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The Synchrotron Radiation Protein Crystallography Core Facility (SPXF) at the National Synchrotron Radiation Research Center has been pivotal in advancing structural biology research in Taiwan. Since the 1990s, Taiwan has invested in the development of synchrotron light sources, including the Taiwan Light Source and the Taiwan Photon Source, which have profoundly enhanced protein structure analysis capability. Through the high‐performance beamlines, SPXF has enabled significant scientific achievements, contributing to disease research and drug development. The facility's move towards automation and its integration of advanced techniques, such as in situ serial synchrotron crystallography, underscore its commitment to meeting the evolving needs of the research community. The SPXF continues to foster innovation and collaboration, providing world‐class resources for both domestic and international users. The SPXF has revolutionized structural biology research through its advanced light sources, enabling crucial breakthroughs in disease research. The facility's integration of automation and cutting‐edge techniques provides world‐class resources for global researchers.

Background Percutaneous coronary interventions (PCI) in very small vessel lesions represent an intriguing aspect of coronary artery disease (CAD). Uncertainty still exists in stent implantation in very small caliber vessels. This study aimed to evaluate the long‐term outcomes of patients treated with 2.0‐mm drug‐eluting stent (DES). Method This retrospective observational study included 134 patients undergoing PCI with 2.0‐mm zotarolimus DES from December 2016 to May 2020. The primary endpoint was major adverse cardiovascular events (MACE) at 2‐year follow‐up, which was composed of all‐cause mortality, target vessel myocardial infarction, and ischemia‐driven target lesion revascularization. Multiple logistic regression analysis was used to identify the independent predictors of MACE, and odds ratios (OR) and 95% confidence intervals (CI) were calculated. Result The lesions were diffuse (mean length 20.9 ± 5.51 mm) and belong to type B2/C lesions (90.3%). On follow‐up, the MACE rate was 20.1% and mostly driven by late lumen loss demanding revascularization (11.9%). In multivariable analysis, chronic kidney disease (CKD) (OR: 4.291, 95% CI: 1.574−11.704, p = 0.004) and calcified lesions (OR: 3.688, 95% CI: 1.311−10.371, p = 0.013) were the independent predictors of subsequent cardiovascular events, whereas statin was associated with better outcomes (OR: 0.335, 95% CI: 0.119−0.949, p = 0.040). Conclusion 2.0‐mm DES is a feasible option for treating very small vessel CAD in complex lesions. Patients with CKD and calcified lesions carry the hazard of worse outcomes, and careful consideration should be taken before stenting in this high‐risk population. Long‐term outcomes and associated factors of 2.0 mm drug‐eluting stent implantation in very small vessel coronary artery disease.

Background Acute coronary syndrome (ACS) is a major cause of morbidity and mortality worldwide. Identifying biomarkers that predict outcomes is essential for guiding management. This study evaluated whether elevated serum uric acid (SUA) is associated with increased risks of major adverse cardiovascular events (MACE), recurrent myocardial infarction (re-MI), and all-cause mortality (ACM) in patients with ACS. Methods This retrospective cohort study enrolled 829 inpatients with ACS admitted to a tertiary referral hospital in Taiwan from 2015 to 2019. Patients were divided into normal (< 7.25 mg/dL, n  = 566) and high (≥ 7.25 mg/dL, n  = 263) SUA groups based on a receiver operating characteristic–derived cutoff for whole cohort. All patients received standard ACS care, and SUA levels were retrospectively analyzed. The primary outcome was MACE, defined as ACM, re-MI, and target lesion/vessel revascularization (TLR/TVR), assessed up to 60 months. Kaplan–Meier survival analysis, logistic regression, and Cox proportional hazards regression were applied. Results The overall incidences of MACE (19.54%), re-MI (2.90%), and ACM (4.46%) were higher in the high SUA group compared with the normal SUA group (MACE: 26.62% vs. 16.25%, p  = 0.0005; re-MI: 6.08% vs. 1.41%, p  = 0.0002; ACM: 7.22% vs. 3.18%, p  = 0.0087). No significant difference was observed in TLR/TVR (overall 11.94%; 11.48% vs. 12.93%, p  = 0.5508). Kaplan–Meier analysis at 60 months demonstrated higher event-free rates for MACE, re-MI, and ACM in the normal SUA group (log-rank p  = 0.0117, 0.0006, and 0.0261, respectively). Multivariable logistic regression showed that SUA ≥ 7.25 mg/dL was associated with increased odds of MACE (odds ratio = 1.639, 95% confidence interval [CI] = 1.084–2.477, p  = 0.0191). Cox regression revealed higher hazards of MACE (hazard ratio [HR] = 1.399, 95% CI = 1.024–1.191, p  = 0.0350), re-MI (HR = 3.758, 95% CI = 1.605–8.799, p  = 0.0023), and ACM (HR = 1.956, 95% CI = 1.019–3.753, p  = 0.0438) in the high SUA group after adjustment for age, uremia, use of drug-eluting stent, and number of diseased vessels. Conclusions Elevated SUA is an independent prognostic marker for increased risks of MACE, re-MI, and ACM in patients with ACS. SUA assessment can enhance risk stratification, helping to identify higher-risk patients who may benefit from more intensive secondary prevention strategies and closer follow-up.

Ketol-acid reductoisomerase (KARI) is a bifunctional enzyme in the second step of branched-chain amino acids biosynthetic pathway. Most KARIs prefer NADPH as a cofactor. However, KARI with a preference for NADH is desirable in industrial applications including anaerobic fermentation for the production of branched-chain amino acids or biofuels. Here, we characterize a thermoacidophilic archaeal Sac-KARI from Sulfolobus acidocaldarius and present its crystal structure at a 1.75-Å resolution. By comparison with other holo-KARI structures, one sulphate ion is observed in each binding site for the 2′-phosphate of NADPH, implicating its NADPH preference. Sac-KARI has very high affinity for NADPH and NADH, with K M values of 0.4 μM for NADPH and 6.0 μM for NADH, suggesting that both are good cofactors at low concentrations although NADPH is favoured over NADH. Furthermore, Sac-KARI can catalyze 2( S )-acetolactate (2 S -AL) with either cofactor from 25 to 60 °C, but the enzyme has higher activity by using NADPH. In addition, the catalytic activity of Sac-KARI increases significantly with elevated temperatures and reaches an optimum at 60 °C. Bi-cofactor utilization and the thermoactivity of Sac-KARI make it a potential candidate for use in metabolic engineering or industrial applications under anaerobic or harsh conditions.

Background and Objectives: Iron-deficiency anemia (IDA) could predispose the afflicted individuals to various infections and musculoskeletal disorders. This study attempted to investigate the association between IDA and septic arthritis (SA), a musculoskeletal disease. Materials and Methods: We investigated all the eligible subjects in the Taiwanese longitudinal health insurance database (LHID) between 2000 and 2012. Subjects with the diagnosis of IDA (International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM): 280) were allocated to the IDA cohort. The control subjects were randomly matched to every subject with IDA coding by age and sex at the 1:4 ratio. All of the recruited subjects were followed since the index date to the onset of SA (ICD-9-CM: 711.0), withdrawal from the insurance (including death), or 31 December 2013. Results: The cumulative incidence of SA was assessed. We showed that the cumulative incidence of SA was higher in the IDA cohort than in the control cohort (p-value < 0.0001). After adjustment of the comorbidities, the IDA patients had a 2.53-fold risk of SA compared to control subjects (aHR = 2.53, 95% CI = 1.89–3.38). Conclusions: IDA was associated with an increased risk of SA.

Background: Hallux valgus is a common forefoot disorder with hundreds of proposed management techniques. Distal chevron osteotomy with a modified McBride procedure has been traditionally recommended for mild hallux valgus because of its simple and less invasive nature with fewer complications, faster recovery, and reliable outcomes. In recent years, the indications for this procedure have expanded to include hallux valgus with severe deformities. This study aims to compare the radiographic outcomes of the surgical treatment for moderate versus severe hallux valgus patients from the perspective of sesamoid bone reduction. Materials and Methods: A retrospective review of medical records identified 99 feet from 94 patients that were treated with distal chevron osteotomy with a modified McBride procedure. These feet were divided by the preoperative hallux valgus angle and intermetatarsal angle into the moderate and severe groups. Results: Postoperative radiographic parameters significantly improved in both groups after treatment, indicating adequate deformity correction. Improvement in the sesamoid position was better in the moderate group compared to that in the severe group. The recurrence rate in the severe group was higher than that in the moderate group without statistical significance. Conclusions: Based on the radiographic results of the postoperative position following sesamoid reduction, the distal chevron osteotomy with a modified McBride procedure is effective for treating moderate hallux valgus deformities. However, this treatment strategy may be associated with a higher recurrence rate in cases of severe hallux valgus deformity. A complete reduction in the sesamoids should be emphasized during the management of severe hallux valgus deformity.

Study Design Retrospective cohort study. Objective Reciprocal changes (RCs) in unfused spinal segments can significantly affect the global alignment after corrective surgery. Identifying radiographic thresholds for guiding surgical strategies is critical for optimizing the outcomes. Materials and Methods Ninety-eight ASD patients who underwent staged surgeries, including lateral lumbar interbody fusion (LLIF) and posterior spinal fusion (PSF), were analyzed. According to the final follow-up image, the patients were classified into balanced (BG) and imbalanced (IG) groups, with IG further stratified into proximal junctional kyphosis/failure (IG-PJK/PJF) and non-PJK/PJF (IG-NPJK/PJF). Radiographic and clinical data were collected preoperatively, postoperatively, and at 2-year follow-up. Results The IG exhibited greater RCs in thoracic kyphosis (TK) and PI-LL mismatch from postoperative to follow-up than the BG (P = .030, P = .008). Significant predictors included Age >65.5 y/o (AUC: .672) and Post-PT >17.5° (AUC: .852) for imbalance and Post-TK >34.5° (AUC: .755) for IG-PJK/PJF. IG-PJK/PJF showed poorer ODI scores than BG and IG-NPJK/PJF (P = .021 and P = .022, respectively). IG-PJK/PJF showed poorer total SRS-22 scores than IG-NPJK/PJF (P = .021). Conclusion Increased RCs in TK was associated with adverse outcomes. Extending the upper instrumented vertebra (UIV) to the upper thoracic spine and addressing excessive TK (>34.5°) may improve alignment and reduce complications. Radiographic thresholds can provide actionable guidance in surgical planning.

BackgroundUse of statin has been associated with reduced risk of cardiovascular diseases events and mortality. However, in patients with end-stage renal disease (ESRD), the protective effects of statin are controversial. To evaluate the impact of chronic statin use on clinical outcomes of patients with acute myocardial infarction (AMI) with ESRD.MethodsWe enrolled 8056 patients with ESRD who were initially diagnosed and admitted for first AMI from Taiwan’s National Health Insurance Research Database. Of which, 2134 patients underwent statin therapy. We randomly selected and use age, sex, hypertension, diabetes mellitus (DM), peripheral vascular diseases (PVD), heart failure (HF), cerebrovascular accidents (CVA), chronic obstructive pulmonary disease, matched with the study group as controls (non-stain user). We compared the effects of statin use in term of all-cause death among patients with AMI with ESRD.ResultsStatin use resulted in a significantly higher survival rate in patients ith AMI with ESRD compared with non-statin users. After adjusted the comorbidities the male patients and patients with DM, PVD, HF and CVA had lower long-term survival rate (all p<0.001). Patients who underwent percutaneous coronary intervention (p<0.001), ACE inhibitors/angiotensin II receptor blockers (p<0.001), β receptor blockers (p<0.001) and statin therapy (p=0.007) had better long-term survival rate. Patients with AMI with ESRD on statin therapy exhibited a significantly lower risk of mortality compared with non-statin users (p<0.0001).ConclusionAmong patients with ESRD with AMI, statin therapy was associated with reduced all-cause mortality.

Study design Retrospective cohort study. Objective To analyze the efficacy and safety of Halo-femoral traction (HFT) following spinal release, and preoperative Halo-gravity traction (HGT) in patients with severe spinal kyphoscoliosis and spinal cord risk classification (SCRC) type 3 at the apex. Methods A total of 73 patients (24 males, 49 females, mean age 22.4 ± 6.4 years) and 56 patients (15 males, 41 females, mean age 22.9 ± 10.4 years) were included in the HFT and HGT group, respectively. Radiographic parameters were measured at the initial assessment, post-traction, post-final surgery, and during each follow-up. Neurologic function was assessed using the Frankel score system. IONM alerts and all complications were documented. Quality-of-life was evaluated using the SF-36 questionnaire. Results In the HFT vs HGT group, the total correction rates were 39.9 ± 7.2% v.s. 41.3 ± 6.8% for the major Cobb and 36.6 ± 9.3% v.s. 44.4 ± 9.2% for global kyphosis (GK) after final surgery, respectively. The traction contributions were 57.6 ± 11.1% v.s. 52.3 ± 9.3% for major Cobb and 70.1 ± 10.5% v.s. 63.9 ± 11.1% for global kyphosis (GK), respectively. More than half of the total correction can be achieved gradually and safely through preoperative traction with patients in an awake state. No deterioration in neurological function was found post-final surgery. During the last follow-up, SF-36 questionnaire scores improved significantly in both groups (P < .05). Conclusions Significant outcomes can be expected in patients with severe kyphoscoliosis, even with spinal cord risk classification (SCRC) type 3 at the apex undergoing HFT and HGT.

The Sso7c4 from Sulfolobus solfataricus forms a dimer, which is believed to function as a chromosomal protein involved in genomic DNA compaction and gene regulation. Here, we present the crystal structure of wild-type Sso7c4 at a high resolution of 1.63 Å, showing that the two basic C-termini are disordered. Based on the fluorescence polarization (FP) binding assay, two arginine pairs, R11/R22' and R11'/R22, on the top surface participate in binding DNA. As shown in electron microscopy (EM) images, wild-type Sso7c4 compacts DNA through bridging and bending interactions, whereas the binding of C-terminally truncated proteins rigidifies and opens DNA molecules, and no compaction of the DNA occurs. Moreover, the FP, EM and fluorescence resonance energy transfer (FRET) data indicated that the two basic and flexible C-terminal arms of the Sso7c4 dimer play a crucial role in binding and bending DNA. Sso7c4 has been classified as a repressor-like protein because of its similarity to Escherichia coli Ecrep 6.8 and Ecrep 7.3 as well as Agrobacterium tumefaciens ACCR in amino acid sequence. Based on these data, we proposed a model of the Sso7c4-DNA complex using a curved DNA molecule in the catabolite activator protein-DNA complex. The DNA end-to-end distance measured with FRET upon wild-type Sso7c4 binding is almost equal to the distance measured in the model, which supports the fidelity of the proposed model. The FRET data also confirm the EM observation showing that the binding of wild-type Sso7c4 reduces the DNA length while the C-terminal truncation does not. A functional role for Sso7c4 in the organization of chromosomal DNA and/or the regulation of gene expression through bridging and bending interactions is suggested.