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Hu L.-W.,Tungs Taichung Metro Harbor Hospital | Ho Y.-F.,Nephrology Education Nurse | Lin P.-C.,Taipei Medical University
Journal of Nursing and Healthcare Research | Year: 2012

Background: Nursing is a highly stressful job. Following a health-promoting lifestyle can assist nurses to reduce work stress and promote personal health. Purpose: The purpose of this study was to explore the health-promoting lifestyles of clinical nurses and related factors. Methods: We conducted a cross-sectional questionnaire survey on 297 nurses at a regional teaching hospital in central Taiwan. Results: Nurses gave themselves the highest scores on interpersonal support followed by self-actualization, stress management, nutrition, health responsibility, and exercise. Nurses who received more social support, had stronger self-efficacy, were happier, had more positive health conceptualization, and were more likely to have internal locus of control and authority outside control tended to follow a more health-promoting lifestyle. Self-efficacy, work shift, and age were significant predictors, explaining 48% of total health-promoting lifestyle variance. Conclusions/Implications for practice: Findings may provide a valuable reference for nurse administrators to create a health promotion culture in hospitals targeted to improve nurses' health.

Chao A.-C.,Kaohsiung Medical University | Hsu H.-Y.,Tungs Taichung Metro Harbor Hospital | Hsu H.-Y.,Chung Shan Medical University | Chung C.-P.,Taipei Veterans General Hospital | And 6 more authors.
Stroke | Year: 2010

BACKGROUND AND PURPOSE-: The safety and efficacy of alteplase for ischemic stroke has not been examined in Chinese patients. We assessed the safety and efficacy of alteplase for acute ischemic stroke in daily clinical practice in Taiwan. METHODS-: A prospective, multicenter, observational study was conducted in Taiwan from December 2004 to July 2008. Eligible patients (241) receiving alteplase were recruited and divided into 2 groups: standard dose (0.90±0.02 mg/kg, n=125) and lower dose (0.72±0.07 mg/kg, n=116). Primary outcome measures were safety: symptomatic intracerebral hemorrhage and death within 3 months. The secondary outcome measure was efficacy a modified Rankin scale of 0 to 2 after 3 months. RESULTS-: The standard-dose group had higher rates of symptomatic intracerebral hemorrhage using National Institute of Neurological Diseases and Stroke, European Cooperative Acute Stroke Study, and Safe Implementation of Thrombolysis in Stroke-Monitoring Study definitions (10.4% versus 5.2%, 8.0% versus 2.6%, and 5.6% versus 1.7%, respectively) and mortality within 3 months (12.8% versus 6.9%), twice that of the lower-dose group. This pattern was more prominent in older patients. Significantly higher rates of symptomatic intracerebral hemorrhage per European Cooperative Acute Stroke Study (15.4% versus 3.3%, P=0.0257) and mortality (21.1% versus 5.0%, P=0.0099) and significantly lower independence rate (32.6% versus 53.6%, P=0.0311) were observed among patients â‰170 years old receiving the standard dose than those receiving the lower dose. CONCLUSIONS-: This study suggests that the standard dose of 0.9 mg/kg alteplase may not be optimal for treating aged Chinese patients. However, the dose of recombinant tissue plasminogen activator for ischemic stroke in Chinese patients should be based on more broad and convincing evidences and randomized trials of lower versus higher doses are needed. © 2010 American Heart Association, Inc.

Hsu C.-W.,Tungs Taichung Metro Harbor Hospital | Yin P.-H.,Taipei Veterans General Hospital | Lee H.-C.,National Yang Ming University | Chi C.-W.,Taipei Veterans General Hospital | And 2 more authors.
Breast Journal | Year: 2010

Mutations and reduced mitochondrial DNA (mtDNA) content are commonly observed in breast cancer, yet their functional significance is not clear. This study aimed to determine whether the mtDNA content in breast cancer plays an important role in modulating the response to anthracycline treatment in vivo and in vitro. The mtDNA content in tumor cells was analyzed using quantitative polymerase chain reaction in 60 Taiwanese breast cancer patients to correlate with their survival. In addition, human breast cancer MDA-MB-231 cells were treated with ethidium bromide to decrease mtDNA copy number. Cell survival was determined by trypan blue exclusion assay and intracellular reactive oxygen species (ROS) were determined by flow cytometry. After an anthracycline-based regimen, the disease-free survival of patients with higher mtDNA content breast cancer was significantly lower than that of patients with lower mtDNA content breast cancer (p = 0.03). Moreover, the MDA-MB-231 cells with low copies of mtDNA had higher sensitivity to doxorubicin treatment and increased ROS production when compared with higher mtDNA parental cells. Our results suggest that the level of mtDNA copy number in breast cancer may be a potential biomarker for prediction of the response to anthracycline-containing regimens in breast cancer patients.

Chang Y.-T.,Tungs Taichung Metro Harbor Hospital | Tseng H.-C.,Chung Shan Medical University | Huang C.-C.,Chung Shan Medical University | Chen Y.-P.,Chung Shan Medical University | And 2 more authors.
European Journal of Clinical Investigation | Year: 2011

Background: Cancer is often caused by disturbance in the regulation and/or execution of programmed cell death (PCD, including apoptosis and autophagy). Our aim was to investigate these two pathways simultaneously in the same samples to understand further the pathological roles of PCDs in colorectal cancer.Materials and methods: Real time quantitative PCR (RT-qPCR) array was used to analyse the mRNA levels of 22 apoptosis and autophagy-related genes involved in pro- and anti-action of the pathways in 15 paired (tumour and non-cancerous part) colorectal samples using Glyceraldehyde 3-phosphate dehydrogenase (GAPDH) as the reference gene.Results: GAPDH mRNA content was significantly higher (approximately 4·01 fold) in tumour tissue than that of paired non-cancerous part. The absolute mRNA levels for most of the 22 genes were higher in the tumour tissue also. However, after normalization with GAPDH Ct, the expressions of all the analysed genes were decreased in the tumour tissues, except for damage-regulated autophagy modulator (DRAM). The expression of most of the genes involved in the same pathway was closely correlated to each other in both tumour and non-cancerous tissues, and the correlation of tumour necrosis factor receptor (TNFR) and Akt to other genes in the same pathway was increased in tumour tissues.Conclusions: The high level expression of GAPDH might reflect the metabolic state of cancer cells, and PCDs were down-regulated in the tumour tissues when metabolic state was taken into consideration. This relative suppression of PCDs in tumour tissue is supposed to be in favour of cancer cell survival. © 2010 The Authors. European Journal of Clinical Investigation © 2010 Stichting European Society for Clinical Investigation Journal Foundation.

Tung M.-C.,Tungs Taichung Metro Harbor Hospital | Hsieh S.-C.,Chung Shan Medical University | Yang S.-F.,Chung Shan Medical University | Cheng C.-W.,Chung Shan Medical University | And 3 more authors.
Prostate | Year: 2013

BACKGROUND Lipocalin-2 (LCN2) is a member of the lipocalin superfamily, and it has an important role in the regulation of cellular oncogenesis and apoptosis. However, the role for LCN2 in prostate cancer remains unclear. METHOD LCN2 expression has been determined by Western blotting, qRT-PCR, and immunohistochemistry in the human prostate cell lines PC3, DU145, LNCaP, and 22Rv, and in human prostate tissue array. In this study, we identified shRNA-LCN2 to determine the role of LCN2 in prostate-cancer cell proliferation, migration, and invasion. Cell proliferative ability was measured by MTT, colony-formation, and cell-cycle analysis. The role of LCN2 in prostate-cancer cell migration and invasion was analyzed by cell-migration assay and Matrigel invasion assay. The effect of LCN2 knockdown on prostate tumor growth was assessed in a subcutaneous xenograft model. RESULTS LCN2 protein and mRNA expression are higher in PC3 and DU145 cells than in LNCaP and 22Rv cells, and prostate cancer tissue correlated significantly with tumor differentiation (P < 0.017) and Gleason's grade (P < 0.02). LCN2 knockdown in PC3 and DU145 cells decreased cell proliferation, colony formation, cell cycle arrest, migration, and invasion. Conversely, LCN2 overexpression in 22Rv cells produced the opposite effect. Subcutaneous xenografts in mice models showed decreased tumor growth in the LCN2-knockdown mice. CONCLUSIONS Our results suggest that LCN2 might play an important role in regulation of proliferation and invasion of human prostate cancer, and that it can be a valuable marker of prostate cancer progression. Copyright © 2013 Wiley Periodicals, Inc.

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