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Infective endocarditis (IE) is an uncommon but potentially devastating disease. Recently published data have revealed a significant increase in the incidence of IE following the restriction on indications for antibiotic prophylaxis as recommended by the revised guidelines. This study aims to reexamine the basic assumption behind the rationale of prophylaxis that dental procedures increase the risk of IE.Using the Longitudinal Health Insurance Database of Taiwan, we retrospectively analyzed a total of 739 patients hospitalized for IE between 1999 and 2012. A case-crossover design was conducted to compare the odds of exposure to dental procedures within 3 months preceding hospitalization with that during matched control periods when no IE developed.In the unadjusted model, the odds ratio (OR) was 0.93 for tooth extraction (95% confidence interval [CI] 0.54–1.59), 1.64 for surgery (95% CI 0.61–4.42), 0.92 for dental scaling (95% CI 0.59–1.42), 1.69 for periodontal treatment (95% CI 0.88–3.21), and 1.29 for endodontic treatment (95% CI 0.72–2.31). The association between dental procedures and the risk of IE remained insignificant after adjustment for antibiotic use, indicating that dental procedures did not increase the risk of IE.Therefore, this result may argue against the conventional assumption on which the recommended prophylaxis for IE is based.  相似文献   
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Activating mutations of the interleukin‐7 receptor (IL7R) occur in approximately 10% of patients with T cell acute lymphoblastic leukaemia (T‐ALL). Most mutations generate a cysteine at the transmembrane domain leading to receptor homodimerization through disulfide bond formation and ligand‐independent activation of STAT5. We hypothesized that the reducing agent N‐acetylcysteine (NAC), a well‐tolerated drug used widely in clinical practice to treat acetaminophen overdose, would reduce disulfide bond formation, and inhibit mutant IL7R‐mediated oncogenic signalling. We found that treatment with NAC disrupted IL7R homodimerization in IL7R‐mutant DND‐41 cells as assessed by non‐reducing Western blot, as well as in a luciferase complementation assay. NAC led to STAT5 dephosphorylation and cell apoptosis at clinically achievable concentrations in DND‐41 cells, and Ba/F3 cells transformed by an IL7R‐mutant construct containing a cysteine insertion. The apoptotic effects of NAC could be rescued in part by a constitutively active allele of STAT5. Despite using doses lower than those tolerated in humans, NAC treatment significantly inhibited the progression of human DND‐41 cells engrafted in immunodeficient mice. Thus, targeting leukaemogenic IL7R homodimerization with NAC offers a potentially effective and feasible therapeutic strategy that warrants testing in patients with T‐ALL.  相似文献   
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The objective of this study was to determine whether proteomic profiling in serum samples can be utilized in identifying and differentiating mood disorders. A consecutive sample of patients with a confirmed diagnosis of unipolar (UP n=52) or bipolar depression (BP-I n=46, BP-II n=49) and controls (n=141) were recruited. A 7.5-ml blood sample was drawn for proteomic multiplex profiling of 320 proteins utilizing the Myriad RBM Discovery Multi-Analyte Profiling platform. After correcting for multiple testing and adjusting for covariates, growth differentiation factor 15 (GDF-15), hemopexin (HPX), hepsin (HPN), matrix metalloproteinase-7 (MMP-7), retinol-binding protein 4 (RBP-4) and transthyretin (TTR) all showed statistically significant differences among groups. In a series of three post hoc analyses correcting for multiple testing, MMP-7 was significantly different in mood disorder (BP-I+BP-II+UP) vs controls, MMP-7, GDF-15, HPN were significantly different in bipolar cases (BP-I+BP-II) vs controls, and GDF-15, HPX, HPN, RBP-4 and TTR proteins were all significantly different in BP-I vs controls. Good diagnostic accuracy (ROC-AUC⩾0.8) was obtained most notably for GDF-15, RBP-4 and TTR when comparing BP-I vs controls. While based on a small sample not adjusted for medication state, this discovery sample with a conservative method of correction suggests feasibility in using proteomic panels to assist in identifying and distinguishing mood disorders, in particular bipolar I disorder. Replication studies for confirmation, consideration of state vs trait serial assays to delineate proteomic expression of bipolar depression vs previous mania, and utility studies to assess proteomic expression profiling as an advanced decision making tool or companion diagnostic are encouraged.  相似文献   
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Nonrapid eye movement (NREM) sleep is associated with fading consciousness in humans. Recent neuroimaging studies have demonstrated the spatiotemporal alterations of the brain functional connectivity (FC) in NREM sleep, suggesting the changes of information integration in the sleeping brain. However, the common stationarity assumption in FC does not satisfactorily explain the dynamic process of information integration during sleep. The dynamic FC (dFC) across brain networks is speculated to better reflect the time‐varying information propagation during sleep. Accordingly, we conducted simultaneous EEG‐fMRI recordings involving 12 healthy men during sleep and observed dFC across sleep stages using the sliding‐window approach. We divided dFC into two aspects: mean dFC (dFCmean) and variance dFC (dFCvar). A high dFCmean indicates stable brain network integrity, whereas a high dFCvar indicates instability of information transfer within and between functional networks. For the network‐based dFC, the dFCvar were negatively correlated with the dFCmean across the waking and three NREM sleep stages. As sleep deepened, the dFCmean decreased (N0~N1 > N2 > N3), whereas the dFCvar peaked during the N2 stage (N0~N1 < N3 < N2). The highest dFCvar during the N2 stage indicated the unstable synchronizations across the entire brain. In the N3 stage, the overall disrupted network integration was observed through the lowest dFCmean and elevated dFCvar, compared with N0 and N1. Conclusively, when the network specificity (dFCmean) breaks down, the consciousness dissipates with increasing variability of information exchange (dFCvar).  相似文献   
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The conventional method for impressions of flabby tissue uses modified trays and highly flowable materials, but mucostatic impressions are difficult to achieve due to the viscous and the elastic natures of impression materials. In this report, a technique is presented in which conventional impression and intraoral scanning for a fully edentulous patient with flabby tissue are combined. The definitive impression was obtained by applying appropriate pressure to each tissue area, and the denture can be maintained passively and stable at rest and during function.  相似文献   
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In 2008, we published a review article entitled “Differential diagnosis of gynecologic organ-related diseases in women presenting with ascites” in the Taiwanese Journal of Obstetrics and Gynecololgy. Ascites might be the results of the physiological or pathological status, and the underlying mechanisms varied greatly in the different genders. The diagnostic challenge is frequently found in clinical practice. This review summarizes the recent knowledge and clinical practice for women presenting with ascites. Approach includes history, physical examination, laboratory examination, ultrasound, paracentesis and possible laparoscopy. Accurate and prompt diagnosis not only provides the better care and management but also diminishes the unnecessary psychological stress in women presenting with ascites.  相似文献   
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Xu  Xiaoxia  Zhu  Hua  Liu  Fei  Zhang  Yan  Yang  Jianhua  Zhang  Lifang  Xie  Qing  Zhu  Lin  Li  Nan  Kung  Hank F.  Yang  Zhi 《European journal of nuclear medicine and molecular imaging》2020,47(10):2280-2292
European Journal of Nuclear Medicine and Molecular Imaging - The purpose of this study was to compare dynamic 18F-FGln PET/CT images of healthy subjects and cancer patients and explore the best...  相似文献   
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