Taiwanese Parents’ Experience of Making a “Do Not Resuscitate” Decision for Their Child in Pediatric Intensive Care Unit

Shu-Mei Liu,Hung-Ru Lin,Frank L. Lu,Tzu-Ying Lee 한국간호과학회 2014 Asian Nursing Research Vol.8 No.1

Purpose: The purpose of this project was to explore the parental experience of making a “do not resuscitate” (DNR) decision for their child who is or was cared for in a pediatric intensive care unit in Taiwan. Methods: A descriptive qualitative study was conducted following parental signing of a standard hospital DNR form on behalf of their critically ill child. Sixteen Taiwanese parents of 11 children aged 1 month to 18 years were interviewed. Interviews were recorded, transcribed, analyzed and sorted into themes by the sole interviewer plus other researchers. Results: Three major themes were identified: (a) “convincing points to sign”, (b) “feelings immediately after signing”, and (c) “postsigning relief or regret”. Feelings following signing the DNR form were mixed and included “frustration”, “guilt”, and “conflicting hope”. Parents adjusted their attitudes to thoughts such as “I have done my best,” and “the child’s life is beyond my control.” Some parents whose child had died before the time of the interview expressed among other things “regret not having enough time to be with and talk to my child”. Conclusion: Open family visiting hours plus staff sensitivity and communication skills training are needed. To help parents with this difficult signing process, nurses and other professionals in the pediatric intensive care unit need education on initiating the conversation, guiding the parents in expressing their fears, and providing continuing support to parents and children throughout the child’s end of life process.

Preferred Clause Structure n Mandarin Spoken and Written Discourse

( Shu Mei Liu ) 한국언어정보학회 1995 국제 워크샵 Vol.1995 No.-

Use of Clozapine for the Treatment of Schizophrenia: Findings of the 2006 Research on the China Psychotropic Prescription Studies

Tian-Mei Si,Yun-shu Zhang,Liang Shu,Ke-Qing Li,Xie-He Liu,Qi-Yi Mei,Gao-Hua Wang,Pei-Shen Bai,Li-Ping Ji,Xian-Sheng Cheng,Cui Ma,Jian-Guo Shi,Hong-Yan Zhang,Hong Ma,Xin Yu 대한정신약물학회 2012 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.10 No.2

Objective: Clozapine is one of the most commonly used antipsychotic drugs in China. To date, few studies have investigated the patterns the prescription of clozapine nationwide. The present study examined these patterns in China in 2006 and identified the demographic and clinical characteristics associated with the use of clozapine. Methods: Using a standardized protocol and data collection procedure, we surveyed 5,898 patients with schizophrenia in 10provinces with differing levels of economic development. Results: Overall, clozapine had been prescribed for 31.9% (n=1,883) of the patients; however we found considerable variation among the 10 provinces. The frequency of clozapine use was highest in Sichuan (39.3%) and lowest in Beijing (17.3%). The mean daily dose of clozapine was 210.36±128.72 mg/day, and 25.1% of the patients were treated with clozapine in combination with other antipsychotics. Compared with the group not receiving clozapine, clozapine-user had been treated for longer durations and had experienced a greater number of relapses and hospitalizations. Furthermore, those in the clozapine-user had lower family incomes, were less able to seek psychiatric services, and more likely to be male and have a positive family history of schizophrenia. A multiple logistic regression analysis revealed that age, sex, professional help-seeking behaviors, duration of illness, economic status, educational level, and clinical manifestations were associated with the use of clozapine. Conclusion: Clozapine use is common in China. However, use of the antipsychotic varies among provinces, and demographic and clinical factors play important roles in the prescription of clozapine.

The Lived Experience of First-time Mothers with Congenital Heart Disease

Liu Yu-Ting,Lu Chun-Wei,Mu Pei-Fan,Shu Ying-Mei,Chen Chi-Wen 한국간호과학회 2022 Asian Nursing Research Vol.16 No.3

Purpose: Nowadays most children with congenital heart disease (CHD) are expected to survive to adulthood. The healthcare focus needs to pay close attention to the important developmental tasks during their growth process. The women with CHD face some challenges in their critically developmental stages during pregnancy, delivery, and even motherhood. The lived experience of being a mother needs to be further concerned. This study aimed to explore the lived experience of first-time mothers with CHD. Methods: Descriptive phenomenological design was adopted. Semi-structured interviews were conducted from April to August 2018 with 11 primiparous women with CHD, who were recruited from the pediatric and adult cardiology outpatient departments at a medical center and who had a child aged between 6 months and 3 years. Giorgi's phenomenological analysis method was employed. Results: Six main themes arose from the analysis: (1) recognizing pregnancy risks, (2) performing selfcare for health, (3) building self-worth from my baby, (4) adapting to postpartum life and adjusting priorities, (5) enjoying being a first-time mother, and (6) the factors contributing to success in high-risk childbirth. Conclusions: The experiences that occurred prior to and after labor that were identified in this study can assist women with CHD to more capably prepare for and understand the process of becoming a mother, including recognition of the importance of a prepregnancy evaluation. The findings of this study can help women with CHD to better understand the path to becoming a mother and prepare themselves for the challenges that lie ahead.

Cervical Cancer Gene Therapy by Gene Loaded PEG-PLA Nanomedicine

Liu, Bo,Han, Shu-Mei,Tang, Xiao-Yong,Han, Li,Li, Chang-Zhong Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.12

Background and Aims: Advances in the treatment of cervical cancer over the last decade have predominantly involved the development of genes directed at molecular targets. Gene therapy is recognized to be a novel method for the treatment of cervical cancer. Genes can be administered into target cells via nanocarriers. This study aimed to develop systemically administrable nano-vectors. Floate (Fa) containing gene loaded nanoparticles (NPs) could target HeLa human cervical cancer cells through combination with receptors on the cells to increase the nuclear uptake of genetic materials. Methods: Fa was linked onto Poly (ethylene glycol)-b-poly (D, L-lactide) (PEG-PLA) to form Fa-PEG-PLA, and the resulting material was used to load plasmids of enhanced green fluorescence protein (pEGFP) to obtain gene loaded nanoparticles (Fa-NPs/DNA). Physical-chemical characteristics, in vitro release and cytotoxicity of Fa-NPs/DNA were evaluated. The in vitro transfection efficiency of Fa-NPs/DNA was evaluated in HeLa cells and human umbilical vein endothelial cells (HUVEC). PEG-PLA without Fa was used to load pEGFP from NPs/DNA as a control. Results: Fa-NPs/DNA has a particle size of 183 nm and a gene loading quantity of 92%. After 72h of transfection, Fa-NPs/DNA displayed over 20% higher transfection efficiency than NPs/DNA and 40% higher than naked DNA in HeLa cells. However, in HUVECs, no significant difference appeared between Fa-NPs/DNA and NPs/DNA. Conclusions: Fa-PEG-PLA NPs could function as excellent materials for gene loading. This nano-approach could be used as tumor cell targeted medicine for the treatment of cervical cancer.

Fatty Acid Binding Protein 5 (FABP5) Promotes Aggressiveness of Gastric Cancer Through Modulation of Tumor Immunity

Shu Zhang,Mei-qing Qiu,Hui-jun Wang,Ya-fei Ju,Zhen Liu,Tao Wang,Shi-feng Kan,Zhen Yang,Ya-yun Cui,You-qiang Ke,Hong-min He,Li Sun 대한위암학회 2023 Journal of gastric cancer Vol.23 No.2

Purpose: Gastric cancer (GC) is the second most lethal cancer globally and is associated with poor prognosis. Fatty acid-binding proteins (FABPs) can regulate biological properties of carcinoma cells. FABP5 is overexpressed in many types of cancers; however, the role and mechanisms of action of FABP5 in GC remain unclear. In this study, we aimed to evaluate the clinical and biological functions of FABP5 in GC. Materials and Methods: We assessed FABP5 expression using immunohistochemical analysis in 79 patients with GC and evaluated its biological functions following in vitro and in vivo ectopic expression. FABP5 targets relevant to GC progression were determined using RNA sequencing (RNA-seq). Results: Elevated FABP5 expression was closely associated with poor outcomes, and ectopic expression of FABP5 promoted proliferation, invasion, migration, and carcinogenicity of GC cells, thus suggesting its potential tumor-promoting role in GC. Additionally, RNA-seq analysis indicated that FABP5 activates immune-related pathways, including cytokine-cytokine receptor interaction pathways, interleukin-17 signaling, and tumor necrosis factor signaling, suggesting an important rationale for the possible development of therapies that combine FABP5-targeted drugs with immunotherapeutics. Conclusions: These findings highlight the biological mechanisms and clinical implications of FABP5 in GC and suggest its potential as an adverse prognostic factor and/or therapeutic target.

Zebrafish Dnd protein binds to 3`UTR of geminin mRNA and regulates its expression

( Shu Chen ),( Mei Zeng ),( Hua Qin Sun ),( Wen Qian Deng ),( Yi Lu Lu ),( Da Chang Tao ),( Yun Qiang Liu ),( Si Zhong Zhang ),( Yong Xin Ma ) 생화학분자생물학회 (구 한국생화학분자생물학회) 2010 BMB Reports Vol.43 No.6

Dnd (dead end) gene encodes an RNA binding protein and is specifically expressed in primordial germ cells (PGCs) as a vertebrate-specific component of the germ plasma throughout embryogenesis. By utilizing a technique of specific nucleic acids associated with proteins (SNAAP), 13 potential target mRNAs of zebrafish Dnd (ZDnd) protein were identified from 8-cell embryo, and 8 target mRNAs have been confirmed using an RT-PCR analysis. Of the target mRNAs, the present study is focused on the regulation of geminin, which is an inhibitor of DNA replication. Using electrophoretic mobility shift assay (EMSA), we demonstrated that ZDND protein bound the 67-nucleotide region from 864 to 931 in the 3`UTR of geminin mRNA, a sequence containing 60.29% of uridine. Results from a dual-luciferase assay in HEK293 cells showed that ZDND increases the translation of geminin. Taken together, the identification of target mRNA for ZDnd will be helpful to further explore the biological function of Dnd in zebrafish germ-line development as well as in cancer cells. [BMB reports 2010; 43(6): 438-444]

Enhanced ε-Poly-L-lysine Production from Streptomyces ahygroscopicus by a Combination of Cell Immobilization and In Situ Adsorption

( Liu Sheng Rong ),( Qing Ping Wu ),( Ju Mei Zhang ),( Shu Ping Mo ),( Xiao Juan Yang ),( Chun Xiao ) 한국미생물 · 생명공학회 2012 Journal of microbiology and biotechnology Vol.22 No.9

ε-Poly-L-lysine (ε-PL), produced by Streptomyces or Kitasatospora strains, is a homo-poly-amino acid of Llysine, which is used as a safe food preservative. The present study investigates the combined use of cell immobilization and in situ adsorption (ISA) to produce ε-PL in shaken flasks. Loofah sponge-immobilized Streptomyces ahygroscopicus GIM8 produced slightly more ε-PL than those immobilized on synthetic sponge, and sugarcane bagasse. Moreover, loofah sponge supported the maximum biomass. Hence, loofah sponge was chosen for cell immobilization. Meanwhile, the ion-exchange resin D152 was employed for ISA. The loofah sponge-immobilized cells produced 0.54 ± 0.1 g/l ε-PL, which significantly increased to 3.64 ± 0.32 g/l after combining with ISA through the addition of resin bags. The free cells with ISA using the dispersed resin yielded 2.73 ± 0.26 g/l of ε-PL, an increase from 0.82 ± 0.08 g/l. These data illustrate that the proposed combination method improved production most significantly compared with either immobilization or ISA only. Moreover, the immobilized cells could be repeatedly used and an ε-PL total amount of 8.05 ± 0.84 g/l was obtained. The proposed combination method offers promising perspectives for ε-PL production.

Factors that Influence the Presciption of Antipsychotics for Patients with Schizophrenia in China

Tian-Mei Si,Liang Shu,Ke-Qing Li,Xie-He Liu,Qi-Yi Mei,Gao-Hua Wang,Pei-Shen Bai,Li-Ping Ji,Xian-Sheng Chen,Cui Ma,Jian-Guo Shi,Hong-Yan Zhang,Hong Ma,Xin Yu 대한정신약물학회 2011 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.9 No.3

Objective: To investigate the patterns of antipsychotic use in China and to analyze the factors that influence antipsychotic prescriptions. Methods: A standardized survey was conducted from May 20 to 24 2002 in five different regions of China with varying economic levels. The patterns of antipsychotic medication use were analyzed in a sample of 4,779 patients with schizophrenia. The survey gathered information on demographic characteristics, clinical profiles, and antipsychotic medications prescribed. Multiple logistic regression was used to analyze factors related to patterns of antipsychotic medication use. Results: A plurality of patients with schizophrenia was treated with clozapine (39%); this was followed by risperidone, sulpride,chlorpromazine, perphenazine, and haloperidol. More than 56.3% of patients were treated with only one atypical antipsychotic. The mean daily dose of chlorpromazine was 365±253 mg (mean±standard deviation), and 6.5% of patients were treated with depot injections of typical antipsychotic medications. A total of 73.7% (n=3,523) of patients with schizophrenia received monotherapy,24.8% (n=1,183) received two antipsychotics, 1.1% (n=52) received three antipsychotics, and one received four different antipsychotics. Patients often simultaneously received other classes of medications including anticholinergic agents, benzodiazepines,β-blockers, antidepressants, and mood stabilizers. Economic status and clinical symptoms were the main factors that contributed to the patterns of antipsychotic prescription. Conclusion: The present study suggests that atypical antipsychotic medications, especially clozapine, are the primary psychiatric treatments of choice in the management of schizophrenia in China. Moreover, the economic status and clinical profile of the patient are the major factors affecting the prescription of antipsychotic medication.

Pre-treatment Elevated Platelet Count Associates with HER2 Overexpression and Prognosis in Patients with Breast Cancer

Gu, Mei-Ling,Yuan, Cai-Jun,Liu, Xiao-Mei,Zhou, Yi-Chao,Di, Shu-Huan,Sun, Fei-Fei,Qu, Quan-Ying Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.13

Purpose: To research the association between pre-treatment elevated platelet count and clinicopathologic characteristics in breast cancer (BC), as well as explore the relationship between pre-treatment elevated platelet count and HER2 status and prognosis of BC patients. Materials and Methods: A retrospective cohort of BC patients who were newly diagnosed or treated by surgery only and had pathological detection results and platelet values in the Department of Oncology, the First Affiliated Hospital of Liaoning Medical College were enrolled from 1/1/2008 until 31/12/2009, and followed up until 31/12/2014. Age, thrombocyte parameters before chemotherapy and/or radiotherapy, immunohistochemical (IHM) indexes, and regional lymph node (LN) involvement and progression-free survival (PFS) were recorded. Results: A total of 447 eligible subjects were included in this research. As we analyzed, for HER2, positive and negative, the incidence rates of elevated platelet count were 25.8% and 14.7% (P<0.05). In the Cox proportional hazards model both variables were independent risk factors for BC (for HER2, OR, 0.592, 95% confidence interval, CI, 0.355 to 0.985, P=0.044;f or PLT, OR, 0.998, 95% CI, 0.996 to 1.000, P=0.042). For ER, PR, Ki67 and LN involvement, the differences were not statistically significant (P>0.05). Conclusions: In this research, pre-treatment elevated level of platelet count demostrated a significantrelationship with HER2 amplification/overexpression, and both variables significantly influenced the prognosis of BC. However, elevated platelet count did not exhibit any association with ER, PR, Ki67 and LN involvement.