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伴有前后循环颅内动脉粥样硬化的缺血性卒中患者1年死亡和卒中复发的差异

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中华医学杂志 2018年第7期98卷 502-507页

作者：濮月华邹昕颖王伊龙潘岳松向祥龙苏霭欣梁慧康赵性泉王春雪黄家星王拥军刘丽萍首都医科大学附属北京天坛医院神经内科北京100050 首都医科大学附属北京天坛医院神经精神医学与临床心理科北京100050 香港中文大学内科与药物治疗学系

目的探讨伴有前循环和后循环颅内动脉粥样硬化狭窄或闭塞的缺血性卒中患者1年的死亡和卒中复发风险是否存在差异。方法在中国颅内动脉粥样硬化研究（2007年10月至2009年6月）的数据库中，剔除颅外动脉狭窄或闭塞的病例、头核磁弥散加权... 详细信息

目的探讨伴有前循环和后循环颅内动脉粥样硬化狭窄或闭塞的缺血性卒中患者1年的死亡和卒中复发风险是否存在差异。方法在中国颅内动脉粥样硬化研究（2007年10月至2009年6月）的数据库中，剔除颅外动脉狭窄或闭塞的病例、头核磁弥散加权成像未见急性梗死灶的病例和颅内前后循环联合病变的病例，将患者分为无明显颅内动脉病变组（n=964）、前循环动脉病变组（n=440）、后循环动脉病变组（n=233）。预后评估指标为发病后1年内任何原因所致的死亡、卒中复发。结果在纳入分析的1637例患者中，1年随访结果显示，任何原因所致死亡30例，卒中复发58例。与无明显颅内动脉病变组相比，前循环动脉病变组和后循环动脉病变组校正后的死亡风险比（95％可信区间）分别为1．349（0．311～5．851）、4．542（1．227～16．813）；卒中复发分别为1．663（0．620～4．460）、2．464（0．935—6．493）。结论伴有后循环颅内动脉粥样硬化的缺血性卒中患者1年死亡风险高于前循环者，而前后循环动脉病变卒中复发风险差异有待进一步评估。

关键词：缺血性卒中颅内动脉粥样硬化预后卒中复发

维普期刊数据库

Is artificial intelligence the final answer to missed polyps in colonoscopy?

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World Journal of Gastroenterology 2020年第35期26卷 5248-5255页

作者： thomas K L Lui wai K leung Department of Medicine Queen Mary HospitalUniversity of Hong KongHong KongChina

Lesions missed by colonoscopy are one of the main reasons for post-colonoscopy colorectal cancer,which is usually associated with a worse *** the adenoma miss rate could be as high as 26%,it has been noted that endoscopists with higher adenoma detection rates are usually associated with lower adenoma miss *** intelligence(AI),particularly the deep learning model,is a promising innovation in *** studies have shown that AI is not only accurate in colorectal polyp detection but can also reduce the miss ***,the application of AI in real-time detection has been hindered by heterogeneity of the AI models and study design as well as a lack of long-term ***,we discussed the principle of various AI models and systematically reviewed the current data on the use of AI on colorectal polyp detection and miss *** limitations and future prospects of AI on colorectal polyp detection are also discussed.

关键词： Artificial intelligence Adenoma Colonoscopy Colorectal cancer Polyps

Within-Cluster Variability Exponent for Identifying Coherent Structures in Dynamical Systems

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Communications in Computational Physics 2023年第3期33卷 824-848页

作者： wai Ming Chau Shingyu leung Department of Mathematics The Hong Kong University of Science and TechnologyClear Water BayHong Kong

We propose a clustering-based approach for identifying coherent flow structuresin continuous dynamical systems. We first treat a particle trajectory over a finitetime interval as a high-dimensional data point and then cluster these data from differentinitial locations into groups. The method then uses the normalized standarddeviation or mean absolute deviation to quantify the deformation. Unlike the usualfinite-time Lyapunov exponent (FTLE), the proposed algorithm considers the completetraveling history of the particles. We also suggest two extensions of the method. To improvethe computational efficiency, we develop an adaptive approach that constructsdifferent subsamples of the whole particle trajectory based on a finite time interval. Tostart the computation in parallel to the flow trajectory data collection, we also developan on-the-fly approach to improve the solution as we continue to provide more measurementsfor the algorithm. The method can efficiently compute the WCVE over adifferent time interval by modifying the available data points.

关键词： Dynamical system visualization finite time Lyapunov exponent numerical methods for differential equations k-means clustering

Gastrointestinal bleeding in patients on novel oral anticoagulants:Risk,prevention and management

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World Journal of Gastroenterology 2017年第11期23卷 1954-1963页

作者： Ka-Shing Cheung wai K leung Department of Medicine The University of Hong KongQueen Mary HospitalHong KongChina

Novel oral anticoagulants(NOACs), which include direct thrombin inhibitor(dabigatran) and direct factor Xa inhibitors(rivaroxaban, apixaban and edoxaban), are gaining popularity in the prevention of embolic stroke in non-valvular atrial fibrillation as well as in the prevention and treatment of venous thromboembolism. However, similar to traditional anticoagulants, NOACs have the side effects of bleeding, including gastrointestinal bleeding(GIB). Results from both randomized clinical trials and observations studies suggest that high-dose dabigatran(150 mg b.i.d), rivaroxaban and high-dose edoxaban(60 mg daily) are associated with a higher risk of GIB compared with warfarin. Other risk factors of NOAC-related GIB include concomitant use of ulcerogenic agents, older age, renal impairment, Helicobacter pylori infection and a past history of GIB. Prevention of NOAC-related GIB includes proper patient selection, using a lower dose of certain NOACs and in patients with renal impairment, correction of modifiable risk factors, and prescription of gastroprotective agents. Overt GIB can be managed by withholding NOACs followed by delayed endoscopic treatment. In severe bleeding, additional measures include administration of activated charcoal, use of specific reversal agents such as idarucizumab for dabigatran and andexanent alfa for factor Xa inhibitors, and urgent endoscopic management.

关键词： Warfarin Endoscopy Apixaban Edoxaban Gastrointestinal bleeding Dabigatran Rivaroxaban Novel anticoagulants

Application of Big Data analysis in gastrointestinal research

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World Journal of Gastroenterology 2019年第24期25卷 2990-3008页

作者： Ka-Shing Cheung wai K leung wai-Kay Seto Department of Medicine The University of Hong KongQueen Mary HospitalHong KongChina Department of Medicine The University of Hong Kong- Shenzhen HospitalShenzhen 518053Guangdong ProvinceChina

Big Data,which are characterized by certain unique traits like volume,velocity and value,have revolutionized the research of multiple fields including *** Data in health care are defined as large datasets that are collected routinely or automatically,and stored *** the rapidly expanding volume of health data collection,it is envisioned that the Big Data approach can improve not only individual health,but also the performance of health care *** application of Big Data analysis in the field of gastroenterology and hepatology research has also opened new research *** it retains most of the advantages and avoids some of the disadvantages of traditional observational studies(case-control and prospective cohort studies),it allows for phenomapping of disease heterogeneity,enhancement of drug safety,as well as development of precision medicine,prediction models and personalized *** randomized controlled trials,it reflects the real-world situation and studies patients who are often under-represented in randomized controlled ***,residual and/or unmeasured confounding remains a major concern,which requires meticulous study design and various statistical adjustment *** potential drawbacks include data validity,missing data,incomplete data capture due to the unavailability of diagnosis codes for certain clinical situations,and individual *** continuous technological advances,some of the current limitations with Big Data may be further *** review will illustrate the use of Big Data research on gastrointestinal and liver diseases using recently published examples.

关键词： Healthcare dataset Epidemiology Gastric cancer Inflammatory bowel disease Colorectal cancer Hepatocellular carcinoma Gastrointestinal bleeding

Risk of gastric cancer development after eradication of Helicobacter pylori

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World Journal of Gastrointestinal Oncology 2018年第5期10卷 115-123页

作者： Ka-Shing cheung wai K leung Department of Medicine The University of Hong Kong Queen Mary Hospital

Helicobacter pylori(H. pylori) infection is the most important risk factor for gastric cancer(gc) development through the correa's gastric carcinogenesis cascade. However, H. pylori eradication alone does not eliminate gc, as pre-neoplastic lesions(atrophic gastritis, intestinal metaplasia and dysplasia) may have already developed in some patients. It is therefore necessary to identify patients at high-risk for gastric cancer after H. pylori eradication to streamline the management plan. If the patients have not undergone endoscopy with histologic assessment, the identification of certain clinical risk factors and non-invasive testing(serum pepsinogen) can predict the risk of atrophic gastritis. For those with suspected atrophic gastritis, further risk stratification by endoscopy with histologic assessment according to validated histologic staging systems would be advisable. Patients with higher stages may require long-term endoscopic surveillance. Apart from secondary prevention to reduce deaths by diagnosing gc at an early stage, identifying medications that could potentially modify the gc risk would be desirable. The potential roles of a number of medications have been suggested by various studies, including proton pump inhibitors(PPIs), aspirin, statins and metformin. However, there are currently no randomized clinical trials to address the impact of these medications on gc risk after H. pylori eradication. In addition, most of these studies failed to adjust for the effect of concurrent medications on gc risk. Recently, large population-based retrospective cohort studies have shown that PPIs were associated with an increased gc risk after H. pylori eradication, while aspirin was associated with a lower risk. The roles of other agents in reducing gc risk after H. pylori eradication remain to be determined.

关键词： Gastric adenocarcinoma Stomach cancer Helicobacter pylori Chemoprevention Intestinal metaplasia

Risk of stroke after acute myocardial infarction among Chinese

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Chinese Medical Journal 2001年第2期114卷 98-99页

作者： Ping-WingNG wai-KwongCHAN Patrick Kwok-leung K WAN Department of Medicine and Geriatrics United Christian Hospital 130 Hip Wo Street Kwun Tong Kowloon Hong Kong China.

Following an acute myocardial infarction (AMI), patients have an increased risk of stroke. Estimates of risk are mainly derived from AMI treatment trials or secondary prevention studies. The reported incidence of stroke in Caucasians in the early phase after AMI ranged from 0.5% to 2.5%.1-3 Similar assessment of risk in the Chinese population is lacking. As thrombolytic therapy becomes standard treatment for AMI, there is concern that there may be an increase in haemorrhagic stroke complicating AMI treatment, especially since haemorrhagic stroke is more common in Asian populations.

关键词： acute myocardial infarction thrombolytic therapy Chinese population

维普期刊数据库

Urocortin and cardiovascular protection

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Acta Pharmacologica Sinica 2004年第3期25卷 3-11页

作者： Chi-wai LAU,Yau-chi CHAN,Suk-ying TSANG,Franky leung CHAN The Chinese University of hong Kong hong Kong China Department of Anatomy The Chinese University of hong Kong hong Kong China Department of Anatomy The Chinese University of hong Kong hong Kong China Department of Anatomy The Chinese University of hong Kong hong Kong China Department of Anatomy

Urocortin and other hypothalamus corticotropin-releasing factor (CRF) polypeptides play biologically diverse roles in the stress, cardiovascular and inflammatory responses by acting on central and peripheral CRF receptors. Urocortin shows a significantly high sequence homology to CRF, and the concurrent expression of type-2 CRF (CRF2) receptors with urocortin in the heart suggests that urocortin may play a physiological role in the cardiac function. Urocortin is thought to be the endogenous agonist producing the cardiovascular actions previously attributed to CRF. This review highlights the current novel findings on the molecular and cellular mechanisms by which urocortin may exert its cardiovascular protective action.

关键词： urocortin corticotropin-releasing hormone vascular smooth muscle heart vasodilaion second messenger system protein kinases

Icteric flare of chronic hepatitis B in a 95-year old patient

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World Journal of Gastroenterology 2003年第12期9卷 2876-2877页

作者： WS Wong wai Keung leung Henry L Y Chan Department of Medicine and Therapeutics the Prince of Wales HospitalHong Kong SARThe Chinese University of Hong Kong

A 95-year old gentleman developed fatal icteric flare of chronic hepatitis B despite lamivudine treatment. This article highlights the atypical presentations of chronic hepatitis B in elderly patient and the need to c... 详细信息

关键词：慢性乙型肝炎高龄患者黄疸拉米夫定急性暴发性肝炎