Professionals’ experiences and attitudes toward use of Traditional Chinese Medicine in hospice palliative inpatient care units: A multicenter survey in Taiwan

Yu-Jia Lin,Hsiao-Ting Chang,Ming-Hwai Lin,Ru-Yih Chen,Ping-Jen Chen,Wen-Yuan Lin,Jyh-Gang Hsieh,Ying-Wei Wang,Chung-Chieh Hu,Yi-Sheng Liou,Tai-Yuan Chiu,Chun-Yi Tu,Yi-Jen Wang,Bo-Ren Cheng,Tzeng-Ji Ch 한국한의학연구원 2021 Integrative Medicine Research Vol.10 No.2

Background: Medical staff may have difficulties in using conventional medicine to manage symptoms among terminally ill patients, including adverse effects of the treatment. Traditional Chinese medicine (TCM) is regarded as a complementary or alternative medicine, and has been increasingly used in the field of palliative medicine in recent years. This study aimed to investigate the experiences of and attitudes toward using TCM among palliative care professionals, and to provide preliminary information about its use in palliative care. Methods: This was a cross-sectional survey study conducted in eight inpatient hospice wards in Taiwan between December 2014 and February 2016. The questionnaire was self-administered, and was analyzed with descriptive statistics including Pearson’s Chi-square test and Fisher’s exact test. Results: A total of 251 palliative care professionals responded to the questionnaire, of whom 89.7% and 88.9% believed that the use of TCM could improve the physical symptoms and quality of life in terminally ill patients, respectively. Overall, 59.8%, of respondents suggested that TCM had rare side effects, and 58.2% were worried that TCM could affect the liver and kidney function of patients. In total, 89.7% and 88.0% of professionals agreed there were no suitable clinical practice guidelines and educational programs, respectively, for TCM use in palliative care. Conclusions: Most of the respondents agreed there was insufficient knowledge, skills-training, and continuing education on the use of TCM in terminally ill patients in Taiwan. These results show that to address patient safety considerations, guidelines about use of TCM in palliative care should be established.

Cis-3-O-p-hydroxycinnamoyl Ursolic Acid Induced ROS-Dependent p53-Mediated Mitochondrial Apoptosis in Oral Cancer Cells

Ching-Ying Wang,Chen-Sheng Lin,Chun-Hung Hua,Yu-Jen Jou,Chi-Ren Liao,Yuan-Shiun Chang,Lei Wan,Su-Hua Huang,Mann-Jen Hour,Cheng-Wen Lin 한국응용약물학회 2019 Biomolecules & Therapeutics(구 응용약물학회지) Vol.27 No.1

Cis-3-O-p-hydroxycinnamoyl ursolic acid (HCUA), a triterpenoid compound, was purified from Elaeagnus oldhamii Maxim. This traditional medicinal plant has been used for treating rheumatoid arthritis and lung disorders as well as for its anti-inflammation and anticancer activities. This study aimed to investigate the anti-proliferative and apoptotic-inducing activities of HCUA in oral cancer cells. HCUA exhibited anti-proliferative activity in oral cancer cell lines (Ca9-22 and SAS cells), but not in normal oral fibroblasts. The inhibitory concentration of HCUA that resulted in 50% viability was 24.0 μM and 17.8 μM for Ca9-22 and SAS cells, respectively. Moreover, HCUA increased the number of cells in the sub-G1 arrest phase and apoptosis in a concentrationdependent manner in both oral cancer cell lines, but not in normal oral fibroblasts. Importantly, HCUA induced p53-mediated transcriptional regulation of pro-apoptotic proteins (Bax, Bak, Bim, Noxa, and PUMA), which are associated with mitochondrial apoptosis in oral cancer cells via the loss of mitochondrial membrane potential. HCUA triggered the production of intracellular reactive oxygen species (ROS) that was ascertained to be involved in HCUA-induced apoptosis by the ROS inhibitors YCG063 and N-acetyl-L-cysteine. As a result, HCUA had potential antitumor activity to oral cancer cells through eliciting ROS-dependent and p53-mediated mitochondrial apoptosis. Overall, HCUA could be applicable for the development of anticancer agents against human oral cancer.

Clinical Evidence of Chemotherapy or Endocrine Therapy Maintenance in Patients with Metastatic Breast Cancer: Meta-analysis from Randomized Clinical Trials and Propensity Score Matching of Multicentre Cohort Study

Wei Ren,Yunfang Yu,Huangming Hong,Ying Wang,Quanlong Gao,Yongjian Chen,Peixian Chen,Jianli Zhao,Qiyun Ou,Dagui Lin,Tuping Fu,Yujie Tan,Chenchen Li,Xinxin Xie,Guolin Ye,Jun Tang,Herui Yao 대한암학회 2022 Cancer Research and Treatment Vol.54 No.4

Purpose This study aims to comprehensively evaluate the clinical efficacy of chemotherapy or endocrine therapy maintenance in metastatic breast cancer (MBC) patients. Materials and Methods The meta-analysis of randomized clinical trials (RCTs) and propensity score matching of multicenter cohort study evaluated MBC patients who underwent first-line chemotherapy or endocrine therapy maintenance. This study is registered with PROSPERO: CRD42017071858 and ClinicalTrials.gov: NCT04258163. Results A total of 2,867 patients from 15 RCTs and 760 patients from multicenter cohort were included. The results from meta-analysis showed that chemotherapy maintenance improved progression-free survival (PFS) (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.54 to 0.73; p < 0.001; moderate-quality evidence) and overall survival (OS) (HR, 0.87; 95% CI, 0.78 to 0.97; p=0.016; high-quality evidence) than observation. In the cohort study, for hormone receptor–positive MBC patients, chemotherapy maintenance improved PFS (HR, 0.67; 95% CI, 0.52 to 0.85; p < 0.001) and OS (HR, 0.55; 95% CI, 0.42 to 0.73; p < 0.001) compared with observation, and endocrine therapy maintenance also improved PFS (HR, 0.65; 95% CI, 0.53 to 0.80; p < 0.001) and OS (HR, 0.55; 95% CI, 0.44 to 0.69; p < 0.001). There were no differences between chemotherapy and endocrine therapy maintenance in PFS and OS (all p > 0.05). Regardless of the continuum or switch maintenance therapy, showed prolonged survival in MBC patients who were response to first-line treatment. Conclusion This study provided evidences for survival benefits of chemotherapy and endocrine therapy maintenance in MBC patients, and there was no difference efficacy between chemotherapy and endocrine therapy maintenance for hormone receptor–positive patients.

Nonlinear vibration of hybrid composite plates on elastic foundations

Wei-Ren Chen,Chun-Sheng Chen,Szu-Ying Yu 국제구조공학회 2011 Structural Engineering and Mechanics, An Int'l Jou Vol.37 No.4

In this paper, nonlinear partial differential equations of motion for a hybrid composite plate subjected to initial stresses on elastic foundations are established to investigate its nonlinear vibration behavior. Pasternak foundation and Winkler foundations are used to represent the plate-foundation interaction. The initial stress is taken to be a combination of pure bending stress plus an extensional stress in the example problems. The governing equations of motion are reduced to the time-dependent ordinary differential equations by the Galerkin's method. Then, the Runge-Kutta method is used to evaluate the nonlinear vibration frequency and frequency ratio of hybrid composite plates. The nonlinear vibration behavior is affected by foundation stiffness, initial stress, vibration amplitude and the thickness ratio of layer. The effects of various parameters on the nonlinear vibration of hybrid laminated plate are investigated and discussed.

A national survey on how to improve traditional Chinese medicine learning internationally: Perceptions from both teachers and students

Zhu Yu-Hang,Yan Wu,Hao Zhang,Yanfei Zhao,Yule Ren,Wei Hu,Pan Li,Huiyi Wang,Ying Wang,Boda Zhang,Yujie Wang,Hongwen Yuan,Jiping Zhang,Wenqiang Li,Yufang Zhao,Jie Zhao,Yedong Shi,Yanye Shu,Xiao Zhang,Ya 한국한의학연구원 2022 Integrative Medicine Research Vol.11 No.4

Background With the increasing popularity of traditional Chinese medicine (TCM) by the global community, how to teach basic knowledge of TCM to international students and improve the teaching quality are important issues for teachers of TCM. The present study was to analyze the perceptions from both students and teachers on how to improve TCM learning internationally. Methods A cross-sectional national survey was conducted at 23 universities/colleges across China. A structured, self-reported on-line questionnaire was administered to 34 Chinese teachers who taught TCM course in English and to 1016 international undergraduates who were enrolled in the TCM course in China between 2017 and 2021. Results Thirty-three (97.1%) teachers and 900 (88.6%) undergraduates agreed Chinese culture should be fully integrated into TCM courses. All teachers and 944 (92.9%) undergraduates thought that TCM had important significance in the clinical practice. All teachers and 995 (97.9%) undergraduates agreed that modern research of TCM is valuable. Thirty-three (97.1%) teachers and 959 (94.4%) undergraduates thought comparing traditional medicine in different countries with TCM can help the students better understand TCM. Thirty-two (94.1%) teachers and 962 (94.7%) undergraduates agreed on the use of practical teaching method with case reports. From the perceptions of the undergraduates, the top three beneficial learning styles were practice (34.3%), teacher's lectures (32.5%), case studies (10.4%). The first choice of learning mode was attending to face-to-face teaching (82.3%). The top three interesting contents were acupuncture (75.5%), Chinese herbal medicine (63.8%), and massage (55.0%). Conclusion To improve TCM learning among international undergraduates majoring in conventional medicine, integration of Chinese culture into TCM course, comparison of traditional medicine in different countries with TCM, application of the teaching method with case reports, and emphasization of clinical practice as well as modern research on TCM should be fully considered.

The Effect of pH on the Efficiency of an SBR Processing Piggery Wastewater

LiLong Yan,Yu Liu,Yuan Ren,Xiaohui Wang,Haijing Liang,Ying Zhang 한국생물공학회 2013 Biotechnology and Bioprocess Engineering Vol.18 No.6

To treat piggery wastewater efficiently, thehydrolysis of urea (mainly derived from swine urine) inpiggery wastewater with the change of sewage pH must beconsidered. Using activated sludge, piggery wastewaterwas treated in a sequencing batch reactor (SBR), and theeffects of influent pH on SBR processing efficiency, sludgesettle ability, and sludge activity were investigated. Theresults showed that a high influent pH value contributed tothe improvement of the removal rate of ammonia nitrogenand reduction of the chemical oxygen demand (COD). When the influent pH was between 9.0 and 9.5, the removalrate of ammonia nitrogen was higher than 90%, and thereduction of COD from its original value was 80%. Theinfluent pH had a greater influence on sludge concentrationand sludge activity. When the influent pH increased from7.0 to 9.5, the sludge concentration increased from 2,350 to3,947 mg/L in the reactor, and the activities of ammoniumoxidizing bacteria (AOB) and nitrite oxidizing bacteria(NOB) first increased and then decreased. When theinfluent pH was 9.0 and 8.0, the maximum values (0.48 gO2/(g MLSS/day) and 0.080 g O2/(g MLSS/day)) werereached, and the sludge settling ratio was nearly steadybetween 20 and 35% in each reactor.

Nonlinear vibration of hybrid composite plates on elastic foundations

Chen, Wei-Ren,Chen, Chun-Sheng,Yu, Szu-Ying Techno-Press 2011 Structural Engineering and Mechanics, An Int'l Jou Vol.37 No.4

In this paper, nonlinear partial differential equations of motion for a hybrid composite plate subjected to initial stresses on elastic foundations are established to investigate its nonlinear vibration behavior. Pasternak foundation and Winkler foundations are used to represent the plate-foundation interaction. The initial stress is taken to be a combination of pure bending stress plus an extensional stress in the example problems. The governing equations of motion are reduced to the time-dependent ordinary differential equations by the Galerkin's method. Then, the Runge-Kutta method is used to evaluate the nonlinear vibration frequency and frequency ratio of hybrid composite plates. The nonlinear vibration behavior is affected by foundation stiffness, initial stress, vibration amplitude and the thickness ratio of layer. The effects of various parameters on the nonlinear vibration of hybrid laminated plate are investigated and discussed.

The Candidate Tumor Suppressor Gene SLC8A2 Inhibits Invasion, Angiogenesis and Growth of Glioblastoma

Qu, Mingqi,Yu, Ju,Liu, Hongyuan,Ren, Ying,Ma, Chunxiao,Bu, Xingyao,Lan, Qing Korean Society for Molecular and Cellular Biology 2017 Molecules and cells Vol.40 No.10

Glioblastoma is the most frequent and most aggressive brain tumor in adults. Solute carrier family 8 member 2 (SLC8A2) is only expressed in normal brain, but not present in other human normal tissues or in gliomas. Therefore, we hypothesized that SLC8A2 might be a glioma tumor suppressor gene and detected the role of SLC8A2 in glioblastoma and explored the underlying molecular mechanism. The glioblastoma U87MG cells stably transfected with the lentivirus plasmid containg SLC8A2 (U87MG-SLC8A2) and negative control (U87MG-NC) were constructed. In the present study, we found that the tumorigenicity of U87MG in nude mice was totally inhibited by SLC8A2. Overexpression of SLC8A2 had no effect on cell proliferation or cell cycle, but impaired the invasion and migration of U87MG cells, most likely through inactivating the extracellular signal-related kinases (ERK)1/2 signaling pathway, inhibiting the nuclear translocation and DNA binding activity of nuclear factor kappa B ($NF-{\kappa}B$), reducing the level of matrix metalloproteinases (MMPs) and urokinase-type plasminogen activator (uPA)-its receptor (uPAR) system (ERK1/2-$NF-{\kappa}B$-MMPs/uPA-uPAR), and altering the protein levels of epithelial to mesenchymal transitions (EMT)-associated proteins E-cardherin, vimentin and Snail. In addition, SLC8A2 inhibited the angiogenesis of U87MG cells, probably through combined inhibition of endothelium-dependent and endothelium-nondependent angiogenesis (vascular mimicry pattern). Totally, SLC8A2 serves as a tumor suppressor gene and inhibits invasion, angiogenesis and growth of glioblastoma.

Gene regulations and delivery vectors for treatment of cancer

Ming Chen,Yu‑Xin Ren,Ying Xie,Wan‑Liang Lu 한국약제학회 2020 Journal of Pharmaceutical Investigation Vol.50 No.3

Background Resistant residual cancer and cancer stem cells after comprehensive treatment often result in the recurrence of cancer. The refractory nature of cancer is an important scientific problem to be solved. Area covered An emerging gene regulation strategy of cancer is involved in the cross field of chemistry, genomics, bioinformatics and pharmaceutical sciences, which could offer a possible solution to a curative strategy of cancer. Expert opinion In this review, we dealt with the advances and applications of major gene regulation strategies, including DNA modification, gene editing and RNA regulations. Moreover, we also analyzed the representative transfection carriers for delivering the genetic material into cancer cells, including viral and non-viral vectors. Herein, we conclude that the gene regulation by a safe and high efficient transfection vector would be promising to provide a new treatment strategy for fully recovery of cancer disease.

The Candidate Tumor Suppressor Gene SLC8A2 Inhibits Invasion, Angiogenesis and Growth of Glioblastoma

Mingqi Qu,Ju Yu,Hongyuan Liu,Ying Ren,Chunxiao Ma,Xingyao Bu,Qing Lan 한국분자세포생물학회 2017 Molecules and cells Vol.40 No.10

Glioblastoma is the most frequent and most ag-gressive brain tumor in adults. Solute carrier family 8 member 2 (SLC8A2) is only expressed in normal brain, but not present in other human normal tissues or in gliomas. Therefore, we hy-pothesized that SLC8A2 might be a glioma tumor suppressor gene and detected the role of SLC8A2 in glioblastoma and explored the underlying molecular mechanism. The glioblas-toma U87MG cells stably transfected with the lentivirus plasmid containg SLC8A2 (U87MG-SLC8A2) and negative control (U87MG-NC) were constructed. In the present study, we found that the tumorigenicity of U87MG in nude mice was totally inhibited by SLC8A2. Overexpression of SLC8A2 had no effect on cell proliferation or cell cycle, but impaired the invasion and migration of U87MG cells, most likely through inactivating the extracellular signal-related kinases (ERK)1/2 signaling pathway, inhibiting the nuclear translocation and DNA binding activity of nuclear factor kappa B (NF-κB), reducing the level of matrix metalloproteinases (MMPs) and urokinase-type plasminogen activator (uPA)-its receptor (uPAR) system (ERK1/2-NF-κB-MMPs/uPA-uPAR), and altering the protein levels of epithelial to mesenchymal transitions (EMT)-associated proteins E-cardherin, vimentin and Snail. In addition, SLC8A2 inhibited the angiogenesis of U87MG cells, probably through combined inhibition of endothelium-dependent and endothelium-nondependent angiogenesis (vascular mimicry pattern). Totally, SLC8A2 serves as a tumor suppressor gene and inhibits invasion, angiogenesis and growth of glioblastoma.