Genetic and environmental determinants of risk for cholangiocarcinoma in Thailand

Cholangiocarcinoma(CCA) is a difficult cancer to diagnose in the early stage and to treat by curative resec-tion. The incidence of CCA in the northeast of Thailand is the highest in the world. To make progress in detecting a high risk group and in the prevention and detection of CCA, we have been analyzing the risk factors for CCA. Although liver fluke infection is known to be a risk factor, there are patients who are not infected with the liver fluke and not all people infected with the liver fluke will suffer from the disease. Therefore, it is of the utmost importance to analyze the risk factors and the mechanism to prevent the disease and also to detect the disease in its early stage to save patients' lives. Through collaboration among Thai and Japanese researchers, we analyzed the genetic and environmental determinants of risks for CCA. Also, we have been trying to develop methods to detect the disease in a non-invasive way. Without repeating findings reported in various reviews on CCA, we will first discuss the environmental and genetic determinants of the risks for CCA. Second, we will discuss the properties of CCA, including the etiological agents and the mechanism of cholangiocarcinogenesis, and finally, we will discuss future approaches to prevent and cure CCA from the standpoint of evidence-based medicine. We will discuss these points by including the data from our laboratories. We would like to emphasize the importance of the genetic data, especially whole genome approaches, to understand the properties of CCA, to find a high risk population for CCA and to develop effective preventative methods to stop the carcinogenic steps toward CCA in the near future. In addition, it is of the upmost importance to develop a non-invasive, specific and sensitive method to detect CCA in its early stage for the application of modern medical approaches to help patients with CCA.

Fecal-associated microbiome differences between phlegm-dampness constitution and balanced constitution

Objective: This study aimed to explore the structural and functional characteristics of the fecalassociated microbiome(FAM) between the phlegm-dampness constitution(PDC) and balanced constitution(BC), and to screen the related specific operational taxonomic unit(OTU) biomarkers.Methods: This was a cross-sectional study. After strictly identifying the constitution of subjects, their clinical index was recorded and counted. Fecal samples were collected for 16S rDNA sequencing. Alpha diversity, beta diversity, and the relative abundance of dominant bacterial taxa were used to describe the FAM structure, and the Wilcoxon rank-sum test, Metagenome Seq, and linear discriminant analysis effect size(LEf Se) were used to screen specific bacterial taxa. Specific OTUs were screened to construct receiver operating characteristic(ROC) curves.Results: Thirty-two subjects were enrolled, including 22 subjects with BC and 10 subjects with PDC.There were significant differences in cold preference, levels of aspartate transaminase, β2-microglobulin,and creatine kinase MB, and alpha diversity indices(Shannon and Shannoneven) between the two groups. In principal coordinate analysis by abund-jaccard distance measure and partial least squares discriminant analysis, bacterial communities clustered separately between the two groups. Furthermore,based on Metagenome Seq, LEf Se, and the Wilcoxon rank-sum test, a total of 43, 18, and 130 OTUs were differentially distributed between BC group and PDC group, respectively, and OTU200, OTU133, and OTU353 were screened when P≤.01. The area under the ROC curve constructed from the 3 selected OTUs was 0.93.Conclusion: The FAM structure and related functional characteristics of the PDC group differed from those of the BC group. In particular, OTU200, OTU133, and OTU353 can be used as unique markers of PDC to assist clinical diagnosis.

Screening influencing factors of blood stasis constitution in traditional Chinese medicine

Objective To study the influencing factors of blood stasis constitution and provide a basis for treating blood stasis-related diseases by traditional Chinese medicine(TCM) constitution identification.Methods Data were collected using the self-developed TCM constitution identification platform based on B/S model by the project team. The obtained data were divided into blood stasis constitution and normal constitution groups. The differences of the categorical type influencing factors(gender, birth mode, feeding mode within four months of birth, family history, marital status, eating habits, sleeping habits, exercise habits, emotional state, stress situation, and living environment) and the quantitative type influencing factors(sleep time, age,and mother’s age at birth) on the constitution of the two groups were analyzed. In the singlefactor analysis, the Pearson’s chi-square test was selected for the categorical variable, and the independent sample t test and Mann-Whitney U nonparametric test were selected for the quantitative variables according to whether they conformed to the positive-terrestrial distribution;the binary logistic stepwise regression method was selected for the multi-factor analysis.Results The data of 318 cases were collected from the TCM composition identification platform, and 159 cases of blood stasis constitution were used as the experimental group and 159 cases of normal constitution were used as the control group. The Pearson’s chi-square test yielded significant differences(P < 0.05) in the effects of gender, pressure situation, family history, living environment, emotional state, exercise habits, and dietary habits on blood stasis constitution. The independent samples t test yielded differences in sleep duration between the blood stasis constitution and normal constitution populations(P < 0.05), which meant sleep duration of the blood stasis constitution population was less than that of the normal constitution population. The Mann-Whitney U nonparametric test results accepted the original hypothesis that there was no difference in the distribution of age and mother’s age at birth across constitution types(P > 0.05). Binary logistic regression analysis showed that gender, family history, marital status, living environment, exercise habits, and emotional state were risk factors for blood stasis constitution(P < 0.05).Conclusion Gender, family history, living environment, emotional state, and exercise habits were significant influencing factors of blood stasis constitution. Blood stasis constitution populations can pay more attention to these influencing factors in their daily life for the prevention and reconciliation of blood stasis constitution.

Elite-Constructed Constitutions

This article will illustrate the constitution as a result of bargaining and negotiation among the elites to allocatepower and mitigate tension among them. Combining the elite’s concept and its nature of a continuous struggle forpower with the approach that investigates the constitution as a contract among the powerful ruling class, this articlewill reveal how power is allocated among the elites. As a result, this article provides a fundamental notion of theapproach called “elite-constructed constitution”. This approach delivers the instrument to investigate theconstitutional making process as a negotiation mechanism among the elites, which reflects into constitutionalprovision. Therefore, because this type of constitution has been constructed under the contract’s notion,constitutional endurance is unexpected because this type of constitution requires a high level of trust among thecontract parties. This is in contrast to the notion of the elite’s continuous struggle.

China's Constitution:Guarantee for People's Rights

The Communist Party of China, which represents the fundamental interests of the broadest possible masses of the people, has always attached much importance to the rights of the people and the safeguard measures. As early as in the New Democratic Revolution period, it adopted in Ruijin, Jiangxi Province, an Outline Constitution of the All-China Soviet Republic in January 1934. The document stipulated that all workers, peasants, soldiers and other labor populace and their families, irrespective of their gender, ethnic group or religion, are equal before the law of the Soviet and enjoy the right to work, supervision, education and the freedom

Forum on China's Move to Enshrine Human Rights in Constitution

China Society for Human Rights Studies (CSHRS) called a forum of experts and scholars on March 15 to discuss the significance of getting human rights protection enshrined in China’s fundamental law—the Constitution. Presided over by CSHRS President Zhou Jue, the forum was attended by CSHRS vice-presidents Yang Zhengquan and Dong Yunhu and more than 20 human rights experts and scholars from the

Chronic liver disease questionnaire:Translation and validation in Thais

AIM:Quality of life (QOL) is a concept that incorporates many aspects of life beyond“health”.The chronic liver disease questionnaire (CLDQ) was developed to evaluate the impact of chronic liver diseases (CLD) on QOL.The objectives of this study were to translate and validate a liver specific questionnaire,the CLDQ. METHODS:The CLDQ was formally translated from the original version to Thai language with permission.The translation process included forward translation,back translation,cross-cultural adaptation and a pretest.Reliability and validity of the translated version was examined in CLD patients.Enrolled subjects included CLD and normal subjects with age- and sex-matched.Collected data were demography, physical findings and biochemical tests.All subjects were asked to complete the translated versions of CLDQ and SF- 36,which was previously validated.Cronbach's alpha and test-retest were performed for reliability analysis.One-way Anova or non-parametric method was used to determine discriminant validity.Speerman's rank correlation was used to assess convergent validity.P-value<0.05 was considered statistically significant. RESULTS:A total of 200 subjects were recruited into the study,with 150 CLD and 50 normal subjects.Mean ages (SD) were 47.3(11.7) and 49.1(8.5) years,respectively.The number of chronic hepatitis:cirrhosis was 76:74,and the ratio of cirrhotic patients classified as Child A:B:C was 37 (50%):26(35%):11(15%).Cronbach's alpha of the overall CLDQ scores was 0.96 and of all domains were higher than 0.93.Item-total correlation was>0.45.Test-retest reliability done at 1 to 4 wk apart was 0.88 for the average CLDQ score and from 0.68 to 0.90 for domain scores.The CLDQ was found to have discriminant validity.The highest scores of CLDQ domains were in the normal group,scores were lower in the compensated group and lowest in the decompensated group.The significant correlation between domains of the CLDQ and SF-36 was found.The average CLDQ score was strongly correlated with the general health domain of SF-36.(P=0.69:P=0.01). CONCLUSION:The translated CLDQ is valid and applicable in Thais with CLD.CLDQ reveals that QOL in these patients is lower than that in normal population.QOL is more impaired in advanced stage of CLD.

Effect of insulin on hyperkalemia during anhepatic stage of liver transplantation

AIM:To investigate the effectiveness of insulin on decreasing serum potassium concentration during anhepatic stage of orthotopic liver transplantation. METHODS:Sixteen patients with serum potassium concentrations greater than 4.0 mmol/L at the onset of anhepatic stage were randomized into two groups.The patients in control group (n=8) received no treatment, while those in treatment group (n=8) received an intravenous bolus injection of regular insulin (20U) 10 min into the anhepatic stage,followed by a glucose infusion (500mL 50g/L dextrose) over 15 min. RESULTS:In control group,potassium concentration underwent no changes whereas in treatment group,it decreased from 4.8±0.48 mmol/L to 4.19±0.55 mmol/L (mean±SD) within 15 min and to 3.62±0.45 mmol/L 60 min after the therapy.The potassium concentration was lower in treatment group than in control group within 30 min of treatment (3.94±0.57 vs 4.47±0.42 mmol/L, respectively;P<0.05),and increased similarly 30 s after graft reperfusion in both groups of patients,but remained lower in treatment group (5.81±2.78 vs 7.44±1.75 mmol/L, respectively;P<0.05).The potassium concentration returned to pre-reperfusion levels within 5 min after graft reperfusion. CONCLUSION:In patients undergoing orthotopic liver transplantation,the administration of insulin rapidly decreases serum potassium concentration even in the absence of the liver,suggesting an important contribution by extrahepatic tissues in insulin-stimulated uptake of potassium.

1例罕见型Hb Bart′s胎儿水肿综合征胎儿家系分析

目的对罕见型血红蛋白(Hb)Bart′s胎儿水肿综合征胎儿家系进行地中海贫血表型和地中海贫血基因分析,以及产前诊断。方法采集家系成员外周血进行血细胞检查及Hb组分分析;采集家系成员外周血及胎儿羊水采用Gap-PCR及PCR-反向点杂交法进行4种α-缺失型地中海贫血、3种α-非缺失型地中海贫血及17种β-地中海贫血基因检测。结果血液学表型分析显示,先证者母亲及父亲均为小细胞低色素性贫血患者。先证者母亲检出泰国型缺失(--THAI/αα)杂合突变;先证者父亲检出东南亚型缺失(--SEA/αα)杂合突变;先证者兄长地中海贫血基因检测未见异常;先证者检出东南亚型缺失合并泰国型缺失(--SEA/--THAI)双重杂合突变,为HbBart′s胎儿水肿综合征。结论应严格遵循血液学表型与地中海贫血基因型相结合的分析原则,对平均红细胞体积、平均红细胞血红蛋白含量降低和HbA2正常或偏低,而常规α-地中海贫血基因检测未见异常的人群进行罕见型泰国型缺失(--THAI/)α-地中海贫血检测,以预防漏检和误诊。

Opisthorchiasis-associated biliary stones:Light and scanning electron microscopic study

AIM:Biliary stones are frequently encountered in areas endemic for opisthorchiasis in Thailand.The present study was to describe the prevalence and pathogenesis of these stones. METHODS:Gallstones and/or common bile duct stones and bile specimens from 113 consecutive cholecystectomies were included.Bile samples,including sludge and/or microcalculi,were examined for Opisthorchis viverrinieggs, calcium and bilirubin.The stones were also processed for scanning electron microscopic(SEM)study. RESULTS:Of the 113 cases,82 had pigment stones,while one had cholesterol stones.The other 30 cases had no stones.Most of the stone cases(76%,63/83)had multiple stones,while the remainder had a single stone.Stones were more frequently observed in females.Bile examination was positive for O.viverrini eggs in 50% of the cases studied.Aggregates of calcium bilirubinate precipitates were observed in all cases with sludge.Deposition of calcium bilirubinate on the eggshell was visualized by special staining.A SEM study demonstrated the presence of the parasite eggs in the stones.Numerous crystals, morphologically consistent with calcium derivatives and cholesterol precipitates,were seen. CONCLUSION:Northeast Thailand has a high prevalence of pigment stones,as observed at the cholecystectomy,and liver fluke infestation seems involved in the pathogenesis of stone formation.

New Properties of HM16 Ether, with Submicroparticles as Self-Functional Cells Interacting through Percussion Forces, Establishing Nature of Electrical Charges, including Gravitation

Article continues and complements our previous articles on the HM16 ether (ETH) model. Here, we describe the mechanism of occurrence of the submicroparticle (SMP). A general hypothesis, HFVI, is introduced for the modalities of interaction between two SMPs, based on periodic mechanical percussion forces, produced by fundamental vibrations FVs. A mechanism for describing the interaction between a SMPs and the ETH is presented. Positive and negative particles are defined by their membrane types of movement, such as +, −u/+, −v vibrations, and rotations at speeds +Ω/−Ω. The process of creating a pair of SMPs is discussed. Applying HFVI to the interaction between pairs of SMPs immobile in ETH, and considering longitudinal FVL, was obtained the forces of attraction/repulsion +FL21/–FL21, which correspond to the completed Coulomb force FCC including gravitation. The resultant FRL21 will form an oriented field of forces, which is a quasielectric field QE, equivalent to actual E electric field. Considering transversal FVT, was obtained the vibratory forces +, −FT21, whose resultant forms an vibrating field of forces, QHs, a quasimagnetic special field, which may explain some of the quantum properties of SMPs. Considering a mobile SMP, two new γ strains in ETH appear. Strains γL are created by the displacement of SMP with velocity V, whose force +, −FT12 is the support of a component of the magnetic field H (quasimagnetic field QH), giving the QHL component. Strains γR are created by the rotation of SMP with speed Ω, whose force +, −FR12 constitutes physical support of the component QHR of magnetic field H (i.e. QH). The creation of a photon PH is modelled as a special ESMP containing two zones of opposed rotations, and a mechanism is presented for its movement in the ETH with speed c based on the HS hypothesis of screwing in ETH, with frequency ν.

Women’s Councils:A Practical Exploration on the Construction of Democracy, Autonomy and the Rule of Law at the Grassroots Level

The women’s councils are an innovation advocated by the All-China women’s federation for women’s participation in social management and grassroots democracy.They are a beneficial exploration for women to participate in public affairs according to the law in accordance with Article 2 of the Constitution of the People’s Republic of China,and are a model of"the combination of autonomy,rule of law and rule of virtue."The women’s councils have aroused the enthusiasm of women to participate in public affairs,stimulated their autonomous vitality and creativity,and helped to solve the problems of women’s lack of representation and voice in decision-making.The process of deliberation is also the process of developing the awareness of rights,rules,consultation ability,the concept of the rule of law and even thinking about the rule of law.The women’s councils not only help to protect the rights and interests of women and children and promote women’s development,but also has unique value in enriching grassroots consultative democracy,developing grassroots mass autonomy,building a society ruled by law and promoting the implementation of the Constitution.we should therefore fully affirm,support and perfect the women’s councils so as to make it long-term,standardized and institutionalized.

泰国宪政特殊性:泰王的巨大影响力——基于传统政治文化视角

泰王相较其他立宪君主对政治具有巨大影响,凸显泰国宪政特殊性。传统政治文化是透视泰式宪政特殊性的重要视角。泰国传统政治文化是以王权认同为核心,涉及王权、佛教认同和民族主义的民族政治文化,正是这种传统政治文化对泰国宪政产生特殊而深远的影响,也为走出泰式民主困局预示了路径。

检察制度是实现中国宪政的重要形式

宪政无定式但其有定法,不能充分了解宪政形式的多样性和内在规律的趋同性就会对检察制度理论进行随意的攀附、位移甚至替换。在比对各国的宪政体制及其检察制度后,可以看出,中国的检察制度是宪政理论在中国的具体应用。中国检察制度的设计是建立在立宪主义的高度审视我国权力的合理配置,代表了我国宪政体制完善的方向。

论泰国宪政文化的特性

泰国的君主立宪政体肇始于自1932年的六月革命,让人匪夷所思的是,在泰国所确立的立宪君主制却未能走上英日等国君主立宪政体的坦途,而是呈现出泰式宪政所独有的特色,此种独有的宪政特性乃源于其独特的文化,其中王权主义遗绪、权力崇拜意识、父权主义传统、民本道德主义观念、佛教教义影响和宪法工具主义等是泰国宪政文化的显著特性。

“人民”一词的宪法学反思

反思人民的涵义,我们发现:"革命政治"意义上的人民与民主政治意义上的人民相去甚远;"人民意志绝对正确"的观念使得我们从不承认代议机关权力的有限性;对于人民主权原则法国式的、整体化的理解,使人民在"主权"中难以发挥作用;而人民与国家之间本末倒置的关系甚至使得作为"主权者"的人民淹没在"国家至高利益"的"滔天洪水"中。事实上,"人民"是一个个具体的人,保护每一个人的自由与尊严是宪政制度的价值所在。

宪政视野下民生型政府的构建

研究了民生型政府的构建开始成为现代社会的必然趋势及宪政建设对民生型政府构建的重要意义。指出在当前条件下,应该通过多种措施来推动民生型政府的构建。

论中国在建立国际经济新秩序中的战略定位--兼评“新自由主义经济秩序”论、“WTO宪政秩序”论、“经济民族主义扰乱全球化秩序”论

1980年代以来,国际社会中力图阻挠或扭曲建立国际经济新秩序(NIEO)历史潮流的各种学说层出不穷,诸如"新自由主义经济秩序"论、"WTO宪政秩序"论、"经济民族主义扰乱全球化秩序"论等等。这类学说虽然激发了一些新的有益思考,却确实造成了一系列新的思想混乱。建立NIEO乃是1950年代以来全球弱势群体数十亿人口争取国际经济平权地位的共同奋斗目标,当代中国人应当全面、完整、准确地加深理解邓小平的"韬光养晦、有所作为"方针,将中国在建立NIEO历史进程中的战略坐标和基本角色,定位为旗帜鲜明、言行一致的积极推动者。中国理应进一步发扬传统的具有独特内涵的中华民族爱国主义,通过BRICSM类型的"南南联合"群体,成为建立NIEO的积极推手和中流砥柱之一。总之,中国人务必保持清醒,谨防落入上述各种"时髦"理论的陷阱。

愿景与现实的矛盾触碰——美国心理战略委员会东南亚心理战略的筹划、实施与结果

为了遏制共产主义在东南亚的渗透,在美国国家安全委员会的指示下,心理战略委员会特别成立了一个东南亚计划小组来负责制定编号为PSB D-23号的东南亚心理战略计划。但是,在PSB D-23号文件筹划过程中,国务院、中央情报局等部门对如何扩大在东南亚的心理战略计划有不同的看法,使得该文件的制定过程颇多磨难。虽然经过妥协,该计划最终得到国家安全委员会通过,但其实施效果却不应过分夸大。