Epidemiology of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease in Taiwan.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable chronic condition characterized by progressive, partially reversible airflow obstruction. Osteoporosis represents a significant comorbidity in individuals with COPD. However, the incidence and prevalence of osteoporosis among the COPD population remain unclear in Taiwan. Therefore, our objective is to investigate the incidence and prevalence of osteoporosis in patients with COPD. METHODS: In this cross-sectional study, we enrolled a COPD population retrieved from the Taiwan National Health Insurance Research Database (NHIRD) spanning the years 2003 to 2016. Osteoporosis patients were identified using diagnosis codes. The study included newly diagnosed COPD patients from 2003 to 2016. The case group comprised patients who developed osteoporosis or osteoporotic fractures after their COPD diagnosis. We calculated the prevalence and incidence of osteoporosis in individuals with COPD and conducted trend tests. RESULTS: A total of 1,297,579 COPD patients were identified during the period from 2003 to 2016, with 275,233 of them in the osteoporosis group. The average prevalence of osteoporosis among individuals with COPD was 21.21% from 2003 to 2016 in Taiwan. The number of osteoporosis cases increased from 6,727 in 2003 to 24,184 in 2016. The prevalence of osteoporosis among COPD patients increased from 3.62% in 2003 to 18.72% in 2016. The number of osteoporosis cases among individuals with COPD continued to rise over the years, reaching its highest point in 2016 with 24,184 new cases. The incidence of osteoporosis fluctuated during the study period but generally remained around 3,000 cases per 100,000 person-years. Notably, there was a significant upward trend in incidence from 2003 to 2006, after which the trend stabilized and remained relatively constant. CONCLUSIONS: Our study highlights an increase in both the prevalence and incidence of osteoporosis in individuals with COPD. Given the significant medical, economic, and social implications associated with osteoporosis, a comprehensive and robust assessment of its healthcare burden can offer valuable insights for healthcare system planning and policymaking.

Prescription pattern and effectiveness of antihypertensive drugs in patients with aortic dissection who underwent surgery.

Background: Surgical patients with aortic dissection often require multiple antihypertensive drugs to control blood pressure. However, the prescription pattern and effectiveness of antihypertensive drugs for these patients are unclear. We aimed to investigate the prescription pattern and effectiveness of different classes of antihypertensive drugs in surgical patients with aortic dissection. Methods: Newly diagnosed aortic dissection patients who underwent surgery, aged >20 years, from 1 January 2012 to 31 December 2017 were identified. Patients with missing data, in-hospital mortality, aortic aneurysms, or congenital connective tissue disorders, such as Marfan syndrome, were excluded. Prescription patterns of antihypertensive drugs were identified from medical records of outpatient visits within 90 days after discharge. Antihypertensive drugs were classified into four classes: 1) ß-blockers, 2) calcium channel blockers (CCBs), 3) renin-angiotensin system, and 4) other antihypertensive drugs. Patients were classified according to the number of classes of antihypertensive drugs as follows: 1) class 0, no exposure to antihypertensive drugs; 2) class 1, antihypertensive drugs of the same class; 3) class 2, antihypertensive drugs of two classes; 4) class 3, antihypertensive drugs of three classes; or 5) class 4, antihypertensive drugs of four classes. The primary composite outcomes included rehospitalization associated with aortic dissection, death due to aortic dissection, and all-cause mortality. Results: Most patients were prescribed two (28.87%) or three classes (28.01%) of antihypertensive drugs. In class 1, ß-blockers were most commonly used (8.79%), followed by CCBs (5.95%). In class 2, ß-blockers+CCB (10.66%) and CCB+RAS (5.18%) were the most common drug combinations. In class 3, ß-blockers + CCB+RAS (14.84%) was the most prescribed combination. Class 0 had a significantly higher hazard of the composite outcome (HR, 2.1; CI, 1.46-3.02; p < 0.001) and all-cause mortality (HR, 2.34; CI, 1.56-3.51; p < 0.001) than class 1. There were no significant differences in hazards for rehospitalization associated with aortic dissection among classes. Conclusion: Among operated patients with type A aortic dissection, no specific type of antihypertensive drug was associated with a better outcome, whereas among those with type B aortic dissection, the use of ß-blockers and CCBs was related to a significantly lower risk of the composite outcome.

Astragaloside IV Induces Apoptosis, G1-Phase Arrest and Inhibits Anti-apoptotic Signaling in Hepatocellular Carcinoma.

BACKGROUND/AIM: Hepatocellular carcinoma (HCC) is a primary malignancy of the liver and the third leading cause of cancer death worldwide. Although multiple chemotherapies options are available for HCC, chemo-induced toxicity is inevitable during clinical treatment. Therefore, identifying possible adjuvant agents with both liver-protective and antitumor effects is critical. Herbal medicines have chemopreventive and anti-HCC effect, such as Juzen taiho-to and Sho-saiko-to. Astragaloside IV is a compound extracted from the Chinese medical herb Astragalus membranaceus (Fisch.) Bge. with liver protection potential. However, whether astragaloside IV may also possess tumor-inhibitory capability and its underlying mechanism is remaining unknown. MATERIALS AND METHODS: Viability analysis, cell-cycle analysis, apoptosis analysis, western blotting analysis and invasion trans-well assay were performed to identify tumor-inhibitory potential of astragaloside IV on HCC cells (SK-Hep1 and Hep3B cells). RESULTS: We found that astragaloside IV may induce cytotoxicity and extrinsic/intrinsic apoptosis effect, but also trigger G1 arrest in HCC cells. The expression of anti-apoptotic proteins of HCC were all reduced by astragaloside IV. Additionally, astragaloside IV also suppressed HCC cell invasion ability. CONCLUSION: Astragaloside IV effectively suppressed HCC cell proliferation, invasion and anti-apoptosis in vitro.

Novel α-Fe2O3/MXene nanocomposite as heterogeneous activator of peroxymonosulfate for the degradation of salicylic acid.

The development of non-cobalt-based heterogeneous catalysts with efficient catalytic activity, good stability and nontoxicity is very important for the application of peroxymonosulfate-based advanced oxidation processes (AOPs) in water treatment. In this work, with two dimensional MXene as the catalyst substrate, a novel α-Fe2O3/MXene (FM) nanocomposite was fabricated through a facile solvothermal method. Systematic characterization demonstrated that the MXene substrate could facilitate the size reduction and good dispersion of α-Fe2O3 nanoparticles. The FM nanocomposite achieved high efficiency and stability towards activating peroxymonosulfate (PMS) to produce free radicals for the degradation of salicylic acid (SA) in aqueous solution. The operating parameters, including catalyst dosage, PMS dosage, SA concentration and initial pH value, were evaluated and analysed. The co-existence of sulfate radicals (SO4-) and hydroxyl radicals (OH) was confirmed using electron paramagnetic resonance spectroscopy and radical scavenger tests, while SO4-was identified as the main reactive species in the FM/PMS catalytic system. The possible mechanisms for the electron transfer and radical generation during the process of PMS activation by the FM nanocomposite are further investigated using XPS and in situ Raman analysis. The results provide an avenue for rationally constructing and developing alternative catalysts for the treatment of organics in wastewater.

Prescribing patterns of coronary artery aneurysm in Taiwan.

BACKGROUND: Coronary artery aneurysm (CAA) is a rare disease, and there are limited data on prescribing patterns for CAA. The aim of our study was to investigate prescribing patterns for CAA in Taiwan via the National Health Insurance Research Database (NHIRD). METHODS: We included all CAA patients in Taiwan from 2005 to 2011. Data from 1 year before and after the CAA diagnosis were used to analyze examinations, comorbidities and prescribing patterns. RESULTS: A total of 1397 patients diagnosed with CAA were enrolled in our study. Most pediatric patients with CAA were diagnosed with Kawasaki disease (95.7%). In pediatric CAA patients, the utilization rates of aspirin and gamma globulins were 82.9 and 53.6%, respectively, after CAA diagnosis. Among the antithrombotic agents, aspirin was used most commonly, followed by dipyridamole (16.9%), heparin (5.8%) and warfarin (4.6%). In adult CAA patients, common comorbidities included hypertension (63.4%), hyperlipidemia (39.6%), and diabetes mellitus (26.1%). Coronary atherosclerosis was identified in 72.5% of adult patients after CAA diagnosis. Antithrombotic agents, particularly aspirin, clopidogrel and heparin, were prescribed more frequently after CAA diagnosis. Among the prescribed medications, aspirin (75.8%), ß-blockers (48.3%), statins (47.6%), metformin (14.4%), sulfonylureas (14.4%) and isosorbide mononitrate (32.9%) were frequently observed in each category. CONCLUSIONS: Kawasaki disease was the main cause of CAA in pediatric patients, and coronary artery disease was the most common comorbidity in adult CAA patients. The most commonly used antithrombic agent after CAA diagnosis was aspirin in both adult and pediatric patients.

The influence of statins on aortic aneurysm after operation: A retrospective nationwide study.

Aortic aneurysm (AA) is a disease with substantially higher health care costs and very high mortality upon rupture. Statins have a non-lipid-lowering pleiotropic mechanism that may be beneficial for AA in disease progression and improvement of AA patient outcomes. Previous studies have been conducted with some limitations and without considering immortal time bias, lag time, and adherence. The aim of our study was to analyze the effect of statin use on AA postoperation after controlling for these factors.All postoperative patients with a diagnosis of AA in Taiwan from 2004 to 2012 were included from the National Health Insurance Research Database. We excluded patients without computed tomography within 1 year after diagnosis and those who died within 30 days after the operation. We also analyzed the medication, medication possession ratio (MPR), immortal time bias, and lag time. Statin users were defined as those using statins for more than 30 days. Primary composite outcomes included mortality, reoperation for AA and rehospitalization for AA during the study period.Among the whole study population (n = 1633), 199/1633 (12.19%) patients were statin users, while the others (n = 1434) were not. Mortality was higher in statin nonusers than in statin users, with a mortality rate of 40% versus 22.61% (P < .0001). There was no significant difference in reoperation or rehospitalization for AA.Statin use may be beneficial for AA patients in our observational study. Prospective randomized controlled studies are needed to define the effect of statin therapy in this population.

[Comparison of antimicrobial activity of Er,Cr: YSGG laser and ultrasonic irrigation in root canal disinfection].

PURPOSE: The aim of this study was to compare the antimicrobial activity of Er,Cr:YSGG laser and ultrasonic irrigation in root canal disinfection. METHODS: Sixty decayed teeth requiring root canal therapy were divided into 3 groups randomly: Er,Cr:YSGG laser group, ultrasonic irrigation group and control group, 20 in each group. The bacteria in each group were incubated and counted before and after root canal treatment. Statistical analysis was performed using SPSS 19.0 software package. RESULTS: In the 3 groups, the number of bacteria in root canals was reduced significantly after root canal treatment (P<0.05). The number of bacteria in Er,Cr:YSGG laser group and ultrasonic irrigation group decreased significantly greater than the control group (P<0.05), but the Er,Cr:YSGG laser group and ultrasonic irrigation group had no significant difference(P>0.05). CONCLUSIONS: After root canal treatment, the number of bacteria in the root canal is obviously reduced. The antimicrobial activity of three intercanal methods on bacteria in root canals is profound. The reduction of bacteria is more obvious after treatment of Er,Cr:YSGG laser and ultrasonic irrigation than the control.

Clonal production and organization of inhibitory interneurons in the neocortex.

The neocortex contains excitatory neurons and inhibitory interneurons. Clones of neocortical excitatory neurons originating from the same progenitor cell are spatially organized and contribute to the formation of functional microcircuits. In contrast, relatively little is known about the production and organization of neocortical inhibitory interneurons. We found that neocortical inhibitory interneurons were produced as spatially organized clonal units in the developing ventral telencephalon. Furthermore, clonally related interneurons did not randomly disperse but formed spatially isolated clusters in the neocortex. Individual clonal clusters consisting of interneurons expressing the same or distinct neurochemical markers exhibited clear vertical or horizontal organization. These results suggest that the lineage relationship plays a pivotal role in the organization of inhibitory interneurons in the neocortex.

Corrosion behaviour and surface analysis of a Co-Cr and two Ni-Cr dental alloys before and after simulated porcelain firing.

This study evaluated the corrosion behaviour and surface properties of a commercial cobalt-chromium (Co-Cr) alloy and two nickel-chromium (Ni-Cr) alloys [beryllium (Be)-free and Be-containing] before and after a simulated porcelain-firing process. Before porcelain firing, the microstructure, surface composition and hardness, electrochemical corrosion properties, and metal-ion release of as-cast alloy specimens were examined. After firing, similar alloy specimens were examined for the same properties. In both as-cast and fired conditions, the Co-Cr alloy (Wirobond C) showed significantly more resistance to corrosion than the two Ni-Cr alloys. After firing, the corrosion rate of the Be-free Ni-Cr alloy (Stellite N9) increased significantly, which corresponded to a reduction in the levels of Cr, molybdenum (Mo), and Ni in the surface oxides and to a reduction in the thickness of the surface oxide film. The corrosion properties of the Co-Cr alloy and the Be-containing Ni-Cr alloy (ChangPing) were not significantly affected by the firing process. Porcelain firing also changed the microstructure and microhardness values of the alloys, and there were increases in the release of Co and Ni ions, especially for Ni from the Be-free Ni-Cr alloy. Thus, the corrosion rate of the Be-free Ni-Cr alloy increased significantly after porcelain firing, whereas the firing process had little effect on the corrosion susceptibility of the Co-Cr alloy and the Be-containing Ni-Cr alloy.

[Study of dental alloys in the artificial saliva using an electrochemical impedance spectroscopy].

PURPOSE: With the help of electrochemical impedance spectroscopy (EIS), the purpose of the study was to investigate the corrosion resistance of CoCr alloys ,NiCr alloys and commercially pure Ti(cp Ti) in the artificial saliva(AS). METHODS: With the EIS, a test was made on the three alloys/metals in the AS (See Bode plot and Nyquist plot). And then, an analysis was made on what was known in the test by the software of ZSimpWin, after which the corrosion resistance of the alloys/metals was evaluated against the parameters of equivalent circuit [R(CR)]. RESULTS: In the Nyquist plot, the capacitance arc radius was in the sequence of cp Ti>CoCr>NiCr. From the Bode plot, an one time constant was able to be obtained. That was the capacitor layer. According to the equivalent circuit[R(CR)], there was no significant difference in the capacitor layer of the three alloys/metals. And the sequence of the impedance value of the three alloys/metals was cp Ti>CoCr>NiCr. CONCLUSIONS: The EIS results suggest that the three alloys/metals have a great corrosion resistance with cp Ti having the highest corrosion resistance and that CoCr alloys is better than NiCr alloys in the corrosion resistance. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality (Grant No.08DZ2271100) and Shanghai Leading Academic Discipline Project(Grant No.T0202).