Tzu Chi Medical Journal最新文献

{"title":"Combined laryngopharyngeal reflux and obstructive sleep apnea (CLOSA) - Salivary pepsin test for laryngopharyngeal reflux in obstructive sleep apnea patients.","authors":"Shih-Chieh Shen, Yen-Ting Chiang, Liang-Wei Tseng, Chun-Ting Lu, Wan-Ni Lin, Li-Ang Lee, Tuan-Jen Fang, Wen-Nuan Cheng, Hsueh-Yu Li","doi":"10.4103/tcmj.tcmj_55_25","DOIUrl":"10.4103/tcmj.tcmj_55_25","url":null,"abstract":"<p><strong>Objectives: </strong>Reflux disease including gastroesophageal reflux and laryngopharyngeal reflux (LPR) is often found in obstructive sleep apnea (OSA) patients. Endoscopic examination is a gold standard diagnosis for reflux disease. However, the invasive procedure limits its widespread use. The pathophysiological characteristics of LPR are associated with refluxate components, of which pepsin is known to damage the tissues of the larynx and pharynx. Therefore, the detection of salivary pepsin to diagnose LPR becomes a potentially clinical application with noninvasiveness. In this study, we aimed to (1) validate the feasibility of salivary pepsin test for LPR in OSA patients, (2) establish the threshold of salivary pepsin in diagnosing LPR, and (3) explore the relationship between OSA and LPR.</p><p><strong>Materials and methods: </strong>Seventy adult polysomnography-diagnosed OSA patients were enrolled. Reflux finding score (RFS) and salivary pepsin test were utilized to evaluate LPR. RFS is a set of eight objective laryngoscopic findings (total score: 0-26), with a total score of >7 as RFS-positive representing LPR-positive. The salivary pepsin concentration was detected by enzyme-linked immunosorbent assay with a standard protocol.</p><p><strong>Results: </strong>Salivary pepsin test was performed quickly and smoothly in all subjects with no discomfort or side effects. Based on RFS positive, the prevalence of LPR was up to 86% in our study population. There is a trend that the median salivary pepsin concentration in RFS-positive patients was higher than RFS-negative patients (14.9 ng/ml vs. 7.23 ng/ml). The cutoff point (2.3 ng/ml) of salivary pepsin concentration yielded a sensitivity of 93% in the diagnosis of LPR. Neither apnea/hypopnea index nor salivary pepsin concentration was different between LPR-positive versus LPR-negative groups and nonsevere versus severe OSA groups.</p><p><strong>Conclusion: </strong>LPR is highly prevalent in OSA patients. Salivary pepsin test could be an alternative to endoscopic findings for the diagnosis of LPR with noninvasiveness. The threshold of salivary pepsin concentration of 2.3 ng/ml offers 93% sensitivity in the diagnosis of LPR. The relationship between OSA and LPR is bidirectional and more likely to be an overlapping syndrome-combined laryngopharyngeal reflux and OSA (CLOSA). Pharmacologic therapy for LPR is needed in patients with CLOSA for comprehensive treatment.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 4","pages":"437-443"},"PeriodicalIF":1.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432602","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":"Behavioral and pharmacological intervention in autism spectrum disorder: CARS score changes across cognitive levels.","authors":"Purboyo Solek, Uni Gamayani, Kusnandi Rusmil, Irvan Afriandi, Taufan Prasetya, Anggia Farrah Rizqiamuti, Eka Nurfitri, Burhan, Indra Sahril, Kevin Gunawan","doi":"10.4103/tcmj.tcmj_324_24","DOIUrl":"10.4103/tcmj.tcmj_324_24","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate the core symptom of autism in Indonesian children using Childhood Autism Rating Scale (CARS) scores and their relationship with cognitive profiles while evaluating the effectiveness of aripiprazole and behavioral intervention across different cognitive levels.</p><p><strong>Materials and methods: </strong>A multicenter, randomized, double-blind, placebo-controlled trial was conducted in Bandung City, Indonesia, from February 2023 to January 2024. Participants aged 6-10 years with autism spectrum disorder (ASD) were assessed using CARS and Stanford-Binet Intelligence Scales Form L-M. They were randomized to receive either aripiprazole with behavioral therapy (BT) or placebo with BT for 12 weeks. CARS scores and cognitive levels were evaluated at baseline and after treatment.</p><p><strong>Results: </strong>The study enrolled 51 participants (29 placebo and 22 aripiprazole). Both groups showed significant improvements in CARS and cognitive scores over 12 weeks. The aripiprazole group demonstrated greater reductions in CARS scores (5.17 points for higher-cognitive level [HC-ASD]; 4.88 points for lower-cognitive level [LC-ASD] compared to the placebo group. Significant improvements were observed in visual response, taste/smell/touch response, and fear/nervousness CARS subcategories (<i>P</i> < 0.05). Receiver operating characteristic analysis revealed that CARS scores at end-of-treatment (EoT) were strong predictors of cognitive improvement, with an optimal cutoff of 36.25 achieving high sensitivity and specificity (AUC 0.776, <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Early identification, accurate differentiation between LC-ASD and HC-ASD, and targeted interventions combining pharmacological treatment with BT are essential for improving outcomes in children with ASD. These approaches can reduce symptom complexity while fostering long-term functional skills development.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 4","pages":"444-451"},"PeriodicalIF":1.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432549","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":"Effect of early return to work after laparoscopic total extraperitoneal hernia repair: A retrospective comparative cohort study.","authors":"Vincent F S Tsai, Ting-En Tai, Yao-Chou Tsai","doi":"10.4103/tcmj.tcmj_287_24","DOIUrl":"10.4103/tcmj.tcmj_287_24","url":null,"abstract":"<p><strong>Objectives: </strong>Laparoscopic total extraperitoneal (TEP) hernia repair is one of the widely used surgical methods for symptomatic inguinal hernia. Although laparoscopic procedures provide advantages on postoperative complications and shorter convalescence, there is currently no global consensus on the timing for returning to work following laparoscopic hernia repair. This study compared the outcomes of early and late return to work after laparoscopic TEP inguinal hernia repair.</p><p><strong>Materials and methods: </strong>Between March 2008 and December 2019, we reviewed 506 cases of laparoendoscopic TEP hernia repair. Among these, 231 cases where patients returned to work within 1 week postsurgery were classified as the early group, while 275 cases of patients either unemployed or returning to work after more than 1 week were classified as the late group. The primary endpoint was inguinal hernia recurrence. The secondary endpoints included postoperative chronic inguinal pain (defined as persistent pain 6 months postoperation), seroma formation, and the physical function domain of SF-36 v2.</p><p><strong>Results: </strong>The two groups had similar baseline characteristics, except that the early return-to-work group was younger (51 ± 13.1 vs. 58.2 ± 15.9, <i>P</i> < 0.001) and had a lower risk of constipation before the operation (10.0% vs. 18.5%, <i>P</i> = 0.006). The early group did not exhibit an increased rate of inguinal hernia recurrence (1.7% vs. 2.9%, <i>P</i> = 0.386). In addition, the early group experienced significantly less chronic pain (4.8% vs. 11.6%, <i>P</i> = 0.006). There were no differences in postoperative seroma formation or scores of the physical function domain of SF-36 v2 between the early and late groups.</p><p><strong>Conclusion: </strong>Patients who underwent laparoscopic TEP hernia repair and returned to work within 1 week did not show increased hernia recurrence rates or complications. In addition, early return to work was associated with significantly less chronic pain. Returning to work early after TEP repair is both safe and feasible. Patients are encouraged to resume work early following TEP repair.</p>","PeriodicalId":45873,"journal":{"name":"Tzu Chi Medical Journal","volume":"37 4","pages":"418-423"},"PeriodicalIF":1.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145432533","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":"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":"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":"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":"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}