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Storylines of family medicine Ⅲ:core principles—primary care,systems and family

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Family Medicine and Community health 2024年第S3期12卷 23-32页

作者： William B Ventres Leslie A Stone Timothy A Joslin John W Saultz Sommer Aldulaimi Paul R Gordon John C Lane Eric R Lee Jacob Prunuske Limor Gildenblatt Michael h Friedman Colleen T Fogarty Susan h McDaniel Tessa Rohrberg amy Odom Family and Preventive Medicine University of Arkansas for Medical Sciences College of MedicineLittle RockArkansasUSA Family Medicine Oregon Health&Science UniversityPortlandOregonUSA Family and Community Medicine University of Arizona Medical Center–South CampusTucsonArizonaUSA Family and Community Medicine University of Arizona Medical Center–University CampusTucsonArizonaUSA UAMS West Regional Campus Family Medicine Residency Program Fort SmithArkansasUSA Medical College of Wisconsin–Central Wisconsin Campus WausauWisconsinUSA Family and Community Medicine Medical College of Wisconsin–Central Wisconsin CampusWausauWisconsinUSA Family Medicine Advocate Illinois Masonic Medical CenterChicagoIllinoisUSA Family Medicine Presence Saints Mary and Elizabeth Medical CenterChicagoIllinoisUSA Family Medicine University of Rochester Medical CenterRochesterNew YorkUSA Psychiatry and Family Medicine University of Rochester Medical CenterRochesterNew YorkUSA Family and Community Medicine University of Kansas School of Medicine-WichitaWichitaKansasUSA Sparrow/Michigan State University Family Medicine Residency Program LansingMichiganUSA

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine,as interpreted by individual family physicians and medical educators in the USA and elsewhere around the ***‘Ⅲ:core principles—primary care,systems,and family’,authors address the following themes:‘Continuity of care—building therapeutic relationships over time’,‘Comprehensiveness—combining breadth and depth of scope’,‘Coordination of care—managing multiple realities’,‘Access to care—intersectional,systemic,and personal’,‘Systems theory—a core value in patient-centered care’,‘Family-oriented practice—supporting patients’health and well-being’,‘Family physician as family member’and‘Family in the exam room’.May readers develop new understandings from these essays.

关键词： individual Storyline principles

Fish-on-Chips:unveiling neural processing of chemicals in small animals through precise fluidic control

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Neural Regeneration Research 2024年第11期19卷 2351-2353页

作者： Samuel K.h.Sy ho Ko Division of Neurology Department of Medicine and TherapeuticsFaculty of MedicineThe Chinese University of Hong KongShatinNew TerritoriesHong Kong Special Administrative RegionChina Li Ka Shing Institute of health Sciences Faculty of MedicineThe Chinese University of Hong KongShatinNew TerritoriesHong Kong Special Administrative RegionChina Department of Electrical and Electronic Engineering Faculty of EngineeringThe University of Hong KongPok Fu LamHong Kong IslandHong Kong Special Administrative RegionChina Advanced Biomedical Instrumentation Center Hong Kong Science ParkPak Shek KokNew TerritoriesHong Kong Special Administrative RegionChina Margaret K.L.cheung Research Center for Management of Parkinsonism Faculty of MedicineThe Chinese University of Hong KongShatinNew TerritoriesHong Kong Special Administrative RegionChina Lau Tat-chuen Research Center of Brain Degenerative Diseases in Chinese Faculty of MedicineThe Chinese University of Hong KongShatinNew TerritoriesHong Kong Special Administrative RegionChina Gerald Choa Neuroscience Institute The Chinese University of Hong KongShatinNew TerritoriesHong Kong Special Administrative RegionChina

Precise chemical cue presentation alongside advanced brainwide imaging techniques is important to the study of chemosensory processing in ***,the dynamic nature of chemical-carrying media,such as water or air,poses a significant challenge for delivering highly-controlled chemical flow to an animal ***,contact-based cue manipulation and delivery easily shift the position of the animal subject,which is often undesirable for high-quality brain ***,more advanced interfacing tools that align with the diverse range of body part sizes of an animal,ranging from micrometer-scale neurons to meter-long limbs,are much *** is particularly crucial when dealing with dimensions that are beyond the reach of conventional experimental tools.

关键词： dealing precise sizes

Antecedents and sex/gender differences in youth suicidal behavior

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World Journal of Psychiatry 2014年第4期4卷 120-132页

作者： Anne E Rhodes Michael h Boyle Jeffrey A Bridge Mark Sinyor Paul S Links Lil Tonmyr Robin Skinner Jennifer M Bethell Corine Carlisle Sarah Goodday Travis Salway hottes Amanda Newton Kathryn Bennett Purnima Sundar amy h cheung Peter Szatmari Institute for Clinical Evaluative Sciences Toronto M4N 3M5 Ontario Canada Department of Psychiatry University of Toronto Toronto M5T 1R8 Ontario Canada Suicide Studies Unit St. Michael’s Hospital Toronto M5B 1W8 Ontario Canada Dalla Lana School of Public health University of Toronto Toronto M5T 3M7 Ontario Canada Department of Psychiatry and Behavioural Neurosciences Mc Master University Hamilton L8N 3K7 Ontario Canada The Offord Centre for Child Studies Hamilton L8S 4K1 Ontario Canada The Research Institute at Nationwide Children’s hospital Columbus OH 43205 United States The Ohio State University College of Medicine Columbus OH 43210 United States Sunnybrook health Sciences Centre Toronto M4N 3M5 Ontario Canada Department of Psychiatry University of Western Ontario London N6A 5W9 Ontario Canada The Injury and Child Maltreatment Section Public Health Agency of Canada Ottawa K1A 0K9 Ontario Canada The Centre for Addiction and Mental health Toronto M6J 1H4 Ontario Canada Department of Pediatrics University of Alberta Edmonton Alberta T6G 1C9 Canada The Department of Clinical Epidemiology and Biostatistics Mc Master University Hamilton L8S 4K1 Ontario Canada The Ontario Centre of Excellence for Child and Youth Mental health Ottawa K1G 0Z1 Ontario Canada The hospital for Sick Children Toronto M5G 1X8 Ontario Canada

Suicide is the second leading cause of death in youth globally; however, there is uncertainty about how best to intervene. Suicide rates are typically higher in males than females, while the converse is true for suicide attempts. We review this "gender paradox" in youth, and in particular, the age-dependency of these sex/gender differences and the developmental mechanisms that may explain them. Epidemiologic, genetic,neurodevelopmental and psychopathological research have identified suicidal behaviour risks arising from genetic vulnerabilities and sex/gender differences in early adverse environments, neurodevelopment, mental disorder and their complex interconnections. Further, evolving sex-/gender-defined social expectations and norms have been thought to influence suicide risk. In particular, how youth perceive and cope with threats and losses(including conforming to others' or one's own expectations of sex/gender identity) and adapt to pain(through substance use and helpseeking behaviours). Taken together, considering brain plasticity over the lifespan, these proposed antecedents to youth suicide highlight the importance of interventions that alter early environment(s)(e.g., childhood maltreatment) and/or one's ability to adapt to them. Further, such interventions may have more enduring protective effects, for the individual and for future generations, if implemented in youth.

关键词： Suicide Attempted suicide Sex Gender Child Adolescent Review

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胆道纤维化的发生发展与治疗

中华消化外科杂志 2024年第7期23卷 989-1000页

作者：赵进玉林延延岳平姚佳米宁宁李麻图付文康高龙 Azumi Suzuki Peng F Wong Kiyohito Tanaka Rungsun Rerknimitr henrik h Junger Tan T cheung Emmanuel Melloul Nicolas Demartines Joseph W Leung 袁金秋 hans J Schlitt 孟文勃兰州大学第一临床医学院兰州730030 兰州大学第一医院普通外科兰州730030 浜松医学中心消化科日本浜松432-8002 詹姆斯库克大学医院血管外科英国米德尔斯堡TS43BW 京都第二红十字医院消化科日本京都602-8031 朱拉隆功国王纪念医院胃肠内镜卓越中心泰国曼谷10330 雷根斯堡大学医学中心外科德国雷根斯堡93053 香港大学外科学系中国香港999077 洛桑大学医院内脏外科瑞士洛桑CH-1015 加州大学戴维斯分校医学中心和萨克拉门托退伍军人医学中心胃肠肝病科美国萨克拉门托95817 中山大学附属第七医院临床研究中心深圳518107

胆道纤维化(BF)是病理性胆道损伤修复的结果,主要表现为胆管壁的增厚硬化和管腔的进行性狭窄,最终可能导致胆道梗阻、胆汁性肝硬化、肝衰竭、肝胆恶性肿瘤等严重不良结局。目前的研究将BF描述为某些胆管病的病理特征,对其病因、病理生... 详细信息

胆道纤维化(BF)是病理性胆道损伤修复的结果,主要表现为胆管壁的增厚硬化和管腔的进行性狭窄,最终可能导致胆道梗阻、胆汁性肝硬化、肝衰竭、肝胆恶性肿瘤等严重不良结局。目前的研究将BF描述为某些胆管病的病理特征,对其病因、病理生理、分子机制和治疗缺乏系统总结。BF是胆道系统普遍存在但容易被忽略的疾病状态,可能通过病理性胆道损伤后的异常修复机制促进肝胆疾病的发生和进展,笔者结合国内外最新研究进展,综述BF的概念、临床表现、病因、发病机制和治疗策略,为临床医师提供参考。

关键词：胆道疾病纤维化胆管反应病因信号通路治疗

Simple Metrics for Representing East Asian Winter Monsoon Variability:Urals Blocking and Western Pacific Teleconnection Patterns

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Advances in Atmospheric Sciences 2016年第6期33卷 695-705页

作者： hoffman h.N.cheung Wen ZhOU Guy Carpenter Asia-Pacific Climate Impact Centre School of Energy and EnvironmentCity University of Hong KongHong Kong SAR City University of hong Kong Shenzhen Research Institute Shenzhen 518057

Instead of conventional East Asian winter monsoon indices （EAWMIs）, we simply use two large-scale teleconnection patterns to represent long-term variations in the EAWM. First, the Urals blocking pattern index （UBI） is closely related to cold air advection from the high latitudes towards western Siberia, such that it shows an implicit linkage with the Siberian high intensity and the surface air temperature （SAT） variations north of 40°N in the EAWM region. Second, the well-known western Pacific teleconnection index （WPI） is connected with the meridional displacement of the East Asian jet stream and the East Asian trough. This is strongly related to the SAT variations in the coastal area south of 40°N in the EAWM region. The temperature variation in the EAWM region is also represented by the two dominant temperature modes, which are called the northern temperature mode （NTM） and the southern temperature mode （STM）. Compared to 19 existing EAWMIs and other well-known teleconnection patterns, the UBI shows the strongest correlation with the NTM, while the WPI shows an equally strong correlation with the STM as four EAWMIs. The UBI-NTM and WPI-STM relationships are robust when the correlation analysis is repeated by （1） the 31-year running correlation and （2） the 8-year high-pass and low-pass filter. hence, these results are useful for analyzing the large-scale teleconnections of the EAWM and for evaluating this issue in climate models. Int particular, more studies should focus on the teleconnection patterns over extratropical Eurasia.

关键词： East Asian winter monsoon Urals blocking high western Pacific teleconnection pattern teleconnection

Exacerbated VEGF up-regulation accompanies diabetes-aggravated hemorrhage in mice after experimental cerebral ischemia and delayed reperfusion

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Neural Regeneration Research 2022年第7期17卷 1566-1575页

作者： Angela Ka Wai Lai Tsz Chung Ng Victor Ka Lok hung Ka cheung Tam Chi Wai cheung Sookja Kim Chung amy Cheuk Yin Lo Department of Ophthalmology Li Ka Shing Faculty of MedicineThe University of Hong KongHong Kong Special Administration RegionChina Department of Anesthesiology Laboratory and Clinical Research Institute for PainThe University of Hong KongHong Kong Special Administration RegionChina Macao University of Science and Technology TaipaMacao Special Administration RegionChinaSchool of Biomedical SciencesThe State Key Laboratory of Pharmaceutical BiotechnologyThe University of Hong KongHong Kong Special Administration RegionChina

Reperfusion therapy is the preferred treatment for ischemic stroke,but is hindered by its short treatment window,especially in patients with diabetes whose reperfusion after prolonged ischemia is often accompanied by exacerbated *** mechanisms underlying exacerbated hemorrhage are not fully *** study aimed to identify this mechanism by inducing prolonged 2-hour transient intraluminal middle cerebral artery occlusion in diabetic Ins2Akita/+mice to mimic patients with diabetes undergoing delayed mechanical *** results showed that at as early as 2 hours after reperfusion,Ins2Akita/+mice exhibited rapid development of neurological deficits,increased infarct and hemorrhagic transformation,together with exacerbated down-regulation of tight-junction protein ZO-1 and upregulation of blood-brain barrier-disrupting matrix metallopeptidase 2 and matrix metallopeptidase 9 when compared with normoglycemic Ins2+/+*** indicated that diabetes led to the rapid compromise of vessel integrity immediately after reperfusion,and consequently earlier death and further aggravation of hemorrhagic transformation 22 hours after *** observation was associated with earlier and stronger up-regulation of pro-angiogenic vascular endothelial growth factor(VEGF)and its downstream phospho-Erk1/2 at 2 hours after reperfusion,which was suggestive of premature angiogenesis induced by early VEGF up-regulation,resulting in rapid vessel disintegration in diabetic *** reticulum stress-related pro-apoptotic C/EBP homologous protein was overexpressed in challenged Ins2Akita/+mice,which suggests that the exacerbated VEGF up-regulation may be caused by overwhelming endoplasmic reticulum stress under diabetic *** conclusion,the results mimicked complications in patients with diabetes undergoing delayed mechanical thrombectomy,and diabetes-induced accelerated VEGF up-regulation is likely to underlie exacerbated hemorrhagic transformat

关键词： blood-brain barrier brain injury diabetes mellitus hemorrhagic transformation infarct ischemia/reperfusion injury middle cerebral artery occlusion mouse model stroke vascular endothelial growth factor

heavy metal concentrations in edible bivalves and gastropods available in major markets of the Pearl River Delta

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Journal of Environmental Sciences 2001年第2期13卷 210-217页

作者： FANG Zhan-qiang cheung R.Y.h. WONG M.h. Department of Biology South China Normal UniversityGuangzhou 510631China Department of Biology and Chemistry City University of Hong Kong83 Tat Chee AvenueKowloonHong Kong Institute for Natural Resources and Waste Management and Department of BiologyHong Kong Bapt ist UniversityKowloon TongHong Kong

Molluscs are able to accumulate heavy metals and impose health hazard to consumers. The main objective of the present study is to investigate the heavy metal concentrations in edible bivalves and gastropods available in major markets of the Pearl River Delta. Fourteen species of edible molluscs were purchased from six markets in hong Kong and Guangdong Province. The fresh of these biota were tested for their cadmium (Cd), copper (Cu), zinc (Zn), lead (Pb), nickel (Ni), chromium (Cr), antimony (Sb) and tin (Sn) concentrations (based on wet weight). The results indicated that amongst the 14 edible molluscs, only Cd, Pb, Ni, Cr, Sb and Sn concentrations in three species (Ruditapes philippinarum, Perna viridis and hemifusus tuba) were within the local regulatory limits. Over 60% of bivalve species exceeded maximum permitted levels of Cd (2 mug/g) and Cr (1 mug/g), while over 40% of gastropod species exceeded the maximum levels of Sb (1 mug/g) and Cr (1 mug/g). Most of the samples collected from hong Kong had significantly higher contents of Pb and Sb, but similar levels of Cd, Cu and Zn when compared with samples collected across the border ( p he molluscs purchased in Guangdong markets had higher metal contents than those purchased from the hong Kong markets. When compared with the Provisional Tolerable Weekly Intake or Maximum Acceptable Daily Load recommended by FAO/WhO Expert Committee on Food Additives, Cd levels of five species (Anadara ferruginea, Pinna pectinata, Chlamys nobilis, Babylonia lutosa and hemifusus terntanus) and Cr levels of seven species ( Anadara ferruginea, Paphia undulata, Pinna pectinata, Babylonia lutosa, hemifusus terntanus, Cymbium melo and Cipangopaludina chinensis) were higher than both the human daily acceptable limits (for Cd and Cr respectively) and the local regulatory levels (for Cd and Cr respectively).

关键词： heavy metals edible molluscs human health Pearl River Delta

Laser Induced Fluorescence Spectroscopy of IrN

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Chinese Journal of Chemical Physics 2009年第2期22卷 157-161页

作者： h. F. Pang A. S. C. cheung Department of Chemistry The University of Hong Kong Pokfulam Road Hone Kong China

high resolution laser induced fluorescence, spectra of IrN in the spectral region between 394 and 520 nm were recorded using laser vaporization/reaction free jet expansion and laser induced fluorescence spectroscopy. Seven new vibronic transition bands were observed and analyzed. Two Ω=1 and five Ω=0 new states were identified. Least squares fit of rotationally resolved transition lines yielded accurate molecular constants for the upper states. Spectra of isotopic molecules were observed, which provided confirmation for the vibrational assignment. Comparison of the observed electronic states of IrB, IrC, and IrN provides a good understanding of the chemical bonding of this group of molecules.

关键词： Electronic transition Rotational analysis Iridium mononitride Laser induced fluorescence spectroscopy

Biliary fibrosis is an important but neglected pathological feature in hepatobiliary disorders:from molecular mechanisms to clinical implications

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Medical Review 2024年第4期4卷 326-365页

作者： Jinyu Zhao Ping Yue Ningning Mi Matu Li Wenkang Fu Xianzhuo Zhang Long Gao Mingzhen Bai Liang Tian Ningzu Jiang Yawen Lu haidong Ma Chunlu Dong Yong Zhang hengwei Zhang Jinduo Zhang Yanxian Ren Azumi Suzuki Peng F.Wong Kiyohito Tanaka Rungsun Rerknimitr henrik h.Junger Tan T.cheung Emmanuel Melloul Nicolas Demartines Joseph W.Leung Jia Yao Jinqiu Yuan Yanyan Lin hans J.Schlitt Wenbo Meng Department of General Surgery The First Hospital of Lanzhou UniversityLanzhouGansuChina The First School of Clinical Medicine Lanzhou UniversityLanzhouGansu 730000China Key Laboratory of Biotherapy and Regenerative Medicine of Gansu Province LanzhouGansu 730000China Clinical Research Center Big Data CenterThe Seventh Affiliated HospitalSun Yat-sen UniversityShenzhenGuangdong 518000China Department of General Surgery The First Hospital of Lanzhou UniversityLanzhouGansu 730000China Department of Surgery University Medical Center Regensburg93053 RegensburgGermany

Fibrosis resulting from pathological repair secondary to recurrent or persistent tissue damage often leads to organ failure and *** fibrosis is a crucial but easily neglected pathological feature in hepatobiliary disorders,which may promote the development and progression of benign and malignant biliary diseases through pathological healing mechanisms secondary to biliary tract *** the etiology and pathogenesis of biliary fibrosis is beneficial to the prevention and treatment of biliary *** this review,we emphasized the importance of biliary fibrosis in cholangiopathies and summarized the clinical manifestations,epidemiology,and aberrant cellular composition involving the biliary ductules,cholangiocytes,immune system,fibroblasts,and the micro*** also focused on pivotal signaling pathways and offered insights into ongoing clinical trials and proposing a strategic approach for managing biliary fibrosis-related *** review will offer a comprehensive perspective on biliary fibrosis and provide an important reference for future mechanism research and innovative therapy to prevent or reverse fibrosis.

关键词： biliary fibrosis cholangiopathy etiology mechanism therapeutic strategy