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Evaluation and management of the child with hypothyroidism

World Journal of Pediatrics 2019年第2期15卷 124-134页

作者： Alexander K.C.leung Alexander A.C.leung Department of Pediatrics The University of Calgaryand The Alberta Children's Hospital#200233-16th Avenue NWCalgaryAB T2M 0H5Canada Department of Medicine The University of CalgaryCalgaryABCanada

Background Thyroid hormones are critical for early neurocognitive development as well as growth and development throughout *** recognition and treatment of hypothyroidism is,therefore,of utmost importance to optimize physical and neurodevelopmental *** sources A PubMed search was completed in Clinical Queries using the key terms 'hypothyroidism'.Results Hypothyroidism may be present at birth (congenital hypothyroidism) or develop later in life (acquired hypothyroidism).Thyroid dysgenesis and dyshormonogenesis account for approximately 85% and 15% of permanent cases of congenital primary hypothyroidism,*** than 95% of infants with congenital hypothyroidism have few,if any,clinical manifestations of *** screening programs allow early detection of congenital *** developed countries,Hashimoto thyroiditis is the most common cause of goiter and acquired hypothyroidism in children and ***,iodine deficiency associated with goiter is the most common cause of *** hypothyroidism is uncommon and may be associated with other congenital syndromes and deficiencies of other pituitary *** of the clinical features would allow prompt diagnosis and institution of *** To optimize neurocognitive outcome in infants with congenital hypothyroidism,treatment with levothyroxine should be started as soon as possible,preferably within the first 2 weeks of *** with acquired hypothyroidism should also be treated early to ensure normal growth and development as well as cognitive *** target is to keep serum TSH < 5 mIU/L and to maintain serum free T4 or total T4 within the upper half of the age-specific reference range,with elimination of all symptoms and signs of hypothyroidism.

关键词： Dysgenesis Dyshormonogenesis Hashimoto thyroiditis Hypothyroidism Iodine deficiency Levothyroxine Mental retardation Stunted growth

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DYNAMIC RESOURCE ALLOCATION FOR EFFICIENT PATIENT SCHEDULING： A DATA-DRIVEN APPROACH

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Journal of Systems Science and Systems Engineering 2017年第4期26卷 448-462页

作者： Monique Bakker Kwok-leung Tsui Department of Systems Engineering and Engineering Management City University of Hong Kong China

Efficient staff rostering and patient scheduling to meet outpatient demand is a very complex and dynamic task. Due to fluctuations in demand and specialist availability, specialist allocation must be very flexible and non-myopic. Medical specialists are typically restricted in sub-specialization, serve several patient groups and are the key resource in a chain of patient visits to the clinic and operating room （OR）. To overcome a myopic view of once-off appointment scheduling, we address the patient flow through a chain of patient appointments when allocating key resources to different patient groups. We present a new, data-driven algorithmic approach to automatic allocation of specialists to roster activities and patient groups. By their very nature, simplified mathematical models cannot capture the complexity that is characteristic to the system being modeled. In our approach, the allocation of specialists to their day-to-day activities is flexible and responsive to past and present key resource availability, as well as to past resource allocation. Variability in roster activities is actively minimized, in order to enhance the supply chain flow. With discrete-event simulation of the application case using empirical data, we illustrate how our approach improves patient Service Level （SL, percentage of patients served on-time） as well as Wait Time （days）, without change in resource capacity.

关键词： Patient scheduling dynamic rostering patient care path discrete-event simulation

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An in-depth investigation into the relationships between structural metrics and unit testability in object-oriented systems

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Science china(Information Sciences) 2012年第12期55卷 2800-2815页

作者： leung Hareton Department of Computing Hong Kong Polytechnic University

There is a common belief that structural properties of classes are important factors to determine their unit ***,few empirical studies have been conducted to examine the actual impact of structural properties of *** this paper,we employ multiple linear regression(MLR) and partial least square regression(PLSR) to investigate the relationships between the metrics measuring structural properties and unit testability of a *** investigated structural metrics cover five property dimensions,including size,cohesion,coupling,inheritance,and *** results from open-source software systems show that:(1) most structural metrics are statistically related to unit testability in an expected direction,among which size,complexity,and coupling metrics are the most important predictors;that(2) multivariate regression models based on structural metrics cannot accurately predict unit testability of classes,although they are better able to rank unit testability of classes;that(3) the transition from MLR to PLSR could significantly improve the ability to rank unit testability of classes but cannot improve the ability to predict the unit testing effort of classes.

关键词： testability metrics object-oriented testing effort unit testing prediction

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Fifteen years' review of advanced childhood neuroblastoma from a single institution in Hong Kong

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chinese Medical Journal 1998年第5期111卷 83-86页

作者： Chan Keywordsong leung Division of Pediatric Surgery Department of Surgery University of Hong Kong Queen Mary Hospital Hong Kong China

Objective To assess the progress in the treatment of advanced childhood *** From 1981 to 1996, there were 32 children with neuroblastoma (NB) diagnosed, staged and treated in our institution. There were 4 patients with stage Ⅱ NB (12%), 5 stage Ⅲ (16%), 21 stage Ⅳ (66%) and 2 stage Ⅳs (6%). The NBs were excised if CT scan indicated that the tumors were operable. For advanced NB, stages Ⅲ and Ⅳ, multiple drug chemotherapy was started first and operability was assessed with serial CT scan examinations. Once the X-ray imaging indicated the tumors were operable, surgical interventions were done. The medical records of the advanced NB were *** In the initial period of the study, 9 patients were treated using the VAC protocol [vincristine (vcr), adriamycin(adria) and cyclophosphamide (cyc)]. No patient was convertible to operable and all died with a mean survival of 10 months. OPEC [vcr, cyc, VM26, cisplatin (cis)], Rapid COJEC (carboplatin, VP16, vcr, cis and cyc) and more recently N6 protocol (cyc, adria, vcr, VP16, cis) was used for 17 patients. 80% of them were converted to operable. In 4 patients, surgical specimens showed only necrotic tissue without viable tumor tissue and 6 (35%) tumors were converted to ganglioneuroma or ganglioneuroblastoma. Although 2 (12%) patients died of fungal septicemia and 1 (6%) developed Fanconi's syndrome after chemotherapy, the mean survival period increased to 27 months. In the 10 survivors (60%), 4 had megatherapy with melphalan followed by autologous peripheral blood stem cell (PBSC) transplantation and 2 were waiting for transplantation. Conclusions There is a high percentage of advanced NB on presentation in Hong Kong. With more potent multiple drug chemotherapy for advanced stage NB there are (1) improvement in the survival of these patients, (2) opportunities for more operations for tumor excision and (3) opportunities for autologous PBSC transplantation for better tumor eradication.

关键词： review of advanced childhood neuroblastoma from a single institution in Hong Kong Fifteen years

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Coordination and nursing care of pediatric patients undergoing double balloon enteroscopy

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World Journal of Gastroenterology 2011年第25期17卷 3049-3053页

作者： Ying-Kit leung Department of Gastroenterology Children's Hospital of Fudan University

AIM:To review safety,efficacy,and proper nursing care of double-balloon enteroscopy (DBE) in pediatric patients with small intestinal ***:Our study included 37 patients with abdominal pain,diarrhea,passage of blood in the stools,and other symptoms,who underwent DBE from December 2006 to July *** was retrograde in 36 procedures,antegrade in six,and from both ends in *** diagnostic significance and salient points in nursing care are discussed in this ***:At least one lesion was discovered in 28 out of 37 patients,which yielded a positive diagnosis in 75.7% of *** bowel preparation and skilled nursing care not only shortened the procedure time,but could also alleviate patient discomfort and enhance the quality of *** serious procedure-related complications were observed in any ***:DBE is a new modality of endoscopic procedure that improves the standard of diagnosis and treatment of small bowel diseases in *** nursing care is essential to the successful execution of the procedure.

关键词： children Double-balloon enteroscopy Nurs-ing care Small intestinal disease

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(-)Epicatechin induces and modulates endothelium-dependent relaxation in isolated rat mesenteric artery rings

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Acta Pharmacologica Sinica 2002年第12期23卷 135-139页

作者： CHAN Franky leung china chinese University of Hong Kong Department of Anatomy

AIM: The present study was aimed to examine the role of endothelial nitric oxide in the relaxant response to green tea (-)epicatechin and its modulation of endothelium-mediated relaxation in the isolated rat mesenteric artery rings. METHODS: Changes in the isometric tension were measured with Grass force-displacement transducers. RESULTS: The (-)epicatechin-induced relaxation was largely dependent on the presence of intact endothelium and was re-versed by NG-nitro-L-arginine methyl ester 10 μmol/L or methylene blue 10 μmol/L, the inhibitors of nitric oxide-mediated relaxation. L-Arginine at 1 mmol/L antagonized the effect of L-NAME or methylene blue. Pretreatment of endothelium-intact rings with (-)epicatechin 10 μmol/L enhanced the relaxation induced by endothelium-dependent vasodilator, acetylcholine, while this concentration did not influence the endothelium-independent relaxation in-duced by sodium nitroprusside in the endothelium-denuded artery rings. CONCLUSION: The results indicate that the en

关键词： (-)epicatechin vascular endothelium nitric oxide muscle relaxation mesenteric artery rats

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Long-term survival after intraluminal brachytherapy for inoperable hilar cholangiocarcinoma: A case report

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World Journal of Gastroenterology 2005年第20期11卷 3161-3164页

作者： Siu-Yin Chan Ronnie T. Poon Kelvin K. Ng chi-leung Liu Raymond T. Chan Sheung-Tat Fan Centre for the Study of Liver Disease and Department of Surgery The University of Hong Kong PokfulamHong Kong China Department of Clinical Oncology The University of Hong Kong Pokfulam Hong Kong China

Surgical resection with a tumor-free margin is the onlycurative treatment for hilar cholangiocarcinoma (Klatskin tumor). However, over half of the patients present late with unresectable tumors. Radiotherapy using external beamirradiation or intraluminal brachytherapy (ILBT) has been used to treat unresectable hilar cholangiocarcinoma with satisfactory outcome. We reported a patient with unresectable hilar cholangiocarcinoma surviving more than 6 years after combined external beam irradiation and ILBT.

关键词： Brachytherapy Hilar cholangiocarcinoma

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Should borderline personality disorder be included in the fourth edition of the chinese classification of mental disorders?

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chinese Medical Journal 2007年第1期120卷 77-82页

作者： ZHONG Jie leung Freedom Department of Psychology Peking University Beijing 100871China Department of Psychology The Chinese University of Hong KongHong Kong Special Administrative Region China

Borderline personality disorder （BPD） is a serious personality disorder characterized by a pervasive pattern of disturbances in mood regulation, impulse control, self-image and interpersonal relationships） In the United States, the prevalence of BPD has been estimated at 1%-2% of the general population, 10% of psychiatric outpatients, and 20% of inpatients. According to the 4th text revision of diagnostic and statistical manual of mental disorders （DSM-IV-TR）, about 75% of BPD patients are women. The BPD diagnosis has been associated with heightened risk （8.5% to 10.0% among BPD patients） for completed suicide, a rate almost 50 times higher than in the general population.

关键词： borderline personality disorder emotional unstable personality disorder impulsive personality disorder

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Study on the wind field and pollutant dispersion in street canyons using a stable numerical method

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Journal of Environmental Sciences 2005年第3期17卷 488-490页

作者： Dennis Y.C. leung Department of Mechanical Engineering the University of Hong Kong Hong Kong China

A stable finite element method for the time dependent Navier-Stokes equations was used for studying the wind flow and pollutant dispersion within street canyons. A three-step fractional method was used to solve the velocity field and the pressure field separately from the governing equations. The Streamline Upwind Petrov-Galerkin(SUPG) method was used to get stable numerical results. Numerical oscillation was minimized and satisfactory results can be obtained for flows at high Reynolds numbers. Simulating the flow over a square cylinder within a wide range of Reynolds numbers validates the wind field model. The Strouhal numbers obtained from the numerical simulation had a good agreement with those obtained from experiment. The wind field model developed in the present study is applied to simulate more complex flow phenomena in street canyons with two different building configurations. The results indicated that the flow at rooftop of buildings might not be assumed parallel to the ground as some numerical modelers did. A counter-clockwise rotating vortex may be found in street canyons with an inflow from the left to right. In addition, increasing building height can increase velocity fluctuations in the street canyon under certain circumstances, which facilitate pollutant dispersion. At high Reynolds numbers, the flow regimes in street canyons do not change with inflow velocity.

关键词： finite element method Streamline Upwind Petrov-Galerkin method three-step fractional method

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A new method to encode calling contexts with recursions

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Science china(Information Sciences) 2016年第5期59卷 64-78页

作者： Lulu WANG Bixin LI Hareton leung School of Computer Science and Engineering Southeast University Department of Computing Hong Kong Polytechnic University

Calling context encoding(CCE) uses some integers to represent the current context of any execution point, and is valuable in a wide range of applications. Existing studies already ensure accurate results of CCE,but they use stack to store the encoding when recursive calls happen. This may cost much for cyclic call graphs with deep recursive calls. This paper presents a novel approach(called RCCE) to address this problem. With a modified strategy for encoding, it requires less frequent access of the stack and gives more succinct representation of contexts on deep recursion. Experimental results show that compared to Precise Calling Context Encoding,RCCE is more practical and efficient on calling contexts with recursions.

关键词： calling context encoding recursive calls dynamic analysis profiling call graph

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