Study of an outbreak of ciguatera fish poisoning in Hong Kong.

Ciguatera fish poisoning (CFP) has been a significant and increasing public health problem in Hong Kong since 1980s. With growing demand for imported live coral fishes, the number of people who suffered from this disease has also been increasing. An outbreak of CFP in 2004 was the second most prominent in record as compared with the most significant one that occurred in 1998. In 2004, out of a total of 823 reported food poisoning outbreaks involving 3159 persons, 65 incidents (7.9%) affecting 247 people (7.8%) were attributed to CFP. Validated mouse bioassay analysis of surveillance samples revealed that seven samples (13%) were confirmed to be contaminated with ciguatoxins (CTXs). Typical symptoms of CTXs were found in mice injected with 20mg of fish extracts. The causative fishes included Cheilinus undulatus, Epinephelus coioides, Plectropomus areolatus, and Plectropomus leopardus. Most of these CTX-positive samples analyzed had only trace amounts of CTXs in their extract, except a C. undulatus sample which contained a mice lethal dose (2.5MU/20mg ether extract). This fish species was also the major origin of coral fish that caused clusters of CFP in the last quarter of 2004. Cigua-Check analysis of 20 flesh grains from seven CTX-positive fishes, previously confirmed as CTX-positive samples by mouse bioassay, showed that 50% of flesh grains were CTX contaminated.     

中草药药品进军欧洲市场的前景与法律探讨

一般来说,欧盟有关人用药品的法律皆适用于草药药品。2004年时,欧盟通过一个指令,为传统草药药品上市销售引进一个新途径,名为简化注册程序。在满足一定条件后,传统草药药品的注册可以无需提交有关安全性、有效性的检测和实验的数据和文件,但必须提交这些药品30年药用历史的充分证明,其中的15年是在欧盟境内。因此理论上来说,药厂申请上市销售许可时应可节省大量的金钱、时间与精力的投入。但这个新途径在实践时并不如预期般畅顺地解决问题。文章分析了多个影响草药药品(包括现代与传统在内)发展的欧盟法律,草药药品需求不断增长的原因,欧盟对最新市场趋势作出的反应,以及中国药厂应如何把握机会进入欧洲市场等问题。同时文章强调一个现实情况,就是争取中医药科研文章能在国际医学杂志上发表,将会是这行业将来得以成功发展的关键因素。     

Neonatal clavicular fracture: clinical analysis of incidence, predisposing factors, diagnosis, and outcome

The objective of this study is to identify maternal, perinatal, and fetal risk factors for clavicular fracture in a single institution. We performed a prospective study of all deliveries during a 14-month period to identify confirmed cases of neonatal clavicular fracture. The control group consisted of the deliveries immediately preceding and following the index cases. Fifty-three cases of clavicular fracture were identified among the 4789 deliveries from October 1995 through November 1996 for an incidence of 1.11%. Three neonates in the clavicular fracture group were delivered through cesarean section. Neonates with fracture were significantly heavier at birth than those without (3564 vs. 3283 g, p <0.001), and had a lower mean head-to-abdominal circumference ratio (0.93 vs. 1.08, p <0.001), history of giving birth to a macrosomia (21 vs. 4%, p <0.05). The anterior shoulder was the predominant site of fracture (30/53). Fracture was detected mostly during the first 3 days of neonatal life (46/53). The outcome was benign, with complete recovery in all cases and no associated neurological sequelae. Neonatal clavicular fracture tended to be associated with neonatal somatometric characteristics and difficult deliveries. Considering the benign nature of this birth trauma, more invasive intrapartum management to lower its incidence is not advised.     

IFPA Meeting 2012 Workshop Report III: Trophoblast deportation,gestational trophoblastic disease,placental insufficiency and fetal growth restriction,trophoblast over-invasion and accreta-related pathologies,placental thrombosis and fibrinolysis

Workshops are an important part of the IFPA annual meeting as they allow for discussion of specialized topics. At IFPA meeting 2012 there were twelve themed workshops, five of which are summarized in this report. These workshops related to various aspects of placental biology but collectively covered areas of clinical research and pregnancy disorders: 1) trophoblast deportation; 2) gestational trophoblastic disease; 3) placental insufficiency and fetal growth restriction; 4) trophoblast overinvasion and accreta-related pathologies; 5) placental thrombosis and fibrinolysis.     

Healthy Taiwanese Eating Approach (TEA) toward Total Wellbeing and Healthy Longevity

A healthy dietary pattern review for Asian countries is scarce, which is crucial for guiding healthy eating. We reviewed Taiwanese dietary pattern discovery studies. Included were 19 studies, the majority of which employed dimension reduction methods to find dietary patterns associated with various health conditions. To show what is a high or low intake of foods in Taiwan, we also report the average dietary content and the 25th and 75th percentile values of the adult population for six food groups gathered by the Nutrition and Health Survey in Taiwan, 2017–2020. The healthy Taiwanese dietary approach is cohesive across multiple health outcomes occurring at different ages. It is featured with higher intakes of plant-based foods, aquatic foods, and some beneficial ethnic foods (soy products), drinks (tea), and cooking methods (boiling and steaming); lower intakes of fast foods, fatty and processed meats, sugar, salt rich foods/drinks, and fried foods; but with mixed findings for dairy and egg. Yet, the average Taiwanese person consumed many refined staple foods and livestock, but not sufficient vegetables, fruits, whole grains and roots, beans, and nuts. Dairy consumption remains low. In conclusion, Taiwanese discovery studies point to a mortality-lowering total wellbeing dietary pattern consistent with the current knowledge, which discloses potential benefits of soy product, tea, and boiling and steaming.     

Theoretical and Experimental Models to Evaluate the Possibility of Corrosion Resistant Concrete for Coastal Offshore Structures

This study built theoretical and practical models to evaluate the corrosion resistance of concrete for coastal offshore structures in Vietnam. A mathematical model was developed in the form of a system of nonlinear partial differential equations characterizing the diffusion “free calcium hydroxide” in a solid of a concrete structure. The model describes the process of non-stationary mass conductivity observed in the “concrete structure—marine environment” system under non-uniform arbitrary initial conditions, as well as combined boundary conditions of the second and third kind, taking into account the nonlinear nature of the coefficients of mass conductivity k and mass transfer β. It was shown that the solution of the boundary value problem of non-stationary mass conductivity allows us to conclude about the duration of the service life of a concrete structure, which will be determined by the processes occurring at the interface: in concrete—mass conductivity, depending on the structural and mechanical characteristics of hydraulic structures, and in the liquid phase—mass transfer, determined by the conditions of interaction at the interface of the indicated phases.     

Accelerated-strategy renal replacement therapy for critically ill patients: A systematic review and meta-analysis

Background:The aim of this study was to investigate the clinical effect and safety of accelerated-strategy initiation of renal replacement therapy (RRT) in critically ill patients.Methods:PubMed, Embase, OVID, EBSCO, and the Cochrane Library databases were searched for relevant articles from inception to December 30, 2020. Only RCTs that compared the clinical efficacy and safety between accelerated-strategy RRT and standard-strategy RRT among critically ill adult patients with acute kidney injury (AKI) were included. The primary outcome was 28-day mortality.Results:A total of 5279 patients in 12 RCTs were included in this meta-analysis. The 28-day mortality rates of patients treated with accelerated and standard RRT were 37.3% (969/2596) and 37.9% (976/2573), respectively. No significant difference was observed between the groups (OR, 0.92; 95% CI, 0.70–1.12; I² = 60%). The recovery rates of renal function were 54.5% and 52.5% in the accelerated- and standard-RRT groups, respectively, with no significant difference (OR, 1.03; 95% CI, 0.89–1.19; I² = 56%). The rate of RRT dependency was similar in the accelerated- and standard-RRT strategies (6.7% vs 5.0%; OR, 1.11; 95% CI, 0.71–1.72; I² = 20%). The accelerated-RRT group displayed higher risks of hypotension, catheter-related infection, and hypophosphatemia than the standard-RRT group (hypotension: OR, 1.26; 95% CI, 1.10–1.45; I² = 36%; catheter-related infection: OR, 1.90; 95% CI, 1.17–3.09; I² = 0%; hypophosphatemia: OR, 2.11; 95% CI, 1.43–3.15; I² = 67%).Conclusions:Accelerated RRT does not reduce the risk of death and does not improve the recovery of kidney function among critically ill patients with AKI. In contrast, an increased risk of adverse events was observed in patients receiving accelerated RRT. However, these findings were based on low quality of evidence. Further large-scale RCTs is warranted.     

Investigation of borneols sold in Taiwan by chiral gas chromatography

Borneol is a monoterpene that is widely used in traditional Chinese medicine. There are two different products sold in Taipei's traditional Chinese medicine market, natural and chemically synthesized borneol. Chemically synthesized borneol contains four stereoisomers, (+)-isoborneol, (?)-isoborneol, (?)-borneol, and (+)-borneol. The ratio of these four isomers in chemically synthesized and natural borneol products was determined by gas chromatography mass spectrometry. A huge variation between these products is highlighted in this survey. The results suggest that the Food and Drug Administrations in Asian countries should establish a regulatory standard regarding the ratio of the four different borneol isomers in both natural and chemically synthesized borneol.     

Two BRM promoter polymorphisms predict poor survival in patients with hepatocellular carcinoma

Polymorphisms in the promoter of the BRM gene, a critical subunit of the chromatin remodeling SWI/SNF complex, have previously been implicated in risk and prognosis in Caucasian‐predominant lung, head and neck, esophageal, and pancreatic cancers, and in hepatocellular cancers in Asians. We investigated the role of these polymorphisms in hepatocellular carcinoma (HCC) risk and prognosis. HCC cases were recruited in a comprehensive cancer center while the matched controls were recruited from family practice units from the same catchment area. For risk analyses, unconditional logistic regression analyses were performed in HCC patients and matched healthy controls. Overall survival analyses were performed using Cox proportional hazard models, Kaplan‐Meier curves, and log‐rank tests. In 266 HCC cases and 536 controls, no association between either BRM promoter polymorphism (BRM‐741 or BRM‐1321) and risk of HCC was identified (P > 0.10 for all comparisons). There was significant worsening of overall survival as the number of variant alleles increased: BRM‐741 per variant allele adjusted hazards ratio (aHR) 5.77, 95% confidence interval (CI) 2.89‐11.54 and BRM‐1321 per variant allele aHR 4.09, 95%CI 2.22‐7.51. The effects of these two polymorphisms were at least additive, where individuals who were double homozygotes for the variant alleles had a 45‐fold increase in risk of death when compared to those who were double wild‐type for the two polymorphisms. Two BRM promoter polymorphisms were strongly associated with HCC prognosis but were not associated with increased HCC susceptibility. The association was strongest in double homozygotes for the allele variants.     

Polycystic ovary syndrome in asian women

There is substantial heterogeneity of symptoms and signs among women with polycystic ovary syndrome (PCOS). In addition to different diagnostic criteria used, the ethnic background of women with PCOS may affect the clinical, hormonal, and metabolic characteristics of this condition. We present here studies related to the clinical, hormonal, and metabolic characteristics and response to the treatment of PCOS in Asia, which may be different from those in Western countries. It is important to take into consideration the ethnic background of patients in future studies related to PCOS.