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Transfusion-transmitted hepatitis E:What we know so far?

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World Journal of Gastroenterology 2022年第1期28卷 47-75页

作者： Carmen Ka Man Cheung Sunny Hei Wong Alvin Wing Hin law Man fai law Medicine and Therapeutics Prince of Wales HospitalHong Kong 852China Institute of Digestive Disease and Department of Medicine and Therapeutics the Chinese University of Hong KongHong Kong 852China Lee Kong Chian School of Medicine Nanyang Technological UniversitySingapore 639798Singapore West Island School Hong Kong 852China

Hepatitis E virus(HEV)is a major cause of viral hepatitis *** is growing concern about transfusion-transmitted HEV(TT-HEV)as an emerging global health *** can potentially result in chronic infection in immunocompromised patients,leading to a higher risk of liver cirrhosis and even *** 0.0013%and 0.281%of asymptomatic blood donors around the world have HEV viremia,and 0.27%to 60.5%have anti-HEV immunoglobulin *** is infectious even at very low blood concentrations of the *** patients who develop persistent hepatitis E infection should have their immunosuppressant regimen reduced;ribavirin may be considered as *** interferon can be considered in those who are refractory or intolerant to ***,a nucleotide analog,showed modest antiviral activity in some clinical studies but sustained viral response was not ***,rescue treatment remains an unmet *** need for HEV screening of all blood donations remains *** screening has been adopted in some countries after consideration of risk and resource *** pathogen reduction methods have also been proposed to reduce the risk of *** studies are needed to define the incidence of transmission through transfusion,their clinical features,outcomes and prognosis.

关键词： Hepatitis E virus Acute and chronic hepatitis Immunosuppression Blood transfusion Transplantation

Efficacy of Vaccine Protection Against COVID-19 Virus Infection in Patients with Chronic Liver Diseases

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Journal of Clinical and Translational Hepatology 2023年第3期11卷 718-735页

作者： Carmen Ka Man Cheung Kimmy Wan Tung law Alvin Wing Hin law Man fai law Rita Ho Sunny Hei Wong Department of Medicine and Therapeutics Prince of Wales HospitalHong KongChina West Island School Hong KongChina Department of Medicine North District HospitalHong KongChina Institute of Digestive Disease and Department of Medicine and Therapeutics State Key Laboratory of Digestive DiseaseLi Ka Shing Institute of Health SciencesThe Chinese University of Hong KongHong KongChinaLee Kong Chian School of MedicineNanyang Technological UniversitySingapore

The outbreak of coronavirus disease 2019 (COVID-19) has resulted in significant morbidity and mortality worldwide. Vaccination against coronavirus disease 2019 is a use-ful weapon to combat the virus. Patients with chronic liver diseases (CLDs), including compensated or decompensated liver cirrhosis and noncirrhotic diseases, have a decreased immunologic response to coronavirus disease 2019 vaccines. At the same time, they have increased mortality if infected. Current data show a reduction in mortality when patients with chronic liver diseases are vaccinated. A suboptimal vac-cine response has been observed in liver transplant recipi-ents, especially those receiving immunosuppressive therapy, so an early booster dose is recommended to achieve a better protective effect. Currently, there are no clinical data com-paring the protective efficacy of different vaccines in patients with chronic liver diseases. Patient preference, availability of the vaccine in the country or area, and adverse effect profiles are factors to consider when choosing a vaccine. There have been reports of immune-mediated hepatitis after coronavi-rus disease 2019 vaccination, and clinicians should be aware of that potential side effect. Most patients who developed hepatitis after vaccination responded well to treatment with prednisolone, but an alternative type of vaccine should be considered for subsequent booster doses. Further prospec-tive studies are required to investigate the duration of immu-nity and protection against different viral variants in patients with chronic liver diseases or liver transplant recipients, as well as the effect of heterologous vaccination.

关键词： COVID-19 SARS-CoV-2 Chronic liver disease Liver transplanta-tion Vaccine mRNA.

Prevention and management of hepatitis B virus reactivation in patients with hematological malignancies in the targeted therapy era

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World Journal of Gastroenterology 2023年第33期29卷 4942-4961页

作者： Joyce Wing Yan Mak Alvin Wing Hin law Kimmy Wan Tung law Rita Ho Carmen Ka Man Cheung Man fai law Department of Medicine and Therapeutics Prince of Wales HospitalHong Kong 852China West Island School Hong Kong 852China Department of Medicine North District HospitalHong Kong 852China

Hepatitis due to hepatitis B virus(HBV)reactivation can be serious and potentially fatal,but is *** reactivation is most commonly reported in patients receiving chemotherapy,especially rituximab-containing therapy for hematological malignancies and those receiving stem cell *** with inactive and even resolved HBV infection still have persistence of HBV genomes in the *** expression of these silent genomes is controlled by the immune *** or ablation of immune cells,most importantly B cells,may lead to reactivation of seemingly resolved HBV ***,all patients with hematological malignancies receiving anticancer therapy should be screened for active or resolved HBV infection by blood tests for hepatitis B surface antigen(HBsAg)and antibody to hepatitis B core *** found to be positive for HBsAg should be given prophylactic antiviral *** patients with resolved HBV infection,there are two *** first is pre-emptive therapy guided by serial HBV DNA monitoring,and treatment with antiviral therapy as soon as HBV DNA becomes *** second approach is prophy-lactic antiviral therapy,particularly for patients receiving high-risk therapy,especially anti-CD20 monoclonal antibody or hematopoietic stem cell *** and tenofovir are the preferred antiviral *** new effective therapies for hematological malignancies have been introduced in the past decade,for example,chimeric antigen receptor(CAR)-T cell therapy,novel monoclonal antibodies,bispecific antibody drug conjugates,and small molecule inhibitors,which may be associated with HBV *** there is limited evidence to guide the optimal preventive measures,we recommend antivi-ral prophylaxis in HBsAg-positive patients receiving novel treatments,including Bruton’s tyrosine kinase inhibitors,B-cell lymphoma 2 inhibitors,and CAR-T cell *** studies are needed to determine the risk o

关键词： Hepatitis B Hematologic neoplasms Chimeric antigen receptor-T cell therapy Monoclonal antibodies Bruton’s tyrosine kinase inhibitors Antiviral agents

Identification of TWIST-interacting genes in prostate cancer

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Science China(Life Sciences) 2017年第4期60卷 386-396页

作者： Peng Lyu Shu-Dong Zhang hiu-Fung Yuen Cian M.McCrudden Qing Wen Kwok-Wah Chan Hang fai Kwok Faculty of Health Sciences University of Macao Avenida de Universidade Macao 999078 China Northern Ireland Centre for Stratified Medicine C-TRIC Building Altnagelvin Hospital Campus Ulster University Londonderry BT47 6SB UK Institute of Molecular and Cellular Biology Agency for Science Technology and Reseach Singapore 138673 Singapore School of Pharmacy Queen's University of Belfast Belfast BT9 7BL UK Centre for Cancer Research & Cell Biology School of Medicine Dentistry and Biomedical Sciences Queen's University Belfast Belfast BT9 7BL UK Department of Pathology Queen Mary Hospital University of Hong Kong Hong Kong 999077 China

Prostate cancer is one of the most common cancers in men worldwide, and the number of diagnosed patients has dramatically increased in recent years. Currently, the clinical parameters used to diagnose prostate cancer, such as Gleason score, pathological tumor staging, and prostate-specific antigen(PSA) expression level, are considered insufficient to inform recommendation to guide clinical practice. Thus, identification of a novel biomarker is necessary. TWIST is one of the well-studied targets and is correlated with cancer invasion and metastasis in several human cancers. We have investigated two largest prostate cancer patient cohorts available in GEO database and found that TWIST expression is positive correlated with Gleason score and associated with poorer survival. By using a prostate cancer cohort and a prostate cancer cell line dataset, we have identified three potential downstream targets of TWIST, PPM1 A, SRP72 and TBCB. TWIST's prognostic capacity is lost when the gene is mutated. Further investigation in the prostate cancer cohort revealed that gene expression of SERPINA, STX7, PDIA2, FMP5, GP1 BB, VGLL4,KCNMA1, SHMT2, SAA4 and DIDO1 influence the prognostic significance of TWIST and vice versa. Importantly, eight out of these ten genes are prognostic indicator by itself. In conclusion, our study has further confirmed that TWIST is a prognostic marker in prostate cancer, identified its potential downstream targets and genes that could possibly give additional prognostic value to predict TWIST-mediated prostate cancer progression.

关键词： Gleason prognostic staging cohort progression invasion downstream metastasis biomarker interacting

Gastrointestinal and hepatic side effects of potential treatment for COVID-19 and vaccination in patients with chronic liver diseases

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World Journal of Hepatology 2021年第12期13卷 1850-1874页

作者： Man fai law Rita Ho Kimmy Wan Tung law Carmen Ka Man Cheung Department of Medicine and Therapeutics Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina Department of Medicine North District HospitalHong KongChina West Island School Hong KongChina

The outbreak of coronavirus disease 2019(COVID-19)is a global *** clinical trials have been performed to investigate potential treatments or vaccines for this disease to reduce the high morbidity and *** drugs of higher interest include umifenovir,bromhexine,remdesivir,lopinavir/ritonavir,steroid,tocilizumab,interferon alpha or beta,ribavirin,fivapiravir,nitazoxanide,ivermectin,molnupiravir,hydroxychloroquine/chloroquine alone or in combination with azithromycin,and ***(GI)symptoms and liver dysfunction are frequently seen in patients with COVID-19,which can make it difficult to differentiate disease manifestations from treatment adverse *** symptoms of COVID-19 include anorexia,dyspepsia,nausea,vomiting,diarrhea and abdominal *** injury can be a result of systemic inflammation or cytokine storm,or due to the adverse drug effects in patients who have been receiving different *** monitoring of liver function should be ***-19 vaccines have been rapidly developed with different technologies including mRNA,viral vectors,inactivated viruses,recombinant DNA,protein subunits and live attenuated *** with chronic liver disease or inflammatory bowel disease and liver transplant recipients are encouraged to receive vaccination as the benefits outweigh the *** against COVID-19 is also recommended to family members and healthcare professionals caring for these patients to reduce exposure to the severe acute respiratory syndrome coronavirus 2 virus.

关键词： COVID-19 treatment Gastrointestinal side effects Hepatic side effects COVID-19 vaccine Chronic liver disease Liver transplantation

Rare case of intussusception in an adult with acute myeloid leukemia

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World Journal of Gastroenterology 2015年第2期21卷 688-693页

作者： Man fai law Cheuk Kei Wong Chun Yin Pang Hay Nun Chan Ho Kei Lai Chung Yin Ha Celia Ng Yiu Ming Yeung Sze fai Yip Department of Medicine Tuen Mun Hospital Department of Medicine and Therapeutics Prince of Wales Hospital Department of Radiology Kwong Wah Hospital Department of Pathology Tuen Mun Hospital

Intussusception is rarely reported in adult patients with acute leukemia. We report a case of intussusception in a 29-year-old woman with acute myeloid leukemia(AML). She developed right lower quadrant pain, fever, and vomiting on day 16 of induction *** examination showed tenderness and guarding at the right lower quadrant of the abdomen. Abdominal computed tomography(CT) showed distension of the cecum and ascending colon, which were filled with loops of small bowel, and herniation of the ileocecal valve into the cecum. We proceeded to laparotomy and revealed ileocecal intussusception with the ileocecal valve as the leading point. The terminal ileum was thickened and invaginated into the cecum, which showed gangrenous changes. Right hemicolectomy was performed and microscopic examination of the colonic tissue showed infiltration of leukemic cells. The patient recovered after the operation and was subsequently able to continue treatment for AML. This case demonstrates that the diagnosis of intussusception is difficult because the presenting symptoms can be non-specific, but abdominal CT can be informative for preoperative diagnosis. Resection of the involved bowel is recommended when malignancy is suspected or confirmed. Intussusception should be considered in any leukemia patients presenting with acute abdomen. A high index of clinical suspicion is important for early diagnosis.

关键词： Intussusception Acute leukemia Abdominal pain Colo

The combined role of MRI prostate and prostate health index in improving detection of significant prostate cancer in a screening population of Chinese men

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Asian Journal of Andrology 2023年第6期25卷 674-679页

作者： Peter KF Chiu Thomas YT Lam Chi-fai Ng Jeremy YC Teoh Carmen CM Cho hiu-Yee Hung Cindy Hong Monique J Roobol Winnie CW Chu Samuel YS Wong Joseph JY Sung SH Ho Urology Centre Department of SurgeryThe Chinese University of Hong KongHong Kong SARChina The Jockey Club School of Public Health and Primary Care The Chinese University of Hong KongHong Kong SARChina Department of Imaging and Interventional Radiology The Chinese University of Hong KongHong Kong SARChina Erasmus MC Cancer Institute Erasmus Medical UniversityRotterdam 3015The Netherlands Lee Kong Chian School of Medicine Nanyang Technological UniversitySingapore 308232Singapore

Using prostate-specific antigen(PSA)for prostate cancer(PCa)screening led to overinvestigation and overdiagnosis of indolent *** aimed to investigate the value of prostate health index(PHI)and magnetic resonance imaging(MRI)prostate in an Asian PCa screening *** aged 50–75 years were prospectively recruited from a community-based PSA screening *** with PSA 4.0–10.0 ng ml^(−1) had PHI result *** prostate was offered to men with PSA 4.0–50.0 ng ml−1.A systematic prostate biopsy was offered to men with PSA 4.0–9.9 ng ml^(−1) and PHI≥35,or PSA 10.0–50.0 ng ml^(−1).Additional targeted prostate biopsy was offered if they had PI-RADS score≥*** significant PCa(csPCa)was defined as the International Society of Urological Pathology(ISUP)grade group(GG)≥2 or ISUP GG 1 with involvement of≥30%of total systematic *** total,12.8%(196/1536)men had PSA≥4.0 ng ml^(−1).Among 194 men with PSA 4.0–50.0 ng ml^(−1),187(96.4%)received MRI *** them,28.3%(53/187)had PI-RADS≥3 ***,7.0%(107/1536)men were indicated for biopsy and 94.4%(101/107)men received *** the men received biopsy,PCa,ISUP GG≥2 PCa,and csPCa was diagnosed in 42(41.6%),24(23.8%),and 34(33.7%)men,*** with PSA/PHI pathway in men with PSA 4.0–50.0 ng ml^(−1),additional MRI increased diagnoses of PCa,ISUP GG≥2 PCa,and csPCa by 21.2%(from 33 to 40),22.2%(from 18 to 22),and 18.5%(from 27 to 32),*** benefit of additional MRI was only observed in PSA 4.0–10.0 ng ml^(−1),and the number of MRI needed to diagnose one additional ISUP GG≥2 PCa was 20 in PHI≥35 and 94 in PHI<*** them,45.4%(89/196)men with PSA≥4.0 ng ml^(−1) avoided unnecessary biopsy with the use of PHI and MRI.A screening algorithm with PSA,PHI,and MRI could effectively diagnose csPCa while reducing unnecessary *** benefit of MRI prostate was mainly observed in PSA 4.0–9.9 ng ml^(−1) and PHI≥35 *** was an important risk stratification step for PCa

关键词： magnetic resonance imaging prostate prostate cancer prostate health index prostate-specific antigen screening

Imaging of the anterior cruciate ligament

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World Journal of Orthopedics 2011年第8期2卷 75-84页

作者： Wing Hung Alex Ng James Francis Griffith Esther hiu Yee Hung Bhawan Paunipagar Billy Kan Yip law Patrick Shu Hang Yung Department of Imaging and Interventional Radiology Prince of Wales HospitalChinese University of Hong KongHong KongChina Department of Orthopedics and Traumatology Prince of Wales HospitalChinese University of Hong KongHong KongChina

The anterior cruciate ligament(ACL)is an important structure in maintaining the normal biomechanics of the knee and is the most commonly injured knee ***,the oblique course of the ACL within the intercondylar fossa limits the visualization and assessment of the pathology of the *** pictorial essay provides a comprehensive and illustrative review of the anatomy and biomechanics as well as updated information on different modalities of radiological investigation of ACL,particularly magnetic resonance imaging.

关键词： Magnetic resonance Knee Anterior cruciate ligament Tear

Patients with Helicobacter pylori positive and negative duodenal ulcers have distinct clinical characteristics

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World Journal of Gastroenterology 2005年第23期11卷 3518-3522页

作者： Kent-Man Chu Ka-fai Kwok Simon law Kam-Ho Wong Department of Surgery

AIM: To assess the clinical characteristics of Helicobacterpylori(H pylori) negative duodenal ***: Patients with an endoscopic diagnosis of duodenal ulcer between 1996 and 2002 were included in the present study. Patients were considered to be negative for Hpylori, if both histological examination and rapid urease test of biopsy specimens were negative. A comparison was made between patients with H pyloripositive and negative duodenal ***: A total of 1 343 patients were studied. Their mean age was 54.7±0.5 years. There was a male preponderance (M:F = 2.5:1). Three hundred and ninetyeight patients (29.6%) did not have H pylori infection. The annual proportion of patients with H pylori negative duodenal ulcers increased progressively from 1996 to2002. On multivariate analysis, patients with H pylorinegative duodenal ulcer were more likely to be older, have concomitant medical problem, pre-existing malignancy, recent surgery, underlying sepsis, or taken non-steroidal anti-inflammatory drugs. In terms of clinical presentations, patients with H pylori negative duodenal ulcer were more likely to present with bleeding, multiple ulcers and larger ***: The proportion of patients with H pylori negative duodenal ulcers is on the rise because of a continued drop in incidence of H pylori positive duodenalulcers in recent years. Such patients have distinct clinical characteristics and it is important to ascertain the H pylori status before starting eradication therapy.

关键词： Helicobacter pylori Duodenal ulcer