","doi":"10.4103/tcmj.tcmj_62_25","DOIUrl":"10.4103/tcmj.tcmj_62_25","url":null,"abstract":"<p><p>This review focuses on the multifaceted roles of exosomal noncoding RNAs (ncRNAs) in colorectal cancer (CRC), utilizing the provided document as the primary source of information. Exosomes, nanoscale vesicles ranging from 30 to 150 nm, act as crucial mediators of intercellular communication, encapsulating bioactive molecules such as microRNAs (miRNAs) and long ncRNAs (lncRNAs). The biogenesis of exosomes involves the endocytic pathway, including the formation of multivesicular bodies and subsequent release of intraluminal vesicles into the extracellular space. This process is regulated by the endosomal sorting complex required for transport (ESCRT) machinery and other ESCRT-independent mechanisms, as well as RNA-binding proteins (RBPs) that selectively package ncRNAs. MiRNAs, shorter single-stranded RNA molecules, regulate gene expression post-transcriptionally by binding to target mRNAs, leading to translational repression or mRNA degradation. LncRNAs, longer RNA molecules, are involved in chromatin remodeling and transcriptional regulation and act as competing endogenous RNAs that modulate miRNA availability. Exosomal ncRNAs play a crucial role in tumorigenesis, where certain miRNAs promote proliferation while others act as tumor suppressors. Furthermore, these ncRNAs are central to the epithelial-mesenchymal transition, a critical process that facilitates metastasis. They also play a role in chemoresistance by modulating drug metabolism and apoptotic pathways. Exosomal ncRNAs also show promise as diagnostic and prognostic biomarkers due to their presence in body fluids and their association with disease progression. Moreover, they hold potential as therapeutic agents through RNA-based therapeutics and exosome-based drug delivery. The challenges involve standardizing exosome research, elucidating the underlying mechanisms, and ensuring successful clinical translation.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 3","pages":"235-246"},"PeriodicalIF":1.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Production of monoclonal antibodies against carcinoembryonic antigen-related cell adhesion molecule 6 and detection of their binding affinities.","authors":"Yun-Hsin Wang, Yau-Hung Chen","doi":"10.4103/tcmj.tcmj_331_24","DOIUrl":"10.4103/tcmj.tcmj_331_24","url":null,"abstract":"<p><strong>Objectives: </strong>Carcinoembryonic antigen-related cell adhesion molecule 6 (CEACAM6) is a glycophosphatidylinositol-anchored member of the immunoglobulin superfamily, often overexpressed in various malignancies. Targeting CEACAM6 by suppressing its expression can potentially reverse these effects, making it a promising therapeutic target. In this study, we generated five monoclonal antibodies (CEAS1, CEAS2, CEAS3, CEAS4, and CEAS5; CEAS1-S5) against the recombinant CEACAM6 protein.</p><p><strong>Materials and methods: </strong>Through enzyme-linked immunosorbent assay (ELISA) and surface plasmon resonance (SPR) assay, we demonstrated that each antibody specifically binds to CEACAM6 without interfering with the binding of others. SPR analysis further revealed the rate of association (K_a), dissociation (K_d), and equilibrium dissociation constants (K_D) for each antibody.</p><p><strong>Results: </strong>The K_D values ranged from 5.089 × 10^-11 to 1.213 × 10^-13 M, with CEAS5 exhibiting the highest binding affinity. In addition, CEAS5, unlike CEAS1-S4, could bind to both CEACAM5 and CEACAM6, indicating its bivalent nature.</p><p><strong>Conclusion: </strong>These findings highlight the strong antigen-binding capabilities of CEAS1-S5, warranting further investigation.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 4","pages":"395-402"},"PeriodicalIF":1.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term cardiovascular outcomes after exercise-based cardiac rehabilitation among coronavirus disease 2019 survivors: A nationwide cohort study.","authors":"Jing-Wun Lu, Sheng-Hsiang Ma, Wei-Fan Ou, Hsin-Hua Chen, Tai-Li Chen, Chung-Chao Liang","doi":"10.4103/tcmj.tcmj_154_24","DOIUrl":"10.4103/tcmj.tcmj_154_24","url":null,"abstract":"<p><strong>Objectives: </strong>Coronavirus disease 2019 (COVID-19) is associated with poor cardiac outcomes and an increased risk of long-term cardiovascular disease. Long-term cardiovascular outcomes among patients with COVID-19 after exercise-based cardiac rehabilitation remain largely unknown. This study aimed to investigate the long-term cardiovascular outcomes of COVID-19 survivors after exercise-based cardiac rehabilitation using real-world data.</p><p><strong>Materials and methods: </strong>We analyzed the data from the US Collaborative Network of the TriNetX Research Database. Adults aged ≥18 years who were diagnosed with COVID-19 between 2020 and 2022 were enrolled in this study. The comparison comprised a cohort of patients receiving exercise-based cardiac rehabilitation and 1:1 propensity score-matched controls.</p><p><strong>Results: </strong>The exercise-based cardiac rehabilitation group was found to have lower risks of developing several long-term cardiovascular outcomes than the controls, such as mortality (hazard ratio [HR] = 0.75 [0.63-0.89]), stroke (HR = 0.81 [0.68-0.94]), myocardial infarction (HR = 0.75 [0.61-0.89]), ischemic cardiomyopathy (HR = 0.86 [0.75-0.99]), heart failure (HR = 0.73 [0.65-0.83]), and nonischemic cardiomyopathy (HR = 0.78 [0.63-0.92]).</p><p><strong>Conclusion: </strong>Among COVID-19 survivors, those undergoing cardiac rehabilitation had lower risks of cardiovascular outcomes, including mortality, stroke, myocardial infarction, ischemic cardiomyopathy, heart failure, and nonischemic cardiomyopathy, than those of controls.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 3","pages":"293-298"},"PeriodicalIF":1.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating quality certification to optimize traumatic brain injury care: A retrospective study.","authors":"Chiu-Feng Wu, Valeria Chiu, Yu-Chen Nien, Kuo-Feng Huang, Tin-Chou Li, Hsien-Ta Hsu","doi":"10.4103/tcmj.tcmj_326_24","DOIUrl":"10.4103/tcmj.tcmj_326_24","url":null,"abstract":"<p><strong>Objectives: </strong>This study assesses the clinical and operational impact of implementing a quality certification program on the care of traumatic brain injury (TBI) patients at a medical center. By evaluating key performance metrics before and after program implementation, this study aims to determine the program's effectiveness in enhancing patient outcomes.</p><p><strong>Materials and methods: </strong>The study retrospectively analyzed 1197 cases, with 827 cases precertification (January 2019-June 2023) and 370 cases postcertification (July 2023-June 2024). Key metrics included Glasgow Coma Scale (GCS) scores, modified Rankin Scale (mRS) scores, Barthel Index (BI) scores, compliance with clinical protocols, hospital length of stay (LOS), healthcare costs, readmission rates, and patient satisfaction. Statistical significance was determined at <i>P</i> < 0.05.</p><p><strong>Results: </strong>The implementation of the quality certification program significantly improved compliance with key protocols. GCS assessment compliance increased from 79.61% to 100%, and timely computed tomography imaging improved from 94.17% to 96.64%. Functional recovery also improved, with mean mRS scores decreasing from 3.63 to 2.79, and mean BI scores increasing from 27.2 to 59.9. Hospital LOS decreased from 10.94 to 9.00 days (<i>P</i> = 0.027). Thirty-day unplanned readmission rates dropped from 5.88% to 3.54%, and patient satisfaction scores improved from 87 to 89, including increases in physician care (+5.84 points) and respect for autonomy (+4.80 points). Healthcare costs decreased marginally from New Taiwan Dollar (NTD) 106,530 to NTD 86,182, though this reduction was not statistically significant (<i>P</i> = 0.23).</p><p><strong>Conclusion: </strong>The quality certification program fostered multidisciplinary collaboration and standardized care, resulting in improved clinical outcomes, greater functional recovery, and enhanced patient satisfaction. These findings underscore the program's value in modern healthcare settings and its potential to optimize TBI care.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"38 1","pages":"110-116"},"PeriodicalIF":1.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective effects of 7-hydroxyflavone on mitochondrial membrane potential and hydrogen peroxide-induced apoptosis in cardiomyocytes.","authors":"Hsuan-Li Huang, Lu-Kai Wang, Fu-Ming Tsai","doi":"10.4103/tcmj.tcmj_21_25","DOIUrl":"10.4103/tcmj.tcmj_21_25","url":null,"abstract":"<p><strong>Objectives: </strong>The objective is to evaluate the protective effects of six coumarin derivatives against peroxide-induced cardiomyocyte damage and investigate their action mechanisms.</p><p><strong>Materials and methods: </strong>Intracellular reactive oxygen species and mitochondrial membrane potential (MMP) were analyzed using dihydrorhodamine 123 and JC-1 combined with flow cytometry. Cell viability and apoptosis were assessed using WST-1 and lactate dehydrogenase analysis kits, respectively. The apoptotic signaling pathway was analyzed using a mouse apoptosis array kit. Cellular protein expression was detected using Western blotting.</p><p><strong>Results: </strong>Among the six coumarin derivatives tested, only 7-hydroxyflavone demonstrated the ability to protect cardiomyocytes from hydrogen peroxide (H₂O₂)-induced damage. Protein expression analysis revealed that 7-hydroxyflavone reduced cytochrome c release from the mitochondria and inhibited H₂O₂-induced activation of caspase-3. In addition, 7-hydroxyflavone maintained MMP stability in cardiomyocytes exposed to H₂O₂.</p><p><strong>Conclusion: </strong>7-hydroxyflavone has potential as an effective antioxidant supplement for cardiac tissues. Further research is required to elucidate its pharmacokinetics and metabolic profile in humans to facilitate its therapeutic application.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 4","pages":"403-411"},"PeriodicalIF":1.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial co-infection and secondary infection in critically ill patients with acute respiratory failure of coronavirus disease 2019.","authors":"Yi-Ting Chen, Ya-Ju Wu, Li-Liang Chuang, Hui-Sheng Wang, Yuan-Chieh Chang","doi":"10.4103/tcmj.tcmj_255_24","DOIUrl":"10.4103/tcmj.tcmj_255_24","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of the study is to understand the prevalence of bacterial co-infection and secondary infection in severe coronavirus disease 2019 (COVID-19) pneumonia in a tertiary hospital intensive care unit (ICU), the spectrum of pathogens, and the impact of these infections on clinical outcomes.</p><p><strong>Materials and methods: </strong>Retrospective analysis of all patients with COVID-19 with acute hypoxemic respiratory failure who were admitted to the ICU requiring invasive mechanical ventilation (IMV) or high-flow nasal cannula (HFNC) from January 2021 to August 2022.</p><p><strong>Results: </strong>Of the 123 cases, 59.3% had culture-confirmed bacterial co-infection, mostly lower respiratory tract infections (LRTIs). Patients with bacterial co-infection had higher 30-day mortality (28.8% vs. 12%, hazard ratio [HR] = 2.96, %95 confidence interval [CI] =1.1-7.99; adjusted HR [aHR] = 1.34, %95 CI = 0.43-4.17). <i>Klebsiella pneumoniae, Staphylococcus aureus, and Pseudomonas aeruginosa</i> were the most common co-infection pathogens. Of the 108 cases who stayed in the ICU for >2 days, 34 (31.5%) cases developed secondary bacterial infections within 30 days, of whom all cases had LRTI, 4 had bacteremia, and 8 had urinary tract infections. IMV users had a higher 1-month incidence of secondary bacterial infections than HFNC users (47.5% vs. 8.9%, <i>P</i> < 0.0001). Patients with secondary bacterial infections had higher 60-day mortality (32.4% vs. 11.2% HR = 3.45, 95% CI = 1.27-9.4; aHR = 2.29, %95 CI =0.8-6.67). The most common secondary infection pathogens were <i>Acinetobacter</i> species, <i>P</i>. <i>aeruginosa, Stenotrophomonas maltophilia</i>, and <i>K</i>. <i>pneumoniae</i>. At the 30-day follow-up, 54 events of ICU-acquired secondary bacterial LRTI were noted in 34 patients, 18 (33.3%) events, and 15 (44%) patients were infected by carbapenem-resistant Gram-negative bacilli.</p><p><strong>Conclusion: </strong>The high incidence of bacterial co-infection and secondary infection in critically ill patients with COVID-19 might associated with increased mortality. Infection by drug-resistant pathogens may develop during the treatment course.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 3","pages":"304-310"},"PeriodicalIF":1.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of survival between open and minimally invasive radical hysterectomies for stage IB1 cervical cancer (≤2 cm): A systematic review and meta-analysis.","authors":"Wing Lam Tsui, Guang-Hong Deng, Tsung-Cheng Hsieh, Pei-Chen Li, Dah-Ching Ding","doi":"10.4103/tcmj.tcmj_268_24","DOIUrl":"10.4103/tcmj.tcmj_268_24","url":null,"abstract":"<p><strong>Objectives: </strong>Cervical cancer remains a leading cause of death among women globally, with surgery being a key treatment for early-stage disease. However, the survival outcomes (disease-free survival [DFS] and overall survival [OS]) of patients with early-stage cervical cancer treated using different surgical methods remain controversial. This systematic review and meta-analysis aimed to evaluate the survival outcomes of laparoscopic radical hysterectomy (LRH) versus open radical hysterectomy (ORH) for treating early-stage cervical cancer (tumor ≤2 cm).</p><p><strong>Materials and methods: </strong>A comprehensive search of the PubMed, Web of Science, and Cochrane databases from 1960 to 2022 identified 12 retrospective cohort studies for inclusion. The primary outcome included DFS and OS. The pooled hazard ratio (HR) with 95% confidence intervals (CI) was calculated to compare DFS and OS. The <i>I</i> ² statistic was used to estimate the heterogeneity of the included studies. A funnel plot was used to examine publication bias. Review Manager version 5.4 software was used for the analysis. <i>P</i> < 0.05 was statistically significant.</p><p><strong>Results: </strong>The results showed no significant difference between LRH and ORH in a 5-year OS (HR = 1.25; 95% CI, 0.82-1.86; <i>P</i> = 0.3) or 5-year DFS (HR = 1.03; 95% CI, 0.67-1.57; <i>P</i> = 0.9), with minimal publication bias in DFS.</p><p><strong>Conclusion: </strong>LRH is a safe and effective alternative to ORH for early-stage cervical cancer, with similar survival outcomes. The results may encourage further research into optimizing minimally invasive techniques, potentially influencing the clinical guidelines and promoting the broader adoption of LRH in treating cervical cancer.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 4","pages":"430-436"},"PeriodicalIF":1.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The best pooling strategy to reduce polymerase chain reaction tests during the coronavirus disease-19 pandemic at low prevalence.","authors":"Chen-Lun Chu, Tai-Yin Wu, Sheng-Mou Hou, Kao-Shang Shih, Yo-Lun Chu, Cheng-Kuang Chen, Li-Wei Hung, Hao-Wei Hsu, Chen-Kun Liaw","doi":"10.4103/tcmj.tcmj_244_24","DOIUrl":"10.4103/tcmj.tcmj_244_24","url":null,"abstract":"<p><strong>Objectives: </strong>Pooling can reduce reverse transcriptase polymerase chain reaction (RT-PCR) tests during the coronavirus disease-19 (COVID-19) pandemic. Pooling strategy is a complex issue. Recent advances in computer science may provide a better strategy.</p><p><strong>Materials and methods: </strong>We developed our algorithm which can help healthcare workers set up their pooling policy during the COVID-19 pandemic.</p><p><strong>Results: </strong>Comparing with three other strategies, naming single pooling, array pooling, and hypercube pooling, our multiple pooling shows to be the best with minimal RT-PCR tests per patient.</p><p><strong>Conclusion: </strong>We hope clinicians in COVID-19 pandemic regions can use our algorithm to reduce both RT-PCR tests and time and hence save more lives.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 3","pages":"299-303"},"PeriodicalIF":1.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}