Impact of coronavirus disease 2019 (COVID-19) on antimicrobial resistance among major pathogens causing healthcare-associated infection.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has caused great impact on healthcare systems, including antibiotic usage and multi-drug resistant (MDR) bacterial infections at hospitals. We aim to investigate the trends of antimicrobial resistance among the major pathogens causing healthcare-associated infection (HAI) at intensive care units (ICU). MATERIAL AND METHODS: The demographic characteristics of hospitalization, usage of antimicrobial agents, counted by half-an-year DID (defined daily dose per 1000 patient-days), and HAI density of five major MDR bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Klebsiella pneumoniae (CRKP), and carbapenem-resistant Pseudomonas aeruginosa (CRPA), of ICU patients at a medical center in Taiwan during January 2017 to December 2021 were collected and analyzed. RESULTS: The total antibiotic usage, counted by DID, had a significant increasing trend, before COVID-19 occurrence in 2017-2019, but no further increase during the pandemic period in 2020-2021. However, comparing the two time periods, antibiotics consumption was significantly increased during pandemic period. There was no significant change of HAI density in MRSA, VRE, CRAB, CRKP, and CRPA, comparing the pandemic to the pre-pandemic period. Although, CRKP and CRPA infection rates were increasing during the pre-pandemic period, there was no further increase of CRKP and CRPA HAI rates during the pandemic period. CONCLUSION: During COVID-19 pandemic, there was no significant increase in HAI density of five major MDR bacteria at ICU in Taiwan, despite increased antibiotic usage. Strict infection prevention measures for COVID-19 precautions and sustained antimicrobial stewardship probably bring these effects.

Monitoring the performance of a dedicated weaning unit using risk-adjusted control charts for the weaning rate in prolonged mechanical ventilation.

BACKGROUND: Weaning rate is an important quality indicator of care for patients with prolonged mechanical ventilation (PMV). However, diverse clinical characteristics often affect the measured rate. A risk-adjusted control chart may be beneficial for assessing the quality of care. METHODS: We analyzed patients with PMV who were discharged between 2018 and 2020 from a dedicated weaning unit at a medical center. We generated a formula to estimate monthly weaning rates using multivariate logistic regression for the clinical, laboratory, and physiologic characteristics upon weaning unit admission in the first two years (Phase I). We then applied both multiplicative and additive models for adjusted p-charts, displayed in both non-segmented and segmented formats, to assess whether special cause variation existed. RESULTS: A total of 737 patients were analyzed, including 503 in Phase I and 234 in Phase II, with average weaning rates of 59.4% and 60.3%, respectively. The p-chart of crude weaning rates did not show special cause variation. Ten variables from the regression analysis were selected for the formula to predict individual weaning probability and generate estimated weaning rates in Phases I and II. For risk-adjusted p-charts, both multiplicative and additive models showed similar findings and no special cause variation. CONCLUSION: Risk-adjusted control charts generated using a combination of multivariate logistic regression and control chart-adjustment models may provide a feasible method to assess the quality of care in the setting of PMV with standard care protocols.

Automatic tube compensation for liberation from prolonged mechanical ventilation in tracheostomized patients: A retrospective analysis.

BACKGROUND: To analyze the predictability of an automatic tube compensation (ATC) screening test compared with the conventional direct liberation test performed before continuous oxygen support for MV liberation. METHODS: This retrospective study analyzed tracheostomized patients with prolonged MV in a weaning unit of a medical center in Taiwan. In March 2020, a four-day ATC test to screen patient eligibility for ventilator liberation was implemented, intended to replace the direct liberation test. We compared the predictive accuracy of these two screening methods on the relevant outcomes in the two years before and one year after the implementation of this policy. RESULTS: Of the 403 cases, 246 (61%) and 157 (39%) received direct liberation and ATC screening tests, respectively. These two groups had similar outcomes: successful weaning upon leaving the Respiratory Care Center (RCC), success on day 100 of MV, success at hospital discharge, and in-hospital survival. Receiver operating characteristic curve analysis showed that the ATC screening test had better predictive ability than the direct liberation test for RCC weaning, discharge weaning, 100-day weaning, and in-hospital survival. CONCLUSION: This closed-circuit ATC screening test before ventilator liberation is a feasible and valuable method for screening PMV patients undergoing ventilator liberation in the pandemic era. Its predictability for a comparison with the open-circuit oxygen test requires further investigation.

Update and review of the gerodontology prospective for 2020's: Linking the interactions of oral (hypo)-functions to health vs. systemic diseases.

New lines of evidence suggest that the oral-systemic medical links and oral hypo-function are progressively transcending beyond the traditional clinical signs and symptoms of oral diseases. Research into the dysbiotic microbiome, host immune/inflammatory regulations and patho-physiologic changes and subsequent adaptations through the oral-systemic measures under ageism points to pathways leading to mastication deficiency, dysphagia, signature brain activities for (neuro)-cognition circuitries, dementia and certain cancers of the digestive system as well. Therefore, the coming era of oral health-linked systemic disorders will likely reshape the future of diagnostics in oral geriatrics, treatment modalities and professional therapies in clinical disciplines. In parallel to these highlights, a recent international symposium was jointly held by the International Association of Gerontology and Geriatrics (IAGG), Japanese Society of Gerodontology (JSG), the representative of USA and Taiwan Academy of Geriatric Dentistry (TAGD) on Oct 25th, 2019. Herein, specific notes are briefly addressed and updated for a summative prospective from this symposium and the recent literature.

Small nucleolar RNA is potential as a novel player in leukemogenesis and clinical application.

Lack of clarity of the mechanisms that underlie leukemogenesis obstructs the diagnosis, prognosis, and treatment of leukemia. Research has found that small nuclear RNA (snoRNA) plays an essential role in leukemia. These small non-coding RNAs are involved in ribosome biogenesis, including the 2'-O-methylation and pseudouridylation of precursor ribosomal RNA (pre-rRNA), and pre-rRNA splicing. Recently, many snoRNAs were found to be orphans that have no predictable RNA modification targets, but these RNAs have always been found to be located in different subcellular organelles, and they play diverse roles. Using high-throughput technology, snoRNA expression profiles have been revealed in leukemia, and some of the deregulated snoRNAs may regulate the cell cycle, differentiation, proliferation, and apoptosis in leukemic cells and confer drug resistance during leukemia treatment. In this review, we discuss the expression profiles and functions of snoRNAs, particularly orphan snoRNAs, in leukemia. It is possible that the dysregulated snoRNAs are promising diagnosis and prognosis markers for leukemia, which may serve as potential therapeutic targets in leukemia treatment.

Preceptors' Subjective Competency Ratings in Acute Care Hospitals in Taiwan.

BACKGROUND: This study focused on developing a Subjective Competency Scale (SCS) in acute care hospitals and identified factors that affect preceptors' competency to precept new graduate nurses (NGNs). METHOD: This study was conducted in two stages that included collecting information on preceptor training courses and conducting a cross-sectional questionnaire survey. A total of 350 preceptors completed the survey in 2011. The validity and reliability of the SCS were determined. RESULTS: An SCS was developed using 22 items and five factors: teaching/assessment skills, interpersonal/communication skills, confidence/self-assurance, problem-solving/stress-coping skills, and self-reflection. These explained 69.73% of the variance. Cronbach's alpha for these five factors of scale ranged from .715 to .889. Preceptors' subjective competency was correlated positively with age, years as a nurse, years as a preceptor, willingness to be a preceptor, and self-rated relationship with NGNs (p < .001). CONCLUSION: The SCS exhibited high validity and reliability; therefore, it can be used for future preceptors' subjective competency assessment and evaluation. [J Contin Educ Nurs. 2019;50(2):69-78.].

Chemopreventive effect of Toona sinensis leaf extract on 7,12-dimethylbenz[a]anthracene-induced hamster buccal pouch squamous cell carcinogenesis.

OBJECTIVE: Toona sinensis leaf extract (TSL) has been shown to have anti-tumor effects on cancer cell lines. This study aimed to investigate the chemopreventive potential and the underlying mechanism of TSL during 7,12-dimethylbenz[a]anthracene (DMBA)-induced hamster buccal pouch (HBP) carcinogenesis. METHODS: One hundred hamsters were divided into control (n=30), carcinogenic (n=20), preventive (n=42), and therapeutic (n=8) groups. The animals in carcinogenic and preventive groups were administered reverse osmosis water (carcinogenic group) or TSL (1g/kg bw) (preventive group) by gavage daily for 4 weeks, and their bilateral pouches were painted with a 0.5% DMBA solution for 4, 9, and 12 weeks. The animals in the therapeutic group were treated with DMBA for 12 weeks prior to TSL administration for 4 weeks. Expression levels of survivin, X chromosome-linked inhibitor of apoptosis (XIAP), proliferating cell nuclear antigen (PCNA), inducible nitric oxide synthase (iNOS), and cyclooxygenase-2 (COX-2) proteins were analyzed by immunohistochemistry. Apoptotic activity was examined by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) method, cytochrome C, and poly (ADP-ribose) polymerase (PARP). RESULTS: In the preventive group, the results showed significant decreases not only in the incidences of squamous cell carcinoma (SCC) (50%) and epithelial dysplasia (62.5%) but also in the tumor number, tumor volume, tumor burden, and the severity of dysplastic lesions. The down-regulation of survivin, XIAP, PCNA, iNOS, and COX-2 proteins and the increased apoptotic activity indicated anti-proliferative and apoptosis-inducing abilities of TSL on DMBA-induced HBP carcinogenesis. CONCLUSIONS: The results suggested that TSL might be a promising candidate for the prevention of oral cancer.

Sialolithiasis of minor salivary glands: A review of 17 cases.

BACKGROUND/PURPOSE: To our knowledge, sialolithiasis in minor salivary glands is very rare, and information about the disease is limited. The current study aimed to provide updated data regarding the disease in Taiwan. The data were compared with those of previous case series studies. MATERIALS AND METHODS: The features of 17 cases of histopathologically confirmed sialolithiasis in minor salivary glands between 1991 and 2015 in our institution were retrospectively analyzed. RESULTS: Most of the patients were male (n = 14; 82.35%), with only three female patients (17.65%). The mean age of the 17 patients was 62.93 years (range, 35-82 years). Fifteen cases (∼88%) were found within the 6th-9th decades. Seven cases (∼41%) were identified in patients aged ≥70 years, six of which had been diagnosed in the most recent 5 years (2011-2015). The most common site was the buccal mucosa (n = 7; 41.18%), followed by the upper lip (n = 5; 29.41%), lower lip (n = 3; 17.65%), and vestibule and retromolar area (each n = 1; 5.88%). Only one case (5.88%) was clinically diagnosed as sialolithiasis prior to biopsy examination. CONCLUSION: The current study demonstrated an aging tendency and a male predilection of sialolithiasis in minor salivary glands in Taiwan when compared with published case series studies.

The Impact of Flip Angle and TR on the Enhancement Ratio of Dynamic Gadobutrol-enhanced MR Imaging: In Vivo VX2 Tumor Model and Computer Simulation.

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is widely used to diagnose cancer and monitor therapy. The maximum enhancement ratio (ERmax) obtained from the curve of signal intensity over time could be a biomarker to distinguish cancer from normal tissue or benign tumors. We evaluated the impact of flip angle (FA) and repetition time (TR) on the ERmax values of dynamic gadobutrol-enhanced MR imaging, obtaining T1-weighted (T1W) MR imaging of VX2 tumors using 2-dimensional fast spoiled gradient echo (2D FSPGR) with various FAs (30°, 60° and 90°) at 1.5 tesla before and after injection of 0.1 mmol/kg gadobutrol. In vivo study indicated significant differences between ERmax values and area under the ER-time curve (AUC100) of VX2 tumors and muscle tissue, with the highest ERmax and AUC100 at FA 90°. Computer simulation also demonstrated the ER as a strictly increasing monotonic function in the closed interval [0°, 90°] for a given TR when using T1W FSPGR, and the highest ER value always occurred at FA 90°. The FA for the highest ER differed from that for the highest signal-to-noise or contrast-to-noise ratio. For long TR, the ER value increases gradually. However, for short TR, the ER value increases rapidly and plateaus so that the ER value changes little beyond a certain FA value. Therefore, we suggest use of a higher FA, near 90°, to obtain a higher ERmax for long TR in 2D SPGR or FSPGR and a smaller FA, much less than 90°, to reach an appropriate ERmax for short TR in 3D SPGR or FSPGR. This information could be helpful in setting the optimal parameters for DCE-MRI.

Differentiation of human umbilical cord mesenchymal stem cells into germ-like cells in mouse seminiferous tubules.

Our previous study demonstrated that human umbilical cord mesenchymal stem cells (HUMSCs) were capable of differentiation into germ cells in vitro. To assess this potential in vivo, HUMSCs were microinjected into the lumen of seminiferous tubules of immunocompetent mice, which were treated with busulfan to destroy endogenous spermatogenesis. Bromodeoxyuridine labeling studies demonstrated that HUMSCs survived in the tubule for at least 120 days, exhibited a round cell shape typical of proliferating or differentiating germ cells, migrated to the basement of the tubule, where proliferating spermatogonia reside and returned to the luminal compartment, where differentiating spermatids and spermatozoa reside. The migration pattern resembled that of germ cell development in vivo. Immunohistochemical and colocalization studies revealed that transplanted HUMSCs expressed the germ cell markers octamer-binding transcription factor 4, α6 integrin, C-kit and VASA, confirming the germ cell differentiation. In addition, it was observed that tubules transplanted with HUMSCs exhibited marked improvement in the histological features damaged by the chemotherapeutic busulfan, as judged by morphology and quantitative histology. Taken together, these data demonstrated the capacity of HUMSCs to form germ cells in the testes and to repair testicular tissue. These findings suggest a potential utility of HUMSCs to treat the infertility and testicular insufficiency caused by cancer therapeutics.

Perceptions and experiences of nurse preceptors regarding their training courses: a mixed method study.

BACKGROUND: Although the benefits of preceptor training programs on the performance of nurse preceptors have been reported, research related to nurse preceptors' perceptions of and experiences with preceptor training courses is relatively limited. OBJECTIVES: To explore nurse preceptors' perceptions of preceptor training courses and obtain information on their experiences in working as preceptors. DESIGN: A mixed method design was conducted. PARTICIPANTS AND SETTINGS: Nurse preceptors who currently work at one of eight hospitals in northern Taiwan were recruited to participate in this study. METHODS: A questionnaire survey and focus group interviews were conducted. A training course perception scale was developed and generated based on the current nurse preceptor training programs offered in eight hospitals. Focus group interviews were conducted to obtain additional information on nurse preceptors' experiences in working as preceptors. The survey data were analyzed using descriptive statistics. Interview data were transcribed and analyzed using a qualitative content analysis approach. RESULTS: The results from the surveys of 386 nurse preceptors revealed that most courses included in the current preceptor training programs did not fulfill the learning needs of nurse preceptors and were clinically impractical. The most necessary and clinically useful course was the communication skills course, whereas the least useful course was the adult learning theory and principles course. Three themes were identified as problems based on the three focus group interviews conducted with 36 nurse preceptors: inadequate training was received before nurses were appointed as nurse preceptors, the courses were more theoretical rather than practical, and the preceptors experienced stress from multiple sources. CONCLUSIONS: The results revealed that the current preceptor training courses are impractical; therefore, the content of preceptor training courses must be altered to fulfill nurse preceptors' training needs. Furthermore, problems identified through the focus group interviews reinforce the survey results.

Retrospective study of oral and maxillofacial lesions in older Taiwanese patients.

OBJECTIVE: The aim was to provide information regarding oral and maxillofacial (OMF) lesions in an older Taiwanese population. BACKGROUND: The rate of increase of older people in Taiwan is expected to be rapid. OMF lesions are very frequent in the older population, but no studies have been performed on these lesions in Taiwan. MATERIALS AND METHODS: OMF cases (between 2000 and 2011) in geriatric patients (≥60 years of age) with records of age, sex and histological diagnoses were retrieved from the Oral Pathology Department of our institution. These lesions were classified into four main categories: tumour/tumour-like reactive lesions, cystic/pseudocystic lesions, inflammatory/infective lesions and other miscellaneous lesions. RESULTS: Six thousand seven hundred and twenty-six lesions were collected from a total of 39 503 OMF lesions in older Taiwanese patients in this study. Most of these lesions were distributed in the inflammatory/infective group, followed by tumour/tumour-like reactive lesions. Squamous cell carcinoma was the most common lesion, and, additionally, there was a high frequency of oral potentially malignant disorders. CONCLUSIONS: The present study showed trends similar to previous reports from other countries. However, some detailed information was different, perhaps due to the different criteria and different geographic distribution. Worthy of note, our results indicated that screening for oral potentially malignant disorder and oral malignancy in the older population is essential.

Advanced Cu chemical displacement technique for SiO2-based electrochemical metallization ReRAM application.

This study investigates an advanced copper (Cu) chemical displacement technique (CDT) with varying the chemical displacement time for fabricating Cu/SiO2-stacked resistive random-access memory (ReRAM). Compared with other Cu deposition methods, this CDT easily controls the interface of the Cu-insulator, the switching layer thickness, and the immunity of the Cu etching process, assisting the 1-transistor-1-ReRAM (1T-1R) structure and system-on-chip integration. The modulated shape of the Cu-SiO2 interface and the thickness of the SiO2 layer obtained by CDT-based Cu deposition on SiO2 were confirmed by scanning electron microscopy and atomic force microscopy. The CDT-fabricated Cu/SiO2-stacked ReRAM exhibited lower operation voltages and more stable data retention characteristics than the control Cu/SiO2-stacked sample. As the Cu CDT processing time increased, the forming and set voltages of the CDT-fabricated Cu/SiO2-stacked ReRAM decreased. Conversely, decreasing the processing time reduced the on-state current and reset voltage while increasing the endurance switching cycle time. Therefore, the switching characteristics were easily modulated by Cu CDT, yielding a high performance electrochemical metallization (ECM)-type ReRAM.

Sphere-forming-like cells (squamospheres) with cancer stem-like cell traits from VX2 rabbit buccal squamous cell carcinoma.

Previous studies have demonstrated that spheroid type cells grown under suspension culture conditions have cancer stem cell (CSC) traits in a number of cancers, but this phenomenon has not yet been reported in the VX2 rabbit oral cancer model. Hence, this study aimed to study the spheroid cells from VX2 rabbit buccal squamous cell carcinomas (SCCs) and assess their CSC characteristics. Five adult male New Zealand white outbred rabbits were used to generate VX2 rabbit buccal SCC. Sphere-forming cell culture was performed for the VX2 rabbit buccal SCC specimens. The self-renewal capability; cluster of designation (CD) 44, CD133, acetaldehyde dehydrogenase 1 (ALDH1), B cell-specific Moloney murine leukemia virus integration site 1 (Bmi-1), Nestin, octamer-binding transcription factor 4 (Oct4) and reduced expression protein-1 (Rex-1) expression with reverse transcription-polymerase chain reaction (RT-PCR); chemoresistance to cisplatin and 5-fluorouracil; and in vivo tumorigenicity of spheroid cell transplantation in nude mice were evaluated to determine the CSC characteristics of the resulting spheroid cells. We successfully obtained spheroid cells from the VX2 rabbit OSCC tissues. The spheroid cells exhibited CSC traits, including the expression of CSC and stem cell markers (CD44, Bmi-1, Nestin, Oct4 and Rex-1), capacity to generate new spheroid colonies within 1 week of reseeding from single-dissociated spheroid cells, chemoresistance capacity and generation of tumour xenografts (with histological features resembling those of the original VX2 rabbit buccal SCC) from the transplantation of 10(3) undifferentiated spheroid cells into nude mice. In summary, we demonstrated that spheroid cells with CSC cell traits can be derived from VX2 rabbit buccal SCCs, indicating that this animal cancer model is applicable for studying CSCs in human oral cancers.

Retrospective study of biopsied head and neck lesions in a cohort of referral Taiwanese patients.

INTRODUCTION: A study of the whole spectrum of biopsied head and neck (HN) diseases in Taiwan has not yet been performed. Therefore, the current study aimed to provide updated information about HN lesions in a cohort of referral Taiwanese patients for histopathological examination. METHODS: HN lesions (2000-2011) in patients with records of age, sex, and histological diagnoses were retrieved from the Oral Pathology Department of the institution. These lesions were classified into four main categories: tumor/tumor-like reactive lesions, cystic/pseudocystic lesions, inflammatory/infective lesions, and others/miscellaneous lesions. RESULTS: A total of 37,210 HN lesions were included in the current study. Most of these lesions were distributed in the group of tumor/tumor-like reactive lesions, followed by the groups of inflammatory/infective lesions, cystic/pseudocystic lesions, and others/miscellaneous lesions. Squamous cell carcinoma was the most common HN lesion, and was also the most frequent malignant lesion among the referral patients. CONCLUSION: It was worthy of note that squamous cell carcinoma and oral potentially malignant disorders comprised high percentages of all HN lesions for the present cohort of referral patients.

[Anti-atherosclerosis role of N-oleoylethanolamine in CB2].

To observe a PPAR-alpha agonist effect of N-oleoylethanolamine (OEA) on CB2 (cannabinoid receptor 2), an anti-inflammatory receptor in vascular endothelial cell, healthy HUVECs and TNF-alpha induced HUVECs were used to establish a human vascular endothelial cell inflammatory model. Different doses of OEA (10, 50 and 100 micromol x L(-1)) had been given to HUVECs, cultured at 37 degrees C for 7 h and then collected the total protein and total mRNA. CB2 protein expression was detected by Western blotting and CB2 mRNA expression was assayed by real-time PCR. As the results shown, OEA (10 and 50 micromol x L(-1)) could induce the CB2 protein and mRNA expression, but not 100 micromol x L(-1). To detect if anti-inflammation effect of OEA is partly through CB2, CB2 inhibitor AM630 was used to inhibit HUVEC CB2 expression, then the VCAM-1 expression induced by TNF-alpha was detected, or THP-1 adhere to TNF-alpha induced HUVECs was examined. OEA (50 micromol x L(-1)) could inhibit TNF-alpha induced VCAM-1 expression and THP-1 adhere to HUVECs, these effects could be partly inhibited by a CB2 inhibitor AM630. The anti-inflammation effect of OEA is induced by PPAR-alpha and CB2, suggesting that CB2 signaling could be a target for anti-atherosclerosis, OEA have wide effect in anti-inflammation, it may have better therapeutic potential in anti-inflammation in HUVECs, thus achieving anti-atherosclerosis effect.

Clear-cell variant of calcifying epithelial odontogenic tumor (Pindborg tumor) in the mandible.

We present an uncommon case (female patient aged 59 years) of the clear-cell variant of calcifying epithelial odontogenic tumor (CEOT) (also known as Pindborg tumor) in the mandible. The clinical characteristics and probable origins of the clear tumor cells of previously reported cases of clear-cell variant of intraosseous CEOT are also summarized and discussed.

A retrospective comparison of the location and diameter of the inferior alveolar canal at the mental foramen and length of the anterior loop between American and Taiwanese cohorts using CBCT.

PURPOSE: The aim was to retrospectively compare the measurements of the location and size of the inferior alveolar canal at the mental foramen and the length of the anterior loop between two cohorts of Americans and Taiwanese using cone-beam computed tomography (CBCT). METHODS: CBCT was performed with an I-CAT(®) Cone-Beam 3D Dental Imaging System and reconstructed into multiple-plane views to measure two populations. RESULTS: There was no statistically significant difference (P = 0.2681) in the distance from the mental foramen to the inferior border of the mandible (mandibular border height) between Americans (9.84 ± 2.01 mm) and Taiwanese (10.13 ± 1.66 mm). No significant difference was found (p = 0.1161) in the inferior alveolar canal diameter between these two cohorts (2.26 ± 0.67 and 2.13 ± 0.47 mm, respectively). However, the anterior loop length of Taiwanese (7.61 ± 1.81 mm) was significantly longer than that of Americans (6.22 ± 1.68 mm) (P < 0.0001). CONCLUSION: Our study indicated that (1) the location of mental foramen of Americans was closer to the inferior border of the mandible than Taiwanese; (2) the diameter of the inferior alveolar canal of Americans was larger than Taiwanese; (3) the anterior loop of Taiwanese was longer than Americans. These differences may be, at least partly, due to the racial influence and this information may possess potential valuable clinical relevance.

Overexpression of Smad proteins, especially Smad7, in oral epithelial dysplasias.

OBJECTIVE: Transforming growth factor ß, via membrane-bound receptors and downstream Smad2-4, 7, can modulate tumorigenesis. Smad2 and Smad3 heterodimerize with Smad4, and the complex migrates to the nucleus to regulate the expression of target genes. Smad7 is a key negative regulator of this signaling pathway. This study aimed to examine Smad2-4, 7 expression and phosphorylated Smad2-3 (p-Smad2-3) in oral epithelial dysplasia and compared it with normal oral mucosa, hyperkeratosis/epithelial hyperplasia and squamous cell carcinoma (SCC). MATERIALS AND METHODS: Immunohistochemical staining of Smad2-4, 7 and p-Smad2-3, was performed for 75 samples of human oral mucosa, including hyperkeratosis/epithelial hyperplasia (n = 20), mild epithelial dysplasia (n = 11), moderate to severe epithelial dysplasia (n = 11), and SCC (n = 43). Normal buccal mucosa samples (n = 9) were also included. RESULTS: A significant increase in Smad7 expression was observed in the ascending order of samples of normal oral mucosa, hyperkeratosis/epithelial hyperplasia/mild oral epithelial dysplasia, moderate to severe oral epithelial dysplasia, and well-differentiated oral SCC/moderately to poorly differentiated oral SCC. Additionally, significant increases in Smad7 expression were noted as compared with expression of Smad2-4 and p-Smad2-3 in lesions of hyperkeratosis/epithelial hyperplasia, mild oral epithelial dysplasia, moderate to severe oral epithelial dysplasia, well-differentiated oral SCC, and moderately to poorly differentiated oral SCC. CONCLUSIONS: Our results indicate that Smad proteins, particularly Smad7, in oral epithelial dysplasia and SCC could contribute to the attenuation of Smads anti-proliferative signaling in cancer development. CLINICAL RELEVANCE: Smad7 could be a marker for risk of malignant transformation of oral epithelial dysplasia.

[The hypolipidemic and liver protective effect of (Z)-N-(2-hydroxyethyl) docos-13-enamide on hyperlipidemic golden hamsters].

This study is to observe preventive effect of (Z)-N-(2-hydroxyethyl) docos-13-enamide on hyperlipidemia and fatty liver of golden hamsters. Hyperlipidemic golden hamsters fed with high-fat diet was administered orally with (Z)-N-(2-hydroxyethyl) docos-13-enamide (10, 20 and 40 mg x kg(-1)) for 5 weeks. Levels of serum and hepatic lipid content, liver histology, hepatic MDA and SOD levels, serum ALT and AST levels were evaluated in golden hamsters. (Z)-N-(2-Hydroxyethyl) docos-13-enamide has a hypolipidemic effect, and could reduce hepatic lipid content, serum ALT and AST levels, hepatic MDA level, increase hepatic SOD activity. (Z)-N-(2-Hydroxyethyl) docos-13-enamide plays an important role in reducing serum lipid, restraining hepatic fatty deposition and protecting liver to get rid of peroxidation injury of hyperlipidemic golden hamsters. The exact lipid-lowering mechanism of (Z)-N-(2-hydroxyethyl) docos-13-enamide needs further investigation.