Journal of the Chinese Medical Association : JCMA最新文献

{"title":"Comprehensive genomic profiling of Taiwanese triple-negative breast cancer with a large targeted sequencing panel.","authors":"Chi-Cheng Huang, Yi-Chen Yeh, Han-Fang Cheng, Bo-Fang Chen, Chun-Yu Liu, Yi-Fang Tsai, Hsiang-Ling Ho, Ling-Ming Tseng","doi":"10.1097/JCMA.0000000000001258","DOIUrl":"10.1097/JCMA.0000000000001258","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is a leading cause of cancer-related deaths in women, particularly those with the triple-negative (TN) phenotype. Although novel therapeutic options are emerging, most are biomarker driven. This study utilized comprehensive genomic profiling (CGP) via targeted sequencing to identify actionable alterations in a TN subcohort of the VGH-TAYLOR study.</p><p><strong>Method: </strong>The study included patients with either early-stage (defined by first-line surgery or neoadjuvant therapy) or late-stage (defined by relapse or de novo metastatic disease) breast cancer. CGP was performed using the Illumina TruSight Oncology 500 assay. The level of actionability was assessed using the European Society for Medical Oncology (ESMO) Scale of Clinical Actionability of Molecular Targets (ESCAT) criteria, with additional annotations provided by the PierianDx software and OncoKB database.</p><p><strong>Results: </strong>CGP was successfully performed on 104 TN breast cancer samples. The most common actionable genes (occurring in >10% of cases) were PIK3CA (38%), BRCA2 (25%), PTEN (13%), BRCA1 (13%), ERBB2 (12%), and ERBB3 (11%). After applying a stringent per-variant filter, these frequencies were reduced to 22%, 6%, 5%, 4%, 4%, and 1% for PIK3CA, PTEN, BRCA2, BRCA1, AKT1, and PALB2, respectively. Based on the standard cut-off of 10 mutations/megabase, 24 samples were classified as tumor mutation burden (TMB)-high, whereas 80 were TMB-low. The proportion of TMB-high cases was lower among the early-stage patients compared to the late-stage patients (19% vs. 36%, p < 0.05).</p><p><strong>Conclusion: </strong>This study demonstrates the clinical feasibility and utility of large-scale CGP, enabling the investigation of a broad range of genes and multi-gene signatures, such as TMB and microsatellite instability (MSI). The identification of actionable biomarkers offers the potential to expand therapeutic opportunities for TN breast cancer patients.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repetitive transcranial magnetic stimulation in spinocerebellar ataxia: A promising avenue amidst clinical trial challenges.","authors":"Jong-Ling Fuh","doi":"10.1097/JCMA.0000000000001257","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001257","url":null,"abstract":"","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study of Chinese herbal enema combined with Mesalazine versus Mesalazine alone in the treatment of ulcerative colitis: A randomized controlled trial.","authors":"Jiao Zhang, Bin Shi, Da Li, Yan Du, Shujiang Gu, Haiying Yao, Dongxuan Zhang, Yuan Tao","doi":"10.1097/JCMA.0000000000001259","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001259","url":null,"abstract":"<p><strong>Background: </strong>Mesalazine is a standard treatment for ulcerative colitis (UC). However, it is unclear whether the efficacy of mesalazine combined with traditional Chinese medicine (TCM) enemas is superior to that of mesalazine alone. Therefore, this study aimed to evaluate the clinical effectiveness of TCM enema hydrotherapy combined with mesalazine for active UC.</p><p><strong>Methods: </strong>Patients with active UC were randomly assigned to two treatment groups: a combination of mesalazine and TCM enemas and mesalazine alone. Outcome measures included TCM symptom scores, levels of inflammatory markerss [interleukin-8 (IL-8), tumor necrosis factor α (TNF-α), high-sensitivity C-reactive protein (hs-CRP)], colonoscopy scores (Baron score), disease activity indices [Sutherland Disease Activity Index (DAI), modified Mayo score], and recurrence rates.</p><p><strong>Results: </strong>A total of 80 patients were included in the study. Regarding the primary outcomes, the total effective rate in the combination group was 95%, which was significantly higher than the 75% observed in the mesalazine group (p < 0.05). The recurrence rate was lower in the combined group (2.5%) than in the mesalazine group (17.5%) (p < 0.05). Regarding secondary outcomes, the combination group showed higher reductions in TCM symptom scores than the mesalazine group, particularly in the areas of bloody stool, diarrhea, and abdominal pain (p < 0.05). The combined group also showed significantly lower inflammatory markers (IL-8, TNF-α, hs-CRP) and disease activity scores (Baron score, DAI, modified Mayo score) compared to the mesalazine group (p < 0.05).</p><p><strong>Conclusion: </strong>The combination of TCM enema hydrotherapy and mesalazine therapy led to significant clinical improvement with lower inflammatory responses and reduced recurrence rates in patients with active UC. The combination treatment may be more effective than mesalazine alone and shows promise as a management option for UC.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of endovascular thrombectomy in acute ischemic stroke patients air-transferred from Kinmen to mainland Taiwan.","authors":"Kuan-I Chu, Chun Chien, Chia-Jung Hsu, Hui-Chi Huang, Jui-Yao Tsai, Tzu-Ching Liu, Li-Chi Hsu, Hung-Yu Liu, Nai-Fang Chi, I-Hui Lee, Chih-Ping Chung, Chun-Jen Lin","doi":"10.1097/JCMA.0000000000001256","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001256","url":null,"abstract":"<p><strong>Background: </strong>Since 2018, Taipei Veterans General Hospital (TVGH) has performed endovascular thrombectomy (EVT) on acute ischemic stroke patients air-transferred from Kinmen Hospital (KMH). This study evaluated the clinical profiles and outcomes of these patients, comparing them to those treated directly at TVGH.</p><p><strong>Methods: </strong>In this retrospective study, we included consecutive acute ischemic stroke patients air-transferred from KMH to TVGH for EVT between January 2018 and April 2024. A comparison group comprised patients who presented directly to TVGH and underwent EVT during the same period. Transfer decisions at KMH were based on clinical presentation and neuroimaging evidence of large vessel occlusion. Only patients with salvageable brain tissue (substantial penumbra without a large infarct core) were transferred. Exclusion criteria included a premorbid modified Rankin Scale (mRS) score ≥3, in-hospital stroke, serious advanced illness, or life expectancy <6 months. Primary outcomes were 90-day functional independence (mRS 0-2), 30-day mortality, and symptomatic intracerebral hemorrhage (sICH). Analyses included Mann-Whitney, chi-square tests, and multivariate logistic regression.</p><p><strong>Results: </strong>A total of 275 patients were included: 15 from KMH (mean age 71.1 ± 11.7 years; 40% male; median NIHSS 15) and 260 from TVGH (mean age 73.5 ± 13.6 years; 53% male; median NIHSS 18). KMH patients had longer onset-to-door times [median (IQR) 452.0 (400.0) vs. 217.0 (442.8) minutes; p < 0.001] but shorter door-to-puncture times [121.5 (43.5) vs. 144.0 (55.3) minutes; p = 0.031]. Among KMH patients, the substantial reperfusion rate was 73.3%, 90-day functional independence was 40.0%, sICH rate was 13.3%, and 30-day mortality was 13.3%, outcomes comparable to those of TVGH patients.</p><p><strong>Conclusion: </strong>Despite longer transfer times, air-transferred patients achieved similar safety and efficacy outcomes after EVT compared to directly treated patients. Further studies are warranted to optimize transfer strategies and patient selection.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic insights for neuroendocrine prostate cancer.","authors":"Peng-Hui Wang, Szu-Ting Yang, Chia-Hao Liu","doi":"10.1097/JCMA.0000000000001255","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001255","url":null,"abstract":"","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complexity of Metabolic dysfunction-associated steatotic liver disease (MASLD): State of art review.","authors":"Hsiao-Yun Yeh, Shang-Wei Lin, Hsiao-Chin Shen, Tzu-Hao Li, Hung-Cheng Tsai, Ying-Ying Yang, Han-Chieh Lin, Ming-Chih Hou","doi":"10.1097/JCMA.0000000000001254","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001254","url":null,"abstract":"<p><p>This article reviews the advancements made in the diagnosis and treatment of Metabolic dysfunction-associated steatotic liver disease (MASLD) and its progression to metabolic dysfunction-associated steatohepatitis (MASH). For inhibition of the MASLD progression, newly approved thyroid hormone receptor beta agonists and potential agents, including farnesoid X receptor agonists agonists, peroxisome proliferator-activated receptor agonists, glucagon-like peptide-1 (GLP-1) receptor agonists, GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor co-agonists, and or GIP/GLP-1/glucagon receptor co-agonists, offering new prospects for the the pharmacological management of MASLD. Lifestyle interventions, particularly personalized dietary and exercise regimens, as well as multidisciplinary collaboration, are recognized as vital components of treatment strategies. Although surgical options can yield significant benefits in certain cases, their risks and the criteria for patient selection necessitate more stringent research and guidance. Given the complexity of MASLD-related hepatocellular carcinoma (HCC), various insulin resistance, oxidative stress, gut-liver axis dysregulation, genetics, and epigenetics-based anti-tumor treatments have been ongoing explored to improve outcomes. Considering the global prevalence of MASLD and the relatively young age of disease onset, healthcare providers should be more vigilant in the timely diagnosing of MASLD progression to MASH, cirrhosis, and HCC. Likewise, regular medical check-ups are essential for early disease diagnosis and prevention prior to the development of complications, thereby improving their overall quality of life. Significant progress has been made in the research surrounding MASLD, MASH, and HCC, instilling new hope for future clinical practices.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is C3c structure useful as biomarkers for epithelial ovarian cancer?","authors":"Peng-Hui Wang, Wei-Ting Chao, Tsung-Cheng Kuo","doi":"10.1097/JCMA.0000000000001253","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001253","url":null,"abstract":"","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased serum APOC3 in patients with syphilis can predict the absence of Jarisch-Herxheimer reaction after benzathine penicillin treatment.","authors":"Hung-Chin Tsai, Pei-Yun Chou, Hui-Min Chang, Susan Shin-Jung Lee, Yao-Shen Chen","doi":"10.1097/JCMA.0000000000001238","DOIUrl":"10.1097/JCMA.0000000000001238","url":null,"abstract":"<p><strong>Background: </strong>Apolipoprotein C3 (APOC3) was found to induce inflammation in human monocytes. Jarisch-Herxheimer reaction (JHR) was perceived to be caused by immune reactions of dividing spirochaetes to penicillin treatment. The aim of this study was to investigate the role of APOC3 in patients with syphilis and JHR.</p><p><strong>Methods: </strong>This prospective cohort study enrolled adult patients with active syphilis with/without JHR. Serum samples were collected before and after administration of the first dose of benzathine penicillin and the serum levels of APOC3 were determined by enzyme-linked immunosorbent assay (ELISA). The APOC3 level and changes in APOC3 level before and after benzathine penicillin treatment in different groups were compared with the Mann-Whitney U test or Kruskal-Wallis test.</p><p><strong>Results: </strong>Forty adult patients with syphilis and 32 controls were enrolled. All 40 patients with syphilis were men who have sex with men, and 30 (75%) were people living with human immunodeficiency virus (HIV). Overall, 19 patients (47%) developed JHR. The active syphilis group had a significantly higher serum APOC3 level (median 38.3 µg/mL, interquartile range [IQR]: 34.5-48.0 µg/mL) than the controls ( p = 0.020). The serum levels of APOC3 were higher in the 21 patients without JHR before and after benzathine penicillin treatment compared with the controls (38.9 µg/mL [IQR: 34.5-66.7 µg/mL] and 39.4 µg/mL [IQR: 33.7-62.9] µg/mL vs 31.8 µg/mL [IQR: 27.5-42.2 µg/mL]). Receiving operating characteristic curve analysis showed that the best cutoff value of APOC3 to predict the absence of JHR before benzathine penicillin therapy compared to the controls was 34.2 µg/mL (area under the curve 0.695, p = 0.017, CI = 0.544-0.846, sensitivity = 0.81, specificity = 0.406).</p><p><strong>Conclusion: </strong>A high baseline serum APOC3 level can predict the absence of JHR in patients with syphilis treated with the first dose of benzathine penicillin.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"461-468"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Far-infrared therapy on arteriovenous fistula among hemodialysis patients: A systematic review and meta-analysis.","authors":"Ruhana Che Yusof, Mohd Noor Norhayati, Mohd Yacob Azman","doi":"10.1097/JCMA.0000000000001236","DOIUrl":"10.1097/JCMA.0000000000001236","url":null,"abstract":"<p><strong>Background: </strong>Far-infrared (FIR) is one of the alternative therapies used to improve the performance of arteriovenous fistula (AVF) in hemodialysis patients. This review was done to pool the mean difference of vascular access flow and AVF diameter between the FIR and the control group. It also pooled the risk ratio of 1-year unassisted AVF patency, AVF occlusion, surgical intervention, and AVF malfunction between groups.</p><p><strong>Methods: </strong>The studies were reviewed using a systematic review, meta-analysis, and a search of four databases. The risk of bias in non-randomized studies of interventions (ROBINS-I) and the Revised Cochrane risk-of-bias instrument for randomized trials (RoB-2) were used to assess the data quality. The meta-analysis was performed using the random-effects model by inverse variance to measure the mean difference for continuous data and the Mantel-Haenszel method for dichotomous data.</p><p><strong>Results: </strong>FIR therapy group had a significant difference in risk ratio in 1-year unassisted AVF patency (risk ratio: 1.23 [95% CI, 1.12-1.36]), AVF occlusion (risk ratio: 0.24 [95% CI, 0.08-0.68]), surgical intervention (risk ratio: 0.45 [95% CI, 0.23-0.86]), and AVF malfunction (risk ratio: 0.44 [95% CI, 0.30-0.62]) compared with the control group. However, for vascular access flow and AVF diameter, there was no difference between the groups (mean difference: 68.38 [95% CI, -3.84 to 140.61] and -0.07 [95% CI, -0.31 to 0.17], respectively).</p><p><strong>Conclusion: </strong>The findings showed that the FIR therapy improved AVF performance. However, the limited number of studies primarily from Taiwanese may act differently from others.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"425-432"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential risk factors for delayed neurological sequelae and myocardial injury following acute carbon monoxide poisoning: a retrospective study: Erratum.","authors":"Min-Po Ho, Yuan-Hui Wu, Tsan-Chi Chen, Kuang-Chau Tsai, Chen-Chang Yang","doi":"10.1097/JCMA.0000000000001240","DOIUrl":"10.1097/JCMA.0000000000001240","url":null,"abstract":"","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"492"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}