Sofosbuvir/Ledipasvir in the Treatment of Chronic Hepatitis C - A Subgroup Analysis from A Nationwide Real-World HCV Registry Program (TACR) in Taiwan

( Ming-Lung Yu ),( Chi-Yi Chen ),( Kuo-Chih Tseng ),( Ching-Chu Lo ),( Pin-Nan Cheng ),( Cheng-Yuan Peng ),( Ming-Jong Bair ),( Chih-Lang Lin ),( Chi-Ming Tai ),( Chi-Chieh Yang ),( Chih-Wen Lin ),( C 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: TASL HCV Registry (TACR) is a nationwide registry program organized and supervised by Taiwan Association for the Study of the Liver (TASL), which aims to setup the database and biobank of patients with chronic hepatitis C (CHC) in Taiwan. The present study aimed to evaluate the treatment outcome of sofosbuvir (SOF)/ledipasvir (LDV) in Taiwanese CHC patients in TACR. Methods: By May 2020, 19 tertiary hospitals, 23 community hospitals and one primary care clinic join the TACR program. The baseline characteristics, prior liver and non-liver related medical history, DAA regimens, laboratory results, treatment course and outcome were recorded. The primary objective was sustained virological response, defined as undetectable HCV RNA 3 months after end-of-treatment (SVR12). Results: A total of 4742 SOF/LDV+ ribavirin treated CHC patients with available SVR12 data from 39 sites were enrolled in the current analysis. The mean age was 61.3 years, and female accounted for 54.8% of the population. The dominant viral genotypes were GT1b (52.6%) and GT2 (35.6%). 1354 (28.6%) patients had liver cirrhosis, including 156 (3.3%) with liver decompensation, 552 (11.6%) had preexisting hepatocellular carcinoma (HCC) before DAAs treatment and 413 (8.7%) had hepatitis B virus dual infections. The overall SVR12 rate was 98.5%, with 98.5%, 98.2%, 99.7% and 98.6% in treatment- naïve non-cirrhotics, treatment-naïve cirrhotics, treatment- experienced non-cirrhotics and treatment-experienced cirrhotics patients, respectively. While patients were stratified by HCV genotype, the SVR12 was 98.5%, 98.4% and 98.5% among those with GT1, GT2 and GT6 infection, respectively. The strongest factor independent associated with treatment failure was DAA adherence < 60% (odds ratio [OR]/95% confidence intervals [CI]: 125.4/25.7-612.4, P<0.0001), followed by active HCC (OR/CI: 6.20/2.57-14.97, P<0.0001), HIV co-infection (OR/CI: 3.01/1.14-7.92, P=0.026), and male gender (OR/ CI: 1.85/1.09-3.13, P=0.023). The eGFR decreased significantly at the end of treatment (EOT) (89.3 ml/min/1.73㎡ vs. 93.2 ml/min/1.73㎡, P< 0.001) and remained stable 3 months after EOT (89.3 ml/min/1.73㎡). However, the decreased eGFR was observed only in patients whose baseline eGFR > 90 ml/ min/1.73㎡. Instead, patients with chronic kidney diseases whose pretreatment eGFR < 60 ml/min/1.73㎡ had improved eGFR after SOF/LDV. Conclusions: SOF/LDV is highly effective in treating CHC patients in real-world setting of Taiwan. The satisfactory result could be explicitly generalized to patients with different viral genotypes and liver disease severities.

Tenofovir Alafenamide for Chronic Hepatitis B Patients with Advanced Fibrosis and Partial Virologic Responses to Oral Nucleos(T)Ide Analogues- Interim Report

( Ming-lung Yu ),( Ming-lun Yeh ),( Chi-yi Chen ),( Pin-nan Cheng ),( Ming-jong Bair ),( Jyh-jou Chen ),( Ching-chu Lo ),( Chi-ming Tai ),( Ching-yang Tsai ),( Kuo-chih Tseng ),( Chien-hung Chen ),( C 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: Insufficient data regarding the treatment strategy for partial response to nucleot(s)ide analogue (NUC) raised the aim of investigating tenofovir alafenamide (TAF) switching for chronic hepatitis B (CHB) patients with advanced fibrosis and partial response to other NUCs. Methods: CHB patients with advanced fibrosis (stage 3 or 4) and under NUC (except TAF) therapy with detectable hepatitis B virus (HBV) DNA for >52 weeks are enrolled to TAF 25 mg/day for 96 weeks. The objectives are viral suppression, alanine aminotransferase (ALT) normalization and safety. Results: From Feb. 2019, 34 patients, including 21 (61.8%) with entecavir, 10 (29.4%) TDF and 3 (8.8%) lamivudine or adefovir, were enrolled (15 [44.1%] male, median 53 years). The fibroscan demonstrated a mean of 10.5 kPa (7 [20.6%] cirrhotic). Sixteen (47.1%) patients were HBV e antigen positive, seven (20.6%) had YMDD mutation. The median HBV DNA level declined from 68.5 IU/mL at enrollment to 27.0 IU/mL at 4^th week, and undetectable at 12^th, 24^th, 36^th week, respectively, after TAF switching, with undetectable HBV DNA in 14/34 (41.2%), 17/33 (51.5%), 15/25 (60.0%), and 9/15 (60.0%) patients and rate of ALT normalization (≤40 U/L) of 85.3%, 85.3%, 84.8%, 92.0%, and 80.0%, respectively, after TAF switching. (figure 1) Two patients experienced transient virological breakthrough and another one developed at the final time follow up. Serum creatinine and eGFR levels were stable after TAF switching (figure 1). Two patients early terminated including one at 12^th week due to personal reason, and another one accidently died at 20^th week due to acute heart attack. Others suffered only mild degrees of adverse events which were considered unrelated to treatment. Conclusions: The preliminary results demonstrated the TAF switching is effective and safe in viral suppression for CHB patients with advanced fibrosis and partial virologic responses to other NUCs.

Real-World Effectiveness and Safety of SOF/LDV for Pa-tients with Chronic Hepatitis C in Taiwan

( Ching-chu Lo ),( Pin-nan Cheng ),( Chi-yi Chen ),( Chung-feng Huang ),( Hsing-tao Kuo ),( Kuo-chih Tseng ),( Yi-hsiang Huang ),( Chi-ming Tai ),( Cheng-yuan Peng ),( Ming-jong Bair ),( Chien-hung Ch 대한간학회 2021 춘·추계 학술대회 (KASL) Vol.2021 No.1

Morphology control of mesoporous Cu₂O by reductants and its photocatalytic activity

Chu, Xiao-Zhong,Cheng, Zhi-Peng,Zhao, Yi-Jiang,Xu, Ji-Ming,Li, Mei-Sheng,Hu, Lei,Zhou, Shou-Yong,Wu, Fei-Yue,Lee, Chang-Ha Elsevier 2017 CERAMICS INTERNATIONAL Vol.43 No.11

<P><B>Abstract</B></P> <P>Mesoporous Cu<SUB>2</SUB>O particles with different morphologies were synthesized via simple one-pot reactions. Effects of reducing agents, dispersant, template, and temperature on the <B>structure</B> of the prepared materials were investigated. Mesoporous flower-shaped Cu<SUB>2</SUB>O materials were obtained at 70℃ using glucose <B>as a reductant</B>. Different hollow microsphere shapes of Cu<SUB>2</SUB>O could be prepared at 40℃ using <B>another type of reductant, ascorbic acid</B>. The results indicated that the uniform morphology of synthesized Cu<SUB>2</SUB>O with mesopores presented a maximum specific surface area of 45.3m<SUP>2</SUP>/g. Furthermore, the as-prepared Cu<SUB>2</SUB>O particles showed good photodegradation efficiencies of methyl orange in the range of 86.0–93.7%, depending on their morphologies.</P>

Comparative analysis of metabolites and in vitro hypoglycemic activity of Taiwanofungus camphoratus cultured using various methods

Ming YongFei,Li Yin,Chu JianZhi,Zhou XiaoShuang,Huang YuXuan,Yang ShuDe,Mu YueJun,Wang Lin,Zhang Rui,Cheng XianHao 한국응용생명화학회 2024 Applied Biological Chemistry (Appl Biol Chem) Vol.67 No.-

Taiwanofungus camphoratus has attracted much attention because it can abundantly produce various active substances that exhibit blood-sugar lowering, immunity improving, and antioxidant properties. Currently, T. camphoratus is cultured using four main methods: cutting wood culture, solid-state fermentation, submerged fermentation, and dish culture. T. camphoratus produces different metabolites under different culture methods. In this study, nontargeted metabolomics was used to compare the metabolites of T. camphoratus produced under these four culture methods. Principal component analysis and supervised partial least squares-discriminant analysis were used to analyze the differences in the metabolites. Moreover, in vitro hypoglycemic activity of T. camphoratus extracts produced under four culture methods was compared by assessing their ability to inhibit the activity of α-glucosidase, α-amylase, and sucrase. A total of 186 metabolites were identified. In total, 127 metabolites were common under the four culture methods. Under solid-state fermentation, submerged fermentation, and cutting wood culture, 12, 1, and 4 metabolites were unique, respectively. The differential metabolites produced by T. camphoratus under four culture methods were mainly triterpenoids, phenolic compounds, and fatty acid compounds. α-glucosidase, α-amylase, and sucrase activity inhibition was the best using T. camphoratus extract obtained under cutting wood culture; the inhibition rates were 55.97%, 51.96%, and 78.02%, respectively, which were comparable to those exhibited by 0.001, 3, and 12 mg/mL acarbose (positive control). The metabolites produced by T. camphoratus and α-glucosidase, α-amylase, and sucrase inhibitory activities were different under the four culture methods. Cutting wood culture exhibited the best enzyme inhibitory activity. This study provided a theoretical basis for further use and development of various culture methods for the rational production of active metabolites of T. camphoratus.

Physical and Physico - Chemical Property Session / Cross - Linked Chitosan and Compound Adsorbent

(Zhen Chu Guo),(Fen Ming Cheng) 한국키틴키토산학회 1998 한국키틴키토산학회지 Vol.3 No.4

Classifying Endemic Fagaceae Species in Taiwan using Leaf Images

( Hao-chun Hsu ),( Cheng-hao Lee ),( Chih-kai Yang ),( Fang-hua Chu ),( Ming-jer Tsai ),( Yan-fu Kuo ) 한국농업기계학회 2018 한국농업기계학회 학술발표논문집 Vol.23 No.1

Fagaceae is one of the plant family which dominate the broad-leaved forests in Taiwan and have considerable value in economy and ecology. Traditionally, plant species identification based on leaf morphologies and is conducted using naked-eye observation. This study is proposed to distinguish the Fagaceae species using image processing and machine learning. In this study, leaf images of 10 Fagaceae species were collected. A serial of traits relevant to leaf morphologies, such as morphological, color, shape, and venation traits, were quantified from the leaf images. A support vector machine classifier was then developed to identify the species using the quantified traits. The proposed approach reached an identification accuracy of 95.8%.

Hypoglycemia Revisited in the Acute Care Setting

Shih-Hung Tsai,Der-Ming Chu,Yen-Yue Lin,Chin-Wang Hsu,Chien-Sheng Cheng 연세대학교의과대학 2011 Yonsei medical journal Vol.52 No.6

Hypoglycemia is a common finding in both daily clinical practice and acute care settings. The causes of severe hypoglycemia (SH) are multi-factorial and the major etiologies are iatrogenic, infectious diseases with sepsis and tumor or autoimmune diseases. With the advent of aggressive lowering of HbA1c values to achieve optimal glycemic control, patients are at increased risk of hypoglycemic episodes. Iatrogenic hypoglycemia can cause recurrent morbidity, sometime irreversible neurologic complications and even death, and further preclude maintenance of euglycemia over a lifetime of diabetes. Recent studies have shown that hypoglycemia is associated with adverse outcomes in many acute illnesses. In addition, hypoglycemia is associated with increased mortality among elderly and non-diabetic hospitalized patients. Clinicians should have high clinical suspicion of subtle symptoms of hypoglycemia and provide prompt treatment. Clinicians should know that hypoglycemia is associated with considerable adverse outcomes in many acute critical illnesses. In order to reduce hypoglycemia-associated morbidity and mortality, timely health education programs and close monitoring should be applied to those diabetic patients presenting to the Emergency Department with SH. ED disposition strategies should be further validated and justified to achieve balance between the benefits of euglycemia and the risks of SH. We discuss relevant issues regarding hypoglycemia in emergency and critical care settings.

Threshold-based Filtering Buffer Management Scheme in a Shared Buffer Packet Switch

Yang, Jui-Pin,Liang, Ming-Cheng,Chu, Yuan-Sun The Korea Institute of Information and Commucation 2003 Journal of communications and networks Vol.5 No.1

In this paper, an efficient threshold-based filtering (TF) buffer management scheme is proposed. The TF is capable of minimizing the overall loss performance and improving the fairness of buffer usage in a shared buffer packet switch. The TF consists of two mechanisms. One mechanism is to classify the output ports as sctive or inactive by comparing their queue lengths with a dedicated buffer allocation factor. The other mechanism is to filter the arrival packets of inactive output ports when the total queue length exceeds a threshold value. A theoretical queuing model of TF is formulated and resolved for the overall packet loss probability. Computer simulations are used to compare the overall loss performance of TF, dynamic threshold (DT), static threshold (ST) and pushout (PO). We find that TF scheme is more robust against dynamic traffic variations than DT and ST. Also, although the over-all loss performance between TF and PO are close to each other, the implementation of TF is much simpler than the PO.

ONYX-II: Efficacy of Ombitasvir/Paritaprevir/Ritonavir + Dasabuvir + Ribavirin in HCV Genotype 1b-Infected Patients with Compensated Cirrhosis from South Korea and Taiwan

( Seung Woon Paik ),( Chi-jen Chu ),( Yan Luo ),( Kwang-hyub Han ),( Jia-horng Kao ),( Jeong Heo ),( Cheng-yuan Peng ),( Yoon Jun Kim ),( Ting-tsung Chang ),( Young-suk Lim ),( Ming Lung Yu ),( Linda 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Background: Chronic hepatitis C virus (HCV) infection is associated with development of complications including hepatocellular carcinoma, liver failure and cirrhosis. Patients with cirrhosis are historically more difficult to cure. In southeastern Asia, the most prevalent HCV genotype (GT) is GT1b. In western populations, the 3 direct-acting antiviral (3-DAA) regimen of ombitasvir (OBV), ritonavir-boosted paritaprevir (PTV/r; identified by AbbVie and Enanta) and dasabuvir (DSV) ± ribavirin (RBV) demonstrated sustained virologic response (SVR) at post-treatment week 12 (SVR12) rates of 99% in patients with GT1b infection and compensated cirrhosis regardless of prior treatment experience. The regimen, however, has not been investigated in southeastern Asian populations. The ONYX-II study is evaluating the efficacy and safety of this regimen in Asian patients with HCV GT1b infection and compensated cirrhosis. Methods: Treatment-naive and interferon-based therapy-experienced patients with HCV GT1b-infection and compensated cirrhosis were enrolled in South Korea, Taiwan, and China, and received 12 weeks of OBV/PTV/r (25 mg/150 mg/100 mg once daily) and DSV (250 mg twice daily) with RBV (weight-based). Patients will be followed for 48 weeks after the last dose of study drugs. The primary objectives are to compare the SVR12 rate to the known SVR rate of telaprevir + peg-interferon (IFN) + RBV therapy, and to assess the safety of OBV/PTV/r + DSV + RBV. Results: Twenty-one and 20 subjects were enrolled in South Korea and Taiwan, respectively. Of South Korean patients, 52% were male and 71% were treatment-experienced; of Taiwanese patients, 45% were male and 65% were treatment-experienced. Safety data and SVR at post-treatment week 4 (SVR4) will be available for presentation. Conclusions: The ONYX-II study evaluates the 3-DAA regimen of OBV/PTV/r + DSV with RBV for Asian patients with compensated cirrhosis and HCV GT1b infection. Resultant data may provide evidence for treatment guidelines for HCV GT1b in this population.