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Misdiagnosis of Sexually Transmitted Diseases in Hong Kong Outpatient Private Healthcare

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Open Journal of Medical Microbiology 2023年第1期13卷 31-42页

作者： Andes lau David W. y. Ho Clinical Laboratory Service Unit Pangenia Life Sciences Ltd. Hong Kong China

Background and objective: Early and accurate diagnosis is one of the critical requirements for successful management of all diseases. yet, delayed diagnosis and misdiagnosis remain as vital problems, consequently impose adverse effects on patient treatment. Sexually transmitted disease (STD) is one of the most common infectious diseases, and more than one million of STD cases are acquired every day globally. Misdiagnosis of STD inevitably exists, therefore should not be overlooked. Being a medical diagnostic laboratory providing various STDs diagnosing service in Hong Kong, we aimed to determine the misdiagnosis rate of STDs and investigate the possible underlying cause. Methods: Specimens were collected for STD diagnosis from multiple clinics during 1 June 2021 to 20 October 2021 from different clinics and hospitals were included in the study. DNA extraction was performed using magnetic bead based method;then the extracted DNA was tested using the DiagCor GenoFlowTM STD Array kit to detect the existence of any targeted pathogens. Results: 1459 specimens were collected and included during the designated time period, with 643 specimens found to be positive with at least one targeted STD pathogen. 494 of these were found to be aligned with test ordered by physicians, and the remaining 149 positive cases had at least one pathogen detected but not requested to be tested by the physicians resulting in misdiagnosis. The overall misdiagnosis rate was determined to be 23.2% (149/643), with high frequency of misdiagnosis occurred to tests ordered for one to three pathogens detection. Also, Ureaplasma urealyticum and/or Ureaplasma parvum (UU/UP) was the commonest pathogen detected in this study. Conclusion: The findings suggested incorrect test selection made by physicians was one of the major reasons of STDs misdiagnosis in outpatient settings. To reduce diagnostic errors in STD diagnosis, physicians are encouraged to select and request test that allow detection o

关键词： Sexually Transmitted Diseases (STDs) Diagnostic Error Misdiagnosis Incorrect Decision

Methods of vascular control technique during liver resection:a comprehensive review

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Hepatobiliary & Pancreatic Diseases International 2010年第5期9卷 473-481页

作者： Wan-yee lau Eric C.H.Lai Stephanie H.y.lau Faculty of Medicine the Chinese University of Hong KongShatinNew TerritoriesHong Kong SARChina

BACKGROUND: Significant hemorrhage together with blood transfusion increases postoperative morbidity and mortality of hepatic resection. Hepatic vascular occlusion is effective in minimizing bleeding during hepatic parenchymal transection. This article aimed to review the current role and status of various techniques of hepatic vascular occlusion during hepatic resection. DATA SOURCES: The relevant manuscripts were identified by searching MEDLINE, and PubMed for articles published between January 1980 and April 2010 using the keywords 'vascular control', 'vascular clamping', 'vascular exclusion' and 'hepatectomy'. Additional papers were identified by a manual search of the references from the key articles. RESULTS: One randomized controlled trial (RCT) and 5 RCTs showed intermittent Pringle maneuver and ischemic preconditioning followed by continuous Pringle maneuver were superior to continuous Pringle maneuver alone, respectively. Two RCTs compared the outcomes of hepatectomy with and without intermittent Pringle maneuver. One showed Pringle maneuver to be beneficial, while the other failed to show any benefit. One RCT showed that ischemic preconditioning had significantly less blood loss than using intermittent Pringle maneuver. Four RCTs evaluated the use of hemihepatic vascular occlusion. One RCT showed it had significantly less blood loss than Pringle maneuver, while the other 3 showed no significant difference. Only 1 RCT showed it had significantly less liver ischemic injury. No RCT had been carried out to assess segmental vascular occlusion. Two RCTs compared the outcomes of total hepatic vascular exclusion (THVE) and Pringle maneuver. One RCT showed THVE resulted in similar blood loss, but a higher postoperative complication. The other RCT showed less blood loss using THVE but the postoperative complication rate was similar. Both studies showed similar degree of liver ischemic injury. Only one RCT showed that selective hepatic vascular exclusion (SHVE) had

关键词： vascular control vascular exclusion hepatectomy liver neoplasm Pringle maneuver

The current role of neoadjuvant/adjuvant/chemoprevention therapy in partial hepatectomy for hepatocellular carcinoma:a systematic review

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Hepatobiliary & Pancreatic Diseases International 2009年第2期8卷 124-133页

作者： Wan-yee lau Eric C.H.Lai Stephanie H.y.lau State Key Laboratory for Diagnosis and Treatment of Infectious Diseases First Affiliated HospitalZhejiang University School of Medicine

BACKGROUND: Following curative treatment for hepatocellular carcinoma (HCC), 50%-90% of postoperative death is due to recurrent disease. Intra-hepatic recurrence is frequently the only site of recurrence. Thus, any neoadjuvant or adjuvant therapy, which can decrease or delay the incidence of intra-hepatic recurrence, or any cancer chemoprevention which can prevent a new HCC from developing in the liver remnant, will improve the results of liver resection. This article systematically reviewed the current evidence of neoadjuvant, adjuvant, and chemoprevention in partial hepatectomy of HCC. DATA SOURCES: Studies were identified by searching MEDLINE and PubMed databases for articles from January 1990 to November 2008 using the keywords 'hepatocellular carcinoma', 'hepatectomy', 'adjuvant therapy', 'neoadjuvant therapy', and 'regional therapy'. Additional papers and book chapters were identified by a manual search of the references from the key articles. RESULTS: Neoadjuvant transarterial chemoembolization or adjuvant regional transarterial chemotherapy embolization+systemic chemotherapy did not add benefit. Both adjuvant transarterial radioembolization with (131)I-lipiodol and adjuvant systemic interferon showed promising results. However, there were only a limited number of such studies. CONCLUSIONS: Further randomized controlled studies need to be carried out. Currently, there is no consensus on a standard neoadjuvant/adjuvant/chemoprevention therapy in partial hepatectomy for HCC.

关键词： hepatocellular carcinoma hepatectomy adjuvant therapy neoadjuvant therapy therapeutic embolization

Pheromone Static Routing Strategy for Complex Networks

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Chinese Physics Letters 2012年第12期29卷 254-257页

作者： HU Mao-Bin Henry y.K.lau LING Xiang JIANG Rui Department of Industrial and Manufacturing Systems Engineering The University of Hong KongPokfulam RoadHong Kong School of Engineering Science University of Science and Technology of ChinaHefei 230026 School of Transportation Engineering Hefei University of TechnologyHefei 230009

We adopt the concept of using pheromones to generate a set of static paths that can reach the performance of global dynamic routing strategy[***.E 81(2010)016113].The path generation method consists of two *** the first stage,a pheromone is dropped to the nodes by packets forwarded according to the global dynamic routing *** the second stage,pheromone static paths are generated according to the pheromone *** output paths can greatly improve traffic systems'overall capacity on different network structures,including scale-free networks,small-world networks and random *** the paths are static,the system needs much less computational resources than the global dynamic routing strategy.

关键词： network networks Complex

Chromatic Uniqueness of Certain Complete Tripartite Graphs

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Acta Mathematica Sinica,English Series 2011年第5期27卷 919-926页

作者： G. C. lau y. H. PENG Faculty of Computer & Mathematical Sciences Universiti Teknologi MARA (Segamat Campus) 85100 Segamat Johor Malaysia Department of Mathematics and Institute for Mathematical Research Universiti Putra Malaysia 43400 UPM Serdang Malaysia

Let P（G,A） be the chromatic polynomial of a graph G. A graph G is chromatically unique if for any graph H, P（H, λ） = P（G, λ） implies H is isomorphic to G. Liu et al. [Liu, R. y., Zhao, H. X., ye, C. F.： A complete solution to a conjecture on chromatic uniqueness of complete tripartite graphs. Discrete Math., 289, 175 179 （2004）], and lau and Peng [lau, G. C., Peng, y. H.： Chromatic uniqueness of certain complete t-partite graphs. Ars Comb., 92, 353-376 （2009）] show that K（p - k,p - i,p） for i = 0, 1 are chromatically unique if p ≥ k ＋ 2 ≥ 4. In this paper, we show that if 2 〈 i 〈 4, the complete tripartite graph K（p - k,p - i,p） is chromatically unique for integers k ≥ i and p 〉 k2/4 ＋ i ＋ 1.

关键词： Complete tripartit graphs chromatic polynomial chromatic uniqueness

A ruptured recurrent small bowel gastrointestinal stromal tumour causing hemoperitoneum

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Frontiers of Medicine 2015年第1期9卷 108-111页

作者： Eric C.H. Lai Kam Man Chung Stephanie H.y. lau Wan yee lau Faculty of Medicine The Chinese University of Hong Kong Shatin Hong Kong SAR China Dr. K.M. Chung's Clinic Rm 807 Hang Seng Tsimshatsui Building 18 Carnarvon Road Tsimshatsui Hong Kong SAR China Department of Surgery Pamela Youde Nethersole Eastern Hospital Hong Kong SAR China Department of Surgery Queen Elizabeth Hospital Hong Kong SAR China

Hemoperitoneum is a rare and potentially life-threatening complication of GIST. We reported a 54- year-old man who developed disseminated intra-abdominal recurrence from a previously resected gastrointestinal stromal tumour （GIST） of the small bowel, and the patient presented with hemoperitoneum. Emergent debulking surgery was performed. A high dose imatinib was prescribed. Despite the presence of residual disease, the patient was well clinically 8 months after the operation. Even though, there is no evidence to support the routine use of debulking surgery in the management of GIST. In our patient, disease progression after second line targeted therapy and the absence of alternative treatment options for spontaneous rupture and hemoperitoneum prompted us to treat the patient aggressively. Resection of the ruptured GIST was carried out for control of bleeding and to prevent recurrent bleeding in this patient with good surgical risks. During the treatment decision-making, the patient＇s general condition, the risk of surgery and the extent of dissemination were taken into consideration. In this patient who presented with spontaneous rupture of a small intestinal GIST, the novel use of targeted therapy and aggressive surgical treatment produced reasonably good survival outcome.

关键词： gastrointestinal stromal tumour hemoperitoneum small bowel GIST small bowel neoplasm imatinib

The dilemma of cytomegalovirus and hepatitis B virus interaction

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Gastroenterology Report 2022年第1期10卷 108-114页

作者： Muzammil M.Khan Mukarram J.Ali Hira Hanif Muhammad H.Maqsood Imama Ahmad Javier E.G.Alvarez Maria-Andreea Catana Daryl T.y.lau Department of Medicine Division of GastroenterologyLiver Research CenterBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Department of Medicine North Shore Medical CenterSalemMAUSA

Hepatitis B virus(HBV)remains a global public health problem despite the availability of effective vaccine and antiviral ***(CMV),another hepatotropic virus,is also very prevalent in the general population *** HBV and CMV can persist in the host and have potential to reactivate especially with weakened host cellular *** CMV infection can lead to severe HBV *** pathogenesis of the co-infection of HBV and CMV remains poorly *** reported conflicting results regarding the inhibitory effect of CMV on HBV *** is an unmet need on the management of co-infection of HBV and CMV;research initiatives dedicated to understanding their interactions are urgently needed.

关键词： CMV HBV HBV CMV co-infection CMV reactivation HBV reactivation IgG Avidity test

Stigmatic exudate in the Annonaceae:Pollinator reward,pollen germination medium or extragynoecial compitum?

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Journal of Integrative Plant Biology 2017年第12期59卷 881-894页

作者： Jenny y.y.lau Chun-Chiu Pang Lawrence Ramsden Richard M.K.Saunders School of Biological Sciences the University of Hong KongPokfulam RoadHong KongChina

Although ＂dry-type＂ stigmas are widely re- garded as ancestral in angiosperms, the early-divergent family Annonaceae has copious stigmatic exudate. We evaluate three putative functions for this exudate： as a nutritive reward for pollinators; as a pollen germination medium; and as an extragynoecial compitum that enables pollen tube growth between carpels. Stigmatic exudate is fructose dominated （72.2%）, but with high levels of glucose and sucrose; the dominance of hexose sugars and the diversity of amino acids observed, including many that are essential for insects, support a nutritive role for pollinators. Sugar concentration in pre-receptive flowers is high （28.2%）, falling during the peak period of stigmatic receptivity （17.4%）, and then rising again toward the end of the pistillate phase （32.9%）. Pollen germination was highest in sugar concentrations 〈2%. Sugar concentrations during the peak pistillate phase therefore provide optimal osmolarity for pollen hydration and germination; subsequent changes in sugar concentration during anthesis reinforce protogyny （in which carpels mature before stamens）, enabling the retention of concentrated exudate into the staminate phase as a pollinator food reward without the possibility of pollen germination. Intercarpellary growth of pollen tubes was confirmed： the exudate therefore also functions as a suprastylar extragynoecial compitum, overcoming the limitations of apocarpy.

关键词： Stigmatic exudate in the Annonaceae pollen germination medium or extragynoecial compitum Pollinator reward

Risk of ischaemic and haemorrhagic stroke in Chinese undergoing percutaneous coronary intervention treated with potent P2y12 inhibitor versus clopidogrel

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Stroke & Vascular Neurology 2022年第4期7卷 310-318,I0015-I0019页

作者： Andrew Kei-yan Ng Pauline yeung Ng April Ip Kui Kai lau Chung-Wah Siu Cardiac Medical Unit Grantham HospitalHong KongHong Kong Department of Adult Intensive Care Queen Mary HospitalHong KongHong Kong Department of Medicine The University of Hong KongHong KongHong Kong The State Key Laboratory of Brain and Cognitive Sciences The University of Hong KongHong KongHong Kong

Background Stroke after acute coronary syndrome(ACS)can be *** is uncertain whether the risks of ischaemic stroke or intracranial haemorrhage(ICH)are associated with different choices of P2y12 inhibitors(potent P2y12 inhibitors such as ticagrelor and prasugrel vs clopidogrel).Even though East Asians are known to have different thrombotic and haemorrhagic profiles from Caucasians,data on Chinese patients are *** This was a retrospective cohort study conducting in Chinese patients with ACS who underwent first-ever percutaneous coronary intervention from 14 hospitals in Hong Kong between 2010 and *** primary efficacy endpoint was ischaemic *** secondary efficacy endpoint was a composite outcome of thrombotic events including all-cause mortality,non-fatal myocardial infarction and ischaemic *** primary safety endpoint was *** secondary safety endpoint was a composite of major bleeding *** After adjustment of baseline characteristics by 1:1 propensity score matching,a total of 6220 patients(3110 on each group)were *** with clopidogrel,potent P2y12 inhibitors were associated with a lower risk of ischaemic stroke(HR 0.57;95%CI 0.37 to 0.87;p=0.008)and a lower risk of thrombotic events(HR 0.77;95%CI 0.66 to 0.90;p=0.001).Potent P2y12 inhibitor was associated with similar risk of ICH(HR 0.65;95%CI 0.34 to 1.25,p=0.20)and major bleeding(HR 0.83;95%CI 0.68 to 1.01,p=0.069).Conclusions Potent P2y12 inhibitors were associated with a lower adjusted risk of ischaemic stroke and thrombotic events,compared with *** risks of ICH and major bleeding were similar.

关键词： P2y12 coronary haemorrhagic