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Endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal polyps:A meta-analysis and metaregression with single arm analysis

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World Journal of Gastroenterology 2021年第25期27卷 3925-3939页

作者： Xiong Chang Lim Kameswara Rishi Yeshayahu Nistala cheng han ng Snow Yunni Lin Darren Jun Hao Tan Khek-Yu Ho Choon-Seng Chong Mark Muthiah Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore Department of Medicine National University HospitalSingapore 119074Singapore Department of Surgery National University HospitalSingapore 119074Singapore

BACKGROUND Endoscopic submucosal dissection(ESD)has shown to be effective in management of colorectal neoplasm in the Asian countries,while its implementation in Western countries where endoscopic mucosal resection(EMR)is preferred is still *** To compare the surgical,histological,and oncological outcomes between ESD and EMR in the treatment of colorectal polyps,with subgroup analysis comparing the efficacy of ESD and EMR between Japan and the rest of the *** Embase and Medline databases were searched from inception to October 2020 in accordance with PRISMA guidelines for studies comparing en bloc,complete resection,margin involvement,resection time,need for additional surgery,complications,and recurrence rate of ESD with *** Of 281344 colorectal polyps from 21 studies were *** compared to EMR,the pooled analysis revealed ESD was associated with higher en bloc and complete resection rate,and lower lateral margin involvement and *** led to increased procedural time,need for additional surgery,and perforation *** significant difference in bleeding risk was found between the two ***-regression analysis suggested only right colonic polyps correlated with an increased perforation risk in *** including polyp size and invasion depth did not significantly influence the en bloc and complete resection rate,bleeding risk and *** subgroup analysis,Japan performed better than the rest of the world in both ESD and EMR with perforation risk of 4%and 0.0002%,respectively,as compared to perforation risk of 8%and 1%,respectively,in reports coming from rest of the *** ESD resulted in better resection outcomes and lower recurrence compared to *** appropriate training,ESD is preferred over EMR as the first-line therapy for resection of colorectal polyps,without restricting to lesions greater than 20 mm and those with high suspicion of submucosal invasion.

关键词： Endoscopic mucosal resection Endoscopy Colonic polyps Colorectal neoplasm Colonoscopy

Different position from traditional left lateral for colonoscopy? A meta-analysis and systematic review of randomized control trials

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Chronic Diseases and Translational Medicine 2021年第1期7卷 27-34页

作者： Snow Yunni Lin Clyve Yu Leon Yaow cheng han ng Neng Wei Wong Hui Yu Tham Choon Seng Chong Division of Colorectal Surgery Department of SurgeryNational University HospitalSingapore 119228Singapore

Background: Colonoscopy requires the intubation of the cecum for screening of colorectal diseases. The conventional position used for colonoscopy is the left lateral position (LLP). However, alternative positions have also been utilized to enhance the success of intubation. Thus, the aim of this study was to perform a meta-analysis of the different positions to determine the effectiveness of the individual positions for successful ***: Medline, Embase and Cochrane trials electronic databases were searched for studies on colonoscopy positions. The primary outcome was defined as the cecal intubation rate. Pooled risk ratios (RR) and 95% confidence intervals (CI) for the rates of cecal intubation were estimated. Secondary outcomes such as the cecal intubation time and adenoma detection rate were further analyzed ***: After reviewing 644 identified records, 7 randomized control trials (RCT) studies were included. No significant difference was observed in either comparisons, between the LLP vs. supine position (SP) (RR = 1.01, 95% CI, 0.98 to 1.04,P = 0.55) or the LLP vs. prone position (PP) (RR = 1.02, 95% CI, 0.98 to 1.06,P = 0.27).Conclusions: Amidst available literature, the use of other positions can be considered when performing colonoscopy. These further highlights that the existential practice is based predominantly on familiarity instead of evidence-based-research.

关键词： Colonoscopy Endoscopy Meta analysis Patient positioning

A Class Effect Network Meta-analysis of Lipid Modulation in Non-alcoholic Steatohepatitis for Dyslipidemia

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Journal of Clinical and Translational Hepatology 2022年第6期10卷 1042-1049页

作者： Jieling Xiao cheng-han ng Yip-han Chin Darren Jun Hao Tan Wen-Hui Lim Grace Lim Jingxuan Quek Ansel Shao Pin Tang Kai-En Chan Rou-Yi Soong Nicholas Chew Benjamin Tay Daniel Q.Huang Nobuharu Tamaki Roger Foo Mark Y.Chan Mazen Noureddin Mohammad Shadab Siddiqui Arun J.Sanyaland Mark D.Muthiah Yong Loo Lin School of Medicine National University of SingaporeSingapore Lee Kong Chian School of Medicine Nan-yang Technological UniversitySingapore Department of Cardiology National University Heart CenterNational University HospitalSingapore Division of Gastroenterology and Hepatology Department of MedicineNational University HospitalSingaporeSingapore National University Center for Organ Transplantation National University Health SystemSingapore NAFLD Research Center Division of Gastroenterology and HepatologyDepartment of MedicineUniversity of California at San DiegoLa JollaCAUSA Department of Gastroenterology and Hepatology Musashino Red Cross HospitalTokyoJapan Cedars-Sinai Fatty Liver Program Division of Digestive and Liver DiseasesDepartment of MedicineComprehen-sive Transplant CenterCedars-Sinai Medical CenterLos AngelesCAUSA Division of Gastroenterology Hepatology and NutritionDepartment of Internal MedicineVirginia Commonwealth UniversityRichmondVAUSA

Background and Aims:Pharmaceutical therapy for NASH is associated with lipid modulation,but the consensus on drug treatment is limited and lacks comparative analysis of effectiveness.A network meta-analysis was conducted to compare NASH drug classes in lipid ***:Online databases were searched for randomized controlled trails(RCTs)evaluating NASH treatments in biopsy-proven NASH *** were classified into four groups:(1)inflammation,(2)energy,(3)bile acids,and(4)fibro-sis based on the mechanism of action.A Bayesian network analysis was conducted with outcome measured by mean difference(MD)with credible intervals(Crl)and surface un-der the cumulative ranking curve(SUCRA).Results:Forty-four RCTs were included in the *** acid modulat-ing treatments(MD:0.05,Crl:0.03-0.07)were the best treatment for improvement in high-density lipid(HDL)cho-lesterol,followed by treatments modulating energy(MD:0.03,Crl:0.02-0.04)and fibrosis(MD:0.01,Crl:−0.12 to 0.14)compared with *** top three treatments for reduction in triglycerides were treatments modulating energy(MD:−0.46,Crl:−0.49 to−0.43),bile acids(MD:−0.22,Crl:−0.35 to−0.09),and inflammation(MD:−0.08,Crl:−0.13 to−0.03)compared with *** found treatment modulating fibrosis(MD:−1.27,Crl:−1.76 to−0.79)was the best treatment for reduction in low-density lipid(LDL)cholesterol followed by treatment modulating in-flammation(MD:−1.03,Crl:−1.09 to−0.97)and energy(MD:−0.37,Crl:−0.39 to−0.34)compared with placebo,but LDL cholesterol was worsened by treatments modulat-ing bile ***:Network analysis comparing the class effects of dyslipidemia modulation in NASH found that treatment targets can include optimization of athero-genic *** studies are required to evaluate the cardiovascular outcomes.

关键词： Lipid modulation NASH Dyslipidemia

Foregut bypass *** bariatric procedures for nonalcoholic fatty liver disease:a meta-analysis of 3,355 individuals

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Hepatobiliary Surgery and Nutrition 2023年第5期12卷 658-670,I0001-I0003页

作者： Wen Hui Lim Snow Yunni Lin cheng han ng Darren Jun Hao Tan Jieling Xiao Jie Ning Yong Phoebe Wen Lin Tay Nicholas Syn Yip han Chin Kai En Chan Chin Meng Khoo Nicholas Chew Roger S.Y.Foo Asim Shabbir Eunice X.Tan Daniel Q.Huang Mazen Noureddin Arun J.Sanyal Mohammad Shadab Siddiqui Mark D.Muthiah Yong Loo Lin School of Medicine National University of SingaporeSingaporeSingapore Division of Endocrinology Department of MedicineNational University HospitalSingaporeSingapore Department of Cardiology National University Heart CentreNational University HospitalSingaporeSingapore Division of General Surgery(Upper Gastrointestinal Surgery) Department of SurgeryNational University HospitalSingaporeSingapore Division of Gastroenterology and Hepatology Department of MedicineNational University HospitalSingaporeSingapore National University Centre for Organ Transplantation National University Health SystemSingaporeSingapore Cedars-Sinai Fatty Liver Program Division of Digestive and Liver DiseasesDepartment of MedicineComprehensive Transplant CenterCedars-Sinai Medical CentreLos AngelesCAUSA Division of Gastroenterology Hepatology and NutritionDepartment of Internal MedicineVirginia Commonwealth UniversityRichmondVAUSA

Background:Bariatric surgery represents an important treatment option for severely obese patients with nonalcoholic fatty liver disease(NAFLD).However,there remains inadequate data regarding the effects of different bariatric procedures on various NAFLD parameters,especially for histological ***,this meta-analysis aimed to compare the effects of restrictive bariatric procedures and foregut bypass on the metabolic,biochemical,and histological parameters for patients with ***:Medline and Embase were searched for articles relating to bariatric procedures and *** meta-analysis was conducted to compare efficacy of bariatric procedures ***-procedure with subgroup analysis to further compare restrictive against foregut bypass ***:Thirty-one articles involving 3,355 patients who underwent restrictive bariatric procedures(n=1,460)and foregut bypass(n=1,895)were *** foregut bypass(Phan restrictive procedures(P=0.01)while restrictive procedures resulted in significantly lower alanine transaminase than foregut bypass(P=0.02).Conclusions:The significant histological and metabolic advantages and comparable improvements in biochemical outcomes support the choice of foregut bypass over restrictive bariatric procedures in NAFLD management.

关键词： Bariatric surgery non-alcoholic fatty liver disease(NAFLD) obesity fibrosis endoscopy

Liver resection versus liver transplantation for hepatocellular carcinoma within Milan criteria:a meta-analysis of 18,421 patients

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Hepatobiliary Surgery and Nutrition 2022年第1期11卷 78-93,I0009-I0013页

作者： Jin Hean Koh Darren Jun Hao Tan Yuki Ong Wen Hui Lim cheng han ng Phoebe Wen Lin Tay Jie Ning Yong Mark D.Muthiah Eunice X.Tan Ning Qi Pang Beom Kyung Kim Nicholas Syn Alfred Kow Brian K.P.Goh Daniel Q.Huang Yong Loo Lin School of Medicine National University of SingaporeSingaporeSingapore Division of Gastroenterology and Hepatology Department of MedicineNational University HospitalSingaporeSingapore National University Centre for Organ Transplantation National University Health SystemSingaporeSingapore Division of Hepatobiliary&Pancreatic Surgery Department of SurgeryNational University HospitalSingaporeSingapore Department of Internal Medicine Yonsei University College of MedicineSeoulRepublic of Korea Yonsei Liver Center Severance HospitalYonsei University Health SystemSeoulRepublic of Korea Biostatistics and Modelling Domain Saw Swee Hock School of Public HealthNational University of Singapore and National University Health SystemSingaporeSingapore Department of Hepato-Pancreato-Biliary and Transplant Surgery Division of SurgerySingapore General HospitalSingaporeSingapore Liver Transplant Service SingHealth Duke-NUS Transplant CentreSingaporeSingapore

Background:Outcomes after liver resection(LR)and liver transplantation(LT)for hepatocellular carcinoma(HCC)are heterogenous and may vary by region,over time periods and disease *** aimed to compare overall survival(OS)and disease-free survival(DFS)between LT versus LR for HCC within the Milan ***:Two authors independently searched Medline and Embase databases for studies comparing survival after LT and LR for patients with HCC meeting the Milan ***-analyses and meta-regression were conducted using random-effects ***:We screened 2,278 studies and included 35 studies with 18,421 *** was associated with poorer OS[hazard ratio(HR)=1.44;95%confidence interval(CI):1.14-1.81;Pngs among intention-to-treat(ITT)*** uninodular disease,OS in LR was comparable to LT(P=0.13)but DFS remained poorer(HR=2.95;95%CI:2.30-3.79;Phanced surveillance had comparable OS after LT and LR(P=0.33),but cohorts undergoing usual surveillance had worse OS after LR(HR=1.95;95%CI:1.24-3.07;P<0.01).Conclusions:Mortality after LR for HCC is nearly 50%higher compared to *** between LR and LT were similar in uninodular *** risk of recurrence after LR is threefold that of LT.

关键词： Hepatocellular carcinoma(HCC) liver resection(LR) liver transplant survival recurrence

Rotating electroosmotic flow of an Eyring fluid

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Acta Mechanica Sinica 2017年第2期33卷 295-315页

作者： cheng Qi Chiu-On ng Department of Mechanical Engineering The University of Hong Kong Hong Kong China

A perturbation analysis is presented in this paper for the electroosmotic (EO) flow of an Eyring fluid through a wide rectangular microchannel that rotates about an axis perpendicular to its own. Mildly shear-thinning rheology is assumed such that at the leading order the problem reduces to that of Newtonian EO flow in a rotating channel, while the shear thinning effect shows up in a higher-order problem. Using the relaxation time as the small ordering parameter, analytical solutions are deduced for the leading- as well as first-order problems in terms of the dimensionless Debye and rotation parameters. The velocity profiles of the Ekman-electric double layer (EDL) layer, which is the boundary layer that arises when the Ekman layer and the EDL are comparably thin, are also deduced for an Eyring fluid. It is shown that the present perturbation model can yield results that are close to the exact solutions even when the ordering parameter is as large as order unity. By this order of the relaxation time parameter, the enhancing effect on the rotating EO flow due to shear-thinning Eyring rheology can be significant.

关键词： Electroosmotic flow Eyring fluid Rotating channel

Reproductive medicine gets a new tool

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Journal of Molecular Cell Biology 2011年第6期3卷 320-321页

作者： Wei-Xia Ang cheng-Xu Delon Toh Huck-Hui ng Yuin-han Loh Epigenetics and Cell Fates Laboratory A*STAR Institute of Medical BiologySingapore 138648Singapore NUS Graduate School for Integrative Sciences and Engineering Singapore 117597Singapore Department of Biological Sciences National University of SingaporeSingapore 117543Singapore Gene Regulation Laboratory Genome Institute of SingaporeSingapore 138672Singapore Department of Biochemistry National University of SingaporeSingapore 117597Singapore School of Biological Sciences Nanyang Technological UniversitySingapore 639798Singapore

Infertility is a problem faced by millions *** a recent paper published in Cell,Hayashi et al.(2011)provided a potential solution for male infertility through the generation of functional spermatozoa that can give ris... 详细信息

关键词： infertility offspring

Dual Phase Renewable Fuel Combustion in an Atmospheric Gas Turbine Burner

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Journal of Thermal Science 2023年第3期32卷 1278-1291页

作者： AGWU Ogbonnaya RUNYON Jon GOKTEPE Burak CHOng TUng cheng ng Jo-han GILES Anthony VALERA-MEDINA Agustin School of Engineering Cardiff UniversityWales CF243AAUK China-UK Low Carbon College Shanghai Jiao Tong UniversityLin'gang 201306China Faculty of Engineering and Physical Sciences University of Southampton MalaysiaIskandar Puteri 79100Malaysia

Expanding the fuel flexibility of continuous combustion systems to include multiphase fuel combustion offers additional support to combat the problem of energy security and,potentially,environmental *** this study,apart from establishing stability limits and measuring post-combustion emissions,flames generated from simultaneous combustion of biodiesel and syngas were examined using C_(2)*and CH*chemiluminescence imaging to capture changes in the reaction *** proportion of syngas in the fuel mix was varied from 0 to 30%content(by energy contribution)while maintaining a total power output of 15 *** overall equivalence ratio was held at 0.7 in cases other than for determining the flammability *** results indicate a reduction of stability limits as gas proportion in fuel blend ***,chemiluminescence imaging of the two targeted species suggest a general reduction in reaction rate as well as reaction zone area and length with increase in gas ratio in the dual phase ***,emissions performance in the context of NOxand CO was investigated as liquid-to-gas ratios were ***,the study demonstrates the feasibility,limitations and potential benefits of multiphase renewable fuel combustion in a swirl-stabilised burner.

关键词： dual fuel gas turbine multiphase combustion

Highly sensitive detection of mercury（Ⅱ） ions with few-layer molybdenum disulfide

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Nano Research 2015年第1期8卷 257-262页

作者： Shan Jiang Rui cheng Rita ng Yu Huang Xiangfeng Duan Department of Chemistry and Biochemistry University of California Los Angeles California 90095 USA Department of Materials Science and Engineering University of California Los Angeles California 90095 USA California Nanosystems Institute University of California Los Angeles California 90095 USA

Two-dimensional （2D） layered transition metal dichalcogenide （TMD） materials （e.g., MoS2） have attracted considerable interest due to their atomically thin geometry and semiconducting electronic properties. With ultrahigh surface to volume ratio, the electronic properties of these atomically thin semiconductors can be readily modulated by their environment. Here we report an investigation of the effects of mercury（II）（Hg^2＋） ions on the electrical transport properties of few-layer molybdenum disulfide （MoS2）. The interaction between Hg^2＋ ions and few-layer MoS2 was studied by field-effect transistor measurements and photoluminescence. Due to a high binding affinity between Hg2. ions and the sulfur sites on the surface of MoS2 layers, Hg^2＋ ions can strongly bind to MoS2. We show that the binding of Hg^2＋ can produce a p-type doping effect to reduce the electron concentration in n-type few-layer MoS2. It can thus effectively modulate the electron transport and photoluminescence properties in few-layer MoS2. By monitoring the conductance change of few-layer MoS2 in varying concentration Hg2~ solutions, we further show that few-layer MoS2 transistors can function as highly sensitive sensors for rapid electrical detection of Hg^2＋ ion with a detection limit of 30 pM.

关键词： molybdenum disulfide 2D layered materials mercury doping effect sensors