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Treatment of benign rectal stricture caused by repeated anal insertion by endoscopy and balloon dilation:A case report

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World Journal of Gastrointestinal Endoscopy 2024年第2期16卷 91-97页

作者： Shih-hung Liu Jung-Cheng Kang Je-Ming Hu Chao-Yang Chen Kuan-Hsun Lin Ta-Wei Pu Department of Surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Colon and Rectal Surgery Department of SurgeryTaiwan Adventist HospitalTaipei 105Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Thoracic Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Division of Colon and Rectal Surgery Department of SurgerySongshan BranchTri-Service General HospitalNational Defense Medical CenterTaipei 105Taiwan

BACKGROUND Benign rectal strictures can be categorized as primary(disease-related)and secondary(surgical anastomosis-related).Secondary strictures arise from surgical complications,whereas primary strictures have diverse etiologies,including various inflammatory *** strictures are usually managed by surgery and *** present an unusual etiology of benign rectal stricture caused by the repeated insertion of foreign objects into the rectum for sexual purposes,resulting in rectal injury and subsequent chronic *** SUMMARY A 53-year-old man presented to the outpatient clinic of the Colorectal Surgery Department with symptoms of chronic constipation and bloody *** patient previously experienced rectal injury due to foreign object insertion for sexual *** revealed benign circumferential narrowing of the *** underwent treatment by endoscopic argon plasma coagulation and balloon dilation and follow-up as an outpatient for 4 months.A colonoscopy at the end of the follow-up period revealed no evidence of rectal stricture *** A history of rectal injury,followed by chronic inflammation,should be considered in patients with benign rectal *** with endoscopic argon plasma coagulation and balloon dilation can prevent the need for surgical resection of benign rectal strictures.

关键词： Chronic rectal inflammation Colonoscopy Benign rectal stricture Foreign body insertion Rectal injury Case report

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Impact of antiviral therapy on post-hepatectomy outcome for hepatitis B-related hepatocellular carcinoma

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World Journal of Gastroenterology 2014年第20期20卷 6006-6012页

作者： Charing ching Ning Chong Grace Lai hung Wong Paul Bo San Lai Division of Hepato-biliary and Pancreatic Surgery Department of Surgery Prince of Wales Hospital the Chinese University of Hong Kong Institute of Digestive Disease and Department of Medicine and Therapeutics Prince of Wales Hospital the Chinese University of Hong Kong

The outcome after curative resection for hepatocellular carcinoma(HCC)remains unsatisfactory due to the high recurrence rate after *** patients with hepatitis B virus(HBV)-related HCC,which is the majority of patients with HCC in Asia,a high viral load is a strong risk factor for HCC *** is logical to believe that antiviral therapy may improve the postoperative outcome by promoting viral clearance and hepatocyte regeneration,as well as improving residual liver volume in HCC patients with hepatitis ***,the effect of antiviral therapy on clinical outcomes after liver resection in patients with HBV-related HCC remains to be *** are two main groups of antiviral treatment for HBV-oral nucleos(t)ide analogues and *** treatment reduces the overall incidence of HBV-related HCC in sustained ***,side effects may limit its long-term clinical ***(t)ide analogues carry fewer side effects and are potent in terms of viral suppression when compared to interferon and are typically implemented for patients with more advanced liver *** may also improve the outcome after curative resection for HBV-related *** are increasing evidence to suggest that antiviral therapy could suppress HBV,decrease the perioperative reactivation of viral replication,reduce liver injury,preserve the liver function before and after operation,and may lower the risk of HCC *** all,antiviral therapy may improve the survival after liver resection by reducing recurrence and delaying the liver damage by the virus,resulting in a higher chance of receiving aggressive salvage therapy during HCC recurrence.

关键词： Antiviral therapy Hepatitis B infection Hepatocellular carcinoma Hepatectomy Liver resection Outcome

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Federated Feature Concatenate Method for Heterogeneous Computing in Federated Learning

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计算机、材料和连续体（英文） 2023年第4期75卷 351-371页

作者： Wu-Chun Chung Yung-Chin Chang ching-Hsien Hsu Chih-hung Chang Che-Lun hung Department of Information and Computer Engineering Chung Yuan Christian UniversityTaoyuanTaiwan Department of Computer Science and Information Engineering Asia UniversityTaichungTaiwan Department of Medical Research China Medical University HospitalChina Medical UniversityTaichungTaiwan Department of Computer Science&Communication Engineering Providence UniversityTaichungTaiwan Institute of Biomedical Informatics National Yang Ming Chiao Tung UniversityTaipeiTaiwan

Federated learning is an emerging machine learning techniquethat enables clients to collaboratively train a deep learning model withoutuploading raw data to the aggregation server. Each client may be equippedwith different computing resources for model training. The client equippedwith a lower computing capability requires more time for model training,resulting in a prolonged training time in federated learning. Moreover, it mayfail to train the entire model because of the out-of-memory issue. This studyaims to tackle these problems and propose the federated feature concatenate(FedFC) method for federated learning considering heterogeneous *** leverages the model splitting and feature concatenate for offloadinga portion of the training loads from clients to the aggregation server. Eachclient in FedFC can collaboratively train a model with different cutting ***, the specific features learned in the deeper layer of the serversidemodel are more identical for the data class classification. Accordingly,FedFC can reduce the computation loading for the resource-constrainedclient and accelerate the convergence time. The performance effectiveness isverified by considering different dataset scenarios, such as data and classimbalance for the participant clients in the experiments. The performanceimpacts of different cutting layers are evaluated during the model *** experimental results show that the co-adapted features have a criticalimpact on the adequate classification of the deep learning model. Overall,FedFC not only shortens the convergence time, but also improves the bestaccuracy by up to 5.9% and 14.5% when compared to conventional federatedlearning and splitfed, respectively. In conclusion, the proposed approach isfeasible and effective for heterogeneous clients in federated learning.

关键词： Federated learning deep learning artificial intelligence heterogeneous computing

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Role of body mass index in colon cancer patients in Taiwan

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World Journal of Gastroenterology 2012年第31期18卷 4191-4198页

作者： Chih-chien Chin Yi-hung Kuo chien-Yuh Yeh Jinn-Shiun Chen Reiping Tang Chung-Rong Changchien Jeng-Yi Wang Wen-Shih Huang Division of Colon and Rectal Surgery Department of SurgeryChang Gung Memorial HospitalChiayi 613Taiwan Graduate Institute of Clinical Medical Science College of MedicineChang Gung UniversityTaoyuan 333Taiwan Division of Colon and Rectal Surgery Department of SurgeryChang Gung Memorial HospitalLinko 333Taiwan

AIM： To determine the effect of body mass index （BMI） on the characteristics and overall outcome of colon cancer in Taiwan. METHODS： From January 1995 to July 2003, 2138 patients with colon cancer were enrolled in this study. BMI categories （in kg/m2） were established according to the classification of the Department of Health of Tai- wan. Postoperative morbidities and mortality, and survival analysis including overall survival （OS）, disease- free survival （DFS）, and cancer-specific survival （CSS） were compared across the BMI categories.27 kg/m2） patients. Being female, apparently anemic, hypoalbuminemic, and having body weight loss was more likely among underweight patients than among the other patients （P 〈 0.001）. Underweight patients had higher mortality rate （P = 0.00.7） and lower OS （P 〈 0.001） and DFS （P = 0.002） than the other pa- tients. OS and DFS did not differ significantly between normal-weight, overweight, and obese patients, while CSS did not differ significantly with the BMI category. CONCLUSION： In Taiwan, BMI does not significantly affect colon-CSS. Underweight patients had a higher rate of surgical mortality and a worse OS and DFS than the other patients. Obesity does not predict a worse survival.

关键词： Body mass index Colon cancer Survival IVlorbidity Outcome

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Do China's Outward Direct Investors Prefer Countries with High Political Risk? An International and Empirical Comparison

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China & World Economy 2014年第6期22卷 22-43页

作者： Jiann-jong Guo Guo-chen Wang chien-hung Tung Institute of China Studies Tamkang University Department of Humanities and Social Science Taiwan Normal University Graduate Program of Landscape Architecture and Recreation National Chung-Hsing University

This paper focuses on a conventional debate regarding whether Chinese outward direct investors tend to invest in countries with high political risk. Using 2003 -2011 data from the World Bank, the Heritage Foundation and the KOF Swiss Economic Institute, we investigate China ＇s political risk distribution and political risk index （PRI）. Our results indicate that China ＂s political risk index was ranked 48th among 153 economies in 2011, in the lower risk level of the PRI spectrum. In an international comparison of political risk distribution, the proportion of Chinese outward direct investment （ODI） among countries with high political risk is less than the world average. The Chinese ODI political risk index has significantly improved and remains lower than the world average. To improve Chinese ODI PRI, the Chinese Government should continue to implement differentiation strategies and to offer official development assistance to improve the investment environment in developing countries and reduce political risk.

关键词： government policy outward direct investment political risk distribution political risk index principal component analysis

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Hepatic immune tolerance induced by hepatic stellate cells

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World Journal of Gastroenterology 2015年第42期21卷 11887-11892页

作者： ching-Chuan Hsieh chien-Hui hung Lina Lu Shiguang Qian Department of Surgery Chang Gung Memorial Hospital at Chiayi Graduate Institute of Clinical Medical Sciences Chang Gung University Department of Immunology Lerner Research Institute Transplantation Center Digestive Disease Institute Cleveland Clinic Department of General Surgery Transplantation Center Digestive Disease Institute Cleveland Clinic

The liver, which is a metabolic organ, plays a pivotal role in tolerance induction. Hepatic stellate cells(Hp SCs), which are unique non-parenchymal cells, exert potent immunoregulatory activity during cotransplantation with allogeneic islets effectively protecting the islet allografts from rejection. Multiple mechanisms participate in the immune tolerance induced by Hp SCs, including the marked expansion of myeloid-derived suppressor cells(MDSCs), attenuation of effector T cell functions and augmentation of regulatory T cells. Hp SC conditioned MDSC-based immunotherapy has been conducted in mice with autoimmune disease and the results show that this technique may be promising. This article demonstrates how Hp SCs orchestrate both innate immunity and adaptive immunity to build a negative network that leads to immune tolerance.

关键词： Hepatic stellate cells Myeloid-derived suppressor

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Tracheostomy and venovenous extracorporeal membrane oxygenation for difficult airway patient with carinal melanoma:A case report and literature review

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World Journal of Clinical Cases 2022年第35期10卷 13088-13098页

作者： I-Liang Liu An-Hsun Chou chien-hung Chiu Yu-Ting Cheng Huan-Tang Lin Department of Anesthesiology Chang Gung Memorial HospitalLinkou Medical CenterTaoyuan 333Taiwan College of Medicine Chang Gung UniversityTaoyuan 333Taiwan Division of Thoracic and Cardiovascular Surgery Department of SurgeryChang Gung Memorial HospitalLinkou Medical CenterTaoyuan 333Taiwan Graduate Institute of Clinical Medical Sciences Chang Gung UniversityTaoyuan 333Taiwan

BACKGROUND Anesthesia for tracheal tumor resection is challenging,particularly in patients with a difficult upper *** report a case of a difficult upper airway with a metastatic tracheal tumor causing near-total left bronchial obstruction and requiring emergency tracheostomy and venovenous extracorporeal membrane oxygenation(VV-ECMO)support for rigid bronchoscopy-assisted tumor *** SUMMARY A 41-year-old man with a history of right retromolar melanoma treated by tumor excision and myocutaneous flap reconstruction developed progressive dyspnea on exertion and syncope *** computed tomography revealed a 3.0-cm tracheal mass at the carinal level,causing 90%tracheal lumen *** bronchoscopy revealed a pigmented tracheal mass at the carinal level causing critical carinal *** of aggravated symptoms,emergency rigid bronchoscopy for tumor resection and tracheal stenting were planned with standby *** to limited mouth opening,tracheostomy was necessary for rigid bronchoscopy *** transferring the patient to the operating table,sudden desaturation occurred and awake fiberoptic nasotracheal intubation was performed for ventilation *** and internal jugular vein were catheterized to facilitate possible VV-ECMO *** tracheostomy,progressive desaturation developed and VV-ECMO was instituted *** tumor resection and tracheal stenting,VV-ECMO was weaned smoothly,and the patient was sent for intensive postoperative *** days later,he was transferred to the ward for palliative immunotherapy and subsequently discharged *** In a difficult airway patient with severe airway obstruction,emergency tracheostomy for rigid bronchoscopy access and standby VV-ECMO can be life-saving,and ECMO can be weaned smoothly after tumor *** anesthesia for patients with tracheal tumors causing critical airway obstruction,spontaneous ventilation should be maintaine

关键词： Tracheostomy Extracorporeal membrane oxygenation Tracheal tumor Melanoma Case report

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Diagnostic capability of peripapillary retinal nerve fiber layer parameters in time-domain versus spectral-domain optical coherence tomography for assessing glaucoma in high myopia

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International Journal of Ophthalmology(English edition) 2017年第7期10卷 1106-1112页

作者： Mei-ching Teng Yi-Chieh Poon Kuo-Chi hung Hsueh-Wen Chang Ing-Chou Lai Jen-Chia Tsai Pei-Wen Lin chien-Yun Wu Chueh-Tan Chen Pei-Chang Wu Department of Ophthalmology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineNiaosong Dist Department of Biological Sciences National Sun Yat-Sen University

AIM： To evaluate and compare the diagnostic capabilities of peripapillary retinal nerve fiber layer（p-RNFL） parameters of Spectralis optical coherence tomography（OCT） versus Stratus OCT to detect glaucoma in patients with high myopia. METHODS： This is a retrospective, cross-sectional study. Sixty highly myopic eyes of 60 patients were enrolled, with 30 eyes in the glaucoma group and 30 eyes in the control group. All eyes received peripapillary imaging of the optic disc using Stratus and Spectralis OCT. Areas under the receiver operating characteristic curve（AUROC） and the sensitivity at specificity of 〉80% and 〉95% for p-RNFL parameters obtained using the two devices to diagnose glaucoma were analysed and compared. RESULTS： In Spectralis OCT, p-RNFL thickness parameters with the largest AUROC were the temporal-inferior sector（0.974） and the inferior quadrant（0.951）, whereas in Stratus OCT, the best parameters were the 7-o＇clock sector（0.918） and the inferior quadrant（0.918）. Compared to the Stratus OCT parameters, the Spectralis OCT parameters demonstrated generally higher AUROC; however, the difference was not statistically significant. CONCLUSION： The best p-RNFL parameters for diagnosing glaucoma in patients with high myopia were the temporal-inferior sector on Spectralis OCT and the 7-o＇clock sector on Stratus OCT. There were no significant differences between the AUROCs for Spectralis OCT and Stratus OCT, which suggest that the glaucoma diagnostic capabilities of these two devices in patients with high myopia are similar.

关键词： diagnostic capability glaucoma high myopia optical coherence tomography retinal nerve fiber layer

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Prevalence and risk factors for impaired renal function among Asian patients with nonalcoholic fatty liver disease

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 241-248页

作者： Chao Sun George Boon-Bee Goh Wan-Cheng Chow Wah-Kheong Chan Grace Lai-hung Wong Wai-Kay Seto Yi-Hsiang Huang Han-Chieh Lin I-Cheng Lee Hye Won Lee Seung Up Kim Vincent Wai-Sun Wong Jian-Gao Fan Center for Fatty Liver Disease Department of GastroenterologyXinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai Key Lab of Pediatric Gastroenterology and NutritionShanghai 200092China Department of Gastroenterology&Hepatology Singapore General HospitalSingaporeSingapore Gastroenterology and Hepatology Unit Department of MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia Department of Medicine and Therapeutics and State Key Laboratory of Digestive Disease The Chinese University of Hong KongHong KongChina Department of Medicine The University of Hong KongHong KongChina Institute of Clinical Medicine National Yang Ming Chiao Tung University School of MedicineTaipeiTaiwanChina Division of Gastroenterology and Hepatology Taipei Veterans General HospitalTaipeiTaiwanChina Faculty of Medicine National Yang Ming Chiao Tung University School of MedicineTaipeiTaiwanChina Department of Internal Medicine Yonsei University College of MedicineSeoulKorea

Background:Nonalcoholic fatty liver disease(NAFLD)is associated with impaired renal function,and both diseases often occur alongside other metabolic ***,the prevalence and risk factors for impaired renal function in patients with NAFLD remain *** objective of this study was to identify the prevalence and risk factors for renal impairment in NAFLD ***:All adults aged 18-70 years with ultrasound-diagnosed NAFLD and transient elastography examination from eight Asian centers were enrolled in this prospective *** fibrosis and cirrhosis were assessed by FibroScan-aspartate aminotransferase(FAST),Agile 3+and Agile 4 *** renal function and chronic kidney disease(CKD)were defined by an estimated glomerular filtration rate(eGFR)with value of<90 mL/min/1.73 m^(2) and<60 mL/min/1.73 m^(2),respectively,as estimated by the CKD-Epidemiology Collaboration(CKD-EPI)***:Among 529 included NAFLD patients,the prevalence rates of impaired renal function and CKD were 37.4%and 4.9%,*** multivariate analysis,a moderate-high risk of advanced liver fibrosis and cirrhosis according to Agile 3+and Agile 4 scores were independent risk factors for CKD(P<0.05).Furthermore,increased fasting plasma glucose(FPG)and blood pressure were significantly associated with impaired renal function after controlling for the other components of metabolic syndrome(P<0.05).Compared with patients with normoglycemia,those with prediabetes[FPG≥5.6 mmol/L or hemoglobin A1c(HbA1c)≥5.7%]were more likely to have impaired renal function(P<0.05).Conclusions:Agile 3+and Agile 4 are reliable for identifying NAFLD patients with high risk of *** glycemic control in the prediabetic stage might have a potential renoprotective role in these patients.

关键词： Nonalcoholic fatty liver disease Impaired renal function Agile 3+ Agile 4 Metabolic syndrome

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Effects of acupuncture on post-cesarean section pain

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Chinese Medical Journal 2009年第15期122卷 1743-1748页

作者： WU hung-chien LIU Yu-chi OU Keng-liang CHANG Yung-hsien HSIEH ching-liang TSAI Angela Hsin-chieh TSAI Hong-te CHIU Tsan-hung hung Chih-jen LEE chien-chung LIN Jaung-geng College of Dental Medicine Kaohsiung Medical University Taiwan China School of Post Baccalaureate Chinese Medicine China Medical University Taiwan China Research Center for Biomedical Implants and Microsurgery Devices College of Oral Medicine Taipei Medical University Taiwan China China Medical University Hospital China Medical University Taiwan China Meridian Medical Centre Australia Department of Obstetrics and Gynecology Changhua Christian Hospital Taiwan China Department of Obstetrics and Gynecology China Medical University Hospital Taiwan China Department of Anesthesiology Taichung Veterans General Hospital Taiwan China Mei-Tsung Obstetrics and Gynecology Clinic Taiwan China Graduate Institute of Acupuncture Science China Medical University Taiwan China

Background Post-operation pain is a very subjective phenomenon. The aim of this study was to find out the effects of acupuncture or electro-acupuncture on post-cesarean pain. Methods Sixty women, who had had spinal anesthesia during cesarean section at the Department of Obstetrics of China Medical University Hospital, were randomly assigned to the control group, the acupuncture group, and the electro-acupuncture group. After the operation, we applied subjects with acupuncture or electro-acupuncture on the bilateral acupuncture point, San Yin Jiao （Sp6）, and the patient controlled analgesia （PCA）. The first time of requesting morphine, the frequency of PCA demands in 24 hours, and the doses of PCA used were recorded double blindly. In addition, monitoring the subjects＇ vital signs, the opioid-related side effects, and the pain scores was done. Results The results showed that the acupuncture group and the electro-acupuncture group could delay the time of requesting morphine up to 10-11 minutes when compared with the control group. The total dose of PCA used within the first 24 hours was 30%-35% less in the acupuncture group and the electro-acupuncture group when compared with the control group, which was indicated in statistical significance. However, there was no significant difference between the acupuncture group and the electro-acupuncture group. The electro-acupuncture group＇s and the acupuncture group＇s pain scores were lower than the control group＇s within the first 2 hours. Both were statistically significant. However, two hours later, there were no significant differences of the visual analogue scale （VAS） scores between either of the treatment groups and the control group. Finally, the incidence of opioid-related side effects, such as dizziness, was less in the acupuncture group and electro-acupuncture group than in the control group. Conclusions This study shows that the application of acupuncture and electro-acupuncture could definitely delay the time of r

关键词： cesarean-section childbirth, acupuncture electro-acupuncture pain

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