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Creating favorable conditions for increased quantity of high-quality clinical studies in surgery

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Hepatobiliary Surgery and Nutrition 2020年第3期9卷 330-332页

作者： Tian Yang Wan yee Lau Feng Shen Department of Hepatic Surgery The Eastern Hepatobiliary Surgery HospitalSecond Military Medical University(Naval Medical University)Shanghai 200438China Faculty of Medicine The Chinese University of Hong KongHong KongSARChina

Nowadays,surgeons in china,especially those who are working in teaching hospitals affiliated to universities,concentrate their research efforts in basic researches mainly because these researches can generate scientific articles in journals of high impact factors which are essential for career advancement,job promotion and securing research grants.

关键词： teaching promotion curing

Classification of iatrogenic bile duct injury

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Hepatobiliary & Pancreatic Diseases International 2007年第5期6卷 459-463页

作者： Wan-yee Lau Eric C.H.Lai Department of Surgery the Chinese University of Hong KongShatinNew TerritoriesHong Kong SARChina

BACKGROUND: Iatrogenic bile duct injury continues to be an important clinical problem, resulting in serious morbidity, and occasional mortality, to patients. The ease of management, operative risk, and outcome of bile duct injuries vary considerably, and are highly dependent on the type of injury and its location. This article reviews the various classification systems of bile duct injury. DATA SOURCES: A Medline, PubMed database search was performed to identify relevant articles using the keywords 'bile duct injury', 'cholecystectomy', and 'classification'. Additional papers were identified by a manual search of the references from the key articles. RESULTS: Traditionally, biliary injuries have been classified using the Bismuth's classification. This classification, which originated from the era of open surgery, is intended to help the surgeons to choose the appropriate technique for the repair, and it has a good correlation with the final outcome after surgical repair. However, the Bismuth's classification does not encompass the whole spectrum of injuries that are possible. Bile duct injury during laparoscopic cholecystectomy tends to be more severe than those with open cholecystectomy. Strasberg's classification made Bismuth's classification much more comprehensive by including various other types of extrahepatic bile duct injuries. Our group, Bergman et al, Neuhaus et al, Csendes et al, and Stewart et al have also proposed other classification systems to complement the Bismuth's classification. CONCLUSIONS: None of the classification system is universally accepted as each has its own limitation. Hopefully, a universally accepted comprehensive classification system will be published in the near future.

关键词： laparoscopic cholecystectomy bile duct injury bile duct stricture bile leak classification

Hepatocellular carcinoma: current management and recent advances

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Hepatobiliary & Pancreatic Diseases International 2008年第3期7卷 237-257页

作者： Wan-yee Lau Eric C. H. Lai Faculty of Medicine The Chinese University of Hong Kong Prince of Wales Hospital Shatin New Territories Hong Kong SAR China

BACKGROUND: Hepatocellular carcinoma (HCC) is a major health problem worldwide. It is the fifth most common cancer in the world, and the third most common cause of cancer-related death. Without specific treatment, the prognosis is very poor. The goal of management is 'cancer control'-a reduction in its incidence and mortality as well as an improvement in the quality of life of patients with HCC and their families. This article aims to review the current management of HCC and its recent advances. DATA SOURCES: A MEDLINE database search was performed to identify relevant article using the keywords 'hepatocellular carcinoma', 'hepatectomy', 'liver transplantation', and 'local ablative therapy'. Additional papers and book chapters were identified by a manual search of the references from the key articles. RESULTS: Liver resection and liver transplantation remain the options that give the best chance of a cure. Recent evidence suggests that local ablative therapy may offer comparable survival results in patients with small HCC, and preserved liver function. Transarterial chemoembolization (TACE) is the most promising palliative modality for unresectable HCC, but other techniques, such as transarterial radioembolization (TARE), and local ablative therapy, have also shown comparable results. CONCLUSIONS: Early diagnosis of HCC remains a key goal in improving the prognosis of patients. During the last two decades, operative mortality and surgical outcome of liver resection and liver transplantation for HCC have improved. Progress also has been made in multi-modality therapy which can increase the chance of survival and improve the quality of life for patients with advanced HCC.

关键词： hepatocellular carcinoma hepatectomy liver transplantation local ablative therapy

Impact of work environment on job satisfaction and stress among hemodialysis staff in Klang Valley

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Frontiers of Nursing 2023年第4期10卷 481-492页

作者： Zaima Mat Yusuf Bit Lian yee National Guard Health Affairs King Abdul Aziz Medical CityNursing Education ServicesRiyadh 11426Kingdom of Saudi Arabia Faculty of Technology and Applied Sciences Open University MalaysiaPetaling JayaSelangor 47301Malaysia

Objective:To investigate the factors contributing to satisfaction with the work environment,job satisfaction(JS),and stress among hemodialysis(HD)staff in the central region of ***:A quantitative cross-sectional study was conducted on 215 HD staff working at private and non-government(NGO)dialysis centers using self-administered *** chi-square test was used to determine factors associated with HD staff's JS,stress,and working ***:The scientific proof was apparent that the working environment had an effect on JS and stress among employees at HD ***:This research offers useful insights into the essence and complexities of HD staff's work and will help nurses,dialysis managers,other dialysis personnel,and organizations to better understand the benefits and stresses faced by these workers.

关键词： hemodialysis staff job satisfaction nurses stress work environment

Understanding the interaction of hepatitis C virus with host DEAD-box RNA helicases

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World Journal of Gastroenterology 2014年第11期20卷 2913-2926页

作者： Megha Haridas Upadya Jude Juventus Aweya yee-Joo Tan Department of Microbiology Yong Loo Lin School of MedicineNational University Health System (NUHS)National University of SingaporeSingapore 117597Singapore Institute of Molecular and Cell Biology Agency for ScienceTechnology and Research (A*STAR)Singapore 138673Singapore

The current therapeutic regimen to combat chronic hepatitis C is not optimal due to substantial side effects and the failure of a significant proportion of patients to achieve a sustained virological response. Recently developed direct-acting antivirals targeting hepatitis C virus (HCV) enzymes reportedly increase the virologic response to therapy but may lead to a selection of drug-resistant variants. Besides direct-acting antivirals, another promising class of HCV drugs in development include host targeting agents that are responsible for interfering with the host factors crucial for the viral life cycle. A family of host proteins known as DEAD-box RNA helicases, characterized by nine conserved motifs, is known to play an important role in RNA metabolism. Several members of this family such as DDX3, DDX5 and DDX6 have been shown to play a role in HCV replication and this review will summarize our current knowledge on their interaction with HCV. As chronic hepatitis C is one of the leading causes of hepatocellular carcinoma, the involvement of DEAD-box RNA helicases in the development of HCC will also be highlighted. Continuing research on the interaction of host DEAD-box proteins with HCV and the contribution to viral replication and pathogenesis could be the panacea for the development of novel therapeutics against HCV.

关键词： Hepatitis C virus Chronic hepatitis C Hepatitis C virus therapy DEAD-box helicases Host factors Hepatocellular carcinoma

Anaerobic biodegradation of PAHs in mangrove sediment with amendment of NaHCO_3

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Journal of Environmental Sciences 2015年第4期27卷 148-156页

作者： Chun-Hua Li Yuk-Shan Wong Hong-Yuan Wang Nora Fung-yee Tam State Key Laboratory of Environmental Criteria and Risk Assessment Chinese Research Academy of Environmental Sciences Department of Biology and Chemistry City University of Hong Kong Department of Biology The Hong Kong University of Science and Technology Key Laboratory of Nonpoint Source Pollution Control Ministry of Agriculture/Institute of Agricultural Resources and Regional PlanningChinese Academy of Agricultural Sciences State Key Laboratory on Marine Pollution City University of Hong Kong

Mangrove sediment is unique in chemical and biological properties. Many of them suffer polycyclic aromatic hydrocarbon（PAH） contamination. However, the study on PAH biological remediation for mangrove sediment is deficient. Enriched PAH-degrading microbial consortium and electron acceptor amendment are considered as two effective measures. Compared to other electron acceptors, the study on CO2, which is used by methanogens, is still seldom. This study investigated the effect of Na HCO3 amendment on the anaerobic biodegradation of four mixed PAHs, namely fluorene（Fl）, phenanthrene（Phe）,fluoranthene（Flua） and pyrene（Pyr）, with or without enriched PAH-degrading microbial consortium in mangrove sediment slurry. The trends of various parameters, including PAH concentrations, microbial population size, electron-transport system activities, electron acceptor and anaerobic gas production were monitored. The results revealed that the inoculation of enriched PAH-degrading consortium had a significant effect with half lives shortened by 7–13 days for 3-ring PAHs and 11–24 days for 4-ring PAHs. While Na HCO3 amendment did not have a significant effect on the biodegradation of PAHs and other parameters, except that CO2 gas in the headspace of experimental flasks was *** of the possible reasons is that mangrove sediment contains high concentrations of other electron acceptors which are easier to be utilized by anaerobic bacteria, the other one is that the anaerobes in mangrove sediment can produce enough CO2 gas even without adding Na HCO3.

关键词： Anaerobic biodegradation Electron acceptor amendment Mangrove sediment Na HCO3amendment Polycyclic aromatic hydrocarbon

A comparison between artificial neural network algorithms and empirical equations applied to submerged weir scour evolution prediction

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International Journal of Sediment Research 2023年第1期38卷 105-114页

作者： Dawei Guan Jingang Liu yee-Meng chiew Jian-Hao Hong Liang Cheng Key Laboratory of Ministry of Education for Coastal Disaster and Protection Hohai University School of Civil and Environment Engineering Nanyang Technological University Sustainability Center Nanhua University School of the Environment and Safety Engineering Jiangsu University

Estimating the time evolution of a local scour hole downstream of submerged weirs can help determine the maximum scour depth and length and is essential to designing submerged weir *** the current study, artificial neural networks with a backpropagation learning algorithm were used to estimate the temporal variation of scour profiles downstream of submerged weirs under clear water conditions. Physical factors, such as the flow condition, weir size, and sediment characteristics, are general scour considerations. Two sets of data combinations, namely original and non-dimensional data, were utilized in developing the backpropagation network(BPN) model. Using the data combinations and a trial-and-error method, the appropriate number of hidden neurons in the model architecture was determined. The results indicated that using non-dimensional variables as inputs in estimating the time evolution of scour holes downstream of a submerged weir is more suitable for the BPN model. Comparisons of the prediction results of the BPN model and an empirical regression formula revealed that the BPN model was more accurate and more direct in predicting the temporal variation of the local scour hole profile. In addition, sensitivity analysis showed that the dimensionless time exerted the most significant impact on the time evolution of the non-dimensional scour hole profile.

关键词： Submerged weir Scour profile Artificial neural networks (ANNs) Time evolution Backpropagation

Development and controversies of adjuvant therapy for pancreatic cancer

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Hepatobiliary & Pancreatic Diseases International 2008年第2期7卷 121-125页

作者： Wan-yee Lau Eric C.H.Lai Faculty of Medicine the Chinese University of Hong Kong Prince of Wales Hospital Shatin New TerritoriesHong Kong SAR China

BACKGROUND: Pancreatic cancer is an aggressive malignancy with a dismal prognosis. Radical surgery provides the only chance for a cure with a 5-year survival rate of 7%-25%. An effective adjuvant therapy is urgently needed to improve the surgical outcome. This review describes the current status of adjuvant therapy for pancreatic cancer, and highlights its controversies. DATA SOURCES: A Medline database search was performed to identify relevant articles using the keywords 'pancreatic neoplasm', and 'adjuvant therapy'. Additional papers were identified by a manual search of the references from the key articles. RESULTS: Eight prospective randomized controlled trials (RCTs) on the use of adjuvant chemotherapy and chemoradiation for pancreatic cancer could be identified. The results for adjuvant regimens based on systemic 5-fluorouracil with or without external radiotherapy were conflicting. The recent two RCTs on gemcitabine based regimen gave promising results. CONCLUSIONS: Based on the available data, no standard adjuvant therapy for pancreatic cancer can be established yet. The best adjuvant regimen remains to be determined in large-scale RCTs. Future trials should use a gemcitabine based regimen.

关键词： pancreatic neoplasm pancreatectomy adjuvant therapy radiotherapy chemotherapy

Collar performance in bridge pier scour with debris accumulation

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International Journal of Sediment Research 2022年第3期37卷 328-334页

作者： Hossein Hamidifar Seyed Mohammad Bagher Shahabi-Haghighi yee Meng chiew Water Engineering Department Shiraz University School of Civil and Environmental Engineering Nanyang Technological University

The mechanism of bridge pier scour becomes more complex in the presence of debris accumulation upstream of the pier. While using countermeasures may be effective in reducing scour, their efficacy could be undermined in such a situation. The current study investigates the effectiveness of using a collar in the presence of different types of floating debris accumulation in reducing scour around a cylindrical bridge pier with non-cohesive bed sediment. The experimental results reveal that using a collar can reduce the scour depth by up to 39% when compared to that without the collar in the absence of debris accumulation under the same flow conditions. Also, the collar’s efficiency is reduced by up to 25% when debris accumulation is present. However, depending on the relative size of the accumulated debris and collar, the effectiveness of collars may be increased as a pier-scour protection device. A new parameter,which is defined as the Debris Protrusion Ratio(DPR), is used to quantify the effect of debris layout size on scour depth. Moreover, a semi-empirical equation that may be used to predict the depth of the scour hole that forms around cylindrical collar-fitted piers with floating debris accumulation is proposed. The equation’s performance is evaluated using the available data in the literature. Based on the analysis, the current study shows that the accuracy of the proposed equation is satisfactory in predicting the maximum scour depth.

关键词： Bridge pier Scour Debris Collar Blockage