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Nationwide retrospective study of hepatitis B virological response and liver stiffness improvement in 465 patients on nucleos(t)ide analogue

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World Journal of Gastroenterology 2022年第31期28卷 4390-4398页

作者： Alnoor Ramji Karen Doucette Curtis Cooper Gerald Yosel Minuk Mang Ma alexander wong David wong Edward Tam Brian Conway David Truong Philip wong Lisa Barrett Hin Hin Ko Sarah Haylock-Jacobs Nishi Patel Gilaad G Kaplan Scott Fung Carla S Coffin Department of Medicine University of British ColumbiaVancouver v6t 1z3Canada Department of Medicine University of AlbertaEdmonton t6g 2r7Canada Department of Medicine The Ottawa Hospital Research InstituteUniversity of OttawaOttawa ON K1H 8L6Canada Department of Medicine University of ManitobaWinnipeg r3e 3j7Canada Department of Medicine University of SaskatchewanSaskatoon s7n 5e5Canada Department of Medicine University Health NetworkToronto m5g 2c4Canada Pacific Gastroenterology Associates Vancouver v6z 2k5Canada Vancouver Infectious Disease Centre Vancouver v6z 2c7Canada Department of Medicine McGill UniversityMontreal h3a 0g4Canada Department of Microbiology and Immunology Dalhousie UniversityHalifax b3h 4r2Canada Cumming School of Medicine University of CalgaryCalgary t2n 1n4Canada

BACKGROUND Hepatitis B virus(HBV)nucleos(t)ide analog(NA)therapy reduces liver disease but requires prolonged therapy to achieve hepatitis B surface antigen(HBsAg)*** is limited North American real-world data using non-invasive tools for fibrosis assessment and few have compared 1st generation NA or lamivudine(LAM)to tenofovir disoproxil fumarate(TDF).AIM To assess impact of NA on virological response and fibrosis regression using liver stiffness measurement(LSM)(i.e.,FibroScan®).METHODS Retrospective,observational cohort study from the Canadian HBV *** collected included demographics,NA,HBV DNA,alanine aminotransferase(ALT),and *** were HBV monoinfected patients,treatment naïve,and received 1 NA with minimum 1 year *** In 465(median 49 years,37%female,35%hepatitis B e antigen+at baseline,84%Asian,6%White,and 9%Black).Percentage of 64(n=299)received TDF and 166 were LAM-treated with similar median duration of 3.9 and 3.7 years,*** mean baseline LSM was 11.2 kPa(TDF)vs 8.3 kPa(LAM)(P=0.003).At 5-year follow-up,the mean LSM was 7.0 kPa in TDF vs 6.7 kPa in LAM(P=0.83).There was a significant difference in fibrosis regression between groups(i.e.,mean-4.2 kPa change in TDF and-1.6 kPa in LAM,P<0.05).The last available data on treatment showed that all had normal ALT,but more TDF patients were virologically suppressed(<10 IU/mL)(n=170/190,89%)vs LAM-treated(n=35/58,60%)(P<0.05).None cleared *** In this real-world North American study,approximately 5 years of NA achieves liver fibrosis regression rarely leads to HBsAg loss.

关键词： Nucleos(t)ide analog therapy Functional cure Hepatitis B virus surface antigen loss Fibrosis regression Liver stiffness measurement Transient elastography

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Statin, aspirin and metformin use and risk of hepatocellular carcinoma related outcomes following liver transplantation: A retrospective study

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World Journal of Transplantation 2024年第3期14卷 120-131页

作者： William Chung Kevin wong Noel Ravindranayagam Lauren Tang Josephine Grace Darren wong Danny Con Marie Sinclair Avik Majumdar Numan Kutaiba Samuel Hui Paul Gow Vijayaragavan Muralidharan alexander Dobrovic Adam Testro Department of Gastroenterology Austin HealthHeidelberg 3084VictoriaAustralia Victorian Liver Transplant Unit Austin HealthHeidelberg 3084VictoriaAustralia Department of Radiology Austin HealthHeidelberg 3084VictoriaAustralia Department of Gastroenterology Monash HealthClayton 3168VictoriaAustralia Department of Surgery University of MelbourneAustin HealthHeidelberg 3048VictoriaAustralia Department of Surgery Beacon LaboratoryAustin PrecinctThe University of MelbourneAustin HospitalHeidelberg 3048VictoriaAustralia

BACKGROUND Liver transplantation(LT)is a potentially curative therapy for patients with hepatocellular carcinoma(HCC).HCC-recurrence following LT is associated with reduced *** is increasing interest in chemoprophylaxis to improve HCC-related outcomes *** To investigate whether there is any benefit for the use of drugs with proposed chemoprophylactic properties against HCC,and patient outcomes following *** This was a retrospective study of adult patients who received Deceased Donor LT for HCC from 2005-2022,from a single Australian *** use was defined as statin,aspirin or metformin therapy for≥29 days,within 24 months post-LT.A cox proportional-hazards model with time-dependent covariates was used for survival *** measures were the composite-endpoint of HCC-recurrence and all-cause mortality,HCC-recurrence and HCC-related *** analysis was performed to account for immortality time bias and statin *** Three hundred and five patients were included in this study,with 253(82.95%)males with a median age of 58.90 *** of liver disease were 150(49.18%)hepatitis C,73(23.93%)hepatitis B(HBV)and 33(10.82%)non-alcoholic fatty liver disease(NAFLD).56(18.36%)took statins,51(16.72%)aspirin and 50(16.39%)*** a median follow-up time of 59.90 months,34(11.15%)developed HCC-recurrence,48(15.74%)died,17(5.57%)from HCC-related ***,aspirin or metformin use was not associated with statistically significant differences in the composite endpoint of HCC-recurrence or all-cause mortality[hazard ratio(HR):1.16,95%CI:0.58-2.30;HR:1.21,95%CI:0.28-5.27;HR:0.61,95%CI:0.27-1.36],HCC-recurrence(HR:0.52,95%CI:0.20-1.35;HR:0.51,95%CI:0.14-1.93;HR 1.00,95%CI:0.37-2.72),or HCC-related mortality(HR:0.32,95%CI:0.033-3.09;HR:0.71,95%CI:0.14-3.73;HR:1.57,95%CI:0.61-4.04)*** dosing was not associated with statist-ically significant differences in HCC-related ***

关键词： Liver transplantation Hepatocellular carcinoma Transplant oncology Statins HMG-Co-A reductase Aspirin Metformin Mammalian target of rapamycin

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Evolution of laparoscopy in colorectal surgery:An evidencebased review

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World Journal of Gastroenterology 2014年第17期20卷 4926-4933页

作者： alexander Emmanuel Blackmore Mark Te Ching wong Choong Leong Tang Department of Colorectal Surgery Singapore General HospitalSingapore 169856Singapore

Open surgery for colorectal disease has progressed significantly over the past century from humble beginnings to form the mainstay of treatment for colorectal cancer and a number of benign *** the introduction of laparoscopic abdominal surgery,the next stage in the evolution of the specialty began in the 1990s with the first laparoscopic colonic *** some early concerns regarding its safety and oncological efficacy during the latter part of that decade,laparoscopic colorectal surgery rapidly came into mainstream use in the early part of the current century with evidence supporting its use being made available from large scale randomised controlled *** article provides an evidence-based summary of this evolutionary process as it relates to both benign and malignant colorectal disease,as well as discussion of the next phase of new technologies such as robotic surgery.

关键词： Colorectal surgery Colorectal cancer Pelvic floor Laparoscopy Robotics Laparoscopic resection of gastrointestinal

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Return to sport following tibial plateau fractures: A systematic review

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World Journal of Orthopedics 2017年第7期8卷 574-587页

作者： Greg A J Robertson Seng J wong alexander M Wood Edinburgh Orthopaedic Trauma Unit Royal Infirmary of Edinburgh Orthopaedic Department Leeds General Infirmary

AIM To systemically review all studies reporting return to sport following tibial plateau fracture, in order to provide information on return rates and times to sport, and to assess variations in sporting outcome for different treatment *** A systematic search of CINAHAL, Cochrane, EMBASE, Google Scholar, MEDLINE, PEDro, Scopus, SPORTDiscus and Web of Science was performed in January 2017 using the keywords "tibial", "plateau", "fractures", "knee", "athletes", "sports", "non-operative", "conservative", "operative", "return to sport". All studies which recorded return rates and times to sport following tibial plateau fractures were included. RESULTS Twenty-seven studies were included: 1 was a randomised controlled trial, 7 were prospective cohort studies, 16 were retrospective cohort studies, 3 were case series. One study reported on the outcome of conservative management(n = 3); 27 reported on the outcome of surgical management(n = 917). Nine studies reported on Open Reduction Internal Fixation(ORIF)(n = 193), 11 on Arthroscopic-Assisted Reduction Internal Fixation(ARIF)(n = 253) and 7 on Frame-Assisted Fixation(FRAME)(n = 262). All studies recorded "return to sport"rates. Only one study recorded a "return to sport" time. The return rate to sport for the total cohort was 70%. For the conservatively-managed fractures, the return rate was 100%. For the surgically-managed fractures, the return rate was 70%. For fractures managed with ORIF, the return rate was 60%. For fractures managed with ARIF, the return rate was 83%. For fractures managed with FRAME was 52%. The return rate for ARIF was found to be significantly greater than that for ORIF(OR 3.22, 95%CI: 2.09-4.97, P < 0.001) and for FRAME(OR 4.33, 95%CI: 2.89-6.50, P < 0.001). No difference was found between the return rates for ORIF and FRAME(OR 1.35, 95%CI: 0.92-1.96, P = 0.122). The recorded return time was 6.9 mo(median), from a study reporting on *** Return rates to sport for tibial pl

关键词： Tibial Plateau Fracture Knee Return Sport Rate Time

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Patients ≥ 75 years with acute coronary syndrome but without critical epicardial coronary disease： prevalence, characteristics, and outcome

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Journal of Geriatric Cardiology 2015年第1期12卷 11-16页

作者： Vincent wong Ahmed Farah Hubertus von Korn Nedim Memisevic Stefan Richter KetevanTukhiashvili Bernward Lauer Marc-alexander Ohlow Cardiology Clinic Zentralklinik Bad Berka Robert-Koch-Allee 9 99437 Bad Berka Germany

Objective Absence of significant epicardial coronary artery disease （CAD） in patients with acute onset of chest pain and elevation of myocardial necrosis markers is occasionally observed. The aim of this study was to analyse the clinical characteristics and outcome of such patients with advanced age. Methods We retrospectively analysed 4,311 patients with acute onset of chest pain plus necrosis marker elevation. Two hundred and seventy two patients without CAD on angiogram （6.3%） were identified. Out of them, 50 （1.2%） patients 〉 75 years （Group Ⅰ） were compared with （1） 222 acute coronary syndrome （ACS） patients without CAD on angiogram 〈 75 years （Group Ⅱ）, and （2） 610 consecutive patients ≥ 75 years with Non-ST-elevation Myocardial Infarction （NSTEMI） undergoing percutaneous coronary intervention （Group Ⅲ）. Results Group 1 compared to Group III patients made up for more females （64.0% vs. 49.2%; P 〈 0.0001）, and had more severe anginal symptoms on presentation [Canadian Cardiovascular Society （CCS） class Ⅰ/Ⅱ, 26.0% vs. 49.8%; P = 0.02]. Group I patients also had lower troponin levels （0.62 ± 0.8 ng/mL vs. 27 ± 74 ng/mL; P 〈 0.02）, lower leukocyte count （9.4 ± 3.13 × 10^9 vs. 12 ± 5.1 × 10^9; P = 0.001 ） and better preserved left ventricular function （56.7% ± 14.3 % vs. 45% ± 1 1%; P 〈 0.0001 ）. Event-free survival （cardiac death, myocardial infarction, recurrent angina, and re-hospitalisation） was more frequent in Group Ⅰ and Ⅱ patients compared to Group III patients （64.9%, 66.7%, and 41.6%, respectively; P 〈 0.0001）. Conclusions ACS in patients 〉 75 years without CAD is very infrequent, associated with a （1） similar outcome compared to ACS patients 〈 75 years without CAD, and （2） significant better outcome compared to NSTEMI patients 〉 75 years.

关键词： Acute coronary syndrome Angina Biological markers Coronary stenosis Myocarditis Syndrome

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Impact of IPMOE on nursing tasks in the medical ward: A time-motion study

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International Journal of Nursing Sciences 2018年第1期5卷 50-56页

作者： Ming Leung Kenny Kin Chung Chan Wing Leung wong alexander Chun Bon Law Princess Margaret Hospital Hong KongChina Tuen Mun Hospital Hong KongChina Hong Kong Baptist University Hong KongChina

Introduction:The In-patient Medication Order Entry System (IPMOE) was first implemented in the medical ward of Princess Margaret Hospital,Hong *** was a local developed close-loop system including prescription,dispensing and administration *** on its impact on nursing tasks would be important for practice improvement and subsequent system ***:The study was conducted to quantify the nursing times across medication-associated tasks for paper-based MAR and computer-based IPMOE,including change in the tasks and time patterns before and after IPMOE ***:This was a prospective observation study in medical wards before (Jan 2014-Jun 2014) and after (Mar 2015-Jun 2015) the implementation of *** conducted 8-hr observation studies of individual nurses with a customized application to time various pre-categorized nursing *** inferences and interrupted time series analysis was performed to identify the change in the intercept and trends over time after ***:The average number of medication-related tasks was significantly reduced from 61.07 to 29.81,a reduction of 31.26 episodes per duty (P < 0.001,95% CI 22.9-39.63).The time for the medication-related tasks was reduced from 32 min (SD =21.57) to 26.57 min (SD =11.35) and the medication administration time increased from 37.93 min (SD-14.78) to 44.37 min (SD 19.45),but there was no overall significant difference in the time spent on each duty (P =0.315) between the two *** improving trend in the delayed effect was observed (P =0.03),which indicated a run-in period for new application was needed in clinical ***:Our study had shown the time motion observation could be applied to measure the impact of the IPMOE in a busy clinical *** classification of activities,validation,objective measurement and longitudinal evaluation,the method could be applied in various systems as well as different clinical settings in

关键词： In-patient medication order entry system Medication systems Nursing Time and motion studies

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Consideration of chiral optical fibres

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Frontiers of Optoelectronics 2010年第1期3卷 67-70页

作者： alexander ARGYROS Mark STRATON Andrew DOCHERTY Eun Hee MIN Ziyi GE Kok Hou wong Francois LADOUCEUR Leon POLADIAN Institute of Photonics and Optical Science School of Physics The University of Sydney School of Mathematics and Statistics The University of Sydney School of Electrical Engineering and Telecommunications University of New South Wales

Circular birefringence is a property of chiral materials. In this work, we consider the use of chiral materials in optical fibres to produce circularly birefringent optical fibres and in fibres where a contrast in circular birefringence contributes to forming the waveguide.(–)-menthyl methacrylate is also investigated as a possible material for the fabrication of such fibres.

关键词： microstructured optical fibres microstructured polymer optical fibres photonic crystal fibres chirality chiral waveguides birefringence

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Toll-like receptor 7 deficiency suppresses type 1 diabetes development by modulating B-cell differentiation and function

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Cellular & Molecular Immunology 2021年第2期18卷 328-338页

作者： Juan Huang Jian Peng James alexander Pearson Georgios Efthimiou Youjia Hu Ningwen Tai Yanpeng Xing Luyao Zhang Jianlei Gu Jianping Jiang Hongyu Zhao Zhiguang Zhou F.Susan wong Li Wen National Clinical Research Center for Metabolic Diseases Key Laboratory of Diabetes Immunology(Central South University)Ministry of Educationand Department of Metabolism and EndocrinologyThe Second Xiangya HospitalCentral South UniversityChangshaHunanChina Section of Endocrinology Department of Internal MedicineSchool of MedicineYale UniversityNew HavenCTUSA Division of Infection and Immunity School of MedicineCardiff UniversityCardiffUK Department of Microbiology University of HullHullUK Department of Gastrointestinal Surgery of the First Hospital of Jilin University ChangchunJilinChina Department of Biostatistics Data Science&GeneticsYale School of Public HealthNew HavenCTUSA

Innate immunity mediated by Toll-like receptors(TLRs),which can recognize pathogen molecular patterns,plays a critical role in type 1 diabetes ***7 is a pattern recognition receptor that senses single-stranded RNAs from viruses and host tissue cells;however,its role in type 1 diabetes development remains *** our study,we discovered that Tlr7-deficient(Tlr7^(−/−))nonobese diabetic(NOD)mice,a model of human type 1 diabetes,exhibited a significantly delayed onset and reduced incidence of type 1 diabetes compared with Tlr7-sufficient(Tlr7^(+/+))NOD *** investigations showed that Tlr7 deficiency significantly altered B-cell differentiation and immunoglobulin ***,Tlr7^(−/−)NOD B cells were found to suppress diabetogenic CD4^(+)T-cell responses and protect immunodeficient NOD mice from developing diabetes induced by diabetogenic T *** addition,we found that Tlr7 deficiency suppressed the antigen-presenting functions of B cells and inhibited cytotoxic CD8^(+)T-cell activation by downregulating the expression of both nonclassical and classical MHC class I(MHC-I)molecules on B *** data suggest that TLR7 contributes to type 1 diabetes development by regulating B-cell functions and subsequent interactions with T ***,therapeutically targeting TLR7 may prove beneficial for disease protection.

关键词： Type 1 diabetes Toll-like receptor 7 B cell

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Clinically relevant factors associated with quantitative optical coherence tomography angiography metrics in deep capillary plexus in patients with diabetes

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Eye and Vision 2020年第1期7卷 64-74页

作者： Fang Yao Tang Erica O.Chan Zihan Sun Raymond wong Jerry Lok Simon Szeto Jason C.Chan alexander Lam Clement C.Tham Danny S.Ng Carol Y.Cheung Department of Ophthalmology and Visual Sciences The Chinese University of Hong KongHong Kong Special Administrative RegionKowloonChina Hong Kong Eye Hospital Hong Kong Special Administrative RegionKowloonChina CUHK Eye Centre Hong Kong Eye Hospital147K Argyle StreetKlnKowloonHong KongChina

Background:To test clinically relevant factors associated with quantitative artifact-free deep capillary plexus(DCP)metrics in patients with diabetes mellitus(DM).Methods:563 eligible eyes(221 with no diabetic retinopathy[DR],135 with mild DR,130 with moderate DR,and 77 with severe DR)from 334 subjects underwent optical coherence tomography-angiography(OCT-A)with a swept-source OCT(Triton DRI-OCT,Topcon,Inc.,Tokyo,Japan).Strict criteria were applied to exclude from analysis those DCP images with artifacts and of poor quality,including projection artifacts,motion artifacts,blurriness,signal loss,B-scan segmentation error,or low-quality score.A customized MATLAB program was then used to quantify DCP morphology from the artifact-free DCP images by calculating three metrics:foveal avascular zone(FAZ),vessel density(VD),and fractal dimension(FD).Results:166(29.5%)eyes were excluded after quality control,leaving in the analysis 397 eyes(170 with no DR,101 with mild DR,90 with moderate DR,36 with severe DR)from 250 *** the multiple regression models,larger FAZ area was associated with more severe DR(β=0.687;p=0.037),shorter axial length(AL)(β=−0.171;p=0.003),thinner subfoveal choroid thickness(β=−0.122;p=0.031),and lower body mass index(BMI)(β=−0.090;p=0.047).Lower VD was associated with more severe DR(β=−0.842;p=0.001),shorter AL(β=0.107;p=0.039),and poorer visual acuity(VA)(β=−0.133;p=0.021).Lower FD was associated with more severe DR(β=−0.891;p<0.001)and with older age(β=−0.142;p=0.004).Conclusions:Quantitative artifact-free DCP metrics are associated with VA,DR severity,AL,subfoveal choroidal thickness,age,and BMI in diabetic *** effects of ocular and systemic factors should be considered for meaningful interpretations of DCP changes in DM patients.

关键词： Optical coherence tomography angiography Diabetic retinopathy Deep capillary plexus Visual acuity

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Recombinant chimpanzee adenovirus vector vaccine expressing the spike protein provides effective and lasting protection against SARS-CoV-2 infection in mice

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Virologica Sinica 2022年第4期37卷 581-590页

作者： Mingqing Lu Kunpeng Liu Yun Peng Zhe Ding Yingwen Li alexander Tendu Xue Hu Ge Gao Weiwei Guo Hang Liu Juhong Rao Jiaxuan Zhao Miaoyu Chen Zhiming Yuan Gary wong Chao Shan Yanfeng Yao Jiaming Lan CAS Key Laboratory of Molecular Virology&Immunology Institut Pasteur of ShanghaiChinese Academy of SciencesShanghai200031China State Key Laboratory of Virology Chinese Academy of SciencesWuhan430071China University of Chinese Academy of Sciences Beijing100049China Center for Biosafety Mega-Science Wuhan Institute of VirologyChinese Academy of SciencesWuhan430071China

SARS-CoV-2 infection is a global public health *** are considered amongst the most important tools to control the SARS-CoV-2 *** expected,deaths from SARS-CoV-2 infection have dropped dramatically with widespread ***,there are concerns over the duration of vaccine-induced protection,as well as their effectiveness against emerging variants of ***,we constructed a recombinant chimpanzee adenovirus vectored vaccine expressing the full-length spike of SARS-CoV-2(Ad C68-S).Rapid and high levels of humoral and cellular immune responses were observed after immunization of C57BL/6J mice with one or two doses of Ad ***,neutralizing antibodies were observed up to at least six months after vaccination,without substantial *** or double doses Ad C68-S immunization resulted in lower viral loads in lungs of mice against SARS-CoV-2 challenge both in the short term(21 days)and long-term(6 months).Histopathological examination of Ad C68-S immunized mice lungs showed mild histological abnormalities after SARS-CoV-2 *** together,this study demonstrates the efficacy and durability of the Ad C68-S vaccine and constitutes a promising candidate for clinical evaluation.

关键词： SARS-CoV-2 Vaccine Chimpanzee adenovirus vector Neutralizing antibodies Long-term protection

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