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Quantifying the impact of inhalational burns:a prospective study

Burns & Trauma 2018年第3期6卷 209-218页

作者： Si Jack Chong Yee Onn kok Rosanna Xiang Ying Tay Desai Suneel Ramesh kok chai tan Bien Keem tan Department of Plastic Reconstructive and Aesthetic SurgerySingapore General HospitalLevel 5AcademiaSingapore 169865Singapore Department of Anaesthesiology Singapore General HospitalLevel 5AcademiaSingapore 169865Singapore

Background:Inhalational injury is a major cause of morbidity and mortality in burns patients. This study aims to analyse the clinical outcomes, complications and bacteriology of inhalational burn patients. Methods:A prospective study was done on consecutive admissions to Burn Department, Singapore General Hospital over 15 months from January 2015 to March 2016. Presence of inhalational injury, demographics, complications and outcomes was recorded. Diagnosis of inhalational injury was based on history, symptoms and nasoendoscopy. Diagnosis of acute respiratory distress syndrome (ARDS), acute kidney injury (AKI) and infective complications were according to the Berlin criteria, acute kidney injury network (AKIN) classification stage 2 and above and the American Burns Association guidelines. Results:Thirty-five patients (17.3%) had inhalational burns out of 202 patients (63.4%male, 57.4%Chinese population). The average age was 43 ± 16.7 years (range 16–86), and percentage of total body surface area (%TBSA) was 12.1 ± 18.0 (range 0–88). In patients with inhalational injury, age was 38.9 ± 17.2 years and%TBSA was 30.3 ± 32.3. In patients without inhalational injury, age was 44.1 ± 12.8 years and%TBSA was 8.3 ± 9.59. Compared to patients with cutaneous injury alone, patients with inhalational burns had more surgeries (3 ± 7.07 vs 1 ± 1.54, p=0.003), increased length of stay (21 days vs 8 days, p=0.004) and higher in-hospital mortality rate (17.1%vs 0.6%, p<0.001). Incidence of ARDS and AKI was 48.6%and 37.1%, respectively, compared to 0.6%and 1.2%in the patients without inhalational injury (p<0.001). Patients with inhalational injury had increased incidence of bacteraemia (31.4%vs 2.4%, p<0.001), pneumonia (37.1% vs 1.2%, p<0.001) and burn wound infection (51.4% vs 25.1%, p=0.004). Inhalational injury predicted AKI with an adjusted odds ratio (OR) of 17.43 (95%confidence interval (CI) 3.07–98.87, p<0.001);ARDS, OR=106.71 (95%CI 12.73–894.53, p<0.001) and pneumonia, OR=13.

关键词： Inhalational Burns Injury Acute kidney injury Acute respiratory distress syndrome Pneumonia

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Skin tissue engineering advances in severe burns:review and therapeutic applications

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Burns & Trauma 2016年第1期4卷 13-26页

作者： Alvin Wen Choong Chua Yik Cheong Khoo Bien Keem tan kok chai tan Chee Liam Foo Si Jack Chong Singapore General Hospital Department of PlasticReconstructive andAesthetic Surgery20 College RoadAcademia Level 4Singapore 169845Singapore. Singapore General Hospital Skin Bank UnitBlock 4 Level 3Room 15Outram RoadSingapore 169608Singapore. Transplant TissueCentre c/o Skin Bank UnitSingapore General HospitalBlock 4 Level 3 RoomA7Outram RoadSingapore 169608Singapore. Singapore General Hospital Skin Bank UnitBlock 4 Level 3Room 15Outram RoadSingapore 169608Singapore. Transplant TissueCentre c/o Skin Bank UnitSingapore General HospitalBlock 4 Level 3 RoomA7Outram RoadSingapore 169608Singapore. Singapore General Hospital Department of PlasticReconstructive andAesthetic Surgery20 College RoadAcademia Level 4Singapore 169845Singapore. Singapore General Hospital Skin Bank UnitBlock 4 Level 3Room 15Outram RoadSingapore 169608Singapore.

Current advances in basic stem cell research and tissue engineering augur well for the development of improved cultured skin tissue substitutes:a class of products that is still fraught with limitations for clinical *** the ability to grow autologous keratinocytes in-vitro from a small skin biopsy into sheets of stratified epithelium(within 3 to 4 weeks)helped alleviate the problem of insufficient donor site for extensive burn,many burn units still have to grapple with insufficient skin allografts which are used as intermediate wound coverage after burn *** offered by tissue-engineered skin dermal replacements to meet emergency demand have been used fairly *** the availability of these commercial products,they all suffer from the same problems of extremely high cost,sub-normal skin microstructure and inconsistent engraftment,especially in full thickness *** practice for severe burn treatment has since evolved to incorporate these tissue-engineered skin substitutes,usually as an adjunct to speed up epithelization for wound closure and/or to improve quality of life by improving the functional and cosmetic results *** review seeks to bring the reader through the beginnings of skin tissue engineering,the utilization of some of the key products developed for the treatment of severe burns and the hope of harnessing stem cells to improve on current practice.

关键词： Burns Skin tissue engineering Stem cells Cultured epithelial autografts Dermal substitutes Microskin grafting

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Critical evaluation of contemporary management in a new Pelvic Exenteration Unit: The first 25 consecutive cases

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World Journal of Gastrointestinal Oncology 2017年第5期9卷 218-227页

作者： Min Hoe Chew Yu-Ting Yeh Ee-Lin Toh Stephen Aditya Sumarli Ghee Kheng Chew Lui Shiong Lee Mann Hong tan Tiffany Priyanthi Hennedige Shin Yi Ng Say Kiat Lee Tze Tec Chong Hairil Rizal Abdullah Terence Lin Hon Goh Mohamed Zulfikar Rasheed kok chai tan Choong Leong tang Department of Colorectal Surgery Singapore General Hospital Department of Obstetrics and Gynaecology Singapore General Hospital Department of Urology Singapore General Hospital Department of Orthopaedic Surgery Singapore General Hospital Division of Oncological Imaging National Cancer Centre Singapore Department of Anaesthesiology Singapore General Hospital Vascular Surgery Singapore General Hospital Department of Plastic Reconstructive and Aesthetic SurgerySingapore General Hospital

To critically appraise short-term outcomes in patients treated in a new Pelvic Exenteration (PE) Unit. METHODSThis retrospective observational study was conducted by analysing prospectively collected data for the first 25 patients (16 males, 9 females) who underwent PE for advanced pelvic tumours in our PE Unit between January 2012 and October 2016. Data evaluated included age, co-morbidities, American Society of Anesthesiologists (ASA) score, Eastern Cooperative Oncology Group (ECOG) status, preoperative adjuvant treatment, intra-operative blood loss, procedural duration, perioperative adverse event, lengths of intensive care unit (ICU) stay and hospital stay, and oncological outcome. Quantitative data were summarized as percentage or median and range, and statistically assessed by the χ2 test or Fisher’s exact test, as applicable. RESULTSAll 25 patients received comprehensive preoperative assessment via our dedicated multidisciplinary team approach. Long-course neoadjuvant chemoradiotherapy was provided, if indicated. The median age of the patients was 61.9-year-old. The median ASA and ECOG scores were 2 and 0, respectively. The indications for PE were locally invasive rectal adenocarcinoma (n = 13), advanced colonic adenocarcinoma (n = 5), recurrent cervical carcinoma (n = 3) and malignant sacral chordoma (n = 3). The procedures comprised 10 total PEs, 4 anterior PEs, 7 posterior PEs and 4 isolated lateral PEs. The median follow-up period was 17.6 mo. The median operative time was 11.5 h. The median volume of blood loss was 3306 mL, and the median volume of red cell transfusion was 1475 mL. The median lengths of ICU stay and of hospital stay were 1 d and 21 d, respectively. There was no case of mortality related to surgery. There were a total of 20 surgical morbidities, which occurred in 12 patients. The majority of the complications were grade 2 Clavien-Dindo. Only 2 patients experienced grade 3 Clavien-Dindo complications, and both required procedura

关键词： Colorectal cancer Advanced pelvic tumour Sacrectomy Oncological outcome Pelvic exenteration Chordoma

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Membrane lipid binding molecules for the isolation of bona fide extracellular vesicle types and associated biomarkers in liquid biopsy

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Journal of Cancer Metastasis and Treatment 2019年第9期4卷 1-9页

作者： Ruenn chai Lai kok Hian tan Sai Kiang Lim A*STAR Institute of Medical Biology 8A Biomedical Grove#05-05 ImmunosSingapore 138648Singapore Department of Maternal Fetal Medicine KK Women’s&Children’s HospitalSingapore 229899Singapore Department of Surgery YLL School of MedicineNUSSingapore 119074Singapore

Cancer exacts a heavy socioeconomic cost. Earlier detection and treatment are likely to mitigate this cost. Unfortunately, conventional tissue biopsy, the gold standard in cancer diagnosis cannot fulfill the goal of earlier detection. While liquid biopsy is a promising alternative to tissue biopsy, it has its challenges and limitations. A major challenge is the isolation of bona fide lipid membrane vesicles from biological fluids. In this review, we presented a new perspective of isolating different types of extracellular vesicles (EVs) by their affinity for membrane lipid binding ligands for liquid biopsy. EVs are lipid membrane particles naturally released by almost all cells and are found in almost all biological fluids suitable for liquid biopsy. They carry materials from the secreting cells that could affect the biology of the recipient cells and could thus inform on the state and progress of the disease. However, isolating bona fide EVs is a technical challenge as biological fluids have a complex composition and contain particles or aggregates that are physically similar to EVs. Here we review the use of membrane lipid-binding ligands to isolate different bona fide EV subtypes, and to circumvent the problem of co-isolating physically similar non-EV complexes in current EV isolation protocols. We will discuss the advantages of this technique and its potential for accelerated biomarker discovery and validation through examples of pre-clinical studies. We propose that isolating EV subtypes is a technically viable and robust strategy to overcome the current bottleneck of isolating EVs for liquid biopsy.

关键词： Membrane lipid binding molecules extracellular vesicle cholera toxin B shiga toxin B annexin V biomarker

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Hemorrhoidectomy- making sense of the surgical options

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World Journal of Gastroenterology 2014年第45期20卷 16976-16983页

作者： Danson Yeo kok-Yang tan Department of Surgery Alexandra Health Khoo Teck Puat Hospital

While debate continues as to which is the best surgical method for the treatment of hemorrhoids, none of the currently available surgical methods approach the ideal surgical option, which is one that is effective while being safe and painless. In reality, the less painful the procedure, the more likely it is to be associated with recurrence post-op. Where hemorrhoids surgery is concerned, there isn’t a “one size fits all” option. Most of the randomized controlled trials performed to date include hemorrhoids of various grades and with a focus on only comparing surgical methods while failing to stratify the outcomes according to the grade of hemorrhoid. We believe that surgery needs to be tailored not only to the grade of the hemorrhoids, but also to the size, circumferential nature of the disease, and prevailing symptomatology.

关键词： Hemorrhoidectomy Doppler-guided hemorrhoidal artery ligation Stapler LigaSure Conventional

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AI-Assisted approach for building energy and carbon footprint modeling

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Energy and AI 2021年第3期5卷 201-208页

作者： Chih-Yen Chen kok Keong chai Ethan Lau School of Electronic Engineering and Computer Science Queen Mary University of LondonUnited Kingdom

This paper proposes an energy and carbon footprint modelling using artificial intelligence technique to assess the impact of occupant density for various types of office *** use EnergyPlus to simulate energy con-sumption,and then estimate the related CO₂emissions based on three years(2016–2018)of Actual Meteoro-logical Year(AMY)weather *** occupant densities were used to evaluate the annual energy consumption and CO₂*** this work,a robust deep learning technique of long short-term memory(LSTM)model was established to predict the time-series energy consumption and CO₂emissions.A power exponential curve was suggested to correlate the behaviour of annual energy and CO₂emission for occupant densities range from 10 to 100 m2/person for each office building *** results of LSTM model show high prediction performance and small variations within the three types of office building data,which can be applied to the similar building model to predict and optimise energy consumption and CO₂emission.

关键词： Building energy simulation and benchmarking Carbon footprint Occupant density Artificial intelligence Long short-term memory(LSTM) Smart city

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Phage display creates innovative applications to combat hepatitis B virus

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World Journal of Gastroenterology 2014年第33期20卷 11650-11670页

作者： Wen Siang tan kok Lian Ho Department of Microbiology Faculty of Biotechnology and Biomolecular Sciences Universiti Putra Malaysia 43400 UPM Serdang Selangor Malaysia Department of Pathology Faculty of Medicine and Health Sciences Universiti Putra Malaysia 43400 UPM Serdang Selangor Malaysia

Hepatitis B virus (HBV) has killed countless lives in human history. The invention of HBV vaccines in the 20th century has reduced significantly the rate of the viral infection. However, currently there is no effective treatment for chronic HBV carriers. Newly emerging vaccine escape mutants and drug resistant strains have complicated the viral eradication program. The entire world is now facing a new threat of HBV and human immunodeficiency virus co-infection. Could phage display provide solutions to these life-threatening problems? This article reviews critically and comprehensively the innovative and potential applications of phage display in the development of vaccines, therapeutic agents, diagnostic reagents, as well as gene and drug delivery systems to combat HBV. The application of phage display in epitope mapping of HBV antigens is also discussed in detail. Although this review mainly focuses on HBV, the innovative applications of phage display could also be extended to other infectious diseases.

关键词： Phage display Hepatitis B virus Epitope mapping Drug delivery Gene delivery Antiviral drug Therapeutics Diagnosis Hepatocellular carcinoma Virus-like particle Vaccine

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Current research and treatment for gastrointestinal stromal tumors

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World Journal of Gastroenterology 2017年第27期23卷 4856-4866页

作者： Kheng Tian Lim kok Yang tan Department of Surgery Khoo Teck Puat Hospital

Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal tumors of the gastrointestinal tract and have gained considerable research and treatment interest,especially in the last two decades. GISTs are driven by mutations commonly found in the KIT gene and less commonly in the platelet-derived growth factor receptor alpha gene,BRAF gene and succinate dehydrogenase gene. GISTs behave in a spectrum of malignant potential,and both the tumor size and mitotic index are the most commonly used prognostic criteria. Whilst surgical resection can offer the best cure,targeted therapy in the form of tyrosine kinase inhibitors(TKIs) has revolutionized the management options. As the first-line TKI,imatinib offers treatment for advanced and metastatic GISTs,adjuvant therapy in high-risk GISTs and as a neoadjuvant agent to downsize large tumors prior to resection. The emergence of drug resistance has altered some treatment options,including prolonging the first-line TKI from 1 to 3 years,increasing the dose of TKI or switching to second-line TKI. Other newer TKIs,such as sunitinib and regorafenib,may offer some treatment options for imatinib-resistant GISTs. New molecular targeted therapies are being evaluated,such as inhibitors of BRAF,heat shock protein 90,glutamine and mitogenactivated protein kinase signaling,as well as inhibitors of apoptosis proteins antagonist and even immunotherapy. This editorial review summarizes the recent research trials and potential treatment targets that may influence our future patient-specific management of GISTs. The current guidelines in GIST management from Europe,North America and Asia are highlighted.

关键词： Gastrointestinal stromal tumors KIT gene Platelet-derived growth factor receptor alpha gene BRAF gene Succinate dehydrogenase gene CD117 Tyrosine kinase inhibitor Molecular targeted therapy

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Global Justice,Luck,and Human Needs:Reflections on Gu and Liu

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Fudan Journal of the Humanities and Social Sciences 2019年第2期12卷 255-261页

作者： kok-Chor tan Department of Philosophy University of PennsylvaniaPhiladelphiaUSA

In his paper“Nationalism,Egalitarianism and Global Justice”,Su Gu extends luck egalitarianism to the debate on global justice in an unconventional *** invokes luck egalitarianism not to support global egalitarianism,as is commonly the case,but to push back against *** Liu’s paper,“Global Justice as the Bottom Line:Equal Needs or Equal Rights?”,is also unorthodox[both papers are published in this journal(forthcoming)].Running against one current in global justice,Liu argues that there is no duty of global justice to meet basic needs and that,moreover,global redistributive policies for the purpose of satisfying needs are generally *** Liu and Gu provide different arguments for their conclusions,they both believe that global redistributive demands unfairly impose on those who are expected to *** aim in this brief commentary is to try to situate these papers within the global justice literature and to raise some questions that they provoke.

关键词： Basic needs Distributive justice Global justice Luck egalitarianism

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State of arts on the bio-synthesis of noble metal nanoparticles and their biological application

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Chinese Journal of Chemical Engineering 2021年第2期34卷 272-290页

作者： kok Bing tan Daohua Sun Jiale Huang Tareque Odoom-Wubah Qingbiao Li Department of Chemical and Biochemical Engineering College of Chemistry and Chemical EngineeringXiamen UniversityXiamen 361005China Department of Biomedical Engineering College of Engineering and Computer ScienceWentworth Institute of Technology550 Huntington AvenueBostonMA 02115United States College of Food and Biology Engineering Jimei UniversityXiamen 361021China

Nanomaterials are materials in which at least one of the dimensions of the particles is 100 nm and *** are many types of nanomaterials,but noble metal nanoparticles are of interest due to their uniquely large surface-to-volume ratio,high surface area,optical and electronic properties,high stability,easy synthesis,and tunable surface *** importantly,noble metal nanoparticles are known to have excellent compatibility with bio-materials,which is why they are widely used in biological *** synthesis method of noble metal nanoparticles conventionally involves the reduction of the noble metal salt precursor by toxic reaction agents such as NaBH4,hydrazine,and *** is a major drawback for researchers involved in biological application ***,the bio-synthesis of noble metal nanoparticles(NPs)by bio-materials via bio-reduction provides an alternative method to synthesize noble metal nanoparticles which are potentially non-toxic and safer for biological *** this review,the bio-synthesis of noble metal nanoparticle including gold nanoparticle(AuNPs),silver nanoparticle(AgNPs),platinum nanoparticle(PtNPs),and palladium nanoparticle(PdNPs)are first *** is followed by a discussion of these biosynthesized noble metal in biological applications including antimicrobial,wound healing,anticancer drug,and *** on these,it can be concluded that the study on bio-synthesized noble metal nanoparticles will expand further involving bio-reduction by unexplored ***,many questions remain on the feasibility of bio-synthesized noble metal nanoparticles to replace existing methods on various biological ***,the current development of the biological application by bio-synthesized noble metal NPs is still intensively ongoing,and will eventually reach the goal of full commercialization.

关键词： Noble metal nanoparticles Bio-synthesis Bio-templating Bio-material Bio-logical application Nanomaterials

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