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World Journal of Emergency Medicine 2020年第1期11卷 48-53页

作者： Shao-xi Chen Karren Fan ling-pong leung Accident and Emergency Department University of Hong Kong-Shenzhen Hospital

Dear editor,China is the most populated country and the second economic entity *** Kong and Shenzhen are two adjacent cities in southern China,with similar environmental,cultural,ethnic groups,and economic *** both have a very interesting turning point in their destiny,leading to a miraculous economic ***,their government structure and health care system are totally different.[1]This is a vivid example of Deng Xiaoping’s formulation of the principle of“one country,two systems”.

关键词： editor turning totally

A potentially life-threatening complication of university orientation activities

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World Journal of Emergency Medicine 2012年第1期3卷 71-73页

作者： ling pong leung Accident & Emergency Department Queen Mary Hospital

BACKGROUND:This case report describes a university student who participated in an orientation activity and developed exertional ***:With prompt intravenous volume expansion started in the accident and emergency department,he made an uneventful recovery despite a marked elevation of creatine *** risk factors of developing exertional rhabdomyolysis were *** based on these risk factors were made to the organizers of such orientation ***:He was discharged on day *** follow-up on day 8 after presentation at the accident and emergency department,the CK level was 46 000 U/L and it fell to 2600 U/L in another *** follow-up 3 weeks after the incident,he remained well without ***:For the clinicians,once rhadbomyolysis is suspected or diagnosed,intravenous fluid therapy with a crystalloid should be initiated as soon as possible to prevent the occurrence of acute renal faiure.

关键词： Rhadbomyolysis Acute renal faiure

Performance of a prehospital trauma diversion system in Hong Kong, China

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Chinese Journal of Traumatology 2015年第3期18卷 137-140页

作者： Tak-Wai Lui Kit-ling Fan ling-pong leung Department of Medidne Queen Mary Hospital Hong Kong China Emergency Medicine Unit Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong China

Purpose： To evaluate the performance of a prehospital trauma diversion system in Hong Kong, China. Methods： A retrospective analysis of prospectively collected data in the trauma registry of Queen Mary Hospital, Hong Kong from I January 2009 to 31 December 2013 was done. All adult patients aged 18 years or above, either primarily or secondarily diverted to Queen Mary Hospital according to the trauma patient diversion protocol, were recruited. Need for trauma center level of care was based on a consensus-based criterion standard published in 2014. Performance of the protocol in terms of over-diversion and under-diversion was determined. Results： A total of 209 patients were included for analysis. About 30% of the patients required trauma center level of care. The most common reason was the need for vascular, neurologic, abdominal, thoracic, pelvic, spine or limb-conserving surgery within 24 h of presentation. The over-diversion rate and under-diversion rate were 69.6% and 19.7% respectively. Conclusion： The trauma patient diversion protocol currently in use in Hong Kong is not accurate enough. Further revision and refinement is needed.

关键词： Trauma diversion Triage Prehospital care Hong Kong

An Uncommon Potentially Fatal Complication in a Patient without Predisposing Factor Following Oral Bowel Preparation Commonly Used for Colonoscopy

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Open Journal of Emergency Medicine 2016年第1期4卷 6-10页

作者： Iris Wai Sum Li ling pong leung Sik Hon Tsui Queen Mary Hospital Hospital Authority Hong Kong China Emergency Medicine Unit Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong China Department of Accident & Emergency Queen Mary Hospital Hospital Authority Hong Kong Special Administrative Region Hong Kong China

We described the case report of a patient presented with no known predisposing factor, generalized malaise with vomiting, locked jaw, perioral paraesthesia, carpopedal spasm and a positive Chvostek’s sign which resulted from severe electrolyte disturbance at 5 hours after use of oral sodium phosphate solution (NaPO4) as bowel preparation for colonoscopy. On presentation, she developed hyperphosphatemia and symptomatic hypocalcaemia with serum phosphate of 1.84 mmol/L and adjusted calcium level 1.67 mmol/L respectively. Her symptoms subsided after immediate intravenous calcium gluconate followed by oral calcium supplement. The electrolyte disturbances were normalized with an uneventful clinical course. The potentially fatal complications of sodium phosphate solution which commonly prescribed as bowel preparation for conventional colonoscopy could develop though previously reported as uncommon in patients without predisposing factors, and should not be overlooked. Urgent assessment and immediate correction of electrolyte disturbances are needed. Recommendations on patient selection of use of sodium phosphate to minimize risk of developing adverse events are needed to incorporate in clinical protocols.

关键词： Symptomatic Hypocalcaemia Hyperphosphatemia Sodium Phosphate Solution Bowel

Comparison of two emergency medical services in Beijing and Hong Kong, China

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Chinese Medical Journal 2019年第11期132卷 1372-1374页

作者： Fei Shao Kit-ling Fan Colin Robertson Marcus Ong Nan Liu ling-pong leung Reynold leung Chun-Sheng Li Departm ent of Emergency Medicine Beijing Chao-Yang Hospital Capital Medical University Beijing 100020 China Accident and Emergency Department The Hong Kong University-Shenzhen Hospital Shenzhen Guangdong 518053 China Accident and Emergency Medicine and Surgery University of Edinburgh Scotland UK Department of Emergency Medicine Singapore General Hospital Singapore Health Services Research Centre Singapore Health Services Singapore Emergency Medicine Unit Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong China

To Out-of-hospital cardiac arrest (OHCA) is a major issue in emergency care worldwide. The incidence of OHCA is estimated to be 50 to 60 per 100,000 persons *** advances in treatment and technology, survival following OHCA remains low. There are multiple factors affecting the survival outcome. The type of emergency medical service (EMS) system is likely to be one of them. In Asia, the EMS structure and its service capability in terms of dispatch, airway management, and medications vary widely between communities. This study aimed to evaluate the survival outcomes of OHCA in Beijing and Hong Kong (HK), China and the effect of the type of EMS system on the survival outcomes for patients with OHCA.

关键词： Extrahospital cardiac arrest (ohca) cardiac arrest emergency medical service

Utilization of the Accident & Emergency Departments by Chinese elderly in Hong Kong

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World Journal of Emergency Medicine 2015年第4期6卷 283-288页

作者： Wai Lam Yip Kit ling Fan Chun Tat Lui ling pong leung Fu Ng Kwok leung Tsui Accident & Emergency Department Queen Mary Hospital Emergency Medicine Unit The University of Hong Kong Accident & Emergency Department Tuen Mun Hospital Accident & Emergency Department Caritas Medical Centre

BACKGROUND: The epidemiological data on elderly patients attending Accident and Emergency Departments(AEDs) in Hong Kong is lacking. The study aimed to examine the epidemiology of geriatric patient visits to AEDs in Hong Kong, including demographic data and predictors of life-saving interventions(LSI) and ***: A retrospective cross-sectional study of geriatric patients older than 64 years old attending three AEDs during the year 2012, with a sample of 1 200 patient visits recruited. The data were retrieved from the medical records of the respective hospitals. Descriptive characteristics of the visits were provided. Multivariate logistic regression was performed to evaluate the predictors of LSI and hospital ***: The mean age of the patients was 79.1 years. Totally 49.7% of the patients were male. "Diseases of the respiratory system" was the commonest diagnosis in AEDs as well as that required admission. The admission rate was 56.8%. Logistic regression demonstrated that dependent activity of daily living(ADL), arrival by ambulance, and the higher number of co-morbidities were predictors of LSI, while advanced age, dependent ADL, institutionalized patients, arrival by ambulance, and higher number of co-morbidities were predictors of hospital ***: Ageing population is creating an imminent burden on the emergency service in Hong Kong. Previously unavailable epidemiological information about geriatric attendance to AEDs was described. This forms the basis for development of future studies concerning the medical services on this specific group of patients.

关键词： Elderly Geriatric Emergency department Epidemiology

Mechanism of metastasis by membrane type 1-matrix metalloproteinase in hepatocellular carcinoma

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World Journal of Gastroenterology 2005年第40期11卷 6269-6276页

作者： Ying-Chi Ip Siu-Tim Cheung Ka-ling leung Sheung-Tat Fan Centre for the Study of Liver Disease and Department of Surgery

AIM To investigate the precise role of membrane type 1-matrix metalloproteinase （NTI-NNP） in hepatocellular carcinoma （HCC） metastasis. METHODS- Human HCC cells Hep3B with overexpression of MTT-MMP were established by stable transfection, and compared with control cells carrying the empty vector. Cells were examined in vivo for their differences in the metastatic ability of athymic nude mice, and analyzed in vito for their differences in invasion ability by invasion chamber coated with Matrigel, adhesion towards collagen I and migration through culture chamber. Cell proliferation and apoptosis in adherent and suspension status were evaluated by MTr and flow cytometry analysis. RESULTS We found that overexpression of MT1-MMP could increase intrahepatic metastasis in nude mice with orthotopic implantation of HCC cells （incidence of 100% [MT1-MMP transfectants] vs 40% [vector control transfectants], P〈0.05）. NT1-MMP could also enhance cell invasion through Natrigel （107.7 vs 39.3 cells/field, P〈0.001）, adhesion towards matrix （0.30 vs 0.12 absorbance unit at 540 nm, P〈0.001）, cell migration （89.3 vs 39.0 cells/field, P〈0.001）, and cell proliferation （24.3 vs 40.5 h/doubling, P〈0.001）. We also observed that NTI-NNP supported cell survival （71.4% vs 23.9%, P〈0.001） with reduced apoptosis （43.7% vs51.0%, P〈0.05） in an attachment-free environment. CONCLUSION： MT1-MMP overexpression could enhance metastasis. In addition to its active role in matrix degradation during tumor invasion, MT1-MMP enhances tumor cell survival upon challenge of detachment, which is important during metastasis when cells enter the circulation.

关键词： MT1-MMPIMMP14 Liver cancer Invasion Metastasis

Modulatory Effects and Action Mechanisms of Tryptanthrin on Murine Myeloid Leukemia Cells

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Cellular & Molecular Immunology 2009年第5期6卷 335-342页

作者： Hoi-ling Chan Hon-Yan Yip Nai-Ki Mak Kwok-Nam leung Department of Biochemistry The Chinese University of Hong Kong Shatin HKSAR China Department of Food and Nutritional SciencesProgramme The Chinese University of Hong Kong Shatin HKSAR China Department of Biology Hong Kong Baptist University Kowloon TongHKSAR China Department of Biochemistry and Food and Nutritional Sciences Programme The Chinese University of Hong Kong Shatin HKSAR China

Leukemia is the disorder of hematopoietic cell development and is characterized by an uncoupling of cell proliferation and differentiation. There is a pressing need for the development of novel tactics for leukemia therapy as conventional treatments often have severe adverse side effects. Tryptanthrin （6,12-dihydro-6,12-dioxoindolo- （2,1-b）-quinazoline） is a naturally-occurring, weakly basic alkaloid isolated from the dried roots of medicinal indigo plants （Ban-Lan-Gen）. It has been reported to have various biological and pharmacological activities, including anti-microbial, anti-inflammatory, immunomodulatory and anti-tumor effects. However, its modulatory effects and action mechanisms on myeloid cells remain poorly understood. In this study, tryptanthrin was shown to suppress the proliferation of the murine myeloid leukemia WEHI-3B JCS cells in a dose- and time-dependent manner. It also significantly reduced the growth of WEHI-3B JCS cells in vivo in syngeneic BALB/c mice. However, it exhibited no significant direct cytotoxicity on normal murine peritoneal macrophages. Flow cytometric analysis showed an obvious cell cycle arrest of the tryptanthrin-treated WEHI-3B JCS cells at the G0/G1 phase. The expression of cyclin D2, D3, Cdk 2, 4 and 6 genes in WEHI-3B JCS cells was found to be down-regulated at 24 h as measured by RT-PCR. Morphological and functional studies revealed that tryptanthrin could induce differentiation in WEHI-3B JCS cells, as shown by the increases in vacuolation, cellular granularity and NBT-reducing activity in tryptanthrin-treated cells. Collectively, our findings suggest that tryptanthrin might exert its anti-tumor effect on the murine myelomonocytic leukemia WEHI-3B JCS cells by causing cell cycle arrest and by triggering cell differentiation.

关键词： Ban-Lan-Gen tryptanthrin myeloid leukemia cell differentiation

Helicobacter pylori associated gastric intestinal metaplasia:Treatment and surveillance

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World Journal of Gastroenterology 2016年第3期22卷 1311-1320页

作者： Kevin Sze-Hang Liu Irene Oi-ling Wong Wai K leung Department of Medicine Li Ka Shing Faculty of MedicineUniversity of Hong KongHong KongChina School of Public Health Li Ka Shing Faculty of MedicineUniversity of Hong KongHong KongChina

Gastric cancer(GC) is one of the leading causes of cancer related death in the world, particularly in East Asia. According to the Correa's cancer cascade, noncardia GC is usually developed through a series of mucosal changes from non-atrophic gastritis to atrophic gastritis(AG), intestinal metaplasia(IM), dysplasia and adenocarcinoma. Atrophic gastritis and IM are therefore generally considered to be pre-neoplastic gastric lesions. Helicobacter pylori(H. pylori) infection is an important initiating and promoting step of this gastric carcinogenesis cascade. Emerging long-term data showed that eradication of H. pylori reduced the risk of subsequent cancer development. It however remains confusing whether eradication of the bacterium in individuals with pre-neoplastic gastric lesions could regress these changes as well as in preventing cancer. Whilst H. pylori eradication could likely regress AG, the presence of IM may be a point of no return in this cascade. Hence, surveillance by endoscopy may be indicated in those with extensive IM or those with incomplete IM, particularly in populations with high GC risk. The optimal interval and the best tool of surveillance endoscopy remains to be determined in future studies.

关键词： Helicobacter pylori Gastric cancer Intestinalmetaplasia Treatment Surveillance

Diagnostic accuracy of Focused Abdominal Sonography for Trauma in blunt abdominal trauma patients in a trauma centre of Hong Kong

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Chinese Journal of Traumatology 2012年第5期15卷 273-278页

作者： Cheung Kent Shek Wong Hay Tai leung ling pong Tsang Tat Chi leung Gilberto Ka Kit Department of Accident and Emergency Queen Mary Hospital 102 Pokfulam Road Pokfulam Hong Kong China Department of Surgery Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong China

Objective： Focused Abdominal Sono graphy for Trauma （FAST） is widely used for the detection of intraperitoneal free fluids in patients suffering from blunt abdominal trauma （BAT）. This study aimed at assessing the diagnostic accuracy of this investigation in a designated trauma centre. Methods： This was a retrospective study of BAT pa tients over a 6 year period seen in a trauma centre in Hong Kong. FAST findings were compared with laparotomy, ab dominal computed tomography or autopsy findings, which served as the gold standard for presence of intraperi toneal free fluids. The patients who did not have FAST or gold standard confirmatory test performed, had preexisting peritoneal fluid, died at resuscitation or had imcomplete docu mentation of FAST findings were excluded. The performance of FAST was expressed as sensitivity, specificity, predictive values （PV）, likelihood ratios （LR） and accuracy. Results： FAST was performed in 302 patients and 153 of them were included in this analysis. The sensitivity, specificity, positive PV, negative PV, positive LR, negative LR and accuracy for FAST were respectively 50.0%, 97.3%, 87.0%, 84.6%, 18.8, 0.5 and 85.0%. FAST was found to be more sensitive in less severely injured patients and more specific in more severely injured patients. Conclusion： FAST is a reliable investigation in the initial assessment of BAT patients. The diagnostic values of FAST could be affected by the severity of injury and staff training is needed to further enhance its effective use.

关键词： Laparotomy Autopsy Tomography, X-ray computed Tomography, spiral computed Ultra-sonography