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Non-invasive versus invasive mechanical ventilation for respiratory failure in severe acute respiratory syndrome

中华医学杂志(英文版) 2005年第17期 7-15页

作者： Loretta YC Yam,Alfred YF chan,Thomas MT Cheung,Eva LH Tsui,Jane ck chan,Vivian CW Wong Division of Respiratory and Critical Care Medicine Department ofMedicine Pamela Youde Nethersole Eastern Hospital Hong Kong China Division of Respiratory and Critical Care Medicine Department ofMedicine Pamela Youde Nethersole Eastern Hospital Hong Kong China Division of Respiratory and Critical Care Medicine Department ofMedicine Pamela Youde Nethersole Eastern Hospital Hong Kong China Hong Kong Hospital Authority Head Office Hong Kong China Hong Kong Hospital Authority Head Office Hong Kong China Hong Kong Hospital Authority Head Office Hong Kong China

Background Severe acute respiratory syndrome is frequently complicated by respiratory failure requiringventilatory *** aimed to compare the efficacy of non-invasive ventilation against invasive mechanicalventilation treating respiratory failure in this *** Retrospective analysis was conducted on all respiratory failure patients identified from the HongKong Hospital Authority Severe Acute Respiratory Syndrome *** rate, mortality and secondaryoutcome of a hospital utilizing non-invasive ventilation under standard infection control conditions ( NIVHospital) were compared against13 hospitals using solely invasive ventilation (IMVHospitals).Multiple logisticregression analyses with adjustments for confounding variables were performed to test for association betweenoutcomes and hospital *** Both hospital groups had comparable demographics and clinical profiles, but NIV Hospital (42patients) had higher lactate dehydrogenase ratio and worse radiographic score on admission and ribavirin-corticosteroid *** to IMV Hospitals (451 patients), NIV Hospital had lower adjustedodds ratios for intubation (0.36, 95% CI 0.164 -0.791,P=0.011) and death (0.235, 95% CI 0.077 -0.716,P=0.011), and improved earlier after pulsed steroid *** were no instances of transmission ofsevere acute respiratory syndrome among health care workers due to the use of non-invasive *** Compared to invasive mechanical ventilation, non-invasive ventilation as initial ventilatory supportfor acute respiratory failure in the presence of severe acute respiratory syndrome appeared to be associated withreduced intubation need and mortality.

关键词： acute respiratory failure · infection control · invasive mechanical ventilation · non-invasive ventilation · severe acute respiratory syndrome

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Large-eddy Simulation of Ethanol Spray-Air Combustion and Its Experimental Validation

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Chinese Journal of Chemical Engineering 2014年第2期22卷 214-220页

作者：李科周力行 chan C.K Department of Engineering Mechanics Tsinghua University School of Energy and Environment Inner Mongolian University of Science and Technology Department of Applied Mathematics Hong Kong Polytecnic University

Large-eddy simulation of spray combustion is under its rapid *** combustion models were used by different ***,these models are less validated by detailed experimental *** this paper,large-eddy simulation(LES)of ethanol spray-air combustion was made using an Eulerian-Lagrangian approach,a subgrid-scale kinetic energy stress model,and a filtered finite-rate combustion model,neglecting the sub-grid scale reaction *** simulation results are compared with experimental dada in the literature and validated in *** LES obtained statistically averaged gas temperature is in much better agreement with the experimental results than Reynolds averaged(RANS)modeling using the most complex probability density function(PDF)equation combustion *** instantaneous LES results show the coherent structures of the shear region near the high-temperature flame zone and the fuel vapor concentration map,indicating that the droplets are concentrated in this shear *** instantaneous temperature,oxygen and carbon dioxide concentration maps show the close interaction between the coherent structures and the combustion reaction.

关键词： ethanol-air two-phase flow spray combustion large-eddy simulation

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Non-invasive versus invasive mechanical ventilation for respiratory failure in severe acute respiratory syndrome

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Chinese Medical Journal 2005年第17期118卷 1413-1421页

作者： Loretta YC Yam Alfred YF chan Thomas MT Cheung Eva LH Tsui Jane ck chan Vivian CW Wong Division of Respiratory and Critical Care Medicine Department of MedicinePamela Youde Nethersole Eastern HospitalHong KongChina Hong Kong Hospital Authority Head Office Hong KongChina

Background Severe acute respiratory syndrome is frequently complicated by respiratory failure requiring ventilatory *** aimed to compare the efficacy of non-invasive ventilation against invasive mechanical ventilation treating respiratory failure in this *** Retrospective analysis was conducted on all respiratory failure patients identified from the Hong Kong Hospital Authority Severe Acute Respiratory Syndrome *** rate,mortality and secondary outcome of a hospital utilizing non-invasive ventilation under standard infection control conditions(NIV Hospita1)were compared against 13 hospitals using solely invasive ventilation(IMV Hospitals).Multiple logistic regression analyses with adjustments for confounding variables were performed to test for association between outcomes and hospital *** Both hospital groups had comparable demographics and clinical profiles,but NIV Hospital(42 patients)had higher lactate dehydrogenase ratio and worse radiographic score on admission and ribavirin-corticosteroid *** to IMV Hospitals(451 patients).NIV Hospital had lower adjusted odds ratios for intubation(0.36,95%C10.164-0.791,P=0.011)and death(0.235.95%C10.077-0.716,P=0.O 11),and improved earlier after pulsed steroid *** were no instances of transmission of severe acute respiratory syndrome among health care workers due to the use of non-invasive *** Compared to invasive mechanical ventilation,non-invasive ventilation as initial ventilatory support for acute respiratory failure in the presence of severe acute respiratory syndrome appeared to be associated with reduced intubation need and mortality.

关键词： acute respiratory failure infection control invasive mechanical ventilation non-invasive ventilation severe acute respiratory syndrome

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Association of oral submucous fibrosis （OSF） with outcome of squamous cell carcinoma of tongue

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中国口腔颌面外科杂志 2008年第B5期6卷 123-124页

作者： Hsiao YL Poon ck chan MY Wong YK Department of Dentistry Division of Oral and MaxillofacialSurgery Taichung Veterans General Hospital TaichungTaiwan China

Background: Oral squamous cell carcinoma and oral submucous fibrosis, they both are highly associated with betel quid chewing habit。Like other potentially malignant disorders, oral submucous fibrosis has been known as 3-7% malignant transformation rate。Currently, some emerged evidences have supported that oral submucous fibrosis could be highly related with epithelial-mesenchymal transition (EMT) in oral mucosa, which possibly response to long-term injury from betel quid。Simultaneously, the EMT also seems to play a role in tumor invasion and metastasis in some malignant cells。It is reasonably believed that pathophysiological connections existed between fibrosis and cancer behavior。Purpose: To analysis the influence of oral submucous fibrosis on overall outcome of oral squamous cell carcinoma。Methods: Since 2002-2005, 65 patients were consecutively collected from Department of Oral and Maxillofacial Surgery, Taichung Veterans General Hospital, Taiwan, China。The inclusion criteria were previously untreated patients on tongue without pathological cervical metastasis。The cancer patients with submucous fibrosis were divided into mild, moderate, severe subgroups; patients without betel nut chewing as control group。The overall survival and disease-free rates of patients were analyzed by Kaplan-Meier analysis。Results: Conclusively, variables such as age, grading, tumor size, even status of cut margin all were not statistically difference between subgroups。The overall outcomes also have been not shown any difference between subgroups, such as disease-flee rate (P= 1.35) and overall survival rate (P=1.43)。Conclusion: In this prospective cohort study, the comorbidity of submucous fibrosis with tongue cancer patients should not be considered as a negative influence on overall outcomes。However, we need more long period follow-up these patients for confirming this primary conclusion。

关键词：口腔黏膜纤维化鳞状细胞癌舌癌

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Comparison between empirical prokinetics, Helicobacter test-and-treat and empirical endoscopy in primary-care patients presenting with dyspepsia: A one-year study

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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

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Important role of cardiac spect imaging in patients undergoing percutaneous transluminal coronary angioplasty

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Chinese Medical Journal 1999年第3期 64-67页

作者： Babington Chun kuen Yung, Wai Kwong chan, Chiu Sun Yue, Wai Chau Fan, Kwok Fai Leung Amy Siu ling Fung and James Chi sang chan Department of Radiology and Organ Imaging (Yung ck, Fan WC, chan CS) & Department of Medicine and Geriatrics (

Objective To examine the utilization and contribution of cardiac perfusion scans to patients undergoing percutaneous transluminal coronary angioplasty. Methods From July 1996 to January 1998, 34 patients underwent percutaneous transluminal coronary angioplasty and cardiac SPECT imaging was studied. Twenty five patients had pre procedure SPECT scans. The agreement between angioplasty strategies and SPECT findings of ischemia and hypokinesia was *** When radionuclide imaging was performed before revascularization procedures, 84% of the patients had intervention strategies guided by scan findings. Perfusion scan findings including extent and severity of ischemia, degree of hypokinesia directed the selection of target vessel for angioplasty in the patient subgroup with multi vessel disease. Post angioplasty radionuclide cardiac scans were performed only on symptomatic patients, demonstrating ischemia and hypokinesia in most of them, conceivably reflected the selection *** We recommend routine pre and post angioplasty radionuclide imaging with multigated scans for wall motion assessment for all patients receiving coronary intervention.

关键词： multigated SPECT angioplasty ischemia hypokinesia

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马来西亚注水初期水质研究

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石油参考资料 1990年第3期 41-56页

作者： chan.,ck 孙炳德

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矽肺对肺癌及总死亡影响的回顾性队列研究

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中华劳动卫生职业病杂志 2008年第1期26卷 29-33页

作者：余德新谢立亚梁子超黄子惠谭卓明陈志权香港中文大学社区及家庭医学系香港卫生署肺尘埃沉着病诊所

目的利用香港矽肺患者队列的资料进行分析，探讨矽尘、矽肺与肺癌的关系。方法选择1981年1月113至1998年12月31日期间在香港尘肺诊所登记的2789例男性矽肺病例为研究对象，取用同时期一般男性人群作为对照。用人年的方法估计各死因的标... 详细信息

目的利用香港矽肺患者队列的资料进行分析，探讨矽尘、矽肺与肺癌的关系。方法选择1981年1月113至1998年12月31日期间在香港尘肺诊所登记的2789例男性矽肺病例为研究对象，取用同时期一般男性人群作为对照。用人年的方法估计各死因的标化死亡比（SMR），用Axelson’s法间接调整吸烟的混杂影响。矽尘与肺癌的剂量-效应关系采用多因素p-spline平滑法模型来拟合最佳风险模型。结果该组研究队列人数为2789，共观察24992．6人年，失访率仅为2．9％。该队列主要工种为建筑工人（51．09％）和地下沉箱操作工人（37．54％）。队列总死亡人数为853人，平均死亡年龄为（63．8±10．27）岁，整个队列中86例死于肺癌。全死因及全癌的SMR均明显上升，首位死因是呼吸道疾病，肺癌的SMR明显增加（SMR：1．69，95％CI：1．35～2．09）。去除年龄、时期和吸烟的混杂因素的影响，矽肺对肺癌的相对危险度下降到1．12（95％CI：0．89～1．38）。间接调整吸烟的混杂影响后建筑工人及地下沉箱工人肺癌的相对危险度分别为1．09（95％CI：0．82～1．42）和1．56（0．98～2．36）。多因素p-spline平滑法风险模型分析显示，肺癌与累积呼吸性矽尘总量或平均矽尘浓度的关系无剂量-效应关系。结论队列研究未发现接触矽尘或矽肺能增加肺癌死亡的危险，平滑法模型拟合的风险模型并不支持矽尘与肺癌死亡之间存在剂量-效应关系。

关键词：矽肺肺肿瘤死亡率队列研究

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MESANGIAL IgA GLOMERULONEPHRITIS IN HONG KONG A CLINICAL REVIEW

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中华医学杂志(英文版) 1986年第11期99卷 908-909页

作者： MK chan S Kwan ck Yeunk PY CHau University of Hong Kong Queen Mary HospitalHong Kong

Mesangial IgA glomerulonephritis accounts for 12% of all primary glomerulonephritis diagnosed from renal biopsies performed at Queen Mary Hospital. The clinical features of 106 patients with biopsy proven mesangial IgA glomerulonephritis seen at the renal clinic of the Department of Medicine, University of Hong Kong, were reviewed. There were 55 males and 51 females aged from 12 to 65 years with a mean of 28 years. Six groups of presenting features were recognized. Although the commonest was asymptomatic proteinuria and/or microscopic

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QS Alex 755 nm激光对黑素细胞p16INK4a表达的影响

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中华皮肤科杂志 2004年第7期37卷 413-415页

作者：项蕾红 Henry HL chan Joseph ck Leung 复旦大学附属华山医院皮肤科上海200040 香港大学玛丽医院皮肤科

目的了解激光对黑素细胞潜在恶变作用的可能性。方法QSAlex755nm激光体外照射HTB66、Sk-mel-24和G3613种黑素瘤细胞株,照射剂量为0.85～2J/cm2,24h后收集细胞。应用流式细胞仪和RT-PCR方法分别测定p16INK4a蛋白和p16INK4amRNA在激光照... 详细信息

目的了解激光对黑素细胞潜在恶变作用的可能性。方法QSAlex755nm激光体外照射HTB66、Sk-mel-24和G3613种黑素瘤细胞株,照射剂量为0.85～2J/cm2,24h后收集细胞。应用流式细胞仪和RT-PCR方法分别测定p16INK4a蛋白和p16INK4amRNA在激光照射前后和不同剂量照射后的表达水平。结果激光照射后,HTB66细胞株(p16INK4a蛋白阳性株)的p16INK4a蛋白表达明显增加;而低水平表达的Sk-mel-24和G361细胞株无明显变化。在HTB66细胞株中虽然p16INK4a蛋白的表达上调,但对其功能的测定发现它并不能阻止细胞周期从G0/G1向S/G2M转变。HTB66细胞株的p16INK4amRNA的表达也增加。结论经研究剂量的激光照射后DNA有损伤。具有黑素瘤家族史或个人史的患者可能有p16INK4a基因的突变或丢失,不提倡用激光治疗此类患者的色素性疾病。

关键词： QS Alex 755nm激光黑素细胞 p16INK4a 黑素瘤基因突变

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