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      • KCI등재

        Traditional Chinese medicine attenuates hospitalization and mortality risks in diabetic patients with carcinoma in situ in Taiwan

        Tsai Li-Jen,Chung Chi-Hsiang,Lin Chien-Jung,Su Sheng-Chiang,Kuo Feng-Chih,Liu Jhih-Syuan,Chen Kuan-Chan,Ho Li-Ju,Kuo Chih-Chun,Chang Chun-Yung,Lin Ming-Hsun,Chu Nain-Feng,Lee Chien-Hsing,Hsieh Chang-H 한국한의학연구원 2022 Integrative Medicine Research Vol.11 No.2

        Background: Diabetic patients are at high risk of developing cancer. Traditional Chinese medicine (TCM) has become increasingly popular as an adjuvant treatment for patients with chronic diseases, and some studies have identified its beneficial effect in diabetic patients with cancer. The purpoes of this study was to outline the potential of TCM to attenuate hospitalization and mortality rates in diabetic patients with carcinoma in situ (CIS). Methods: A total of 6,987 diabetic subjects with CIS under TCM therapy were selected from the National Health Insurance Research Database of Taiwan, along with 38,800 of 1:1 sex-, age-, and index year-matched controls without TCM therapy. Cox proportional hazard analysis was conducted to compare hospitalization and mortality rates during an average of 15 years of follow-up. Results: A total of 3,999/1,393 enrolled-subjects (28.62%/9.97%) had hospitalization/mortality, including 1,777/661 in the TCM group (25.43%/9.46%) and 2,222/732 in the control group (31.80%/10.48%). Cox proportional hazard regression analysis showed a lower rate of hospitalization and mortality for subjects in the TCM group (adjusted HR=0.536; 95% CI=0.367–0.780, P<0.001; adjusted HR=0.783; 95% CI=0.574– 0.974, P = 0.022). Kaplan-Meier analysis showed that the cumulative risk of hospitalization and mortality in the case and control groups was significantly different (log rank, P<0.001 and P = 0.011, respectively). Conclusions: Diabetic patients with CIS under TCM therapy were associated with lower hospitalization and mortality rates compared to those without TCM therapy. Thus, TCM application may reduce the burden of national medical resources.

      • Cases Studies on Total Productive Management and Competitive Advantages

        Li, chang-chung,Tsai, Ping-chen 한국품질경영학회 2001 The Asian Journal on Quality Vol.2 No.1

        The purpose of business strategy is to achieve competitive advantages which includes higher efficiency, better quality, more innovation and faster customer response. In other words, The business strategy is to build unique capability of lower cost and/or differentiation. In production aspect, unique capability means better production power with better performance at 3M(Man, Machine, Material) of input and PQCDSM (Product, Quality, Cost, Delivery, Safety, Moral) from output. The Total Productive management (TPM), a series of improvement activities focused on reduction of equipment loss, is a tool to establish business competitive advantages. In this paper, several domestic companies who won the Japan TPM Award have been studied. It is found that there is a strong cause-effect relationship between TPM and competitive advantages because. 1. TPM can change employees mindset effectively. 2. TPM can upgrade employees capabilities. 3. TPM can lead to excellent productivity.

      • KCI등재

        A Hybrid Dynamic Stabilization and Fusion System in Multilevel Lumbar Spondylosis

        Li-Yu Fay,Chih-Chang Chang,Hsuan-Kan Chang,Tsung-Hsi Tu,Tzu-Yun Tsai,Ching-Lan Wu,Wen-Cheng Huang,Jau-Ching Wu,Henrich Cheng 대한척추신경외과학회 2018 Neurospine Vol.15 No.3

        Objective: The Dynesys-Transition-Optima (DTO) hybrid system was designed to achieve arthrodesis and stabilization in patients with lumbar degeneration. Satisfactory outcomes were demonstrated previously. However, no study has evaluated the effects of using the DTO system in patients with lumbar spondylolisthesis or stenosis. Methods: This retrospective study included 35 consecutive patients with multilevel lumbar degeneration with or without spondylolisthesis who underwent surgery using the DTO system. Imaging studies included pre- and postoperative radiography, magnetic resonance imaging, and computed tomography. The clinical outcomes were measured by Japanese Orthopedic Association (JOA) scores, Oswestry Disability Index (ODI) scores, and a visual analogue scale (VAS) for back and leg pain. Results: Thirty patients (85.7%) with a mean age of 61.9 years completed the follow-up, with a mean duration of 35.1 months. There were 21 patients in the spondylolisthesis group and 9 in the stenosis group. The spondylolisthesis group had worse functional scores than the stenosis group preoperatively. After DTO surgery, all patients showed significant improvements in clinical outcomes, including VAS for back and leg pain, ODI, and JOA scores (p<0.05). There were no significant differences in clinical outcomes between the 2 groups. At a 2-year follow-up, lumbar alignment was well maintained in both groups (p=0.116). There were no significant differences in lumbar alignment between the 2 groups. Conclusion: During a follow-up period of over 2 years, both patients with spondylolisthesis and those with stenosis showed improvements and similar disability and pain scores after surgery using the DTO system. Lumbar alignment was also well maintained.

      • KCI등재

        Upregulating sirtuin 6 ameliorates glycolysis, EMT and distant metastasis of pancreatic adenocarcinoma with krüppel-like factor 10 deficiency

        Tsai Yi-Chih,Chen Su-Liang,Peng Shu-Ling,Tsai Ya-Li,Chang Zuong-Ming,Chang Vincent Hung-Shu,Ch’ang Hui-Ju 생화학분자생물학회 2021 Experimental and molecular medicine Vol.53 No.-

        Krüppel-like factor 10 (KLF10) is a tumor suppressor in multiple cancers. In a murine model of spontaneous pancreatic adenocarcinoma (PDAC), additional KLF10 depletion accelerated distant metastasis. However, Klf10 knockout mice, which suffer from metabolic disorders, do not develop malignancy. The mechanisms of KLF10 in PDAC progression deserve further exploration. KLF10-depleted and KLF10-overexpressing PDAC cells were established to measure epithelial-mesenchymal transition (EMT), glycolysis, and migration ability. A murine model was established to evaluate the benefit of genetic or pharmacological manipulation in KLF10-depleted PDAC cells (PDACshKLF10). Correlations of KLF10 deficiency with rapid metastasis, elevated EMT, and glycolysis were demonstrated in resected PDAC tissues, in vitro assays, and murine models. We identified sirtuin 6 (SIRT6) as an essential mediator of KLF10 that modulates EMT and glucose homeostasis. Overexpressing SIRT6 reversed the migratory and glycolytic phenotypes of PDACshKLF10 cells. Linoleic acid, a polyunsaturated essential fatty acid, upregulated SIRT6 and prolonged the survival of mice injected with PDACshKLF10. Modulating HIF1α and NFκB revealed that EMT and glycolysis in PDAC cells were coordinately regulated upstream by KLF10/SIRT6 signaling. Our study demonstrated a novel KLF10/SIRT6 pathway that modulated EMT and glycolysis coordinately via NFκB and HIF1α. Activation of KLF10/SIRT6 signaling ameliorated the distant progression of PDAC. Clinical Trial Registration: ClinicalTrials.gov. identifier: NCT01666184.

      • Improving the Performance of ITO Thin Films by Coating PEDOT:PSS

        Tsai-Cheng Li,Rwei-Ching Chang 한국정밀공학회 2014 International Journal of Precision Engineering and Vol.1 No.4

        This work studies the effect of PEDOT:PSS on electrical, optical and mechanical properties of ITO glass. Various thickness PEDOT:PSS films are deposited on ITO glass by spin coating. The sheet resistance, transmittance, surface roughness, residual stress, friction, and critical load of the coated specimens are tested in sequence. We find that PEDOT:PSS films not only improve the electric performance but also increase the adhesion of ITO glass. The experimental results show that the PEDOT:PSS film improves the surface roughness and then results in a lower electric resistance. It also increases the adhesion and reduces the residual stress of the ITO films. Furthermore, only 1% transmittance is lost due to the PEDOT:PSS film, showing the potential in the applications of organic photovoltaic cells and light-emitting diodes.

      • SCOPUSKCI등재

        An update of preimplantation genetic diagnosis in gene diseases, chromosomal translocation, and aneuploidy screening

        Chang, Li-Jung,Chen, Shee-Uan,Tsai, Yi-Yi,Hung, Chia-Cheng,Fang, Mei-Ya,Su, Yi-Ning,Yang, Yu-Shih The Korean Society for Reproductive Medicine 2011 Clinical and Experimental Reproductive Medicine Vol.38 No.3

        Preimplantation genetic diagnosis (PGD) is gradually widely used in prevention of gene diseases and chromosomal abnormalities. Much improvement has been achieved in biopsy technique and molecular diagnosis. Blastocyst biopsy can increase diagnostic accuracy and reduce allele dropout. It is cost-effective and currently plays an important role. Whole genome amplification permits subsequent individual detection of multiple gene loci and screening all 23 pairs of chromosomes. For PGD of chromosomal translocation, fluorescence $in-situ$ hybridization (FISH) is traditionally used, but with technical difficulty. Array comparative genomic hybridization (CGH) can detect translocation and 23 pairs of chromosomes that may replace FISH. Single nucleotide polymorphisms array with haplotyping can further distinguish between normal chromosomes and balanced translocation. PGD may shorten time to conceive and reduce miscarriage for patients with chromosomal translocation. PGD has a potential value for mitochondrial diseases. Preimplantation genetic haplotyping has been applied for unknown mutation sites of single gene disease. Preimplantation genetic screening (PGS) using limited FISH probes in the cleavage-stage embryo did not increase live birth rates for patients with advanced maternal age, unexplained recurrent abortions, and repeated implantation failure. Polar body and blastocyst biopsy may circumvent the problem of mosaicism. PGS using blastocyst biopsy and array CGH is encouraging and merit further studies. Cryopreservation of biopsied blastocysts instead of fresh transfer permits sufficient time for transportation and genetic analysis. Cryopreservation of embryos may avoid ovarian hyperstimulation syndrome and possible suboptimal endometrium.

      • Creatine Kinase (CK)-MB-to-Total-CK Ratio: a Laboratory Indicator for Primary Cancer Screening

        Chang, Chih-Chun,Liou, Ching-Biau,Su, Ming-Jang,Lee, Yi-Chen,Liang, Chai-Ting,Ho, Jung-Li,Tsai, Huang-Wen,Yen, Tzung-Hai,Chu, Fang-Yeh Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.15

        Background: For the determination of creatine kinase (CK)-MB, the immunoinhibition method is utilized most commonly. However, the estimated CK-MB activity may be influenced by the presence of CK isoenzymes in some conditions like cancer. Thus, a CK-MB-to-total-CK ratio more than 1.0 could be found in such a situation. The study aimed to explore the relationship of cancer to high CK-MB-to-total-CK ratio. Materials and Methods: From January 2011 to December 2014, laboratory data on all CK-MB and total CK test requests were extracted at Far Eastern Memorial Hospital (88,415 requests). Patients with a CK-MB-to-total-CK ratio more than 1.0 were registered in this study. Clinical data including tumor location, tumor TNM stage and metastatic status were also collected. Results: A total of 846 patients were identified with a CK-MB-to-total-CK ratio more than 1.0. Of these, 339 (40.1%) were diagnosed with malignancies. The mean CK-MB-to-total-CK ratio was significantly higher in malignancy than in non-malignancy ($1.35{\pm}0.28$ vs $1.25{\pm}0.23$, p<0.001) groups. The most frequent malignancy with a CK-MB-to-total-CK ratio more than 1.0 was colorectal cancer ($1.42{\pm}0.28$, 16.5%, n=56), followed by lung cancer ($1.38{\pm}0.24$, 15.9%, n=54) and hepatocellular carcinoma (14.5%, n=49). Higher CK-MB-to-total-CK ratios in hematological malignancies ($1.44{\pm}0.41$)were also noted. Additionally, the CK-MB-to-total-CK ratio was markedly higher in advanced stage malignancy than in early stage ($1.37{\pm}0.26$ vs. $1.29{\pm}0.31$, p=0.014) and significantly higher in liver metastasis than in non-liver metastasis ($1.48{\pm}0.30$ vs. $1.30{\pm}0.21$, p<0.001). Conclusions: The CK-MB-to-total-CK ratio is an easily available indicator and could be clinically utilized as a primary screening tool for cancer. Higher ratio of CK-MB-to-total-CK was specifically associated with certain malignancies, like colorectal cancer, lung cancer and hepatocellular carcinoma, as well as some cancer-associated status factors such as advanced stage and liver metastasis.

      • Proactive Consultation by a Clinical Pathologist Prevents Diagnostic Delay in Hematological Malignancies

        Chang, Chih-Chun,Su, Ming-Jang,Ho, Jung-Li,Sun, Jen-Tang,Tsai, Huang-Wen,Tang, Hui-Fei,Chu, Fang-Yeh Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.3

        Background: Diagnostic difficulties in hematological malignancies may lead to unacceptably prolonged help-seeking to diagnostic interval as well as increased complications and poor outcomes. Proactive consultation by a clinical pathologist (PCCP) may help clinical diagnosis and therapeutic strategy. Hence, the aim of this investigation was to evaluate the effect of PCCP on the help-seeking to diagnostic interval in hematological cancer cases. Materials and Methods: From January to November, 2015, abnormal results of hematological laboratory testing with added laboratory comment were selectively screened out, and patients with such abnormalities in hematological laboratory testing and accompanied laboratory comment with PCCP were enrolled. Results: A total of 125 aberrant results of hematological laboratory testing were given with accompanied laboratory comments with PCCP and 40.8% (n=51) of these patient-oriented comments had an effect on clinical diagnosis and therapeutic strategy. Twelve of the subjects belonged to newly diagnosed hematological malignancies with the assistance of PCCP, and the help-seeking to diagnostic interval was also shortened from 42 days to 26 days in chronic lymphoid leukemia (CLL), from 83 days to 11 days in multiple myeloma (MM), and from 128 days to 15 days in myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN). During the monitoring interval, neither complication events nor deaths were reported in the study group. Conclusions: It was seemingly that PCCP prevented diagnostic delay in hematological malignancies via shortening the help-seeking to diagnostic interval, particularly in CLL, MM and MDS/MPN cases. PCCP can be considered to play an essential role in prompt establishment of diagnosis in hematological malignancies for those who newly present.

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