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Endoscopic submucosal dissection vs laparoscopic colorectal resection for early colorectal epithelial neoplasia

World Journal of Gastrointestinal Endoscopy 2015年第17期7卷 1243-1249页

作者： sophie sf hon Simon SM Ng Tiffany CL Wong Philip WY Chiu Tony WC Mak WW Leung Janet FY Lee Department of Surgery Prince of Wales HospitalThe Chinese University of Hong Kong

AIM: To compare the short term outcome of endoscopic submucosal dissection(ESD) with that of laparoscopic colorectal resection(LC) for the treatment of early colorectal epithelial neoplasms that are not amenable to conventional endoscopic removal. METHODS: This was a retrospective cohort study. The clinical data of all consecutive patients who underwent ESD for endoscopically assessed benign lesions that were larger than 2 cm in diameter from 2009 to 2013 were collected. These patients were compared with a cohort of controls who underwent LC from 2005 to 2013. Lesions that were proven to be malignant by initial endoscopic biopsies were excluded. Mid and lower rectal lesions were not included because total mesorectal excision, which bears a more complicated postoperative course, is not indicated for lesions without histological proof of malignancy. Both ESD and LC were performed by the same surgical unit with a standardized technique. The patients were managed according to a standard protocol, and they were closely monitored for complications after the procedures. All hospital records were reviewed, and the following data were compared between the ESD and LC groups: patient demographics, size and location of the lesions, procedure time, shortterm clinical outcomes and pathology results. RESULTS: From 2005 to 2013, 65 patients who underwent ESD and 55 patients who underwent LC were included in this study. The two groups were similar in terms of sex(P = 0.41) and American Society of Anesthesiologist class(P = 0.58), although patients in the ESD group were slightly older(68.6 ± 9.4 vs 64.6 ± 9.9, P = 0.03). ESD could be accomplished with a shorter procedure time(113 ± 66 min vs 153 ± 43 min, P < 0.01) for lesions of comparable size(3.0 ± 1.2 cm vs 3.4 ± 1.4 cm, P = 0.22) and location(colon/rectum:59/6 vs colon/rectum: 52/3, P = 0.43). ESD appeared to be associated with a lower short-term complication rate, but the difference did not reach statistical significance(10.8%

关键词： Early colorectal neoplasia Laparoscopic colectomy

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Telerobotic-assisted laparoscopic abdominoperineal resection for low rectal cancer: Report of the first case in hong Kong and China with an updated literature review

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World Journal of Gastroenterology 2007年第17期13卷 2514-2518页

作者： Simon Siu-Man Ng Janet Fung-Yee Lee Raymond Ying-Chang Yiu Jimmy Chak-Man Li sophie Sok-Fei hon Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin Hong Kong SAR China

Telerobotic surgery is the most advanced development in the field of minimally invasive surgery. The da Vinci surgical system, which is currently the most widely used telerobotic device, was approved by the Food and Drug Administration of the United States of America for clinical use in all abdominal operations in July 2000. The first da Vinci surgical system in China was installed in November 2005 at our institution. We herein report the first telerobotic-assisted laparoscopic abdominoperineal resection using the 3-arm da Vinci surgical system for low rectal cancer in hong Kong and China, which was performed in August 2006. The operative time and blood loss were 240 min and 200 mL, respectively. There was no complication, and the patient was discharged on postoperative day five. An updated review of published literature on telerobotic-assisted colorectal surgery is included in this report, with special emphasis on its advantages and limitations.

关键词：低位直肠癌远程机器人辅助手术腹腔镜腹部手术切除香港

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Outcomes and satisfaction of patients with orthopaedic implants left in-situ for more than three years： a retrospective study

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Chinese Medical Journal 2011年第15期124卷 2297-2300页

作者： Aaran Heng-Chi Leung Jeffrey Shen Andraay hon-Chi Leung Yuk-Wah Hung Anna HW Mok Wing-Hoi Cheung Kwok-Sui Leung Department of Orthopaedics and Traumatology The Chinese University of Hong Kong Shatin New Territories Hong Kong China Specialty Registrar Trauma and Orthopaedics West of Scotland Region NHS Scotland United Kingdom

Background There are no clear guidelines on implant removal. Few have assessed the long-term outcomes of patients with implants left in-situ, or removed. Therefore, removal of implants after fracture fixation remains controversial. Methods In this retrospective study, we reviewed 53 patients with implant for fracture fixation in-situ for more than 3 years. All patients were younger than 60 years. Quality of life of each patient was assessed with the Chinese （hong Kong） validated Short Form-36 and the pain was assessed with visual analogue scale （VAS）. All patients were clinically examined and plain radiographs were taken. Results The total sf-36 score of the patients was not statistically different from the hong Kong norm （P 〉0.05）. Mean score of VAS was 2.08. Thirty-three patients （62.3%） reported limited range of movement, 9 patients （17%） complained of cosmetic problems, and 10 patients （18.9%） complained of weakness. Clinically, 82.6% of patients had no scarring, 84.7% of patients had full range of movement and all had no tenderness on assessment. Radiologically, no abnormality was detected except for one patient with known avascular necrosis of the femoral head after screw fixation. Conclusion As most patients were clinically and radiologically normal with quality of life scores comparable to the norm, removal of implants is not advisable as a routine practice.

关键词： fracture fixation implant removal quality of life visual analogue scale refracture

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Robotic surgery for rectal cancer: A systematic review of current practice

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World Journal of Gastrointestinal Oncology 2014年第6期6卷 184-193页

作者： Tony Wing Chung Mak Janet Fung Yee Lee Kaori Futaba sophie Sok Fei hon Dennis Kwok Yu Ngo Simon Siu Man Ng Division of Colorectal Surgery Department of Surgery The Chinese Uni-versity of Hong Kong Prince of Wales Hospital Department of Colorectal Surgery University Hospital Birmingham NHS Trust

AIM: To give a comprehensive review of current litera-ture on robotic rectal cancer ***: A systematic review of current literature via PubMed and Embase search engines was per-formed to identify relevant articles from january 2007 to november 2013. The keywords used were: "robotic surgery", "surgical robotics", "laparoscopic computer-assisted surgery", "colectomy" and "rectal resection". RESULTS: After the initial screen of 380 articles, 20 pa-pers were selected for review. A total of 1062 patients(male 64.0%) with a mean age of 61.1 years and body mass index of 24.9 kg/m2 were included in the *** of 1062 robotic-assisted operations, 831(78.2%) anterior and low anterior resections, 132(12.4%) in-tersphincteric resection with coloanal anastomosis, 98(9.3%) abdominoperineal resections and 1(0.1%) Hart-mann's operation were included in the review. Robotic rectal surgery was associated with longer operative time but with comparable oncological results and anastomotic leak rate when compared with laparoscopic rectal surgery. CONCLUSION: Robotic colorectal surgery has con-tinued to evolve to its current state with promising re-sults; feasible surgical option with low conversion rate and comparable short-term oncological results. The challenges faced with robotic surgery are for more high quality studies to justify its cost.

关键词： Rectal cancer Robotics Minimal invasive surgery Systematic review Rectal surgery

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Quality of life after laparoscopic vs open sphincter-preserving resection for rectal cancer

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World Journal of Gastroenterology 2013年第29期19卷 4764-4773页

作者： Simon Siu-Man Ng Wing-Wa Leung Cherry Yee-Ni Wong sophie Sok-Fei hon Tony Wing-Chung Mak Dennis KwokYu Ngo Janet Fung-Yee Lee Division for Colorectal Surgery Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital

AIM: To compare quality of life (QoL) outcomes in Chinese patients after curative laparoscopic vs open surgery for rectal cancer. METHODS: Eligible Chinese patients with rectal cancer undergoing curative laparoscopic or open sphincterpreserving resection between July 2006 and July 2008 were enrolled in this prospective study. The QoL outcomes were assessed longitudinally using the validated Chinese versions of the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQCR38 questionnaires before surgery and at 4, 8, and 12 mo after surgery. The QoL scores at the different time points were compared between the laparoscopic and open groups. A higher score on a functional scale indicated better functioning, whereas a higher score on a symptom scale indicated a higher degree of ***: Seventy-four patients (49 laparoscopic and 25 open) were enrolled. The two groups of patients were comparable in terms of sociodemographic data, types of surgery, tumor staging, and baseline mean QoL scores. There was no significant decrease from baseline in global QoL for the laparoscopic group at different time points, whereas the global QoL was worse compared to baseline beginning at 4 mo but returned to baseline by 12 mo for the open group (P = 0.019, Friedman test). Compared to the open group, the laparoscopic group had significantly better physical (89.9±1.4 vs 79.2±3.7, P = 0.016), role (85.0±3.4 vs 63.3±6.9, P = 0.005), and cognitive (73.5±3.4 vs 50.7±6.2, P = 0.002) functioning at 8 mo, fewer micturition problems at 4-8 mo (4 mo: 32.3±4.7 vs 54.7±7.1, P = 0.011; 8 mo: 22.8±4.0 vs 40.7±6.9, P = 0.020), and fewer male sexual problems from 8 mo onward (20.0±8.5 vs 76.7±14.5, P = 0.013). At 12 mo after surgery, no significant differences were observed in any functional or symptom scale between the two groups, with the exception of male sexual problems, which remained worse in the open group (29.2±11.3 vs 80.0±9.7, P = 0.026). CONCLUSION: Laparoscopic sphin

关键词： Quality of life Rectal cancer Laparoscopic surgery Sphincter-preserving surgery European Organization for Research and Treatment of Cancer QLQ-C30 European Organization for Research and Treatment of Cancer QLQ-CR38

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Medium-term surgical outcomes and health-related quality of life after laparoscopic vs open colorectal cancer resection: sf-36 health survey questionnaire

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World Journal of Gastrointestinal Endoscopy 2023年第3期15卷 163-176页

作者： Chao-Ming Hung Kuo-Chuan Hung hon-Yi Shi Shih-Bin Su Hui-Ming Lee Meng-Che Hsieh Cheng-Hao Tseng Shung-Eing Lin Chih-Cheng Chen Chao-Ming Tseng Ying-Nan Tsai Chi-Zen Chen Jung-Fa Tsai Chong-Chi Chiu Department of General Surgery E-Da Cancer HospitalI-Shou UniversityKaohsiung 82445TaiwanChina School of Medicine College of MedicineI-Shou UniversityKaohsiung 82445TaiwanChina Department of Anesthesiology Chi Mei Medical CenterTainan 71004TaiwanChina Department of Hospital and Health Care Administration College of Recreation and Health ManagementChia Nan University of Pharmacy and ScienceTainan 71710TaiwanChina Department of Healthcare Administration and Medical Informatics Kaohsiung Medical UniversityKaohsiung 80708TaiwanChina Department of Business Management National Sun Yat-Sen UniversityKaohsiung 80424TaiwanChina Department of Medical Research Kaohsiung Medical University HospitalKaohsiung 80756TaiwanChina Department of Medical Research China Medical University HospitalChina Medical UniversityTaichung 40402TaiwanChina Department of Occupational Medicine Chi Mei Medical CenterLiouying 73657TaiwanChina Department of Occupational Medicine Chi Mei Medical CenterTainan 71004TaiwanChina Department of Leisure Recreation and Tourism ManagementSouthern Taiwan University of Science and TechnologyTainan 71005TaiwanChina College of Medicine I-Shou UniversityKaohsiung 82445TaiwanChina Department of Hematology-Oncology E-Da Cancer HospitalI-Shou UniversityKaohsiung 82445TaiwanChina Department of Gastroenterology and Hepatology E-Da Cancer HospitalI-Shou UniversityKaohsiung 82445TaiwanChina Department of Gastroenterology and Hepatology E-Da HospitalI-Shou UniversityKaohsiung 82445TaiwanChina Department of Colon and Rectal Surgery E-Da Cancer HospitalI-Shou UniversityKaohsiung 82445TaiwanChina Department of Gastroenterology and Hepatology E-Da Dachang HospitalI-Shou UniversityKaohsiung 80794TaiwanChina Department of Medical Education and Research E-Da Cancer HospitalI-Shou UniversityKaohsiung 82445TaiwanChina Department of General Surgery Chi Mei Medical CenterLiouying 73657TaiwanChina

BACKGROUND Previous studies that compared the postoperative health-related quality of life(HRQoL)outcomes after receiving laparoscopic resection(LR)or open resection(OR)in patients with colorectal cancer(CRC)have different *** To explore the medium-term effect of postoperative HRQoL in such *** This study randomized 567 patients undergoing non-metastatic CRC surgery managed by one surgeon to the LR or OR *** was assessed during the preoperative period and 3,6,and 12 mo postoperative using a modified version of the 36-Item Short Form(sf-36)Health Survey questionnaire,emphasizing eight specific *** This cohort randomly assigned 541 patients to receive LR(n=296)or OR(n=245)surgical *** episodes of postoperative urinary tract infection(P<0.001),wound infection(P<0.001),and pneumonia(P=0.048)were encountered in the OR *** results demonstrated that the LR group subjectively gained mildly better general health(P=0.045),moderately better physical activity(P=0.006),and significantly better social function recovery(P=0.0001)3 mo *** the aspect of social function recovery was claimed at 6 mo,with a significant advantage in the LR group(P=0.001).No clinical difference was found in HRQoL during the 12 *** Our results demonstrated that LR resulted in better outcomes,including intra-operative blood loss,surgery-related complications,course of recovery,and especially some health domains of HRQoL at least within 6 mo *** should undergo LR if there is no contraindication.

关键词： Health-related quality of life Medium-term result Laparoscopic Open surgery Non-metastatic colorectal cancer

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缺血性脑卒中患者诊间血压变异性对长期预后的影响

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中华高血压杂志 2015年第5期23卷 498-498页

作者： Lau KK Wong YK Teo KC Chang RS Chan KH hon sf Wat KL Cheung RT Li LS Siu CW Tse HF

血压变异性（blood pressure variablity，BPV）是动脉粥样硬化疾病发展的新的危险因素。最近研究显示，高BPV能预测腔隙性梗死患者的全因和心血管死亡率。除因小血管阻塞造成的脑卒中患者外，BPV是否对缺血性脑卒中患者的预后产生影响... 详细信息

血压变异性（blood pressure variablity，BPV）是动脉粥样硬化疾病发展的新的危险因素。最近研究显示，高BPV能预测腔隙性梗死患者的全因和心血管死亡率。除因小血管阻塞造成的脑卒中患者外，BPV是否对缺血性脑卒中患者的预后产生影响仍然不清楚。

关键词：脑卒中患者血压变异性长期预后缺血性动脉粥样硬化心血管死亡率腔隙性梗死危险因素

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一种铋复硫盐新矿物——锡林郭勒矿Pb_(3+x)Bi(_(2-(2/3)x))S_(6)

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岩矿测试 1982年第4期1卷 14-18,I0002,I0003页

作者：洪慧第王相文施倪承彭志忠内蒙古自治区地质局实验室武汉地质学院北京研究生部

该矿物发现于内蒙蒙锡林郭勒盟东乌旗朝不楞矿区的矽卡岩型铁矿床中,为一主要含Pb、Bi、S的铋复硫盐新矿物。它的化学成分与硫铋铅矿相近,但其晶体结构不同。根据产地命名为锡林郭勒矿(xilingolite)。

关键词：锡林郭勒矿东乌旗矽卡岩型铁矿床锡林郭勒盟朝不楞晶体结构化学成分

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陕西省基层医疗机构医生培训效果评价及影响因素

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职业与健康 2018年第11期34卷 1573-1576页

作者：尚瑜马永红焦东平严琴琴西安医学院继续教育学院陕西西安710021 西安医学院公共卫生系陕西西安710021

目的调查针对陕西省基层医疗机构万名医生培训效果及影响因素,为规范陕西省基层卫生人员培训工作,提高培训效果提供依据。方法以2014—2016年西安医学院培训的461名陕西省基层卫生机构医生为调查对象,利用自行设计的"基层卫生人员培训... 详细信息

目的调查针对陕西省基层医疗机构万名医生培训效果及影响因素,为规范陕西省基层卫生人员培训工作,提高培训效果提供依据。方法以2014—2016年西安医学院培训的461名陕西省基层卫生机构医生为调查对象,利用自行设计的"基层卫生人员培训效果评价表",通过教学方式、教学内容及组织保障等3个维度对培训效果进行评价,并利用多因素logistic回归分析培训效果影响因素。结果培训效果评价显示满意度得分较高是生活和食宿安排(3.43±0.62)、理论教学方式(3.42±0.59)、教师教学水平(3.34±0.72)及临床诊疗技能(3.22±0.95),满意度得分较低的是临床沟通技能(2.81±0.93)、教学组织及管理(2.82±0.50)、培训目标与内容的一致性(2.88±0.53)。培训效果影响因素显示,学历、工作时间、平均收入、家庭事务困难及此类培训机会是培训效果的危险因素(OR>1),即学历越高越不满意、工作时间越久、平均收入越高、家庭事务困难多及此类培训较多的学员对培训效果越不满意;从事专业为公共卫生专业的学员较满意,临床医疗专业和辅助医疗专业学员不满意。结论陕西省基层医疗机构万名医生培训应进一步明确培训目标、强化全科医学知识和临床沟通技能的讲授及实践、加强培训和考核的组织管理,优化培训制度,医教协同,保障学员待遇,重视对其人文关怀,以提高基层卫生人员培训效果和质量。

关键词：基层医疗机构培训效果影响因素

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西安市家庭医师签约式服务现状及影响因素

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职业与健康 2018年第8期34卷 1125-1128页

作者：张潇李雪萍弥曼马永红高梦琪西安医学院临床医学院陕西西安710021 西安医学院公共卫生学院陕西西安710021

目的调查西安市家庭医师签约式服务签约率及影响因素,为提高签约率提供科学依据。方法采用整群抽样方法,抽取西安市5家社区卫生服务中心辖区内1 200位居民,利用自制《西安市家庭医师签约式服务现状调查表》,对签约率进行调查,利用多因素... 详细信息

目的调查西安市家庭医师签约式服务签约率及影响因素,为提高签约率提供科学依据。方法采用整群抽样方法,抽取西安市5家社区卫生服务中心辖区内1 200位居民,利用自制《西安市家庭医师签约式服务现状调查表》,对签约率进行调查,利用多因素logistic回归分析签约率的影响因素。结果研究结果显示,对西安市家庭医师签约式服务模式知晓的有499人,知晓率为44.32%。其中>60岁居民知晓率最高(48.43%),本科及以上居民知晓率最高(78.57%),慢性病患者的知晓率更高(66.99%),距离较近居民知晓率更高(66.96%)。利用多因素logistic回归分析西安市家庭医师签约式服务签约率影响因素发现,年龄(OR=1.128)、是否慢性病患者(OR=2.231)、家庭医师签约式服务知晓率(OR=2.109)、社区卫生服务机构诊疗水平(OR=1.973)、社区卫生服务机构医疗设施(OR=1.423)、家庭医师服务模式诊疗流程(OR=1.980)。年龄越大(老年人)、慢性病患者、知晓率高、诊疗水平满意度高、医疗设施满意度高、诊疗模式满意度高,签约率越高。结论西安市家庭医师签约式服务签约率仍较低,主要是由于对西安市家庭医师签约式服务模式知晓率低,对诊疗水平、医疗设施、诊疗流程满意度低。建议相关卫生部门加大宣传力度,提高社区卫生服务人员诊疗水平,提升社区卫生服务机构医疗设施,改善家庭医师服务模式诊疗流程。

关键词：家庭医师签约率影响因素

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