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Options and survival benefits of conversion therapy for unresectable hepatocellular carcinoma

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World Journal of Gastroenterology 2024年第18期30卷 2479-2481页

作者： wong hoi She Tan To Cheung Department of Surgery The University of Hong KongHong Kong 999077China

In the study by Wu et al,patients with unresectable hepatocellular carcinoma were subjected to transarterial chemoembolization(TACE)as a conversion therapy in order to render their tumors suitable for resection.A nomogram was devised and shown to be effective in predicting the survival of these *** of the results,however,is questionable since the study subjects consisted of patients who had resection after TACE while excluding patients with the same disease but not suitable for *** can be considered to be an option for conversion ***,markers for determining responses to a conversion therapy and for guiding the decision between TACE and sequential immunotherapy have been *** question of whether effective conversion therapy can truly enhance overall survival remains unanswered.

关键词： Conversion therapy Immunotherapy Liver resection Survival Transarterial chemoembolization Unresectable hepatocellular carcinoma

A Traditional Chinese Medicine Approach in Treating Depression by Promoting Liver Qi Circulation: A Western Medicine Perspective

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Chinese Medicine 2015年第4期6卷 187-195页

作者： Raphaella Wai Lam So hoi shan wong Kam Ming Ko Division of Life Science Hong Kong University of Science & Technology Hong Kong China

Depression is a prevalent mental illness in developed countries. In Western medicine, experimental and clinical investigations have demonstrated that depression is associated with the dysregulation of neurotransmitter signaling, and symptoms of depression can be alleviated by therapeutic intervention. However, patients taking antidepressant drugs often experience serious side effects and high relapse rates. On the other hand, traditional Chinese medicine (TCM) views depression as a manifestation of liver qi stagnation. Practitioners of TCM have long been treating depression with herbs that promote qi circulation in the liver. In this article, we offer a hypothesis stating the biochemical basis of the linkage between liver qi stagnation and depression. Liver qi is involved in the processing of macronutrients into molecules to fuel energy metabolism in brain neurons, as well as the synthesis of plasma proteins that maintain blood circulation to the brain, thereby enabling these fuel molecules to be delivered to the brain. In cases of liver qi stagnation, the failure in delivering sufficient fuel molecules to the brain disrupts mitochondrial ATP production in neurons. Because neurotransmitter release and neurotropin transport are driven by ATP, the deficiency in release and transport processes resulting from insufficient ATP production could lead to depression. Therefore, if liver qi stagnation is causally related to the pathogenesis of depression, the promotion of liver qi circulation by Chinese herbs might offer a promising prospect for the effective treatment of depression.

关键词： Mitochondrial ATP Liver “Qi” Stagnation Depression Traditional Chinese Medicine

A Hypothetical Anti-Aging Mechanism of “Yang-Invigorating” Chinese Tonic Herbs

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Chinese Medicine 2012年第1期3卷 72-78页

作者： Philip Y. Lam hoi shan wong Jihang Chen Kam Ming Ko Division of Life Science The Hong Kong University of Science & Technology Hong Kong China

Chinese tonic herbs are generally classified into Yin and Yang categories based on their health-promoting action. Emerging evidence has suggested that in addition to up-regulating mitochondrial functional status, Yang tonic herbs also enhance cellular/mitochondrial antioxidant capacity, and may thus prevent age-related diseases and prolong the healthy part of lifespan (i.e. healthspan). The proposed biochemical mechanism underlying the antioxidant action of Yang tonic herbs involves a sustained and low level of mitochondrial reactive oxygen species production, which is secondary to the increased activity of the electron transport chain, with the possible involvement of mitochondrial uncoupling. “Yang invigoration” improves antioxidant defense in the body in the long term and thereby offers a promising prospect for preventing or possibly delaying age-related diseases and the detrimental effects of aging.

关键词： Chinese Medicine Yang Mitochondrial Decay Age-Related Diseases

“Qi-Invigorating” Chinese Tonic Herbs (Shens) Stimulate Mitochondrial ATP Generation Capacity in H9c2 Cardiomyocytes in Situand Rat Hearts ex Vivo

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Chinese Medicine 2012年第2期3卷 101-105页

作者： hoi shan wong Weng Fat Cheung Wai Ling Tang Kam Ming Ko Division of Life Science Hong Kong University of Science & Technology Hong Kong China

In the study, using ethanol extracts of Renshen (Panax ginseng C A Meyer), Xiyangshen (Panax quinquefolius L.) and Dangshen (Codonopsis pilosulae), we investigated the effect of these “Qi-invigorating” Chinese tonic herbs on mitochondrial ATP generation capacity (ATP-GC) in H9c2 cardiomyocytes in situ and rat hearts ex vivo. All three types of “Shens” stimulated mitochondrial ATP-GC, with Renshen being most potent. While a parallel enhancement in mitochondrial ATP-GC was observed in Renshen- and Xiyangshen-pretreated rats, Dangshen treatment did not produce detectable effect ex vivo. The discrepancy between in situ and ex vivo assays for Dangshen may be attributed by its limited oral-bioavailability to the heart. The tissue specific activity of Shens on mitochondrial ATP-GC may be explained by the “Meridian Theory” in traditional Chinese medicine.

关键词： Qi Chinese Medicine ATP Mitochondria Cardiomyocytes

Long-Term Treatment with an Herbal Formula MCC Reduces the Weight Gain in High Fat Diet-Induced Obese Mice

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Chinese Medicine 2013年第3期4卷 63-71页

作者： Pou Kuan Leong hoi Yan Leung hoi shan wong Jihang Chen Chung Wah Ma Yiting Yang Kam Ming Ko Division of Life Science Hong Kong University of Science and Technology Hong Kong China Infinitus (China) Company Ltd. Guangzhou China

Obesity is a risk factor for metabolic disorders, with its prevalence being increased in the world over the past several decades. Therapeutical interventions for obesity are thus urgently needed. In the present study, we investigated the effect of long-term treatment (0.51 and 5.1 g/kg/day, 5 days per week for a total of 40 doses) with an herbal formula MCC [which comprises the fruit of Momordica charantia (MC), the pericarpium of Citri reticulata and L-carnitine] in normal diet (ND) and high fat diet (HFD)-fed female ICR mice. Body weight change was monitored during the course of the experiment. Fat pad indices, plasma glucose and lipid contents, as well as metabolic enzyme activities and mitochondrial coupling efficiency in skeletal muscle were measured at 24 hours after the last dosing. Results showed that HFD increased the body weight, fat pad indices, plasma glucose and lipid contents as well as β-hydroxyacyl-Co A dehydrogenase (β-HAD) and carnitine palmitoyl CoA transferase (CPT) activities in skeletal muscle. However, the phosphofructokinase (PFK) activity was decreased in skeletal muscle. MCC treatment reduced the HFD-induced increases in body weight, fat pad indices and plasma lipid contents. MCC treatment only partially reversed the HFD-induced changes in β-HAD and CPT activities, but did not restore the HFD-induced decrease in PFK activity. MCC did not alter the plasma glucose level and mitochondrial coupling efficiency in skeletal muscle of ND and HFD-fed mice. Since MCC formula did not increase activities of energy metabolic enzymes or induce mitochondrial uncoupling, the weight loss effect of MCC is likely related to the reduction of intestinal lipid absorption in HFD-fed mice.

关键词： Obesity Weight Control Momordica Charantia Citri Reticulata L-Carnitine

Hawthorn Nectar Enhances Gastrointestinal Motility as Well as Stimulates Intestinal Am-ylase and Lipase Activities in Mice

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Chinese Medicine 2015年第3期6卷 159-168页

作者： Shiyu Zou Jiangping Li Chungwah Ma Jihang Chen Pou-Kuan Leong hoi-Yan Leung Wing-Man Chan hoi-shan wong Kam-Ming Ko Infinitus (China) Company Ltd. Guangzhou China Division of Life Science Hong Kong University of Science and Technology Hong Kong China

Gastrointestinal (GI) digestion, which facilitates the decomposition of ingested food into absorbable small molecules for further utilization in the body, necessitates both neural- and hormonal-regulated coordination of GI motility and secretion of digestive enzymes in the GI tract. The dysregulation of such coordination is likely associated with a wide range of disorders in the digestive system. Hawthorn Nectar (HN) is a health supplement for improving the wellness of the gastrointestinal digestive system in humans. The ingredients of HN, which include hawthorn, citrus, germinated barley and honeysuckle, are commonly prescribed to increase appetite and to treat digestive disorders in the practice of traditional Chinese medicine. Pharmacological studies have also shown that these herbs can produce beneficial effects on the GI digestive system. In the present study, HN was first examined for its effects on gastric emptying and postprandial intestinal motility in mice. The activities of digestive enzymes in gastric and pancreatic juice were also measured in HN-pretreated mice. Our results showed that long-term HN treatment increased the extents of gastric emptying and postprandial intestinal motility in mice. HN pretreatment also stimulated the activities of intestinal amylase and lipase in mice, while gastric pepsin and intestinal chymotrypsin activities remained unchanged. However, intestinal trypsin activity was suppressed by HN pretreatment. In conclusion, long-term HN consumption may produce beneficial effect on GI digestive function in humans.

关键词： Hawthorn Gastrointestinal Digestion Gastric Emptying Postprandial Intestinal Motility Intestinal Amylase Intestinal Lipase

Acute and Long-Term Treatments with an Herbal Formula V-Vital Capsule Increase Exercise Endurance Capacity in Weight-Loaded Swimming Mice

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Chinese Medicine 2014年第3期5卷 153-164页

作者： Pou Kuan Leong hoi Yan Leung Wing Man Chan Ji Hang Chen hoi shan wong Chung Wah Ma Shi Yu Zou Kam Ming Ko Division of Life Science The Hong Kong University of Science & Technology Hong Kong SAR China Infinitus (China) Company Ltd. Guangzhou China

Fatigue is a self-limiting response arising from physical and/or mental weariness, with a consequent personal and economic morbidity on work performance and social relationships. Anti-fatigue intervention is therefore urgently sought. “Qi-invigorating” Chinese tonic herbs, which can improve the energy status in the body according to the theory of traditional Chinese medicine, may produce beneficial effects in fatigue individuals. The herbal formula V-Vital capsule (VVC), which comprises 3 “Qi-invigorating” herbs, namely the root of Rhodiola rosea, Eleutherococcus senticosus and Panax quinquefolium, may produce anti-fatigue effect. In the present study, we investigated the effect of acute/long-term VVC treatment (acute: 0.75, 0.2 and 3.75 kg/day × 1 dose;long-term: 0.075 and 0.25 g/kg/day × 14 doses) on weight-loaded swimming female ICR mice. The weight-loaded swimming time until exhaustion, indicative of exercise endurance capacity, was recorded. Plasma levels of glucose, non-esterified fatty acid (NEFA), lactate and reactive oxygen metabolites (ROM) were measured in the exhausted mice. Glycogen levels in skeletal muscle and liver tissues were also measured. Mitochondrial function status [such as adenine nucleotide translocase (ANT) activity and coupling efficiency] was assayed. Results showed that acute VVC treatment increased the exercise endurance capacity in weight-loaded swimming mice. The ability of acute VVC treatment to enhance the exercise endurance was associated with increases in plasma glucose levels as well as glycogen levels in skeletal muscles and liver tissues, presumably due to the utilization of plasma lactate for gluconeogenesis and/or glycogen synthesis in the liver. While acute VVC treatment reduced the plasma ROM level in weight-loaded swimming mice, it increased the ANT activity. In this regard, the enhancement in exercise endurance afforded by acute VVC treatment might be due to an increase in the glucose supply to the skeletal muscle, the am

关键词： Fatigue Exercise Endurance Rhodiola rosea Eleutherococcus senticosus Panax quinquefolium

Long-Term Treatment with an Herbal Formula MCC Ameliorates Obesity-Associated Metabolic Dysfunction in High Fat Diet-Induced Obese Mice: A Comparative Study among MCC and Various Combinations of Its Constituents

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Chinese Medicine 2014年第1期5卷 34-46页

作者： Pou Kuan Leong hoi Yan Leung hoi shan wong Ji Hang Chen Wing Man Chan Chung Wah Ma Yi Ting Yang Kam Ming Ko Division of Life Science Hong Kong University of Science and Technology Hong Kong China Infinitus (China) Company Ltd. Guangzhou China

Obesity has been found to be associated with increased incidence of various metabolic disorders. Anti-obesity interventions are therefore urgently needed. An earlier study has demonstrated that treatment with an herbal formula MCC, which comprises the fruit of Momordica charantia (MC), the pericarpium of Citri reticulate (CR) and L-carnitine (CA), reduced the weight gain in high fat diet (HFD)-fed mice. In the present study, we investigated the effect of long-term treatment with MCC (6 g/kg/day × 40 doses) and various combinations of its constituents in HFD-fed female ICR mice. Body weight change was monitored during the course of the experiment. Total and differential adiposity, plasma lipid contents, metabolic enzyme activities and mitochondrial coupling efficiency in skeletal muscle were measured. Glucose homeostasis was also assessed. Results showed that HFD increased the body weight, total and differential adiposity, and plasma lipid contents as well as impaired metabolic status in skeletal muscle and glucose homeostasis. MCC and all combinations of its constituents reduced the weight gain in HFD-fed mice, which was accompanied with an improvement on glucose homeostasis. While MC, CA and CR independently suppressed the HFD-induced weight gain in mice, MC seems to be the most effective in weight reduction, all of which correlated with the induction of mitochondrial uncoupling in skeletal muscle. Only CA and CR, but not MC, significantly reduced the total adiposity and visceral adiposity as well as plasma cholesterol level. However, the two component combinations, MC + CR and MC + CA, decreased the degree of visceral adiposity and plasma cholesterol level, respectively. MCC treatment at 1.5 g/kg (but not a higher dose of 6 g/kg) suppressed visceral adiposity and induced mitochondrial uncoupling in skeletal muscle in HFD-fed mice. The finding suggests that MCC may offer a promising prospect for ameliorating the diet-induced obesity and metabolic disorders in human

关键词： High Fat Diet Obesity Weight Control Momordica Charantia Citri Reticulata L-Carnitine

Post-fontan circulation hepatocellular carcinoma:Open and laparoscopic hepatectomy

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 90-93页

作者： Karin KY Ho wong hoi She Simon HY Tsang Kevin S Lo Tan To Cheung Department of Surgery The University of Hong Kong102 Pok Fu Lam RoadHong KongChina Department of Anaesthesiology Queen Mary Hospital102 Pok Fu Lam RoadHong KongChina

To the Editor:Fontan-associated liver disease shows increasing incidence as advances in pediatric cardiology have prolonged life expectancy in patients with single ventricle congenital heart defects[1].Their unique physiology and procedure-related sequelae present an increasingly relevant challenge in hepatic *** hereby reported a series of patients suffering from hepatocellular carcinoma(HCC)who successfully underwent open and laparoscopic hepatectomy.

关键词： hepatocellular hepatectomy surgery