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Venous thromboembolism in children with acute lymphoblastic leukemia in China:a report from the Chinese Children’s Cancer Group-ALL-2015

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Frontiers of Medicine 2023年第3期17卷 518-526页

作者： Mengmeng Yin Hongsheng Wang Xianmin Guan Ju Gao Minghua Yang Ningling Wang Tianfeng Liu Jingyan Tang alex wk leung Fen Zhou Xuedong Wu Jie Huang Hong Li Shaoyan Hu Xin Tian Hua Jiang Jiaoyang Cai Xiaowen Zhai Shuhong Shen Qun Hu Department of Pediatrics Tongji Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Hematology/Oncology Children’s Hospital of Fudan UniversityShanghai 201100China Department of Hematology/Oncology Shanghai Children’s Medical CenterSchool of MedicineShanghai Jiao Tong UniversityKey Laboratory of Pediatric Hematology&Oncology of China Ministry of HealthShanghai 200120China Department of Hematology/Oncology Chongqing Medical University Affiliated Children’s HospitalChongqing 400015China Department of Pediatrics Key Laboratory of Birth Defects and Related Disease of Women and ChildrenMinistry of EducationWest China Second University HospitalSichuan UniversityChengdu 610041China Department of Pediatrics Xiangya Hospital Central South UniversityChangsha 410008China Department of Pediatrics Anhui Medical University Second Affiliated HospitalHefei 230601China State Key Laboratory of Experimental Hematology and Division of Pediatric Blood Diseases Center Institute of Hematology and Blood Diseases HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesTianjin 300020China Department of Pediatrics Hong Kong Children’s HospitalThe Chinese University of Hong KongHong Kong SAR 999077China Department of Pediatrics Union Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Department of Pediatrics Nanfang HospitalSouthern Medical UniversityGuangzhou 516006China Department of Hematology/Oncology Children’s Hospital of Nanjing Medical UniversityNanjing 210008China Department of Hematology/Oncology Shanghai Children’s HospitalShanghai Jiao Tong UniversityShanghai 200062China Department of Hematology/Oncology Children’s Hospital of Soochow UniversitySuzhou 215002China Department of Hematology/Oncology Kunming Children’s HospitalKunming 650103China Department of Hematology/Oncology Guangzhou Women and Children’s Medical CenterGuangzhou 510620China

Venous thromboembolism(VTE)is a complication in children with acute lymphoblastic leukemia(ALL).The Chinese Children’s Cancer Group-ALL-2015 protocol was carried out in China,and epidemiology,clinical characteristics,and risk factors associated with VTE were *** collected data on VTE in a multiinstitutional clinical study of 7640 patients with ALL diagnosed in 20 hospitals from January 2015 to December ***,VTE occurred in 159(2.08%)patients,including 90(56.6%)during induction therapy and 108(67.92%)in the upper extremities.T-ALL had a 1.74-fold increased risk of VTE(95%CI 1.08–2.8,P=0.022).Septicemia,as an adverse event of ALL treatment,can significantly promote the occurrence of VTE(P<0.001).Catheter-related thrombosis(CRT)accounted for 75.47%(n=120);and,symptomatic VTE,58.49%(n=93),which was more common in patients aged 12–18 years(P=0.023),non-CRT patients(P<0.001),or patients with cerebral thrombosis(P<0.001).Of the patients with VTE treated with anticoagulation therapy(n=147),4.08%(n=6)had *** VTE recurrence rate was 5.03%(n=8).Patients with VTE treated by non-ultrasoundguided venous cannulation(P=0.02),with residual thrombus(P=0.006),or with short anticoagulation period(P=0.026)had high recurrence ***,preventing repeated venous puncture and appropriately prolonged anticoagulation time can reduce the risk of VTE recurrence.

关键词： acute lymphoblastic leukemia child venous thromboembolism epidemiology clinical characteristic risk factor

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Upfront consolidation treatment with 131I-mIBG followed by myeloablative chemotherapy and hematopoietic stem cell transplantation in high-risk neuroblastoma

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Pediatric Investigation 2020年第3期4卷 168-177页

作者： Jianhua Feng Frankie WT Cheng alex wk leung Vincent Lee Eva WM Yeung Hoi Ching Lam Jeanny Cheung Grace KS Lam Terry TW Chow Carol LS Yan Chi Kong Li Department of Paediatrics The Chinese University of Hong KongHong KongChina Department of Paediatrics The First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina Department of Paediatrics and Adolescent Medicine Hong Kong Children’s HospitalHong KongChina Department of Clinical Oncology Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina

Importance:131I-metaiodobenzylguanidine(131I-mIBG)has a significant targeted antitumor effect for ***,currently there is a paucity of data for the use of 131I-mIBG as a"front-line"therapeutic agent in those patients with newly diagnosed high-risk neuroblastoma as part of the conditioning regimen for myeloablative chemotherapy(MAC).Objective:To evaluate the feasibility of upfront consolidation treatment with 131I-mIBG plus MAC and hematopoietic stem cell transplantation(HSCT)in high-risk neuroblastoma ***:A retrospective,single-center study was conducted from 2003-2019 on newly diagnosed high-risk neuroblastoma patients without progressive disease(PD)after the completion of induction *** received 131I-mIBG infusion and MAC followed by ***:A total of 24 high-risk neuroblastoma patients were enrolled with a median age of 3.0 years at *** receiving this sequential consolidation treatment,3 of 13 patients who were in partial response(PR)before 131I-mIBG treatment achieved either complete response(CR)(n=1)or very good partial response(VGPR)(n=2)after *** a median follow-up duration of 13.0 months after 131I-mIBG therapy,the 5-year event-free survival and overall survival rates estimated were 29%and 38%for the entire cohort,and 53%and 67%for the patients who were in CR/VGPR at the time of 131I-mIBG ***:Upfront consolidation treatment with 131I-mIBG plus MAC and HSCT is feasible and tolerable in high-risk neuroblastoma patients,however the survival benefit of this 131I-mIBG regimen is only observed in the patients who were in CR/VGPR at the time of 131I-mIBG treatment.

关键词： Neuroblastoma 131I-mIBG Transplantation

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Differential Expressionof D-type cyclins and p27 in Human Gastric Carcinoma

Differential Expressionof D-type cyclins and p27 in Human Ga...

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2000全国肿瘤学术大会

作者： wk leung EKW Ng MYY Go JJY Sung

＜正＞BackgroundD type（D1,D2,D3）cyclins play a critical role in regulating cell cycle *** cyclin-dependent kinase inhibitor,p27,is a negative regulator of the cell cycle and is a potential tumor suppressor gene. Enhanced expression of D-type cyclins and the decreased p27 expression have been implicated in the pathogenesis of cancer but the role in gastric car- cinogenesis is *** To investigate the roles of cyclin D1,D2,D3 and

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Quality of life and palliative care needs of elderly patients with advanced heart failure

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Journal of Geriatric Cardiology 2016年第5期13卷 420-424页

作者： Helen YL Chan Doris SF Yu Doris YP leung Aileen wk Chan Elsie Hui The Nethersole School of Nursing The Chinese University of Hong Kong Hong Kong China Department of Medicine and Geriatrics Shatin Hospital Hong Kong China

Objective To examine the quality of life and palliative care needs of elderly patients with advanced heart failure （HF）. Methods This was a correlation descriptive study conducted at a 650-bed sub-acute hospital. Patients who were aged 65 or over, diagnosed with HF of New York Heart Association Class III or IV symptoms, and mentally sound were eligible to the study. The Edmonton Symptom Assessment Scale, the overall quality of life single item scale, and the McQill Quality of Life Questionnaire （MQoL）, were used for measurement. Multi- ple regression analysis was performed to determine factors for predicting quality of life. Results A convenience sample of 112 patients was recruited. Their age was 81.5 ± 8.5 years. The three most distressing symptoms reported by the patients were tiredness （5.96 ± 2.78）, drowsiness （5.47± 2.93）, and shortness of breath （5.34 ± 2.96）. Their mean overall quality of life single item scale score was 4.72 ± 2.06 out of 10. The mean MQoL physical subscale score was the lowest （4.20 ± 1.767）, whereas their mean psychological subscale was the highest （7.14 ±2.39）. However, in a multivariate analysis model, quality of life was significantly associated with existential wellbeing, physical wellbeing, psychological wellbeing and educational level. Conclusions The findings highlight that spiritual concerns are significant palliative care needs among elderly patients with advanced HF, in addition to symptom management. This is in line with the argument that palliative care that places great emphasis on holistic care should be integrated to the care of this group of patients.

关键词： Assessment Heart failure Palliative care The elderly

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Gastrointestinal bleeding in patients on novel oral anticoagulants:Risk,prevention and management

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World Journal of Gastroenterology 2017年第11期23卷 1954-1963页

作者： Ka-Shing Cheung Wai K leung Department of Medicine The University of Hong KongQueen Mary HospitalHong KongChina

Novel oral anticoagulants(NOACs), which include direct thrombin inhibitor(dabigatran) and direct factor Xa inhibitors(rivaroxaban, apixaban and edoxaban), are gaining popularity in the prevention of embolic stroke in non-valvular atrial fibrillation as well as in the prevention and treatment of venous thromboembolism. However, similar to traditional anticoagulants, NOACs have the side effects of bleeding, including gastrointestinal bleeding(GIB). Results from both randomized clinical trials and observations studies suggest that high-dose dabigatran(150 mg b.i.d), rivaroxaban and high-dose edoxaban(60 mg daily) are associated with a higher risk of GIB compared with warfarin. Other risk factors of NOAC-related GIB include concomitant use of ulcerogenic agents, older age, renal impairment, Helicobacter pylori infection and a past history of GIB. Prevention of NOAC-related GIB includes proper patient selection, using a lower dose of certain NOACs and in patients with renal impairment, correction of modifiable risk factors, and prescription of gastroprotective agents. Overt GIB can be managed by withholding NOACs followed by delayed endoscopic treatment. In severe bleeding, additional measures include administration of activated charcoal, use of specific reversal agents such as idarucizumab for dabigatran and andexanent alfa for factor Xa inhibitors, and urgent endoscopic management.

关键词： Warfarin Endoscopy Apixaban Edoxaban Gastrointestinal bleeding Dabigatran Rivaroxaban Novel anticoagulants

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The control of glial cell activity by dorsal root ganglion neurons

The control of glial cell activity by dorsal root ganglion n...

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中国药理学会第十一次全国学术会议

作者： H WISH KBS CHOW B YEUNG KY NG CHT CHU KH TSE wk leung YH WONG School of Biomedical Sciences The Chinese University of Hong Kong Faculty of Dentistry The University of Hong Kong Division of Life Science The Hong Kong University of Science and Technology

OBJECTIVE Pain sensations in the periphery are carried by primary sensory neurons whose cell bodies lay in the dorsal root ganglia(DRG).The present study focuses on examining the interactions between DRG neurons and glial cells in vitro in relation to their roles as detectors of tissue *** Acutely dissociated DRG cells were isolated from adult SD rats,and plated on poly-DL-ornithine and laminin-coated tissue culture *** in 3 cell groups were compared over time in culture: mixed DRG cells(45%neurons on plating),neuron-enriched cells(70%neurons on plating) and glial cells(99%glial cells on plating).Cell proliferation was determined by counting cells,protein assay and MTT assay.[H]cAMP production in the presence of specific receptor agonists and antagonists was assayed to detect Gs-coupled *** acidic fibrillary protein(GFAP),glutamine synthase(GS) and Toll-like receptor 4(TLR4) mRNA and protein expression were determined by real time PCR and immunocyto-chemistry, *** The presence of Gs-coupledβAR,CGRP,EP and IP receptors were identified in glial cell preparations although only CGRP receptors have been reported on satellite glial cells in ***,IP receptor-stimulated adenylyl cyclase activity in glial cells was significantly inhibited by the presence of DRG *** neurons did not overtly affect glial cell proliferation or the expression of GFAP(classical markers of glial cell activation),but appeared to inhibit the expression of TLR4 and prevent the loss of GS in glial *** Time-dependent changes occur in DRG glial cells in vitro with regard to the expression of TLR4,Gs-coupled receptors and glial cell markers,and all these changes are influenced by the presence of DRG neurons. Whether similar neuron-glial interactions occur in vivo remains to be determined.

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Selective endoscopic ligation for treatment of upper gastrointestinal protuberant lesions

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World Journal of Gastroenterology 2013年第33期19卷 5581-5585页

作者： Lin Wang Shi-Yao Chen Ying Huang Jie Wu Ying-Kit leung Department of Gastroenterology Children’s Hospital of Fudan University Department of Gastroenterology Zhongshan Hospital of Fudan University

This study explored the clinical value of endoscopic ligation for the treatment of upper gastrointestinal(GI)protuberant lesions in *** to the appearance and size of lesions,we used different ligation techniques for the treatment of the *** ultrasonography was used for preliminary characterization of the *** case diagnosed with PeutzJeghers syndrome was successfully treated by a detachable *** cases with semi-pedunculated or broad-base lesions originating from the submucosal layer of the upper GI were treated with endoscopic variceal ligation;endoscopic examination showed that one case had complete healing 11 wk after ligation,while an ulcer scar was observed at the ligation site after 6 wk in the other *** lesions were successfully ligated at the first *** significant complications occurred either during or after the *** endoscopic ligation of upper GI lesions is an effective and safe treatment for upper GI protuberant lesions in children.

关键词： Endoscopy Ligation Endoscopic ultrasonography Protuberant lesion Children

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香港儿童膳食及血脂研究

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中华儿科杂志 1994年第5期32卷 269-271页

作者：梁淑芳吴文英林伟基李德强香港中文大学医学院儿科学系

对香港１２５名７岁儿童进行膳食调查和体格量度研究。结果表明，肥胖发生率为５０％，平均血胆固醇含量为４．６±０．８ｍｍｏｌ／Ｌ。膳食脂肪、肥胖状况分别与血脂水平有明显相关；膳食中多不饱和与饱和脂肪比例较低者，其血胆固醇... 详细信息

对香港１２５名７岁儿童进行膳食调查和体格量度研究。结果表明，肥胖发生率为５０％，平均血胆固醇含量为４．６±０．８ｍｍｏｌ／Ｌ。膳食脂肪、肥胖状况分别与血脂水平有明显相关；膳食中多不饱和与饱和脂肪比例较低者，其血胆固醇和低密度脂蛋白胆固醇含量较高；肥胖儿童的甘油三酯和极低密度脂蛋白胆固醇含量较高，而高密度脂蛋白胆固醇含量则较低。提示在社会富裕起来的同时必须注意生活与饮食健康教育，警惕各种富裕疾病包括冠心病、糖尿病等发生。

关键词：饮食调查血脂膳食儿童

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Increasing dietary fiber intake in terms of kiwifruit improves constipation in Chinese patients

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World Journal of Gastroenterology 2007年第35期13卷 4771-4775页

作者： Annie On On Chan Gigi leung Teresa Tong Nina YH Wong Department of Medicine The University of Hong KongHong KongChina

AIM： To investigate if increased dietary fiber, in terms of kiwifruit, is effective in Chinese constipated patients. METHODS： 33 constipated patients and 20 healthy volunteers were recruited for a 4-wk treatment of kiwi fruit twice daily. Response during wk 1-4 was defined as an increase in complete spontaneous bowl, motion （CSBM）≥ 1/wk. Secondary efficacy included response during wk 1-4, individual symptoms and scores of bowel habits and constipation. Responses were compared with the baseline run-in period. Colonic transit time and anorectal manometry were performed before and after treatment. RESULTS： Responder rate was 54.5% in the constipated group. The mean CSBM increased after treatment （2.2±2.6 vs 4.4± 4.6, P = 0.013）. There was also improvement in the scores for bothersomeness of constipation （P = 0.02）, and satisfaction of bowel habit （P = 0.001）, and decreased in days of laxative used （P = 0.003）. There was also improvement in transit time （P = 0.003） and rectal sensation （P 〈 0.05）. However, there was no change in the bowel symptoms or anorectal physiology in the healthy subjects. CONCLUSION： Increasing dietary fiber intake is effective in relieving chronic constipation in Chinese population.

关键词： Constipation Dietary fiber Kiwifruit Chinese

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Dietary advanced glycation end-products aggravate non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2016年第35期22卷 8026-8040页

作者： Christopher leung Chandana B Herath Zhiyuan Jia Sof Andrikopoulos Bronwyn E Brown Michael J Davies Leni R Rivera John B Furness Josephine M Forbes Peter W Angus Department of Medicine the University of MelbourneAustin HealthHeidelbergMelbourne Victoria 3084Australia Department of Gastroenterology and Hepatology Austin HealthAustin HospitalHeidelberg MelbourneVictoria 3084 Australia Heart Research Institute Newtown New South Wales 2042Austrulia University of Melbourne Victoria 3052Australia Metabolic Research Unit School of MedicineDeakin UniversityVictoria 3216Austrialia Glycation and Diabetes Complications Group Mater Medical Research InstituteSouth BrisbaneQueensland 4101Australia

AIM To determine if manipulation of dietary advanced glycation end product(AGE), intake affects nonalcoholic fatty liver disease(NAFLD) progression and whether these effects are mediated via RAGE. METHODS Male C57Bl6 mice were fed a high fat, high fructose, high cholesterol(HFHC) diet for 33 wk and compared with animals on normal chow. A third group were given a HFHC diet that was high in AGEs. Another group was given a HFHC diet that was marinated in vinegar to prevent the formation of AGEs. In a second experiment, RAGE KO animals were fed a HFHC diet or a high AGE HFHC diet and compared with wildtype controls. Hepatic biochemistry, histology, picrosirius red morphometry and hepatic mR NA were determined. RESULTS Long-term consumption of the HFHC diet generated significant steatohepatitis and fibrosis after 33 wk. In this model, hepatic 4-hydroxynonenal content(a marker of chronic oxidative stress), hepatocyte ballooning, picrosirius red staining, α-smooth muscle actin and collagen type 1A gene expression were all significantly increased. Increasing the AGE content of the HFHC diet by baking further increased these markers of liver damage, but this was abrogated by pre-marination in acetic acid. In response to the HFHC diet, RAGE-/-animals developed NASH of similar severity to RAGE+/+ animals but were protected from the additional harmful effects of the high AGE containing diet. Studies in isolated Kupffer cells showed that AGEs increase cell proliferation and oxidative stress, providing a likely mechanism through which these compounds contribute to liver injury. CONCLUSION In the HFHC model of NAFLD, manipulation of dietary AGEs modulates liver injury, inflammation, and liver fibrosis via a RAGE dependent pathway. This suggests that pharmacological and dietary strategies targeting the AGE/RAGE pathway could slow the progression of NAFLD.

关键词： Advanced glycation end-products Fructose Steatohepatitis Non-alcoholic fatty liver disease Hepatic fibrosis Oxidative stress

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