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World Journal of Gastroenterology 2006年第31期12卷 5010-5016页

作者： Wayne HC Hu SK lam Cindy LK lam WM Wong KF lam KC lai YH Wong Benjamin CY Wong Annie OO Chan CK Chan Gabriel M Leung WM Hui Department of Medicine University of Hong Kong Hong Kong China Department of Statistics and Actuarial Science University of Hong Kong Hong Kong China Department of Community Medicine University of Hong Kong Hong Kong China

AIM： To investigate the optimal strategy to treat dyspeptic patients in primary care. METHODS： Dyspeptic patients presenting to primary care outpatient clinics were randomly assigned to- （1） empirical endoscopy, （2） H pylori test-and-treat, and （3） empirical prokinetic treatment with cisapride. Early endoscopy was arranged if patients remained symptomatic after 2 wk. Symptom severity, quality-of-life （SF-36） as well as patient preference and satisfaction were assessed. All patients underwent endoscopy by wk 6. Patients were followed up for one year. RESULTS： Two hundred and thirty four patients were recruited （163 female, mean age 49）. 46% were H pylori positive. 26% of H pylori tested and 25% of empirical prokinetic patients showed no improvement at wk 2 follow-up and needed early endoscopy. 15% of patients receiving empirical cisapride responded well to treatment but peptic ulcer was the final diagnosis. Symptom resolution and quality-of-life were similar among the groups. Costs for the three strategies were HK$4343, $1771 and $1750 per patient. 66% of the patients preferred to have early endoscopy. CONCLUSION： The three strategies are equally effective. Empirical prokinetic treatment was the least expensive but peptic ulcers may be missed with this treatment. The H pylori test-and-treat was the most cost-effective option .

关键词： Empirical endoscopy Dyspeptic patients Hpylori test-and treat

A different spectrum of DMD gene mutations in local Chinese patients with Duchenne/Becker muscular dystrophy

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Chinese Medical Journal 2006年第13期119卷 1079-1087页

作者： Ivan Fai-man Lo Kent Keung-san lai Tony Ming-for Tong Stephen Tak-sum lam Clinical Genetic Service Department of HealthHong KongChina

Background Duchenne muscular dystrophy （DMD） and Becker muscular dystrophy （BMD） are X-linked recessive, allelic disorders. This study was conducted to look into the spectrum of DMD gene mutations in Hong Kong Chi... 详细信息

关键词： Duchenne muscular dystrophy Becker muscular dystrophy Chinese DMD mutation deletion duplication

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The Hong Kong consensus statements on unresectable hepatocellular carcinoma:narrative review and update for 2021

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Hepatobiliary Surgery and Nutrition 2023年第3期12卷 366-385页

作者： Tan-To Cheung Simon Chun-Ho Yu Stephen L.Chan Ronnie T.P.Poon Philip Kwok Ann-Shing Lee Anna Tai Derek Tam Chin-Cheung Cheung Tak-Wing lai Nam-Hung Chia Ada Law Tracy Shum Yim-kwan lam Vince Lau Victor Lee Charing Chong Chung-Ngai Tang Thomas Yau Department of Surgery Queen Mary HospitalThe University of Hong KongHong KongChina Department of Imaging&Interventional Radiology Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina State Key Laboratory of Translational Oncology and Department of Clinical Oncology Sir YK Pao Centre for CancerPrince of Wales HospitalThe Chinese University of Hong KongHong KongChina Department of Radiology and Imaging Queen Elizabeth HospitalHong KongChina Department of Clinical Oncology Tuen Mun HospitalHong KongChina Department of Clinical Oncology Queen Elizabeth HospitalHong KongChina Department of Surgery United Christian HospitalHong KongChina Department of Surgery Tuen Mun HospitalHong KongChina Department of Surgery Princess Margaret HospitalHong KongChina Department of Surgery Queen Elizabeth HospitalHong KongChina Department of Clinical Oncology Pamela Youde Nethersole Eastern HospitalHong KongChina Department of Clinical Oncology Princess Margaret HospitalHong KongChina Department of Medicine and Geriatrics United Christian HospitalHong KongChina Department of Radiology Queen Mary HospitalHong KongChina Department of Clinical Oncology Queen Mary HospitalThe University of Hong KongHong KongChina Department of Surgery Prince of Wales HospitalThe Chinese University of Hong KongHong KongChina Department of Surgery Pamela Youde Nethersole Eastern HospitalHong KongChina Department of Medicine Queen Mary HospitalThe University of Hong KongHong KongChina

Background and Objective:Hong Kong,like many parts of Asia,faces a high burden of hepatocellular carcinoma(HCC)caused by high endemic rates of hepatitis B virus *** Kong clinicians have developed a high level of expertise in HCC treatment across surgical,transarterial,ablative,radiotherapeutic and systemic *** publication summarizes the latest evidence-based recommendations on how these modalities should be ***:In two meetings held in 2020,a multidisciplinary panel of surgeons,oncologists and interventional radiologists performed a narrative review of evidence on the management of HCC,with an emphasis on treatment of HCC not amenable to surgical *** attention was paid to new evidence published since the previous version of these statements in *** Content and Findings:The expert panel has formulated 60 consensus statements to guide the staging and treatment of unresectable *** the previous version of these statements,considerable additions have been made to the recommendations on use of targeted therapies and immunotherapies because of the large volume of new ***:Our consensus statements offer guidance on how to select HCC patients for surgical or non-surgical treatment and for choosing among non-surgical modalities for patients who are not candidates for *** particular,there is a need for more evidence to aid physicians in the selection of second-line systemic therapies,as currently most data are limited to patients with disease progression on first-line sorafenib.

关键词： Hepatocellular carcinoma(HCC) Hong Kong guidelines consensus

Impact of microbiota on female fertility and gynecological problems

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生殖与发育医学(英文) 2024年第4期8卷 242-251页

作者： Kumar Manish Jiang Luhan lai Hoi-lam Lee Cheuk-Lun Ng Ernest H. Y. Yeung William S. B. Lee Kai-Fai Department of Obstetrics and Gynaecology LKS Faculty of Medicine The University of Hong Kong Hong Kong SAR China Shenzhen Key Laboratory of Fertility Regulation. The University of Hong Kong-Shenzhen Hospital Shenzhen China

The uterus was previously considered a sterile environment for embryo implantation and fetal growth; however, evidence showed that different microorganisms in the female reproductive tract may regulate human fertility. TheLactobacillus family is among the most prevalent bacteria in the vagina and uterus of the female reproductive system. Interestingly, aLactobacillus-dominated (LD) uterine environment is associated with better pregnancy outcomes. Nevertheless, the mechanism by which an LD environment improves pregnancy outcomes is unknown. In the uterus, many commensal bacteria (eg,Bifidobacterium, Prevotella,Enterobacter,Streptococcus, andStaphylococcus) produce short-chain fatty acids (SCFAs), including acetate, butyrate, and propionate. SCFAs are crucial in modulating cytokine production (eg, IL-6 and IL-10) and immune cell populations (eg, T cells and macrophages) during embryo implantation and gynecological diseases. This minireview provides an overview of the roles of lactobacilli and SCFAs in female fertility and related diseases.

关键词： Endometrial receptivity Embryo implantation Lactobacillus Short-chain fatty acids Infertility Gynecological diseases

Multiparametric magnetic resonance imaging/transrectal ultrasound fusion prostate biopsy with semi-robotic navigation in the Chinese population： initial results

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Asian Journal of Andrology 2018年第1期20卷 93-94页

作者： Wai Kit Ma Brian SH HO Andrew SH lai Ka Cheong lam Yun Sang Chan Lawrance KC Yip Ada TL Ng James HL Tsu Ming Kwong Yiu Division of Urology Department of Surgery The University of Hong Kong Queen Mary Hospital Hong Kong China Department of Diagnostic Radiology The University of Hong Kong Queen Mary Hospital Hong Kong China

Dear Editor, The current standard 12-core systematic transrectal ultrasound （TRUS）-guided biopsy in prostate cancer diagnosis has the disadvantages of overdetecting indolent tumors, while failing to identify clinically significant cancers in up to 35%.1 Advances in imaging techniques, notably the multiparametric magnetic resonance imaging （mpMRI）, allow clinically significant prostate cancers to be detected with more precise localization） Fusion of MRI and real-time TRUS enables targeted biopsy of suspicious lesions, overcoming human error, and inability of biopsy site tracking in cognitive fusion？ Multiple Western series have suggested a higher detection rate, higher specificity, and better risk stratification with fusion biopsy.

关键词： magnetic resonance imaging cancer diagnosis

What are the ten new commandments in severe polytrauma management？

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World Journal of Emergency Medicine 2010年第2期1卷 85-92页

作者： CW Kam CH lai SK lam FL So CL Lau KH Cheung Accident ＆ Emergency Department Tuen Mun Hospital Hong Kong China

This review aims to provide a concise overview of the trauma management evolution in the past decade. 1） Trauma care priorities have incorporated staff protection against infection and early decision making in addition to the conventional ABCDE. 2） Five stratified levels for DAM have replaced the non-specific conventional Plans A ＆ B. 3） CT scanning can be the tunnel to death for the hemodynamically unstable patient. 4） DPL has virtually been replaced by the FAST USG. 5） Direct whole-body MDCT provides rapid imaging diagnosis ＆ expedites the definitive treatment but carries high radiation hazards. 6） The dynamic shock assessment by fluid resuscitation response provides more outcome-specific evaluation than the static blood volume loss model. 7） DCR comprising of permissive hypotension, hemostatic resuscitation ＆ DCS aims to overcome the lethal triad of trauma. Early transfusion of blood components of FFP ＆ platelet concentrates improves the outcome in massive blood transfusion. 8） DCS aims to rectify the deranged physiology and not to fully restore the damaged anatomy. 9） A pre-defined protocol for major pelvic fracture can be life-saving and the novel Pre-PPP （pre-peritoneal pelvic packing） may further reduce mortality coupled with the necessary TCAE. 10） Injury prevention is equally important if not more than the trauma resuscitation ＆ operation.

关键词： Polytrauma Priorities DAM CT MDCT DPL FAST Fluid resuscitation responder DCR DCS Pre-PPP Injury prevention

Prostate health index can stratify patients with Prostate Imaging Reporting and Data System score 3 lesions on magnetic resonance imaging to reduce prostate biopsies

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Asian Journal of Andrology 2024年第1期26卷 20-24页

作者： John Shung-lai Leung Wai-Kit Ma Brian Sze-Ho Ho Stacia Tsun-Tsun Chun Rong Na Yongle Zhan Chi-Yuen Ng Chi-Ho Ip Ada Tsui-Lin Ng Yiu-Chung lam Division of Urology Department of SurgeryQueen Mary HospitalUniversity of Hong KongHong KongChina Division of Urology Department of SurgeryPrincess Margaret HospitalHongKongChina

We aim to evaluate prostate health index as an additional risk-stratification tool in patients with Prostate Imaging Reporting and Data System score 3 lesions on multiparametric magnetic resonance *** with biochemical or clinical suspicion of having prostate cancer who underwent multiparametric magnetic resonance imaging in two tertiary centers(Queen Mary Hospital and Princess Margaret Hospital,Hong Kong,China)between January 2017 and June 2022 were ***-magnetic resonance imaging fusion biopsies were performed after prostate health index *** who only had Prostate Imaging Reporting and Data System score 3 lesions were further stratified into four prostate health index risk groups and the cancer detection rates were *** of the 747 patients,47.3%had Prostate Imaging Reporting and Data System score 3 lesions *** detection rate of clinically significant prostate cancer in this group was 15.0%.The cancer detection rates of clinically significant prostate cancer had statistically significant differences:5.3%in prostate health index<25.0,7.4%in prostate health index 25.0-34.9,17.9%in prostate health index 35.0-54.9,and 52.6%in prostate health index≥55.0(P<0.01).Among the patients,26.9%could have avoided a biopsy with a prostate health index<25.0,at the expense of a 5.3%risk of missing clinically significant prostate *** health index could be used as an additional risk stratification tool for patients with Prostate Imaging Reporting and Data System score 3 *** could be avoided in patients with low prostate health index,with a small risk of missing clinically significant prostate cancer.

关键词： biopsy fusion biopsy magnetic resonance imaging prostate cancer prostate health index

Prader-Willi Syndrome:16-Year Experience in Hong Kong

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Journal of Genetics and Genomics 2012年第4期39卷 191-194页

作者： Ivan F.M. Lo Ho Ming Luk luksite@*** Tony M.F. Tong Kent K.S. lai Daniel H.C. Chan Albert C.F. lam David K.H. Chan Edgar W.L. Hau Connie O.Y. Fung Stephen T.S. lam Clin Genet Serv Dept Hlth Kowloon Hong Kong Peoples R China

Prader-Willi syndrome （PWS） is an important, well-recognized syndromic form of neurodevelopmental disorder. The incidence is about 1 in 15,000-25,000 live births, and it affects both males and females （Vogels et al... 详细信息

关键词： PWS Prader-Willi Syndrome

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Overexpressed Cyclin D1 and CDK4 proteins are responsible for the resistance to CDK4/6 inhibitor in breast cancer that can be reversed by PI3K/mTOR inhibitors

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Science China(Life Sciences) 2023年第1期66卷 94-109页

作者： Zijie Cai Jingru Wang Yudong Li Qianfeng Shi Liang Jin Shunying Li Mengdi Zhu Qi Wang Lok lam Wong Wang Yang Hongna lai Chang Gong Yandan Yao Yujie Liu Jun Zhang Herui Yao Qiang Liu Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation Sun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhou 510120China Breast Tumor Center Sun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhou 510120China Department of Thyroid and Breast Surgery Shenzhen Nanshan District Shekou People’s HospitalShenzhen 518067China

CDK4/6 inhibitors are the standard treatment in advanced HR+/HER2-breast cancer ***,the resistance to CDK4/6 inhibitors is inevitable and the strategies to overcome resistance are of great ***,we show that the palbociclibresistant breast cancer cells expressed significantly higher levels of Cyclin D1 and CDK4 proteins because of upregulated protein *** Cyclin D1 or CDK4 led to cell cycle arrest while silencing Cyclin E1 or CDK2 restored the sensitivity to ***,PI3K/mTOR pathway was hyper-activated in palbociclib-resistant cells,leading to more phosphorylated 4E-BP1 and higher levels of Cyclin D1 and CDK4 *** PI3K/mTOR pathway with a specific PI3Kαinhibitor(BYL719)or an mTOR inhibitor(everolimus)reduced the protein levels of Cyclin D1 and CDK4,and restored the sensitivity to *** tumor samples expressed significantly higher levels of Cyclin D1,CDK4,p-AKT and p-4E-BP1 after progression on palbociclib *** conclusion,our findings suggest that overexpressed Cyclin D1 and CDK4 proteins lead to the resistance to CDK4/6 inhibitor and PI3K/mTOR inhibitors are able to restore the sensitivity to CDK4/6 inhibitors,which provides the biomarker and rationale for the combinational use of CDK4/6 inhibitors and PI3K/mTOR inhibitors after CDK4/6 inhibitor resistance in breast cancer.

关键词： CDK4/6 inhibitor resistance PI3K/mTOR inhibitor Cyclin D1 CDK4

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