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Hypertensive-Nimodipine Therapy for Middle Cerebral Artery Vasospasm after Resection of Glioblastoma Multiforme: A Case Report and Literature Review

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Open Journal of Modern Neurosurgery 2015年第3期5卷 76-83页

作者： Peter Yat Ming Woo Ka Wing Michael See jason kwan ho chow Yung Chan hoi Tung Wong Kwong Yau Chan Department of Neurosurgery Kwong Wah Hospital Hong Kong China

Delayed cerebral ischemia (DCI) due to post-brain tumor resection vasospasm is an often unrecognized yet debilitating complication. We present a patient with DCI after the resection of glioblastoma multiforme (GBM). To our knowledge, this is the first report on DCI after GBM resection. A 52-year-old female patient with headache for one month underwent subtotal resection of a left temporal GBM encasing the proximal middle cerebral artery (MCA). She was well during the immediate postoperative period but developed right upper limb dense monoparesis on postoperative day four with computed tomographic angiography confirming left MCA vasospasm. Symptoms were significantly alleviated with weeklong hypertensive therapy and nimodipine administration;however they recurred soon after cessation of treatment. A high index of clinical suspicion is needed for the diagnosis of post-tumor resection DCI. Any new postoperative neurological deficit that cannot be explained by hemorrhage, seizures or infection should be expeditiously investigated by angiography or transcranial Doppler sonography. Prompt initiation of hypertensive and nimodipine therapy can possibly reverse neurological deficit. Treatment should be guided by Doppler, angiographic or perfusion imaging studies and not by clinical improvement alone.

关键词： Cerebral Vasospasm Delayed Cerebral Ischemia Glioblastoma Multiforme Hypertensive Therapy Nimodipine

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Brain delivering RNA-based therapeutic strategies by targeting mTOR pathway for axon regeneration after central nervous system injury

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Neural Regeneration Research 2022年第10期17卷 2157-2165页

作者： Ming-Xi Li Jing-Wen Weng Eric S.ho Shing Fung chow Chi kwan Tsang Clinical Neuroscience Institute The First Affiliated Hospital of Jinan UniversityGuangzhouGuangdong ProvinceChina Department of Pharmacology and Pharmacy Li Ka Shing Faculty of MedicineUniversity of Hong KongHong Kong Special Administrative RegionChina Department of Biology and Department of Computer Science Lafayette CollegeEastonPAUSA

Injuries to the central nervous system(CNS)such as stroke,brain,and spinal cord trauma often result in permanent disabilities because adult CNS neurons only exhibit limited axon *** brain has a surprising intrinsic capability of recovering itself after ***,the hostile extrinsic microenvironment significantly hinders axon *** advances have indicated that the inactivation of intrinsic regenerative pathways plays a pivotal role in the failure of most adult CNS neuronal ***,substantial evidence has convincingly demonstrated that the mechanistic target of rapamycin(mTOR)signaling is one of the most crucial intrinsic regenerative pathways that drive axonal regeneration and sprouting in various CNS *** this review,we will discuss the recent findings and highlight the critical roles of mTOR pathway in axon regeneration in different types of CNS ***,we will demonstrate that the reactivation of this regenerative pathway can be achieved by blocking the key mTOR signaling components such as phosphatase and tensin homolog(PTEN).Given that multiple mTOR signaling components are endogenous inhibitory factors of this pathway,we will discuss the promising potential of RNA-based therapeutics which are particularly suitable for this purpose,and the fact that they have attracted substantial attention recently after the success of coronavirus disease 2019 *** specifically tackle the blood-brain barrier issue,we will review the current technology to deliver these RNA therapeutics into the brain with a focus on nanoparticle *** will propose the clinical application of these RNA-mediated therapies in combination with the brain-targeted drug delivery approach against mTOR signaling components as an effective and feasible therapeutic strategy aiming to enhance axonal regeneration for functional recovery after CNS injury.

关键词： axon sprouting axon regeneration brain targeted drug delivery CNS injury ischemic stroke mTOR nanoparticle neural circuit reconstruction PTEN RNA-based therapeutics

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Transcanal endoscopic assisted skull base endolymphatic sac tumor resection: A rare disease with advanced technology

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Journal of Otology 2020年第1期15卷 1-5页

作者： Wai Tsz Chang Ka Yue Tam Hung Yao kwan ho chow Michael Chi Fai Tong Department of Otorhinolaryngology Head and Neck Surgerythe Chinese University of Hong KongHong Kong Department of Pathology Princess Margaret HospitalHong Kong Department of Neurosurgery Princess Margaret HospitalHong Kong

Endolymphatic sac tumors(ELSTs) are rare, papillary adenomatous tumors that arise from the endothelium of the endolymphatic sac. We demonstrate a difficult case of endolymphatic sac tumor and how it is managed via transcanal endoscopic assisted technique, with discussion of feasibility of transcanal approach to lateral skull base tumor.

关键词： Endolymphatic sac Lateral skull base Transcanal endoscopic assisted technique Transcanal combined endoscopic microscopic approach

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Intravenous fluid selection rationales in acute clinical management

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World Journal of Emergency Medicine 2018年第1期9卷 13-19页

作者： Wing Yan Shirley Cheung Wai kwan Cheung Chun ho Lam Yeuk Wai Chan Hau Ching chow Ka Lok Cheng Yau Hang Wong Chak Wah Kam Accident and Emergency Department Tuen Mun Hospital

BACKGROUND: Intravenous fluid(IVF) is commonly used in acute clinical management. This study aimed to review the choice and primary considerations in IVF prescriptions and to evaluate the adequacy of guidelines and trainings on it in the New Territories West Cluster(NTWC) of hong ***: This is a descriptive study based on data collected from an online survey. Data were processed by SPSS for statistical analysis. This study focused on a general description and doctor-nurse between group comparison. Participants were asked the choice of IVF for nine acute clinical scenarios and provide reason. A 1–10 scale was used to assess the sufficiency of guideline, training and information, and time for revision on IVF ***: 0.9% sodium chloride was the most familiar IVF(36%), followed by 5% Dextrose solution(26%). In the nine scenarios, the most chosen IVF was 0.9% sodium chloride(37%–61%). There was significant difference in the choice of IVF between doctors and nurses in 7 cases. The second most chosen IVF for doctors was Plasma-Lyte A while that for nurses was Gelofusine. Departmental practice was the most chosen reason to account for the prescription. The adequacy of guideline, information and training, and time for revision was rated 5. Doctors had significantly more time at work than nurses to update knowledge in IVF prescription(5.41 versus 4.57).CONCLUSION: 0.9% sodium chloride was mostly chosen. The choice of IVF was mainly based on departmental practice. Adequacy of guideline, information and training, and time for revision on IVF prescription were average, indicating significant training deficit.

关键词： Intravenous fluid Acute care Resuscitation

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对于非酒精性脂肪肝病的认识——基于亚洲人群的研究

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Gastroenterology Report 2016年第2期4卷 131-135,I0002页

作者： George B.B.Goh Clarence kwan Sze Ying Lim Nanda KK Venkatanarasimha Rafidah Abu-Bakar Thinesh L Krishnamoorthy Hang hock Shim Kiang Hiong Tay Wan Cheng chow Department of Gastroenterology&Hepatology Singapore General HospitalSingapore Duke-NUS Graduate Medical School Singapore Department of Diagnostic Radiology Singapore General HospitalSingapore

背景和目的:非酒性脂肪肝病(NAFLD)是最常见的慢性肝病,同时也是代谢综合征的一项危险因素。NAFLD在全球范围内的患病率基于地域差异在5%~30%不等。尽管流行病学资料显示代谢相关性疾病的患病率在新加坡呈快速增长,但对于该地区NAFLD的... 详细信息

背景和目的:非酒性脂肪肝病(NAFLD)是最常见的慢性肝病,同时也是代谢综合征的一项危险因素。NAFLD在全球范围内的患病率基于地域差异在5%~30%不等。尽管流行病学资料显示代谢相关性疾病的患病率在新加坡呈快速增长,但对于该地区NAFLD的数据却十分有限。本研究旨在了解新加坡NAFLD的患病率及公众对该病的认识。方法:本研究是一项横断面观察研究,旨在评估NAFLD患者的人口统计学、人体测量学及临床资料,研究对象来自于一项胃肠公众论坛的参会者。NAFLD的诊断基于超声学标准;代谢综合征的诊断则基于国际糖尿病联盟的指南。通过自行设计的调查问卷来了解大家对NAFLD这种疾病的看法。结果:共有227名研究对象纳入研究,其中40%被诊断为NAFLD。相对于那些非NAFLD人群,NAFLD者男性居多,年龄更大,体质指数更高,腰围更宽,患代谢性综合征的比例更高(均P0.05)。值得注意的是,75.6%的具有代谢危险因素者,并不认为自己存在NAFLD风险。结论:我们的研究显示NAFLD在新加坡具有较高的患病率,包括在那些非肥胖人群中。考虑到人们对NAFLD的发生风险认识不足,有必要加强公众教育,以提高人们对NAFLD的认识。

关键词：非酒精性脂肪肝病流行病学认识新加坡

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