The evidence on whether Chinese herbal medicines affect outcome in patients with chronic kidney disease (CKD) is limited. Here we retrospectively explored the association of prescribed Chinese herbal medicine use and the risk of end-stage renal disease (ESRD) in patients with CKD. Patients with newly diagnosed CKD in the Taiwan National Health Insurance Research Database from 2000 to 2005 were categorized into new use or nonuse of prescribed Chinese herbal medicine groups. These patients were followed until death, dialysis initiation, or till the end of 2008. Among the 24,971 study patients, 11,351 were new users of prescribed Chinese herbal medicine after CKD diagnosis. Overall, after adjustment for confounding variables, the use group exhibited a significant 60% reduced ESRD risk (cause-specific hazard ratio 0.41, 95% confidence interval 0.37-0.46) compared with the nonuse group. The change was significantly large among patients using wind dampness-dispelling formulas (0.63, 0.51-0.77) or harmonizing formulas (0.59, 0.46-0.74), suggesting an independent association between specific Chinese herbal medicines and reduced ESRD risk. The findings were confirmed using propensity score matching, stratified analyses, and three weighting methods. However, dampness-dispelling and purgative formulas were associated with increased ESRD risk. Thus, specific Chinese herbal medicines are associated with reduced or enhanced ESRD risk in patients with CKD.

A highly sensitive and selective method, using isotope-dilution liquid chromatography with tandem mass spectrometry (LC/MS/MS), for quantification of urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), an important biomarker of oxidative stress, was developed and compared with a method using an enzyme-linked immunosorbent assay (ELISA). The synthesis of (15)N(5)-8-OHdG is described. In this study, 140 urine samples were collected from workers in a coke oven plant, including samples from 49 control workers and 91 workers who had been occupationally exposed to polyaromatic hydrocarbons (PAHs). The major urinary metabolite of PAHs, 1-hydroxypyrene (1-OHP), was measured for the exposed workers. Results from the present study showed a significant correlation between these two measurements for determination of 8-OHdG (p < 0.05, r(2) = 0.70). However, only the LC/MS/MS measurements of urinary levels of 8-OHdG showed a significant difference between the exposed and the control subjects (p < 0.05). The ELISA method failed to demonstrate this difference. Furthermore, only by using the LC/MS/MS method was a significant correlation observed between the urinary levels of 1-OHP and 8-OHdG. These findings suggest that a highly specific and sensitive analytical method such as isotope-dilution LC/MS/MS is extremely important and necessary for accurate measurement and a comprehensive study of oxidative stress in human subjects.

We concluded that both PSA nadir and time to PSA nadir are significant predictors of disease progression for prostate cancer patients receiving ADT.

SummaryNature exhibits modular design in biological systems. Gene-module level analysis is based on this module concept, aiming to understand biological network design and systems behavior in disease and development by emphasizing on modules of genes rather than individual genes. Module-level analysis has been extensively applied in genome wide level analysis, exploring the organization of biological systems from identifying modules to reconstructing module networks and analyzing module dynamics. Such module-level perspective provides a high level representation of the regulatory scenario and design of biological systems, promising to revolutionize our view of systems biology, genetic engineering as well as disease mechanisms and molecular medicine.

Female nurses who have a rotation shift work schedule tend to experience poor sleep quality and mental health, but their sleep quality and mental health improve if they have ≥2 days off after their most recent night shifts. This empirical information is useful for optimizing work schedules for nurses.

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These results suggest that metabolic syndrome is an independent risk factor for sudden sensorineural hearing loss in Taiwan. Vertigo and total hearing loss were indicators of a poor outcome in sudden sensorineural hearing loss.

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