Journal of the Chinese Medical Association : JCMA
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Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgical aortic valve replacement for patients with symptomatic severe aortic stenosis (AS) who have a high surgical risk. In Taiwan, this is the first study reporting TAVI outcomes at a single center offering two different transcatheter heart valve technologies via four types of approaches. Our aim was to compare 30-day and 6-month Valve Academic Research Consortium-2 (VARC-2) outcomes of the two valves. ⋯ For the first time in Taiwan, we have demonstrated that TAVI using either device is complementary and feasible for treating a wide range of patients by using a careful selection of approaches. Favorable overall procedural success rates and 30-day and 6-month outcomes were achieved with both devices.
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When treating patients who have multilevel cervical spondylotic myelopathy (MCSM) with short-segment kyphosis, instability, or major anterior foci, long-level anterior decompression with fusion is often a standard method but can cause obvious loss of range of motion and usually needs further posterior stabilization. For MCSM with correctable kyphosis or simple instability, laminectomy with lateral-mass instrumented fusion is also a treatment of choice, but all the involved segments are immobilized. Combining expansive open-door laminoplasty (EOLP) and anterior short-segment fusion may be an alternative treatment to save more motion segments. ⋯ EOLP with adjunct anterior short-segment decompression fusion yields an excellent outcome for MCSM patients who exhibit concomitant short-segment kyphosis, instability or major anterior pathology. Performing laminoplasty first is safer for the spinal cord due to its posterior shifting while anterior procedures are being done.
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Diabetes mellitus (DM) is a global health care issue resulting from hyperglycemia-mediated life-threatening complications. Although the use of glucose-lowering agents is routinely practiced, high dependence on medication leads to poor quality of life for DM patients. While it is still not feasible to precisely determine the critical timing when DM is truly established, perhaps the best way to reduce DM-associated mortality is to prevent it. ⋯ Recently discovered small noncoding molecules, microRNAs (miRs), in body fluid seem promising to be utilized as a biomarker to monitor DM initiation and progression, as it is believed that expression of circulating miRs reflects disease pathology. Current DM-related miRs were often referred to miRs differentially expressed in insulin target organs (liver, muscle, and adipose tissues) or circulating blood (peripheral blood) in diabetic patients compared to their control counterparts, although these miRs could merely be resultant nucleotides from DM-induced organ impairment instead of the indicators of onset/progression of DM. In the current review, studies showing circulating miRs associated with type 2 DM and its complications are summarized, and future scope of using miRs as biomarkers for disease prognosis/diagnosis is also emphasized.
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Review
Preventive and therapeutic role of traditional Chinese herbal medicine in hepatocellular carcinoma.
Hepatocellular carcinoma (HCC) is one of the most prevalent malignancies worldwide. The clinical management of HCC remains a substantial challenge. Although surgical resection of tumor tissues seems promising, a high recurrence and/or metastasis rate accounting for disease-related death has led to an urgent need for improved postsurgical preventive/therapeutic clinical intervention. ⋯ Because of their enhanced preventive/therapeutic effects, traditional Chinese herbal medicine (CHM)-derived compounds are considered suitable agents for HCC treatment. The CHM-derived compounds also possess multilevel, multitarget, and coordinated intervention effects, making them ideal candidates for inhibition of tumor progression and HCC metastasis. This article reviews the anticancer activity of various CHMs with the hope of providing a better understanding of how to best use CHM for HCC treatment.