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Prevention and management of hepatitis B virus reactivation in patients with hematological malignancies treated with anticancer therapy

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World Journal of Gastroenterology 2016年第28期22卷 6484-6500页

作者： Man Fai Law Rita Ho Carmen KM Cheung Lydia HP Tam Karen Ma Kent CY So bonaventure ip Jacqueline So Jennifer Lai Joyce Ng Tommy HC Tam Department of Medicine and Therapeutics Prince of Wales HospitalHong Kong China Department of Medicine North District HospitalHong Kong China

Hepatitis due to hepatitis B virus(HBV) reactivation can be severe and potentially fatal, but is preventable. HBV reactivation is most commonly reported in patients receiving cancer chemotherapy, especially rituximabcontaining therapy for hematological malignancies and those receiving stem cell transplantation. All patients with hematological malignancies receiving anticancer therapy should be screened for active or resolved HBV infection by blood tests for hepatitis B surface antigen(HBs Ag) and antibody to hepatitis B core antigen(antiHBc). Patients found to be positive for HBs Ag should be given prophylactic antiviral therapy to prevent HBV reactivation. For patients with resolved HBV infection, no standard strategy has yet been established to prevent HBV reactivation. There are usually two options. One is pre-emptive therapy guided by serial HBV DNA monitoring, whereby antiviral therapy is given as soon as HBV DNA becomes detectable. However, there is little evidence regarding the optimal interval and period of monitoring. An alternative approach is prophylactic antiviral therapy, especially for patients receiving highrisk therapy such as rituximab, newer generation of anti-CD20 monoclonal antibody, obinutuzumab or hematopoietic stem cell transplantation. This strategy may effectively prevent HBV reactivation and avoid the inconvenience of repeated HBV DNA monitoring. Entecavir or tenofovir are preferred over lamivudine as prophylactic therapy. Although there is no well-defined guideline on the optimal duration of prophylactic therapy, there is growing evidence to recommend continuing prophylactic antiviral therapy for at least 12 mo after cessation of chemotherapy, and even longer for those who receive rituximab or who had high serum HBV DNA levels before the start of immunosuppressive therapy. Many novel agents have recently become available for the treatment of hematological malignancies, and these agents may be associated with HBV reactivation. Although ther

关键词： Hepatitis B virus reactivation Hematological malignancies Rituximab Hematopoietic stem cell transplant Prophylactic antiviral therapy

Risk stratification in symptomatic intracranial atherosclerotic disease with conventional vascular risk factors and cerebral haemodynamics

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Stroke & Vascular Neurology 2023年第1期8卷 77-85页

作者： Xuan Tian Hui Fang Linfang Lan Hing Lung ip Jill Abrigo Haipeng Liu Lina Zheng Florence S Y Fan Sze Ho Ma bonaventure ip Bo Song Yuming Xu Jingwei Li Bing Zhang Yun Xu Yannie O Y Soo Vincent Mok Ka Sing Wong Thomas W Leung Xinyi Leng Department of Medicine and Therapeutics The Chinese UniversityHong KongChina Department of Neurology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina Department of Neurology The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongChina Department of Imaging and Interventional The Chinese UniversityHong KongChina Research Centre of Intelligent Healthcare Faculty of Health and Life ScienceCoventry UniversityCoventryUK Department of Neurology Nanjing University Medical School Affiliated Nanjing Drum Tower HospitalNanjingJiangsuChina Department of Radiology Nanjing University Medical School Affiliated Nanjing Drum Tower HospitalNanjingJiangsuChina

Background and purpose Symptomatic intracranial atherosclerotic stenosis(sICAS)is associated with a considerable risk of recurrent stroke despite contemporarily optimal medical *** of luminal stenosis in sICAS and its haemodynamic significance quantified with computational fluid dynamics(CFD)models were associated with the risk of stroke *** aimed to develop and compare stroke risk prediction nomograms in sICAS,based on vascular risk factors and these *** Patients with 50%-99%sICAS confirmed in CT angiography(CTA)were *** vascular risk factors were *** of luminal stenosis in sICAS was dichotomised as moderate(50%-69%)and severe(70%-99%).Translesional pressure ratio(PR)and wall shear stress ratio(WSSR)were quantified via CTA-based CFD modelling;the haemodynamic status of sICAS was classified as normal(normal PR&WSSR),intermediate(otherwise)and abnormal(abnormal PR&WSSR).All patients received guideline-recommended medical *** developed and compared performance of nomograms composed of these variables and independent predictors identified in multivariate logistic regression,in predicting the primary outcome,recurrent ischaemic stroke in the same territory(SIT)within 1 *** Among 245 sICAS patients,20(8.2%)had *** D2H2A nomogram,incorporating diabetes,dyslipidaemia,haemodynamic status of sICAS,hypertension and age≥50 years,showed good calibration(P for Hosmer-Lemeshow test=0.560)and discrimination(C-statistic 0.73,95%CI 0.60 to 0.85).It also had better performance in risk reclassification and provided larger net benefits in decision curve analysis,compared with nomograms composed of conventional vascular risk factors only,and plus the severity of luminal stenosis in *** analysis in patients with anterior-circulation sICAS showed similar *** The D2H2A nomogram,incorporating conventional vascular risk factors and the haemodynamic significance of sICAS a

关键词： intracranial otherwise stratification

Pandemic of the aging society—sporadic cerebral small vessel disease

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Chinese Medical Journal 2021年第2期134卷 143-150页

作者： Alexander Yuk Lun Lau bonaventure Yiu Ming ip Ho Ko Bonnie Yin Ka Lam Lin Shi Karen Ka Yan Ma Lisa Wing Chi Au Yannie Oi Yan Soo Thomas Wai Hong Leung Adrian Wong Vincent Chung Tong Mok Division of Neurology Department of Medicine and TherapeuticsThe Faculty of MedicineThe Chinese University of Hong KongHong KongChina Gerald Choa Neuroscience Centre Faculty of MedicineLui Che Woo Institute of Innovative MedicineThe Chinese University of Hong KongHong KongChina Faculty of Medicine School of Biomedical SciencesLi Ka Shing Institute of Health SciencesThe Chinese University of Hong KongHong KongChina Margaret Cheung K.L.Cheung Research Centre for Management of Parkinsonism Faculty of MedicineThe Chinese University of Hong KongHong KongChina Department of Imaging and Interventional Radiology The Chinese University of Hong KongHong KongChina Shenzhen Research Institute The Chinese University of Hong KongShenzhenGuangdongChina.

Age-related sporadic cerebral small vessel disease(CSVD)has gained increasing attention over the past decades because of its increasing prevalence associated with an aging *** widespread application of and advances in brain magnetic resonance imaging in recent decades have significantly increased researchers’understanding in the in vivo evolution of CSVD,its impact upon the brain,its risk factors,and the mechanisms that explain the various clinical manifestation associated with sporadic *** this review,we aimed to provide an update on the pathophysiology,risk factors,biomarkers,and the determinants and spectrum of the clinical manifestation of sporadic CSVD.

关键词： Cerebral small vessel disease Clinical spectrum Pathophysiology

Genome sequencing reveals the role of rare genomic variants in Chinese patients with symptomatic intracranial atherosclerotic disease

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Stroke & Vascular Neurology 2022年第3期7卷 182-189页

作者： Mengmeng Shi Xinyi Leng Ying Li Zihan Chen Ye Cao Tiffany Chung bonaventure YM ip Vincent HL ip Yannie OY Soo Florence SY Fan Sze Ho Ma Karen Ma Anne Y Y Chan Lisa WC Au Howan Leung Alexander Y Lau Vincent CT Mok Kwong Wai Choy Zirui Dong Thomas W Leung Department of Obstetrics and Gynaecology The Chinese University of Hong KongHong KongChina Key Laboratory for Regenerative Medicine Ministry of Education(Shenzhen Base)Shenzhen Research InstituteThe Chinese University of Hong KongShenzhenChina Hong Kong Hub of Paediatric Excellence The Chinese University of Hong KongHong KongChina Department of Medicine and Therapeutics The Chinese University of Hong KongPrince of Wales HospitalHong KongChina Department of Paediatrics The Chinese University of Hong KongHong KongChina The Chinese University of Hong Kong-Baylor College of Medicine Joint Center For Medical Genetics The Chinese University of Hong KongHong KongChina

Objectives The predisposition of intracranial atherosclerotic disease(ICAD)to East Asians over Caucasians infers a genetic basis which,however,remains largely *** prevalence of vascular risk factors(VRFs)in Chinese over Caucasian patients who had a stroke,and shared risk factors of ICAD with other stroke subtypes indicate genes related to VRFs and/or other stroke subtypes may also contribute to *** Unrelated symptomatic patients with ICAD were recruited for genome sequencing(GS,60-fold).Rare and potentially deleterious single-nucleotide variants(SNVs)and small insertions/deletions(InDels)were detected in genome-wide and correlated to genes related to VRFs and/or other stroke *** aneuploidies,copy number variants(CNVs)and chromosomal structural rearrangements were also ***,candidate genes were used for pathway and gene ontology enrichment *** Among 92 patients(mean age at stroke onset 61.0±9.3 years),GS identified likely ICAD-associated rare genomic variants in 54.3%(50/92)of ***-eight patients(52.2%,48/92)had 59 rare SNVs/InDels reported or predicted to be deleterious in genes related to VRFs and/or other stroke *** of the 59 rare variants were identified in local subjects without ICAD(n=126).31 SNVs/InDels were related to conventional VRFs,and 28 were discovered in genes related to other stroke *** study also showed that rare CNVs(n=7)and structural rearrangement(a balanced translocation)were potentially related to ICAD in 8.7%(8/92)of ***,candidate genes were significantly enriched in pathways related to lipoprotein metabolism and cellular lipid catabolic *** Our GS study suggests a role of rare genomic variants with various variant types contributing to the development of ICAD in Chinese patients.

关键词： patients metabolism intracranial

Analysis of Fatigue and Microhardness in Metallic Powder Mixed EDM

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Open Journal of Applied Sciences 2020年第10期10卷 613-624页

作者： Alexis Mouangué Nanimina Nandiguim Lamaï Djimako Bongo Togdjim Jonas bonaventure Danoumbé Ahmad Majdi Abdul-Rani Mechanical Engineering Department Higher National Institute of Sciences and Techniques of Abéché (INSTA) Abéché Ouaddai Chad Higher Normal School of Technology of Sarh Moyen-Chari Chad Mechanical Engineering Department Universiti Teknologi PETRONAS (UTP) Perak Darul Ridzuan Malaysia

The objective of this work research is to investigate the potential of using metallic powder mixed with electrical discharge machining (EDM) dielectric when machining hard electrically conductive materials. Nowadays, the development of industries requires hard materials for various applications. Machining the hard materials using the traditional processes lead to tool break and poor machined product. Even when the conventional EDM can machine hard material as long as it is electrically conductive materials, the machined parts still present drawbacks. Metallic powder mixed with EDM dielectric (PMEDM) was hypothesized to improve the machined part. The presence of metallic powder ensures uniform distribution of spark and the electrical density of the spark decreases which reduces craters, cracks and voids on machined surface. The transfer and deposit of alloying elements during powder mixed electrical discharge machining improve the machined surface properties particularly micro-hardness and fatigue. Discharge current (IP), gap voltage (GapV), ON-time (ON) and aluminum powder are selected as machined variable parameters and the output responses are fatigue performance, micro-hardness and surface topography. The workpiece material selected is molybdenum high speed steel. Micro-hardness was determined using micro-hardness tester device. The fatigue performance was determined using empirical equation. Analysis of material transfer was done using energy dispersive spectroscopy (EDS) attached to FESEM. EDS analysis involves the generation of an X-ray spectrum from the entire scan area of the SEM. The use of PMEDM improved the fatigue, the micro-harnes

关键词： PMEDM Fatigue Micro-Hardness Discharge Current Gap Voltage ON-Time