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Effects of a low-protein nutritional formula with dietary counseling in older adults with chronic kidney disease stages 3–5: a randomized controlled trial

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BMC Nephrology 2023年第1期24卷 372-372页

作者： Yang, Wen-Ching Hsieh, Hui-Min Chen, Jun-Peng Liu, Li-Chun Chen, Cheng-Hsu Department of Food and Nutrition Taichung Veterans General Hospital Taichung Taiwan Biostatistics Group Department of Medical Research Taichung Veterans General Hospital Taichung Taiwan Division of Nephrology Department of Internal Medicine Taichung Veterans General Hospital No. 1650 Sect. 4 Boulevard Taichung Taiwan Department of Post-Baccalaureate Medicine College of Medicine National Chung Hsing University School of Medicine Taichung Taiwan Department of Life Science Tunghai University Taichung Taiwan Program in Tissue Engineering and Regenerative Medicine College of Medicine National Chung-Hsing University Taichung Taiwan

Background: Although combining a low-protein diet (LPD) with oral nutritional supplements increases treatment adherence and nutritional status in patients with chronic kidney disease (CKD), the effect of this combination approach in older adults remains unclear. This study examined the impact of a 6% low-protein formula (6% LPF) with diet counseling in older adults with stage 3–5 CKD. Methods: In this three-month randomized controlled study, 66 patients (eGFR < 60 mL/min/1.73 m², non-dialysis, over 65 years of age) were randomly assigned to an intervention group (LPD plus a 6% LPF) or control group (LPD alone). The 6% LPF comprised 400 kcal, 6 g of protein, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and various micronutrients. All data were collected at baseline and after three months, including physical performance based on hand grip strength (HGS) and gait speed, nutritional status using Mini Nutritional Assessment-Short Form (MNA-SF) scores, body composition through bioelectrical impedance analysis, and dietary intake from 24-h dietary records. Results: This study incorporated 47 participants (median age, 73;median eGFR, 36 ml/min/1.73 m²;intervention group: 24;control group: 23). The intervention group exhibited significant differences in HGS and gait speed, and micronutrient analysis revealed significantly higher monounsaturated fatty acids (MUFA), EPA, DHA, calcium, iron, zinc, copper, thiamine, riboflavin, niacin, B6, B12, and folic acid intake than the control group. MNA-SF scores, macronutrient intake, and body composition did not differ significantly between the two groups. Conclusions: Compared to LPD counseling alone, an LPD prescription with 6% LPF in older adults with CKD stages 3–5 helped relieve physical deterioration and increased micronutrient intake after three months. Trial registration: *** NCT05318014 (retrospectively registered on 08/04/2022). © 2023, The Author(s).

关键词： Aging Chronic kidney disease Gait speed Hand grip strength Low-protein diet Nutritional status Oral nutritional supplements Physical performance

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The mitochondrial stress signaling tunes immunity from a view of systemic tumor microenvironment and ecosystem

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iScience 2024年第9期27卷

作者： Kuo, Cheng-Liang Lin, Ying-Chen Lo, Yu Kang Lu, Yu-Zhi Babuharisankar, Ananth Ponneri Lien, Hui-Wen Chou, Han-Yu Lee, Alan Yueh-Luen National Institute of Cancer Research National Health Research Institutes Miaoli Zhunan 35053 Taiwan Department of Life Sciences College of Health Sciences & Technology National Central University Taoyuan Zhongli 32001 Taiwan Ph.D. Program in Tissue Engineering and Regenerative Medicine College of Medicine National Chung Hsing University Taichung 40402 Taiwan Graduate Institute of Biomedical Sciences China Medical University Taichung 40402 Taiwan Department of Biotechnology College of Life Science Kaohsiung Medical University Kaohsiung 80708 Taiwan

Mitochondria play important roles in cell fate, calcium signaling, mitophagy, and the signaling through reactive oxygen species (ROS). Recently, mitochondria are considered as a signaling organelle in the cell and communicate with other organelles to constitute the mitochondrial information processing system (MIPS) that transduce input-to-output biological information. The success in immunotherapy, a concept of systemic therapy, has been proved to be dependent on paracrine interactions within the tumor microenvironment (TME) and distant organs including microbiota and immune components. We will adopt a broader view from the concept of TME to tumor micro- and macroenvironment (TM²E) or tumor-organ ecosystem (TOE). In this review, we will discuss the role of mitochondrial signaling by mitochondrial ROS, calcium flux, metabolites, mtDNA, vesicle transportation, and mitochondria-derived peptide in the TME and TOE, in particular immune regulation and effective cancer immunotherapy. © 2024 The Author(s)

关键词： Cancer Immune response Microenvironment

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Pioneering Astaxanthin-Tumor Cell Membrane Nanoparticles for Innovative Targeted Drug Delivery on Melanoma

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International journal of nanomedicine 2024年 19卷 2395-2407页

作者： Jui-Jen Chang Yi-Chen Wang Shu-Hui Yang Ju-Yu Wu Ming-Wei Chang Hui-Min David Wang Department of Medical Research China Medical University Hospital China Medical University Taichung 40447 Taiwan. Graduate Institute of Integrated Medicine China Medical University Taichung 40447 Taiwan. Division of Cardiology Department of Internal Medicine Kaohsiung Armed Forces General Hospital Kaohsiung City 802 Taiwan. Institute of Medical Science and Technology National Sun Yat-sen University Kaohsiung 807 Taiwan. Graduate Institute of Biomedical Engineering National Chung Hsing University Taichung 402 Taiwan. Bachelor Program of Biotechnology National Chung Hsing University Taichung 402 Taiwan. Doctoral Program in Tissue Engineering and Regenerative Medicine National Chung Hsing University Taichung 402 Taiwan. Nanotechnology and Integrated Bioengineering Centre University of Ulster Belfast BT15 1AB Northern Ireland UK. Graduate Institute of Medicine College of Medicine Kaohsiung Medical University Kaohsiung 807 Taiwan. Department of Medical Laboratory Science and Biotechnology China Medical University Taichung 404 Taiwan. Center of Applied Nanomedicine National Cheng Kung University Tainan 701 Taiwan.

Background:Recently, the use of the tumor or its secretions as drug carriers has gradually become popular, with the advantages of high biocompatibility and enhanced drug delivery to specific cells. Melanoma is the most malignant tumor of all skin cancers; it is the most metastatic and, therefore, the most difficult to treat. The main purpose of this study is to develop nanovesicles with tumor cell membrane secretion properties to encapsulate target substances to enhance the therapeutic effect of cancer. Methods:Astaxanthin was selected as an anticancer drug due to our previous research finding that astaxanthin has extremely high antioxidant, anti-ultraviolet damage, and anti-tumor properties. The manufacturing method of the astaxanthin nanovesicle carrier is to mix melanoma cells and astaxanthin in an appropriate ratio and then remove the genetic material and inflammatory factors of cancer cells by extrusion. Results:In terms of results, after the co-culture of astaxanthin nanovesicles and melanoma cancer cells, it was confirmed that the ability of astaxanthin nanovesicles to inhibit the growth and metastasis of melanoma cancer cells was significantly better than the same amount of astaxanthin alone, and it had no effect on normal Human cells are also effective. There was no apparent harm on normal cells, indicating the ability of the vesicles to be selectively transported. Conclusion:Our findings illustrated the potential of astaxanthin nanovesicles as an anticancer drug.

关键词： astaxanthin melanoma nanoparticle

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Circular RNA in liquid biopsy as biomarkers toward precision medicine

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Molecular therapy. Nucleic acids 2023年 31卷 689-690页

作者： Yueh-Chun Lee Huey-En Tzeng Hui-Hsuan Lin Kuei-Yang Hsiao Department of Radiation Oncology Chung Shan Medical University Hospital Taichung 40201 Taiwan. School of Medicine Chung Shan Medical University Taichung 40201 Taiwan. Division of Hematology and Medical Oncology Taichung Veterans General Hospital Taichung 40705 Taiwan. Department of Medicine Taichung Veterans General Hospital Taichung 40705 Taiwan. Precision Medicine Center Taichung Veterans General Hospital Taichung 40705 Taiwan. PhD Program in Tissue Engineering and Regenerative Medicine National Chung Hsing University Taichung 40227 Taiwan. Institute of Biochemistry College of Life Sciences National Chung Hsing University Taichung 40227 Taiwan. PhD Program in Translational Medicine College of Life Sciences National Chung Hsing University Taichung 40227 Taiwan. Rong Hsing Research Center for Translational Medicine College of Life Sciences National Chung Hsing University Taichung 40227 Taiwan.

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Enhancing safety with an AI-empowered assessment and monitoring system for BSL-3 facilities

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Heliyon 2025年第1期11卷 e40855页

作者： Fan, Yi-Ling Hsu, Ching-Han Wu, Ju-Yu Tsai, Ying-Ying Chen, Wei J. Lee, Min-Shi Hsu, Fang-Rong Liao, Lun-De Institute of Biomedical Engineering and Nanomedicine National Health Research Institutes 35 Keyan Road Miaoli County Zhunan Town 350 Taiwan Department of Biomedical Engineering & Environmental Sciences National Tsing-Hua University Hsinchu Taiwan Doctoral Program in Tissue Engineering and Regenerative Medicine National Chung Hsing University Taichung Taiwan Center for Neuropsychiatric Research National Health Research Institutes 35 Keyan Road Miaoli County Zhunan Town 350 Taiwan National Institute of Infectious Diseases and Vaccinology National Health Research Institutes 35 Keyan Road Miaoli County Zhunan Town 350 Taiwan Department of Information Engineering and Computer Science Feng Chia University Taichung 407 Taiwan

Introduction: The COVID-19 pandemic has created an urgent demand for research, which has spurred the development of enhanced biosafety protocols in biosafety level (BSL)-3 laboratories to safeguard against the risks associated with handling highly contagious pathogens. Laboratory management failures can pose significant hazards. Methods: An external system captured images of personnel entering a laboratory, which were then analyzed by an AI-based system to verify their compliance with personal protective equipment (PPE) regulations, thereby introducing an additional layer of protection. A deep learning model was trained to detect the presence of essential PPE items, such as clothing, masks, hoods, double-layer gloves, shoe covers, and respirators, ensuring adherence to World Health Organization (WHO) standards. The internal laboratory management system used a deep learning model to delineate alert zones and monitor compliance with the imposed safety protocols. Results: The external detection system was trained on a dataset consisting of 4112 images divided into 15 PPE compliance classes. The model achieved an accuracy of 97.52 % and a recall of 97.03 %. The identification results were presented in real time via a visual interface and simultaneously stored on the administrator's dashboard for future reference. We trained the internal management system on 3347 images, achieving 90 % accuracy and 85 % recall. The results were transmitted in JSON format to the internal monitoring system, which triggered alerts in response to violations of safe practices or alert zones. Real-time notifications were sent to the administrators when the safety thresholds were met. Conclusion: The BSL-3 laboratory monitoring system significantly reduces the risk of exposure to pathogens for personnel during laboratory operations. By ensuring the correct use of PPE and enhancing adherence to the imposed safety protocols, this system contributes to maintaining the integrity of BSL-3 facilities

关键词： Bioengineering Biomedical instrumentation Biomedical laboratory safety Biosafety level-3 laboratory

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Exploring knowledge, attitude, and intention towards advance care planning, advance directive, and the patient self-determination act among hemodialysis patients

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BMC Palliative Care 2023年第1期22卷 201-201页

作者： Tsai, Shang-Feng Chang, Ching-Yi Yang, Jia-Yi Ho, Yu-Ying Hsiao, Ching-Ching Hsu, Shu-Chuan Chen, Shih-Yun Lin, Huan-Yi Yeh, Te-Feng Chen, Cheng-Hsu Division of Nephrology Department of Internal Medicine Taichung Veterans General Hospital 160 Sec. 3 Boulevard Taichung 407 Taiwan Department of Life Science Tunghai University Taichung Taiwan Department of Post-Baccalaureate Medicine College of Medicine National Chung Hsing University Taichung Taiwan Department of Nursing Taichung Veterans General Hospital Taichung Taiwan Department of Ophthalmology Taichung Veterans General Hospital Taichung Taiwan Department of Healthcare Administration Central Taiwan University of Science and Technology Taichung Taiwan Ph.D. Program in Tissue Engineering and Regenerative Medicine College of Medicine National Chung Hsing University Taichung Taiwan

Background: Hemodialysis holds the highest incidence and prevalence rate in Taiwan globally. However, the implementation of advance care planning (ACP), advance directives (AD), and patient self-determination acts (PSDA) remains limited. Our objective was to examine the current status of ACP, AD and PSDA and potential opportunities for enhancement. Methods: We developed a novel questionnaire to assess individuals’ knowledge, attitudes, and intentions regarding ACP, AD, and PSDA. We also collected baseline characteristics and additional inquiries for correlation analysis to identify potential factors. Student’s t-test and Analysis of Variance were employed to assess significance. Results: Initially, a cohort of 241 patients was initially considered for inclusion in this study. Subsequently, 135 patients agreed to participate in the questionnaire study, resulting in 129 valid questionnaires. Among these respondents, 76 were male (59.9%), and 53 were female (41.1%). Only 13.2% had signed AD. A significant portion (85.3%) indicated that they had not discussed their dialysis prognosis with healthcare providers. Additionally, a mere 14% engaged in conversations about life-threatening decisions. Ninety percent believed that healthcare providers had not furnished information about ACP, and only 30% had discussed such choices with their families. The findings revealed that the average standardized score for ACP and AD goals was 84.97, while the attitude towards PSDA received a standardized score of 69.94. The intention score stood at 69.52 in standardized terms. Potential candidates for ACP initiation included individuals aged 50 to 64, possessing at least a college education, being unmarried, and having no history of diabetes. Conclusion: Patients undergoing hemodialysis exhibited a significant knowledge gap concerning ACP, AD, and the PSDA. Notably, a substantial number of dialytic patients had not received adequate information on these subjects. Nevertheless, they display

关键词： Advance care planning (ACP) Advance directive (AD) Attitude Hemodialysis Intention Knowledge Life-sustaining treatment Life-sustaining treatment (LST) Patient right to autonomy act Patient self-determination act (PSDA)

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In vitro biocompatibility of polycaprolactone/hydroxyapatite nanocomposite membranes modified by oleic acid for bone regeneration

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Colloids and Surfaces A: Physicochemical and engineering Aspects 2024年 688卷

作者： Lin, Ruei-Hong Hung, Huey-Shan Tang, Cheng-Ming Tsou, Hsi-Kai Chen, Po-Hsiang Yueh, Chun-Yu Wang, Hui-Min David Functional Neurosurgery Division Neurological Institute Taichung Veterans General Hospital Taichung40293 Taiwan Doctoral Program in Tissue Engineering and Regenerative Medicine National Chung Hsing University Taichung40227 Taiwan Translational Medicine Research China Medical University Hospital Taichung404327 Taiwan Graduate Institute of Biomedical Science China Medical University Taichung404333 Taiwan Institute of Oral Sciences Chung Shan Medical University Taichung40201 Taiwan Department of Dentistry Chung Shan Medical University Hospital Taichung40201 Taiwan Functional Neurosurgery Division Neurological Institute Taichung Veterans General Hospital Taichung40293 Taiwan Department of Rehabilitation Jen-Teh Junior College of Medicine Nursing and Management Miaoli County35664 Taiwan College of Health National Taichung University of Science and Technology Taichung403027 Taiwan School of Medicine China Medical University Taichung404333 Taiwan Graduate Institute of Medicine College of Medicine Kaohsiung Medical University Kaohsiung80708 Taiwan Graduate Institute of Biomedical Engineering National Chung Hsing University Taichung40227 Taiwan Department of Medical Laboratory Science and Biotechnology China Medical University Taichung40402 Taiwan

The bone defect is common in the orthopedic clinic, possibly due to trauma, tumor, or congenital diseases. Also, some patients with alveolar bone defects in the dental clinic result from the different proliferation speeds between soft and hard tissue. Biomaterials made of polymers and bioceramics have been developed to deal with these problems but mixing them directly can result in a low-mechanical strength complex. To solve this, we used oleic acid (C18) as a surfactant to improve the dispersity of hydroxyapatite (HA) in the polycaprolactone (PCL) matrix, and then immerse the material in a simulated biomineralization process. The results showed that the low crystallinity PCL formed an evenly distributed mineralized layer that had phosphate ions signal and a hydroxyapatite peak. The biocompatibility of the material was assessed using MC3T3 cells, and found that the PCL-HA membrane and PCL-C18-HA membranes had significant cell filopodia and lamellipodia. Additionally, the polycaprolactone/oleic acid/hydroxyapatite (PCL-C18-HA) membrane had the highest cell viability among all groups. The addition of C18 also decreased the platelets activation degree but had a significant difference in the reactive oxygen species (ROS) amount compared to the control, which requires further investigation. Overall, this study successfully fabricated a safe and promising polycaprolactone/hydroxyapatite/oleic acid nanocomposite membrane as a potential solution for bone biomaterials. © 2024 Elsevier B.V.

关键词： Hydroxyapatite

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Sialylation is involved in cell fate decision during development, reprogramming and cancer progression

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Protein & Cell 2019年第8期10卷 550-565页

作者： Fenjie Li Junjun Ding Program in Stem Cell and Regenerative Medicine The Third Affiliated Hospital of Sun Yat-Sen University Zhongshan School of Medicine Sun Yat-Sen University Guangzhou China Key Laboratory for Stem Cells and Tissue Engineering Ministry of Education Department of Cell Biology Zhongshan School of Medicine Sun Yat-Sen University Guangzhou China

Sialylation, or the covalent addition of sialic acid to the terminal end of glycoproteins, is a biologically important modification that is involved in embryonic development, neurodevelopment, reprogramming, oncogenesis and immune responses. In this review, we have given a comprehensive overview of the current literature on the involvement of sialylation in cell fate decision during development, reprogramming and cancer progressionSialylation is essential for early embryonic development and the deletion of UDP-GIcNAc 2-epimerase, a rate-limiting enzyme in sialic acid biosynthesis, is embryonically lethal. Furthermore, the sialyltransferase ST6GAL1 is required for somatic cell reprogramming, and its downregulation is associated with decreased reprogramming efficiency. In addition, sialylation levels and patterns are altered during cancer progression, indicating the potential of sialylated molecules as cancer biomarkers. Taken together, the current evidences demonstrate that sialylation is involved in crucial cell fate decision.

关键词： sialylation cell fate development reprogramming cancer

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THE EFFECT OF TELE-YOGA ON PHYSICAL FITNESS AND MENTAL HEALTH OF IRRITABLE BOWEL SYNDROME DURING THE COVID-19 PANDEMIC

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Journal of Science and medicine in Sport 2023年 26卷 S120-S121页

作者： Chao, W. Chen, K. Cheng, B. Huang, C. National Chung Hsing University Program in Tissue Engineering and Regenerative Medicine Taiwan Show Chwan Memorial Hospital Orthopedics Taiwan National Chung Hsing University Graduate Institute of Biomedical Engineering Taiwan Cheng Ching Hospital Chunk Kang Branch Taiwan

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Theranostic doxorubicin encapsulated FeAu alloy@metal-organic framework nanostructures enable magnetic hyperthermia and medical imaging in oral carcinoma

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Nanomedicine: Nanotechnology, Biology, and medicine 2023年 48卷 102652-102652页

作者： Dhawan, Udesh Tseng, Ching-Li Wu, Ping-Hsuan Liao, Mei-Yi Wang, Huey-Yuan Wu, Kevin C.-W. Chung, Ren-Jei Centre for the Cellular Microenvironment Division of Biomedical Engineering School of Engineering University of Glasgow GlasgowG12 8LT United Kingdom Graduate Institute of Biomedical Materials and Tissue Engineering College of Biomedical Engineering Taipei Medical University Taipei City110 Taiwan International Ph. D. Program in Biomedical Engineering College of Biomedical Engineering Taipei Medical University Taipei City110 Taiwan Research Center of Biomedical Device College of Biomedical Engineering Taipei Medical University Taipei City110 Taiwan International Ph. D. Program in Cell Therapy and Regenerative Medicine College of Medicine Taipei Medical University Taipei City110 Taiwan Taipei106344 Taiwan Department of Applied Chemistry National Pingtung University Pingtung 90003 Taiwan Department of Stomatology MacKay Memorial Hospital Taipei104217 Taiwan Department of Chemical Engineering National Taiwan University Taipei10617 Taiwan Institute of Biomedical Engineering & Nanomedicine National Health Research Institute Keyan Road Zhunan Miaoli City350 Taiwan National Taiwan University Taipei106216 Taiwan

Metal-organic frameworks (MOFs) have emerged as attractive candidates in cancer theranostics due to their ability to envelop magnetic nanoparticles, resulting in reduced cytotoxicity and high porosity, enabling chemodrug encapsulation. Here, FeAu alloy nanoparticles (FeAu NPs) are synthesized and coated with MIL-100(Fe) MOFs to fabricate FeAu@MOF nanostructures. We encapsulated Doxorubicin within the nanostructures and evaluated the suitability of this platform for medical imaging and cancer theranostics. FeAu@MOF nanostructures (FeAu@MIL-100(Fe)) exhibited superparamagnetism, magnetic hyperthermia behavior and displayed DOX encapsulation and release efficiency of 69.95 % and 97.19 %, respectively, when stimulated with alternating magnetic field (AMF). In-vitro experiments showed that AMF-induced hyperthermia resulted in 90 % HSC-3 oral squamous carcinoma cell death, indicating application in cancer theranostics. Finally, in an in-vivo mouse model, FeAu@MOF nanostructures improved image contrast, reduced tumor volume by 30-fold and tumor weight by 10-fold, which translated to enhancement in cumulative survival, highlighting the prospect of this platform for oral cancer treatment. © 2023

关键词： Metal nanoparticles

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