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World Journal of Pediatric Surgery 2023年第2期6卷 115-117页

作者： Adrian chi Heng Fung kenneth Kak Yuen wong Department of Surgery The University of Hong KongHong KongChina

Parents play a key role in medical decision-making for their children,who are limited by their intellectual development in under-standing their own health status and treat-ment plans.1 These decisions are challenging as they may have a lifelong impact on patients'physical and mental well-being,and a signif-icant portion of parents are not satisfied with the informed consent *** factors affecting parental satisfaction with the informed consent process have been identi-fied,including parents'knowledge base,the specific types of decisions and the presence of decisional conflicts.

关键词： children their parents

Survival outcomes of liver transplantation for hepatocellular carcinoma in patients with normal, high and very high preoperative alpha-fetoprotein levels

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World Journal of Hepatology 2018年第2期10卷 308-318页

作者： wong Hoi She Albert chi Yan Chan Tan To Cheung Chung Mau Lo kenneth Siu Ho Chok Department of Surgery University of Hong Kong Department of Surgery and State Key Laboratory for Liver Research University of Hong Kong

AIM To investigate the impact of alpha-fetoprotein(AFP) on long-term recurrence rate and overall survival and we also aimed to define the level of AFP leading to a higher risk of disease recurrence and affecting patient *** Data of adult patients who received liver transplant(LT) for hepatocellular carcinoma(HCC) at our hospital from January 2000 to December 2013 were reviewed. Reviewed data included demographic characteristics, preoperative AFP level, operative details, follow-up details, and survival outcomes. Patients were mostly listed for LT based on Milan or UCSF criteria. For the purpose of this study, normal AFP level was defined as AFP value < 10 ng/m L, high AFP level was defined as AFP value ≥ 10 to < 400 ng/m L, and very highAFP level was defined as AFP ≥ 400 ng/m L. The patients were divided into these 3 groups accordingly. Survival rates were plotted as Kaplan-Meier curves and compared by log-rank analysis. Continuous variables were expressed as median(interquartile range). Categorical variables were compared by Spearman's test. Discriminative analysis was used to define the lowest value of AFP that could affect the overall survival in study population. Statistical significance was defined by a P value of < *** Totally 250 adult patients underwent LT for HCC in the study period. Eight-four of them received deceaseddonor LT and 166 had living-donor LT. The patients were divided into 3 groups: Group A, AFP < 10 ng/m L(n = 83); Group B, AFP ≥ 10 to < 400 ng/m L(n = 131); Group C, AFP ≥ 400 ng/m L(n = 36). The commonest etiology was hepatitis-B-related cirrhosis. The Model for End-stage Liver Disease scores in these groups were similar(median, 13 vs 13 vs 12; P = 0.745). The time to operation in Group A was longer(median, 94 vs 31 vs 35 d; P = 0.001). The groups were similar in hospital mortality(P = 0.626) and postoperative complication(P = 0.702). Pathology of explants showed that the 3 groups had similar numbers of tumor nodules, b

关键词： Alpha-fetoprotein Liver transplantation Recurrence Survival

Impact of small-for-size liver grafts on medium-term and long-term graft survival in living donor liver transplantation: A meta-analysis

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World Journal of Gastroenterology 2019年第36期25卷 5559-5568页

作者： Ka Wing Ma Kelly Hiu ching wong Albert chi Yan Chan Tan To Cheung Wing chiu Dai James Yan Yue Fung wong Hoi She Chung Mau Lo kenneth Siu Ho Chok Department of Surgery Queen Mary Hospital Hong Kong China Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong China Department of Surgery The University of Hong Kong Hong Kong China Department of Medicine Queen Mary Hospital Hong Kong China

BACKGROUND Small-for-size grafts (SFSGs) in living donor liver transplantation (LDLT) could optimize donor postoperative outcomes and also expand the potential donor pool. Evidence on whether SFSGs would affect medium-term and long-term recipient graft survival is lacking. AIM To evaluate the impact of small-for-size liver grafts on medium-term and longterm graft survival in adult to adult LDLT. METHODS A systematic review and meta-analysis were performed by searching eligible studies published before January 24, 2019 on PubMed, EMBASE, and Web of Science databases. The primary outcomes were 3-year and 5-year graft survival. Incidence of small-for-size syndrome and short term mortality were also extracted. RESULTS This meta-analysis is reported according to the guidelines of the PRISMA 2009 Statement. Seven retrospective observational studies with a total of 1821 LDLT recipients were included in the meta-analysis. SFSG is associated with significantly poorer medium-term graft survival. The pooled odds ratio for 3-year graft survival was 1.58 [95% confidence interval 1.10-2.29, P = 0.014]. On the other hand, pooled results of the studies showed that SFSG had no significant discriminatory effect on 5-year graft survival with an odds ratio of 1.31 (95% confidence interval 0.87-1.97, P = 0.199). Furthermore, incidence of small-for-size syndrome detected in recipients of SFSG ranged from 0-11.4% in the included studies. CONCLUSION SFSG is associated with inferior medium-term but not long-term graft survival. Comparable long-term graft survival based on liver graft size shows that smaller grafts could be accepted for LDLT with appropriate flow modulatory measures. Close follow-up for graft function is warranted within 3 years after liver transplantation.

关键词： Living donor liver transplantation Small-for-size grafts Small-for-size syndrome Graft survival

Validated model for prediction of recurrent hepatocellular carcinoma after liver transplantation in Asian population

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World Journal of Gastrointestinal Oncology 2019年第4期11卷 322-334页

作者： Ka Wing Ma wong Hoi She Albert chi Yan Chan Tan To Cheung James Yan Yue Fung Wing chiu Dai Chung Mau Lo kenneth Siu Ho Chok Department of Surgery the University of Hong Kong Department of Surgery and State Key Laboratory for Liver Research the University of Hong Kong Department of Medicine and State Key Laboratory for Liver Research The University of Hong Kong

BACKGROUND Liver transplantation(LT) is regarded as the best treatment for both primary and recurrent hepatocellular carcinoma(HCC). Post-transplant HCC recurrence rate is relatively low but significant, ranging from 10%-30% according to different series. When recurrence happens, it is usually extrahepatic and associated with poor prognosis. A predictive model that allows patient stratification according to recurrence risk can help to individualize post-transplant surveillance protocol and guidance of the use of anti-tumor immunosuppressive *** To develop a scoring system to predict HCC recurrence after LT in an Asian *** Consecutive patients having LT for HCC from 1995 to 2016 at our hospital were recruited. They were randomized into the training set and the validation set in a60:40 ratio. Multivariable Cox regression model was used to identity factors associated with HCC recurrence. A risk score was assigned to each factor according to the odds ratio. Accuracy of the score was assessed by the area under the receiver operating characteristic *** In total, 330 patients were eligible for analysis(183 in training and 147 invalidation). Recurrent HCC developed in 14.2% of them. The median follow-up duration was 65.6 mo. The 5-year disease-free and overall survival rates were78% and 80%, respectively. On multivariate analysis, alpha-fetoprotein > 400 ng/mL [P = 0.012, hazard ratio(HR) 2.92], sum of maximum tumor size and number(P = 0.013, HR 1.15), and salvage LT(P = 0.033, HR 2.08) were found to be independent factors for disease-free survival. A risk score was calculated for each patient with good discriminatory power(c-stat 0.748 and 0.85, respectively,in the training and validation sets). With the derived scores, patients were classified into low-(0–9), moderate-(> 9–14), and high-risk groups(> 14), and the risk of HCC recurrence in the training and validation sets was 10%, 20%, 54%(cstat 0.67) and 4%, 22%, 62%(c-stat 0.811), accordin

关键词： Hepatocellular carcinoma Liver transplantation Post-transplant recurrence Predictive model

Epidemiological Characteristics of Influenza A and B in Macau,2010–2018

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Virologica Sinica 2021年第5期36卷 1144-1153页

作者： Hoi Man Ng Teng Zhang Guoliang Wang Si Meng kan Guoyi Ma Zhe Li Chang Chen Dandan Wang Meng In wong chio Hang wong Jinliang Ni Xiaohua Douglas Zhang Clinical Laboratory Kiang Wu Hospital Faculty of Health Sciences University of Macau

Influenza is one of the major respiratory diseases in humans. Macau is a tourist city with high density of population and special population mobility. The study on the epidemiological characteristics of influenza in Macau should bring great value for preventing influenza in tourist cities like Macau in the world. In this study, we collected a total of 104,874 samples with influenza-like illness(ILI) in Macau from 2010 to 2018. chi-square test and binary multivariable logistic regression were used to investigate the epidemiological characteristics of influenza A and B in Macau. Among these ILI samples, the overall positive rate is 17.17% for influenza A and 6.97% for influenza B. The epidemics of influenza in three years(i.e., 2012, 2017 and 2018) differ from the remaining years(i.e., normal years). In a normal year, influenza A occurs year-round whereas influenza B is seasonal. Our research shows significant differences in influenza infections between different age groups in normal years. Interestingly, our analysis shows no significant difference between locals and tourists in influenza A and B infection in a normal year, whereas the odds of influenza A in tourists were significantly higher than those in locals in July 2017 and the odds of influenza B in tourists were significantly higher than those in locals in January–February 2012 and January–February 2018. This is possibly attributed by the policy of free vaccination to everyone in Macau. These findings should be valuable for preventing influenza in not only Macau but also the world.

关键词： Influenza Epidemiology chi-square test Logistic regression Macau

Liver transplantation:would it be the best and last chance of cure for hepatocellular carcinoma with major venous invasion?

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Hepatobiliary Surgery and Nutrition 2021年第3期10卷 308-314页

作者： Ka Wing Ma Albert chi Yan Chan kenneth Siu Ho Chok wong Hoi She Tan To Cheung Wing chiu Dai James Yan Yue Fung Chung Mau Lo Department of Surgery The University of Hong KongHong KongChina Department of Medicine The University of Hong KongHong KongChina

Background:Hepatocellular carcinoma(HCC)with portal vein tumour thrombus(PVTT)signifies advanced disease,whether LT confers any survival superiority over resection remains ***:A propensity score matched(PSM)analysis of liver transplantation(LT)and liver resection(LR)for HCC with PVTT was ***:A consecutive series of 88 patients who received either LT(10 DDLTs and 3 LDLTs)or LR(n=75)respectively were *** PSM,the LT group has a higher MELD score(17.3 vs.7.8,Pching for serum AFP levels and tumour size,1-,3-and 5-year overall survival for LT were 81 ng/mL,3.9 cm,80%,70%and 70%and the corresponding rates for LR were 1,417 ng/mL,5.3 cm,51.8%,19,6%and 9.8%(P value=0.12,0.27 and 0.009 respectively).Conclusions:LT is associated with significantly better oncological outcomes in HCC patients with PVTT involving the lobar or segmental level.A modest expansion of selection criteria to include small HCC with segmental PVTT should be considered.

关键词： Liver transplantation(LT) portal vein tumour thrombus liver resection(LR)Submitted Aug 10,2019.Accepted for publication Oct 15,2019.

Factors Affecting Mesenchymal Stromal Cells Yield from Bone Marrow Aspiration

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chinese Journal of Cancer Research 2011年第1期23卷 43-48页

作者： Jing Li Wilfred Hing-Sang wong Shing Chan James Chor-San chim kenneth Man-Chee Cheung Tsz-Leung Lee Wing-Yan Au Shau-Yin Ha Albert Kwok-Wei Lie Yu-Lung Lau Raymond Hin-Suen Liang Godfrey chi-Fung Chan china Oxford Centre for International Health Research Cardiovascular Institute ＆ Fuwai HospitalChinese Academy of Medical Sciences ＆ Peking Union Medical CollegeBeijing 100037China Department of Paediatrics and Adolescent Medicine Department of Medicine Department of Orthopaedics ＆Traumatology the University of Hong KongHKSARChina

Objective：This study was to investigate the variables in bone marrow harvesting procedure and individual donor factors which can potentially affect the yield of mesenchymal stromal cells（MSC）.Methods：We determined the yield of MSC from bone marrow under different clinical conditions by comparing the MSC colony numbers from：（1） donors of different ages;（2） healthy donors and patients with leukemia;（3） bone marrow aspirated at different time points during marrow harvesting;（4） bone marrow harvested by different ***：During the process of harvesting,the number of MSC significantly decreased with increase number of aspiration,from 675/ml at the initial decreased to 60/ml after 100 ml bone marrow aspirated,and 50/ml after 200 ml bone marrow *** number of MSC retrieved from leukemia patients（99/ml bone marrow） was significantly lower than that of healthy donors（708/ml bone marrow）.However,there was no significant difference in growth *** was no significant age-related difference of MSC yielded from donors 55 *** there was no significant difference in MSC number between the samples from single end-holed needle and those from multiple-side-hole ***：The optimal bone marrow samples for MSC collection should be obtained earlier in the process of harvesting *** marrow from donors 55 years was equally good as MSC *** autologous MSC from leukemia patients can be utilized for in-vitro MSC expansion.

关键词： Mesenchymal stromal cell CFU-F Bone marrow aspiration Leukemia

The Hong Kong consensus recommendations on the diagnosis and management of pancreatic cystic lesions

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Hepatobiliary Surgery and Nutrition 2023年第5期12卷 715-735,I0019-I0020页

作者： Tan-To Cheung Yuk Tong Lee Raymond Shing-Yan Tang wong Hoi She Kai chi Cheng chin Cheung Cheung Keith Wan Hang chiu kenneth Siu Ho Chok Wing Sun Chow Tak Wing Lai Wai-Kay Seto Thomas Yau Department of Surgery Queen Mary HospitalThe University of Hong KongHong KongChina Gastroenterologist in private practice Hong KongChina Department of Medicine and Therapeutics The Chinese University of Hong KongHong KongChina Department of Surgery Kwong Wah HospitalHong KongChina Department of Surgery Tuen Mun HospitalHong KongChina Department of Radiology&Imaging Queen Elizabeth HospitalHong KongChina Department of Medicine The University of Hong KongHong KongChina Department of Surgery Princess Margaret HospitalHong KongChina Department of Medicine School of Clinical MedicineThe University of Hong KongHong KongChina State Key Laboratory of Liver Research The University of Hong KongHong KongChina

Background:The finding of pancreatic cystic lesions(PCL)on incidental imaging is becoming increasingly *** studies report a prevalence of 2.2-44.7%depending on the population,imaging modality and indication for imaging,and the prevalence increases with *** with PCL are at risk of developing pancreatic cancer,a disease with a poor *** publication summarizes recommendations for the diagnosis and management of PCL and post-operative pancreatic exocrine insufficiency(PEI)from a group of local ***:Clinical evidence was consolidated from narrative reviews and consensus statements formulated during two online meetings in March *** expert panel included gastroenterologists,hepatobiliary surgeons,oncologists,radiologists,and ***:Patients with PCL require careful investigation and follow-up due to the risk of malignant transformation of these *** should undergo clinical investigation and pancreas-specific imaging to classify lesions and understand the risk profile of the *** indicated,patients should undergo pancreatectomy to excise *** pancreatectomy,patients are at risk of PEI,leading to gastrointestinal dysfunction and ***,such patients should be monitored for symptoms of PEI,and promptly treated with pancreatic enzyme replacement therapy(PERT).Patients with poor response to PERT may require increases in dose,addition of a proton pump inhibitor,and/or further investigation,including tests for pancreatic *** are also at risk of new-onset diabetes mellitus after pancreatectomy;they should be screened and treated with insulin if ***:These statements are an accurate summary of our approach to the diagnosis and management of patients with PCL and will be of assistance to clinicians treating these patients in a similar clinical landscape.

关键词： Pancreatic cystic lesions pancreatic endocrine insufficiency pancreatic enzyme replacement therapy

Antioxidant and hepatoprotective activities of the ultrasonic-circulating extract powder from Ganoderma lucidum

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Antioxidant and hepatoprotective activities of the ultrasoni...