Hualian, Taiwan
Hualian, Taiwan

Tzu Chi University, or TCU, is a private university located in Hualien City, Hualien County, Taiwan. It was founded by the Tzu Chi Foundation and is famous in Taiwan for the quality of the medical education it provides. TCU has strong ties with Hualien Tzu Chi General Hospital as well as five teaching hospitals in other parts of Taiwan. Wikipedia.


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Aims To evaluate the efficacy and safety of repeated intravesical onabotulinumtoxinA (BoNT-A) injections for treatment of interstitial cystitis/bladder pain syndrome (IC/BPS). Patients and methods Patients confirmed to have IC/BPS and refractory to conventional treatments were treated with intravesical injections of 100 U of BoNT-A plus hydrodistention every 6 months for up to four times. Primary end-point was 6 months after the fourth BoNT-A injection. Measured parameters included O'Leary-Sant symptom score (OSS) including symptom and problem indexes (ICSI/ICPI), visual analogue score (VAS) for pain, voiding diary variables, urodynamic parameters, maximal bladder capacity (MBC), glomerulation grade, and global response assessment (GRA). Multiple measurements and Wilcoxon rank-sum test were used for comparison between groups. Results In overall patients, GRA, OSS, ICSI and ICPI scores, VAS, functional bladder capacity (FBC) and cystometric bladder capacity (CBC) all showed significant improvement. The glomerulation grade decreased (1.77 ± 1.06 vs. 1.19 ± 1.05, p = 0.026), but MBC remained unchanged. Among 31 patients, 19 (61%) had a GRA ≥ 2 and 12 (39%) had a GRA < 2 at end-point. Patients with a GRA ≥ 2 had significantly greater changes in OSS, ICPI, VAS, FBC and CBC than patients with a GRA < 2. Extended study revealed that persistent symptomatic improvement lasted 6-12 months in seven, 13-22 months in six and 23-51 months in six after the fourth BoNT-A injection. Five women who had GRA < 2 were found to have Hunner's ulcer. Lack of control is the main limitation. Conclusion Four repeated intravesical BoNT-A injections were safe and effective for symptom and pain relief and increased bladder capacity for treatment of IC/BPS. © 2013 Blackwell Publishing Ltd.


Purpose The purpose of this study was to evaluate the efficacy and safety of onabotulinumtoxinA injections at bladder base/trigone and compare with injections at bladder body or bladder body/trigone for the treatment of idiopathic detrusor overactivity (IDO) refractory to antimuscarinics. Materials and Methods A single blind, randomized, paralleled, actively controlled trial was performed in patients with urodynamically proven IDO who failed antimuscarinic therapy. Patients were randomly assigned to receive intravesical injections of 100 U of onabotulinumtoxinA into three different bladder sites. All treatments were evaluated by voiding diary variables, urgency severity score, urodynamic studies, and patient perception of bladder condition. Long-term success rates over 12 months were also determined. Results Among the patients, 37 were randomized to injections in the bladder body, 35 into the bladder body/trigone, and 33 into the bladder base/trigone. Successful results were reported in 76 (72%) patients at 3 months: 26 (70%) in the bladder body group, 26 (74%) in the bladder body/trigone group, and 24 (73%) in the bladder base/trigone group. There were no significant differences in success rates, changes in urgency and urgency incontinence episodes, urodynamic variables, or long-term success rates among the three subgroups. The incidence of adverse events was similar among three groups. No vesicoureteral reflux was noted in all patients with or without involving trigone injection. Conclusion Intravesical onabotulinumtoxinA injection is an effective treatment for IDO regardless of the bladder injection site. Bladder base/trigone injection is as safe and effective as bladder body injections with or without trigone involvement. Copyright © 2011 Wiley-Liss, Inc.


Wang C.-C.,Tzu Chi University
American Journal of Gastroenterology | Year: 2016

OBJECTIVES:This study aims to assess whether quantitative HBsAg can predict durability of chronic hepatitis B (CHB) patients stopping entecavir (ETV) treatment.METHODS:We conducted a multicenter study on non-cirrhotic CHB patients who discontinued ETV treatment. The primary end points were clinical relapse and sustained viral response (SVR), which was defined as undetectable serum hepatitis B virus (HBV) DNA levels (<6 IU/ml) at 12 months off-therapy.RESULTS:A total of 117 consecutive CHB patients were enrolled. Among them, 93 patients who received more than 1-year off-therapy follow-up were included for the final analysis. The duration of off-therapy follow-up was 24.8±11.6 months. All 12 patients who did not achieve therapeutic end points had clinical relapse. In 81 patients who achieved therapeutic end points, clinical relapse and SVR were observed in 44 (54.3%) and 11 (13.6%) patients, respectively. The serum HBV DNA at 3 months and 6 months off-therapy were associated with clinical relapse over time, whereas quantitative hepatitis B surface antigen (qHBsAg) level at 6 months off-therapy had a marginal effect. Furthermore, end-of-treatment qHBsAg levels were associated with SVR (P=0.009).CONCLUSIONS:The serum qHBsAg level off-therapy can predict durability of ETV-treated CHB patients. It may guide clinicians to select which patients can maintain sustained viral suppression or need retreatment after discontinuing ETV treatment.Am J Gastroenterol advance online publication, 5 April 2016; doi:10.1038/ajg.2016.109. © 2016 American College of Gastroenterology


Kuo H.-C.,Tzu Chi University
International Journal of Urology | Year: 2014

There is a lack of consensus on the pathophysiology of bladder pain syndrome/interstitial cystitis. The chronic pain symptoms of bladder pain syndrome/interstitial cystitis refractory to local treatment could be a result of central nervous system sensitization and persisting abnormalities in the bladder wall, which activate the afferent sensory system. Evidence also shows that bladder pain syndrome/interstitial cystitis is a heterogeneous syndrome and that the two subtypes, the ulcerative (classic) and non-ulcerative types, represent different disease entities. There is a need for non-invasive markers for the differential diagnoses of the subtypes of bladder pain syndrome/interstitial cystitis, and between bladder pain syndrome/interstitial cystitis and bladder sensory disorders, such as hypersensitive bladder syndrome or overactive bladder. Bladder pain syndrome/interstitial cystitis, but not overactive bladder, involves an aberrant differentiation program in the bladder urothelium that leads to altered synthesis of several proteoglycans, cell adhesion and tight junction proteins, and bacterial defense molecules. These findings have led to the rationale for identifying urinary biomarkers to detect bladder pain syndrome/interstitial cystitis in patients with frequency urgency syndrome. Recently, the markers that have been the focus of the most research are antiproliferative factor, epidermal growth factor, heparin-binding epidermal growth factor, glycosaminoglycans and bladder nitric oxide. In addition, inflammatory proteins in the urine and serum play important roles in the pathogenesis of bladder pain syndrome/interstitial cystitis. The urinary proteome is an easily accessible source of biomarkers for differentiation between inflammatory bladder disorders. Analysis of multiple urinary proteins and serum cytokines could provide a diagnostic basis for bladder pain syndrome/interstitial cystitis, and could be a tool for the differential diagnosis of bladder pain syndrome/interstitial cystitis and other sensory bladder disorders. © 2014 The Japanese Urological Association.


Background: Onabotulinumtoxin-A (BoNT-A) is effective for the treatment of interstitial cystitis/painful bladder syndrome (IC/PBS). However, long-term follow-up does not show successful outcome after a single injection. Objectives: To evaluate the efficacy and safety of repeated intravesical BoNT-A injections for treatment of IC/PBS and compare the success rates among patient groups receiving different injection numbers. Study Design: Prospective interventional study. Setting: Tertiary medical center. Methods: Intravesical injection of 100 U of BoNT-A was performed in 81 patients every 6 months for up to 4 times or until patients' symptoms significantly improved. Patients who received a single injection served as active controls. Measured parameters included O'Leary- Sant symptom indexes (ICSI) and problem indexes (ICPI), visual analogue score (VAS) for pain, voiding diary variables, urodynamic parameters, maximal bladder capacity under anesthesia, glomerulation grade, and global response assessment. Multiple measurements and Kaplan- Meier analysis were used for comparison of consecutive data and success rates among groups. Results: Among 81 patients, 20 received single injections, 19 received 2 injections, 12 received 3 injections, and 30 received 4 injections. The mean (± standard deviation) of ICSI, ICPI, total scores, VAS, functional bladder capacity, and daytime frequency all showed significant improvement after repeated BoNT-A treatment with different injections. Significantly better success rates were noted in patients who received 4 repeated injections (P = 0.0242) and 3 injections (P = 0.050), compared to those who received a single injection. However, there was no significant difference of long-term success rates among patients who received 2, 3, and 4 injections. Limitations: Lack of placebo control group is the main limitation. Conclusion: Repeated intravesical BoNT-A injections were safe and effective for pain relief and they increased bladder capacity and provided a better long-term success rate than a single injection did for treatment of IC/PBS.


A smartcard-based authentication and key agreement scheme for telecare medicine information systems enables patients, doctors, nurses and health visitors to use smartcards for secure login to medical information systems. Authorized users can then efficiently access remote services provided by the medicine information systems through public networks. Guo and Chang recently improved the efficiency of a smartcard authentication and key agreement scheme by using chaotic maps. Later, Hao et al. reported that the scheme developed by Guo and Chang had two weaknesses: inability to provide anonymity and inefficient double secrets. Therefore, Hao et al. proposed an authentication scheme for telecare medicine information systems that solved these weaknesses and improved performance. However, a limitation in both schemes is their violation of the contributory property of key agreements. This investigation discusses these weaknesses and proposes a new smartcard-based authentication and key agreement scheme that uses chaotic maps for telecare medicine information systems. Compared to conventional schemes, the proposed scheme provides fewer weaknesses, better security, and more efficiency. © 2013 Springer Science+Business Media New York.


Aims Patients with spinal cord lesions and detrusor sphincter dyssynergia (DSD) may be treated with urethral sphincter botulinum toxin A (BoNT-A) injection for difficult urination or detrusor BoNT-A injection for incontinence. Although objective data showed improvement, patients might not be satisfied with the result especially in quality of life (QOL) issue. This study investigated the therapeutic results and QOL and patients' satisfaction to these two treatments. Patients and methods Patients with spinal cord lesion and DSD were treated with urethral sphincter injection of 100 U of BoNT-A for main symptoms of difficult urination and detrusor injection of 200 U of BoNT-A for main symptom of incontinence. The urodynamic parameters, QOL scores using UDI-6 and IIIQ-7 and general satisfaction were compared between two groups. Results The overall satisfactory result was perceived in 60.6% and 77.3% in patients who received urethral and detrusor BoNT-A injection, respectively. Urodynamic parameters showed significant improvement in both groups. Urethral injection group had improvement in IIQ-7, but not in UDI-6 scores whereas detrusor injection group had improvement in all scores. The improvement of UDI-6 and IIQ-7 was significantly greater in detrusor than urethral injection group. Increase in incontinence grade was the major cause of dissatisfaction in urethral injection group, whereas increase in difficult urination and needing catheterisation were the main dissatisfaction causes in detrusor injection group. Conclusion There was discrepancy between the objective urodynamic results and patient satisfaction in treatment of DSD by BoNT-A injection. Patients with DSD and treated with detrusor BoNT-A had greater QOL improvement than those treated with urethral injection. © 2013 John Wiley & Sons Ltd.


A method of producing honokiol and analogues thereof, and novel intermediates prepared by virtue thereof are disclosed herein. A pharmaceutical composition for treating Parkinsons disease, which contains honokiol and/or the analogues thereof, is also disclosed herein.


Patent
Tzu Chi University | Date: 2014-03-04

A medicine packet dispensing device with an automatic reminder function comprises a box having a medicine discharge hole; a control device arranged in the box; and a medicine discharge module arranged in the box. The control device includes a processor used to set at least one medication time; at least one reminder unit controlled by the control device to emit an alert according to the medication time; and a plurality of medicine discharge operating interfaces used to input an instruction to the processor to enable the processor to generate a medicine discharge signal to the medicine discharge module. The medicine discharge module has medicine packet accommodation spaces for accommodating medicine packets and sends one medicine packet to the medicine discharge hole according to the medicine discharge signal. The present invention reminds the user to take medicine at designated times and allows the user to change the medication times.


Patent
Tzu Chi University | Date: 2013-10-29

The present invention discloses at least two electrodes disposed at the body of the ECG measuring device of the present invention. When a user normally uses the ECG measuring device, the two electrodes are just adhered to the hands and the face of the user. The ECG measuring method of the present invention is to measure a first ECG signal from the left hand to the left side of face of the user and a second ECG signal from the right hand to the right side of face of the user. Then a plurality of ECG features are obtained from the first ECG signal, the second ECG signal and the result, as related coefficients, of the interactive computing, as a method of plus and subtract, of the first ECG signal and the second ECG signal. Hence, a biometric authorization process is engaged according to the plurality of ECG features.

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