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991.
Ling-Chien Hung Sheng-Feng Sung Cheng-Yang Hsieh Ya-Han Hu Huey-Juan Lin Yu-Wei Chen Yea-Huei Kao Yang Sue-Jane Lin 《Journal of epidemiology / Japan Epidemiological Association》2017,27(1):24-29
Background
Stroke severity is an important outcome predictor for intracerebral hemorrhage (ICH) but is typically unavailable in administrative claims data. We validated a claims-based stroke severity index (SSI) in patients with ICH in Taiwan.Methods
Consecutive ICH patients from hospital-based stroke registries were linked with a nationwide claims database. Stroke severity, assessed using the National Institutes of Health Stroke Scale (NIHSS), and functional outcomes, assessed using the modified Rankin Scale (mRS), were obtained from the registries. The SSI was calculated based on billing codes in each patient's claims. We assessed two types of criterion-related validity (concurrent validity and predictive validity) by correlating the SSI with the NIHSS and the mRS. Logistic regression models with or without stroke severity as a continuous covariate were fitted to predict mortality at 3, 6, and 12 months.Results
The concurrent validity of the SSI was established by its significant correlation with the admission NIHSS (r = 0.731; 95% confidence interval [CI], 0.705–0.755), and the predictive validity was verified by its significant correlations with the 3-month (r = 0.696; 95% CI, 0.665–0.724), 6-month (r = 0.685; 95% CI, 0.653–0.715) and 1-year (r = 0.664; 95% CI, 0.622–0.702) mRS. Mortality models with NIHSS had the highest area under the receiver operating characteristic curve, followed by models with SSI and models without any marker of stroke severity.Conclusions
The SSI appears to be a valid proxy for the NIHSS and an effective adjustment for stroke severity in studies of ICH outcome with administrative claims data. 相似文献992.
Hsiu‐Ju Yen Shih‐Hsiang Chen Tsung‐Yen Chang Chao‐Ping Yang Dong‐Tsamn Lin Iou‐Jih Hung Kai‐Hsin Lin Jiann‐Shiuh Chen Chih‐Cheng Hsiao Tai‐Tsung Chang Te‐Kao Chang Ching‐Tien Peng Ming‐Tsan Lin Tang‐Her Jaing Hsi‐Che Liu Shiann‐Tarng Jou Meng‐Yao Lu Chao‐Neng Cheng Jiunn‐Ming Sheen Shyh‐Shin Chiou Giun‐Yi Hung Kang‐Hsi Wu Ting‐Chi Yeh Shih‐Chung Wang Rong‐Long Chen Hsiu‐Hao Chang Yung‐Li Yang Shu‐Huey Chen Shin‐Nan Cheng Yu‐Hsiang Chang Bow‐Wen Chen Yuh‐Lin Hsieh Fang‐Liang Huang Wan‐Ling Ho Jinn‐Li Wang Chia‐Yau Chang Yu‐Hua Chao Pei‐Chin Lin Yu‐Chieh Chen Yu‐Mei Liao Tung‐Huei Lin Lee‐Yung Shih Der‐Cherng Liang 《Pediatric blood & cancer》2017,64(10)
993.
994.
Steven C Kao Michaela B Kirschner Wendy A Cooper Thang Tran Sjaak Burgers Casey Wright Tiny Korse Daan van den Broek James Edelman Michael Vallely Brian McCaughan Nick Pavlakis Stephen Clarke Mark P Molloy Nico van Zandwijk Glen Reid 《British journal of cancer》2016,114(5):524-531
Background:
We aimed to identify prognostic blood biomarkers using proteomics-based approaches in malignant pleural mesothelioma (MPM).Methods:
Plasma samples from 12 MPM patients were used for exploratory mass spectrometry and ELISA analyses. The significance of secreted protein acidic and rich in cysteine (SPARC) was examined in sera from a Dutch series (n=97). To determine the source of the circulating SPARC, we investigated SPARC expression in MPM tumours and healthy controls, as well as the expression and secretion from cell lines and xenografts.Results:
Secreted protein acidic and rich in cysteine was identified as a putative prognostic marker in plasma. Validation in the Dutch series showed that the median survival was higher in patients with low SPARC compared with those with high SPARC (19.0 vs 8.8 months; P=0.01). In multivariate analyses, serum SPARC remained as an independent predictor (HR 1.55; P=0.05). In MPM tumour samples, SPARC was present in the tumour cells and stromal fibroblasts. Cellular SPARC expression was higher in 5 out of 7 cell lines compared with two immortalized mesothelial lines. Neither cell lines nor xenograft tumours secreted detectable SPARC.Conclusions:
Low circulating SPARC was associated with favourable prognosis. Secreted protein acidic and rich in cysteine was present in both tumour cells and stromal fibroblasts; and our in vitro and in vivo experiments suggest that stromal fibroblasts are a potential source of circulating SPARC. 相似文献995.
996.
997.
998.
A 48-year-old woman suddenly lost consciousness as a result of a right rostral pontine tegmentum haemorrhage. The patient presented with decerebrate rigidity (DR) and regained full consciousness 5 days after the initial onset. The patient was given gabapentin 1200 mg/day nasogastrically and her DR significantly improved, although other antiepileptic drugs such as phenytoin and carbamazepine were given in larger dosages to decrease muscle hypertonicity. The patients' preserved consciousness and motor-evoked potentials to transcranial magnetic stimulation indicated a derangement of the extrapyramidal tracts with preservation of the pyramidal tracts. This case report discusses the possible mechanisms of action of gabapentin in DR. 相似文献
999.
Jawan B Kao YH Goto S Pan MC Lin YC Hsu LW Nakano T Lai CY Sun CK Cheng YF Tai MH Eng HL Wang CS Huang CJ Lin CR Chen CL 《Toxicology and applied pharmacology》2008,229(3):362-373
Propofol (PPF), a widely used intravenous anesthetic for induction and maintenance of anesthesia during surgeries, was found to possess suppressive effect on host immunity. This study aimed at investigating whether PPF plays a modulatory role in the lipopolysaccharide (LPS)-induced inflammatory cytokine expression in a cell line of rat hepatocytes. Morphological observation and viability assay showed that PPF exhibits no cytotoxicity at concentrations up to 300 microM after 48 h incubation. Pretreatment with 100 microM PPF for 24 h prior to LPS stimulation was performed to investigate the modulatory effect on LPS-induced inflammatory gene production. The results of semi-quantitative RT-PCR demonstrated that PPF pretreatment significantly suppressed the LPS-induced toll-like receptor (TLR)-4, CD14, tumor necrosis factor (TNF)-alpha, and granulocyte-macrophage colony-stimulating factor (GM-CSF) gene expression. Western blotting analysis showed that PPF pretreatment potentiated the LPS-induced TLR-4 downregulation. Flow cytometrical analysis revealed that PPF pretreatment showed no modulatory effect on the LPS-upregulated CD14 expression on hepatocytes. In addition, PPF pretreatment attenuated the phosphorylation of mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK) and IkappaBalpha, as well as the nuclear translocation of NF-kappaB primed by LPS. Moreover, addition of PD98059, a MAPK kinase inhibitor, significantly suppressed the LPS-induced NF-kappaB nuclear translocation and GM-CSF production, suggesting that the PPF-attenuated GM-CSF production in hepatocytes may be attributed to its suppressive effect on MAPK/ERK signaling pathway. In conclusion, PPF as an anesthetic may clinically benefit those patients who are vulnerable to sepsis by alleviating sepsis-related inflammatory response in livers. 相似文献
1000.
C.-Y. Lin T. Ma C.-C. Lin C.-H. Kao 《European journal of clinical microbiology & infectious diseases》2016,35(2):219-225
This study evaluated the effect of global budgeting on health service utilization, health care expenditures, and the quality of care among patients with pneumonia in Taiwan. The National Health Insurance Research Database (NHIRD) was used for analysis. Data on patients diagnosed with pneumonia during 2000–2001 (the prebudget group) were used as the baseline data, and data on patients diagnosed with pneumonia during 2004–2005 (the postbudget group) were used as the postintervention data. The length of stay (LOS), diagnostic costs, drug costs, therapy costs, total costs, risk of readmission within 14 days, and risk of revisiting the Emergency Department (ED) within 3 days of discharge before and after implementing the global budget system were analyzed and compared. Data on 32,535 patients with pneumonia were analyzed. The mean LOS increased from 6.36?±?0.07 to 10.78?±?0.09 days after implementing the global budget system. The mean total costs in the prebudget and postbudget groups were 22,697.82?±?542.40 and 62,016.7?±?793.19 New Taiwan dollars (NT$), respectively. The mean rate of revisiting the ED within 3 days decreased from 5.5?±?0.2 % to 4.6?±?0.1 % in the prebudget and postbudget groups, respectively. The mean rates of readmission within 14 days before were 6.1?±?0.2 % and 8.2?±?0.2 % in the prebudget and postbudget groups, respectively. Global budgeting is associated with a significantly longer LOS, higher health care costs, and poorer quality of care among patients with pneumonia. 相似文献