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Evaluation and management of the child with hypothyroidism

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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

Target genes discovery through copy number alteration analysis in human hepatocellular carcinoma

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World Journal of Gastroenterology 2013年第47期19卷 8873-8879页

作者： De-leung Gu Yen-Hsieh Chen Jou-Ho Shih chi-Hung Lin Yuh-Shan Jou chian-Feng Chen Institute of Biomedical Sciences Academia Sinica Institute of Microbiology and Immunology School of Life ScienceNational Yang-Ming University Bioinformatics Program Taiwan International Graduate ProgramAcademia Sinica Genome and Systems Biology Degree Program National Taiwan University VYM Genome Research Center National Yang-Ming University

High-throughput short-read sequencing of exomes and whole cancer genomes in multiple human hepatocellular carcinoma(HCC)cohorts confirmed previously identified frequently mutated somatic genes,such as TP53,CTNNB1 and AXIN1,and identified several novel genes with moderate mutation frequencies,including ARID1A,ARID2,MLL,MLL2,MLL3,MLL4,IRF2,ATM,CDKN2A,FGF19,PIK3CA,RPS6KA3,JAK1,KEAP1,NFE2L2,C16orf62,LEPR,RAC2,and *** classification of these mutated genes suggested that alterations in pathways participating in chromatin remodeling,Wnt/β-catenin signaling,JAK/STAT signaling,and oxidative stress play critical roles in HCC ***,because there are few druggable genes used in HCC therapy,the identification of new therapeutic targets through integrated genomic approaches remains an important *** a large amount of HCC genomic data genotyped by high density single nucleotide polymorphism arrays is deposited in the public domain,copy number alteration(CNA)analyses of these arrays is a cost-effective way to reveal target genes through profiling of recurrent and overlapping amplicons,homozygous deletions and potentially unbalanced chromosomal translocations accumulated during HCC ***,integration of CNAs with other high-throughput genomic data,such as aberrantly coding transcriptomes and non-coding gene expression in human HCC tissues and rodent HCC models,provides lines of evidence that can be used to facilitate the identification of novel HCC target genes with the potential of improving the survival of HCC patients.

关键词： Copy number alteration High-density single nucleotide polymorphism arrays Driver genes Hepatocellular carcinoma

The evolving role of radiation therapy as treatment for liver metastases

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Journal of the National Cancer Center 2022年第3期2卷 183-187页

作者： Khalid Alrabiah Guixiang Liao Qi Shen chi-leung chiang Laura A.Dawson Radiation Medicine Program Princess Margaret HospitalUniversity Health NetworkTorontoCanada Department of Radiation Oncology University of TorontoTorontoCanada Department of Radiation Oncology Shenzhen People’s Hospitalthe Second Clinical Medical CollegeJinan UniversityGuangdongChina Department of Radiation Oncology the First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiChina Department of Clinical Oncology Hong Kong University Shenzhen Hospital and Queen Mary HospitalHong Kong University Li Ka Shing Medical SchoolHong KongChina Department of Clinical Oncology Queen Mary HospitalHong Kong University Li Ka Shing Faculty of MedicineHong KongChina

Liver metastases occur commonly in many solid *** advances in systemic therapies and increased life expectancy,the role of using local therapies in oligo-metastases is rapidly *** body ra-diotherapy(SBRT)is an emerging precision therapy that is being used more frequently in the treatment for un-resectable liver *** review focuses on the role of SBRT for liver metastases,principles of treatment,clinical outcomes,toxicity,and optimal patient selection.

关键词： Liver metastases Stereotactic body radiotherapy Liver Local Treatment Local control Overall survival Toxicity

Rapid onset chilaiditi's sign on top of fulminant hepatic failure

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Hepatobiliary & Pancreatic Diseases International 2004年第3期3卷 476-477页

作者： See-ching Chan chi-leung Liu Chung-Mau Lo Sheung-Tat Fan Centre for the Study of Liver Disease and Departmentof Surgery the University of Hong Kong Pokfulam Hong Kong China

ABSTRACT: Fulminant hepatic failure is a medical emer-gency. When this condition declared itself irreversible, atimely liver transplantation is the only effective treatment.A 34-year-old chinese with fulminant hepatic failure wasevaluated as a potential liver transplantation candidate. Onthe erect chest radiograph, chilaiditi' s sign has developedover a very short period of a week due to rapid shrinkage ofthe liver. Awareness of chilaiditi' s sign facilitated distin-guishing the condition of free gas under the diaphragm dueto bowel perforation and subphrenic abscess by gas formingmicro-organisms. Rapidity of onset of this sign parallels thedeterioration of liver function and reflects the urgency ofcondition.

关键词： chilaiditi's sign fulminant hepatic failure

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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

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

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

(-)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

Outcomes and satisfaction of patients with orthopaedic implants left in-situ for more than three years： a retrospective study

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chinese Medical Journal 2011年第15期124卷 2297-2300页

作者： Aaran Heng-chi leung Jeffrey Shen Andraay Hon-chi leung Yuk-Wah Hung Anna HW Mok Wing-Hoi Cheung Kwok-Sui leung Department of Orthopaedics and Traumatology The Chinese University of Hong Kong Shatin New Territories Hong Kong China Specialty Registrar Trauma and Orthopaedics West of Scotland Region NHS Scotland United Kingdom

Background There are no clear guidelines on implant removal. Few have assessed the long-term outcomes of patients with implants left in-situ, or removed. Therefore, removal of implants after fracture fixation remains controversial. Methods In this retrospective study, we reviewed 53 patients with implant for fracture fixation in-situ for more than 3 years. All patients were younger than 60 years. Quality of life of each patient was assessed with the chinese （Hong Kong） validated Short Form-36 and the pain was assessed with visual analogue scale （VAS）. All patients were clinically examined and plain radiographs were taken. Results The total SF-36 score of the patients was not statistically different from the Hong Kong norm （P 〉0.05）. Mean score of VAS was 2.08. Thirty-three patients （62.3%） reported limited range of movement, 9 patients （17%） complained of cosmetic problems, and 10 patients （18.9%） complained of weakness. Clinically, 82.6% of patients had no scarring, 84.7% of patients had full range of movement and all had no tenderness on assessment. Radiologically, no abnormality was detected except for one patient with known avascular necrosis of the femoral head after screw fixation. Conclusion As most patients were clinically and radiologically normal with quality of life scores comparable to the norm, removal of implants is not advisable as a routine practice.

关键词： fracture fixation implant removal quality of life visual analogue scale refracture

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