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Indications of pro-inflammatory cytokines in laparoscopic and open liver resection for early-stage hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2024年第3期23卷 257-264页

作者： kevin Tak-Pan Ng Li Pang Jia-Qi Wang Wong Hoi She Simon Hing-Yin Tsang Chung Mau Lo kwan Man Tan To Cheung Department of Surgery HKU-SZH&School of Clinical MedicineLi Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina State Key Laboratory of Liver Research The University of Hong KongHong KongChina

Background:Our clinical practice of laparoscopic liver resection(LLR)had achieved better short-term and long-term benefits for patients with hepatocellular carcinoma(HCC)over open liver resection(OLR),but the underlying mechanisms are not *** study was to find out whether systemic inflammation plays an important ***:A total of 103 patients with early-stage HCC under liver resection were enrolled(LLR group,n=53;OLR group,n=50).The expression of 9 inflammatory cytokines in patients at preoperation,postoperative day 1(POD1)and POD7 was quantified by Luminex Multiplex *** relationships of the cytokines and the postoperative outcomes were compared between LLR and ***:Seven of the circulating cytokines were found to be significantly upregulated on POD1 after LLR or OLR compared to their preoperative *** to OLR,the POD1 levels of granulocytemacrophage colony-stimulating factor(GM-CSF),interleukin-6(IL-6),IL-8,and monocyte chemoattractant protein-1(MCP-1)in the LLR group were significantly *** POD1 levels of these cytokines were significantly correlated with longer operative time and higher volume of blood loss during *** levels of these cytokines were positively associated with postoperative liver injury,and the length of hospital ***,a high level of IL-6 at POD1 was a risk factor for HCC recurrence and poor disease-free survival after liver ***:Significantly lower level of GM-CSF,IL-6,IL-8,and MCP-1 after liver resection represented a milder systemic inflammation which might be an important mechanism to offer better short-term and long-term outcomes in LLR over OLR.

关键词： Laparoscopic liver resection Open liver resection Hepatocellular carcinoma Postoperative cytokines Inflammatory responses

Gastrointestinal stromal tumors in a cohort of Chinese patients in Hong Kong

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World Journal of Gastroenterology 2006年第14期12卷 2223-2228页

作者： kam Hoi chan Chun Wing chan Wai Hung Chow Wai Keung kwan Chi kwan Kong ka Fung Mak Miu Yi Leung Lin Kiu Lau Department of Medicine Yan Chai Hospital Tsuen Wan Hong Kong SAR China Department of Surgery Yan Chai Hospital Tsuen Wan Hong Kong SAR China Department of Radiology Yah Chai Hospital Tsuen Wan Hong Kong SAR Chin Department of Pathology Yah Chai Hospital Tsuen Wan Hong Kong SAR China

AIM： To investigate the prevalence and clinical pattern of gastrointestinal stromal tumors （GISTs） in Hong Kong Chinese, and to assess the impact of introduction of CD117 on the disease incidence. METHODS： From the database of the Department of Pathology of Yan Chai Hospital, 47 patients, with GISTs from September 1995 to December 2003 were included in this study. Ten GISTs were diagnosed before the introduction of CD117. The clinical features, tumor characteristics, and treatment were analyzed. Factors predicting tumor related death or recurrence were studied with Cox proportional hazard model. RESULTS： The patients included 26 males and 21 females, with a mean age of 66.6 years （SD 13.1, range 29-87 years）. The estimated prevalence of GISTs was 13.4-15.6 per 100 000 people, with an annual inddence of 1.68-1.96 per 100 000 people. The annual incidence of GISTs before and after the introduction of CD117 was 1.1 per 100 000 people and 2.1 per 100 000 people respectively. Stomach （34 patients, 72.3%） was the most common location for the tumor, followed by the small intestine （8 patients, 17.0%）, esophagus （2 patients, 4.3%）, omentum （2 patients, 4.3%） and colon （1 patient, 2.1%）. Thirty-one patients （66%） had complete tumor resection. Eleven out of 16 deaths （23%） were tumor-related. The median survival time was 26 too. Five-year survival rate was 61.3%. The significant factors associated with tumor-related death or recurrence were incomplete resection, tumor size 5 cm or above, invasion to the adjacent organ or presence of metastasis, CONCLUSION： The incidence of GIST in Hong Kong is comparable to that in the United States but lower than that in Finland. The true incidence of GISTs could be underestimated before the introduction of CD117. Incomplete resection, tumor size 5 cm or above, invasion to the adjacent organ or presence of metastasis are factors predicting tumor-related death or recurrence.

关键词： Gastrointestinal tumor GIST Prognostic factors, Clinical features Incidence

Clinical significance of hepatic derangement in severe acute respiratory syndrome

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World Journal of Gastroenterology 2005年第14期11卷 2148-2153页

作者： Henry Lik-Yuen chan Ambrose Chi-Pong kwan ka-Fai To Sik-To Lai Paul kay-Sheung chan Wai-Keung Leung Nelson Lee Alan Wu Joseph Jao-Yiu Sung Department of Medicine and Therapeutics Chinese University of Hong Kong Hong Kong SARChina Department of Medicine Princess Margaret Hospital Hong Kong SARChina Department of Anatomical and Cellular Pathology Chinese University of Hong Kong Hong Kong SARChina Department of Microbiology Chinese University of Hong Kong Hong Kong SARChina

AIM:Elevation of alanine aminotransferase (ALT) level is commonly seen among patients suffering from severe acute respiratory syndrome (SARS). We report the progression and clinical significance of liver derangement in a large cohort of SARS patient. METHODS: Serial assay of serum ALT was followed in patients who fulfilled the WHO criteria of SARS. Those with elevated ALT were compared with those with normal liver functions for clinical outcome. Serology for hepatitis B virus (HBV) infection was checked. Adverse outcomes were defined as oxygen desaturation, need of intensive care unit (ICU) and mechanical ventilation and death. RESULTS: Two hundred and ninety-four patients were included in this study. Seventy (24%) patients had elevated serum ALT on admission and 204 (69%) patients had elevated ALT during the subsequent course of illness. Using peak ALT >5xULN as a cut-off and after adjusting for potential confounding factors, the odds ratio of peak ALT >5x ULN for oxygen desaturation was 3.24 (95%CI 1.23-8.59, P= 0.018), ICU care was 3.70 (95%CI 1.38-9.89, P= 0.009), mechanical ventilation was 6.64 (95%CI 2.22-19.81, P = 0.001) and death was 7.34 (95%CI 2.28-24.89, P= 0.001). Ninety-three percent of the survived patients had ALT levels normalized or were on the improving trend during follow-up. Chronic hepatitis B was not associated with worse clinical outcomes. CONCLUSION: Reactive hepatitis is a common complication of SARS-coronavirus infection. Those patients with severe hepatitis had worse clinical outcome.

关键词： SARS Hepatitis Hepatitis B virus Coronavirus

Molecular Evidence for the Hybrid Origin of Bauhinia blakeana(Caesalpinioideae)

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Journal of Integrative Plant Biology 2008年第1期50卷 111-118页

作者： Chun Yin Mak ka Shing Cheung Pui Ying Yip Hoi Shan kwan Department of Biology The Chinese University of Hong KongShatinHong KongChina

Bauhinia blakeana Dunn is the Hong Kong Special Administrative Region emblem and a popular horticultural species in many Asian countries. It was first described as a new species from Hong Kong almost a century ago. This plant is sterile and has long been considered a hybrid, possibly from two related species, B. purpurea and B. variegata. However, not much evidence based on molecular methods was available to support this hypothesis. In this study, sequences of internal transcribed spacer I （ITS1）, rbcL and atpB-rbcL intergenic spacer for five Bauhinia species and two varieties of one of the species were determined and compared. There were two types of ITS1 sequences in B. blakeana, one indistinguishable from that of B. purpurea and the other one identical to that of B. variegata. This confirmed that B. blakeana was a hybrid of these two species. Chloroplast atpB-rbcL intergenic spacer sequence of B. blakeana was identical to that of B. purpurea, indicating that B. purpurea was the female parent. The hybridization event seemed to occur only recently and was a rare incident. Its occurrence was likely facilitated by interspecific pollen competition. It appeared that human efforts played a crucial role in the preservation and ubiquity of B. blakeana.

关键词： atpB-rbcL intergenic spacer Bauhinia internal transcribed spacer 1 interspecific hybrid interspecific pollen competition.

Is the treatment outcome of hepatocellular carcinoma inferior in elderly patients?

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World Journal of Gastroenterology 2019年第27期25卷 3563-3571页

作者： kevin ka Wan Chu Kenneth Siu Ho Chok Department of Surgery Queen Mary HospitalHong KongChina Department of Surgery and State Key Laboratory for Liver Research The University of Hong KongHong KongChina

In view of the increasing life expectancy in different parts of the world, a larger proportion of elderly patients with hepatocellular carcinoma(HCC) requiring oncological treatment is expected. The clinicopathological characteristics of HCC in elderly patients and in younger patients are different. Elderly patients, in general, also have more comorbidities. Evaluation of the efficacy of different HCC treatment options in elderly patients is necessary to optimize treatment outcomes for them. Treatment modalities for HCC include hepatectomy, liver transplantation, radiofrequency ablation, transarterial chemoembolization, and molecular-targeted therapy with sorafenib. In this review, current evidence on the risks and outcomes of the different HCC treatments for elderly patients are discussed. According to data in the literature, elderly patients and younger patients benefited similarly from HCC treatments. More clinical data are needed for the determination of selecting criteria on elderly HCC patients to maximize their chance of getting the most appropriate and effective treatments. As such,further studies evaluating the outcomes of different HCC treatment modalities in elderly patients are warranted.

关键词： Hepatocellular carcinoma Aged Clinical outcome Surgery Hepatectomy

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

Association of time to prostate-specific antigen nadir and logarithm of prostate-specific antigen velocity after progression in metastatic prostate cancer with prior primary androgen deprivation therapy

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Asian Journal of Andrology 2017年第1期19卷 98-102页

作者： Jeremy YC Teoh James HL Tsu Steffi KK Yuen Peter KF Chiu Samson YS chan ka-Wing Wong kwan-Lun Ho Simon SM Hou Chi-Fai Ng Ming-Kwong Yiu Division of Urology Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin Hong Kong China Division of Urology Department of Surgery Queen Mary Hospital University of Hong Kong Hong Kong China.

We investigated the association of time to prostate-specific antigen nadir （TTPN） and logarithm of prostate-specific antigen velocity after progression Log（PSAVAP） in metastatic prostate cancer with prior primary androgen deprivation therapy （ADT）. All metastatic prostate cancer patients treated with primary ADT from 2000 to 2009 were reviewed. Patients who developed disease progression were included in the subsequent analyses. Patients were categorized into three groups according to their TTPN： TTPN of 〈3 months, 3-17 months, and 〉17 months. We compared the Log（PSAVAP） between the different TTPN groups using Mann-Whitney U-test and Kruskal-Wallis test. Further multiple linear regression analyses on Log（PSAVAP） were performed to adjust for other potential confounding factors. Among 419 patients who were treated with primary ADT, 306 patients developed disease progression with a median follow-up of 28 months, Longer TTPN was associated with lower Log（PSAVAP）（P = 0.008） within all subgroup analyses （TTPN of 〈3 vs 3-17 months, P = 0.020; TTPN of 3-17 vs 〉17 months, P = 0.009; and TTPN of 〈3 vs 〉17 months, P = 0.001）. Upon multiple linear regression analyses, baseline PSA （regression coefficient 0.001, P = 0.045）, PSA nadir （regression coefficient 0.002, P = 0.040）, and TTPN （regression coefficient -0.030, P = 0.001） were the three factors that were significantly associated with Log（PSAVAP）. In conclusion, a longer TTPN was associated with lower Log（PSAVAP） in metastatic prostate cancer patients following primary ADT. TTPN cut-offs at 3 months and 17 months appeared to have prognostic significance in predicting Log（PSAVAP）. TTPN may serve as a good prognostic indicator in deciding the treatment strategy in patients with disease progression.

关键词： androgen deprivation therapy prostate cancer prostate-specific antigen velocity after progression ti me to prostate-specific antigen nadir

Residential building performance analysis at near extreme weather conditions in Hong Kong through a thermal-comfort-based strategy

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Building Simulation 2023年第1期16卷 13-25页

作者： K.F.Fong C.K.Lee kevin ka-Lun Lau Edward Yan Yung Ng Division of Building Science and Technology College of EngineeringCity University of Hong KongHong KongChina Department of Civil Engineering and Natural Resources Lulea University of TechnologySweden School of Architecture The Chinese University of Hong KongHong KongChina

The precise building performance assessment of residential housings in subtropical regions is usually more difficult than that for the commercial premises due to the much more complicated behavior of the occupants with regard to the change in indoor *** conventional use of a fixed schedule for window opening,clothing insulation and cooling equipment operation cannot reflect the real situation when the occupants respond to the change in thermal comfort,thus affecting the appropriateness of the assessment *** rectify the situation,a new modeling strategy in which the modification of the various operation schedules was based on the calculated thermal comfort(TC),was developed in this *** this new TC-based strategy,the realistic building performances under different cooling provision scenarios applied to a high-rise residential building under the near extreme weather conditions were investigated and *** was found that sole provision of ventilation fans could not meet the zone thermal comfort by over 68%of the time,and air-conditioning was *** optimal use of ventilation fans for cooling could only help reduce the total cooling energy demand by less than 12%at best which could only be realistically evaluated by adopting the present *** studies were conducted which revealed that some design factors could offer opportunities for reducing the total cooling energy under the near extreme weather conditions.

关键词： predicted mean vote thermal comfort ventilation potential building performance simulation residential housings

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