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Emergency ABO-incompatible living donor liver transplant for patients with ultrahigh MELD scores

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Hepatobiliary & Pancreatic Diseases International 2019年第1期18卷 87-89页

作者： Kevin KW Chu Kenneth SH Chok james YY fung Albert CY Chan Wing Chiu Dai Chung Mau Lo Department of Surgery Queen Mary Hospital The University of Hong Kong Department of Medicine Queen Mary Hospital The University of Hong Kong

To the Editor:A 49-year-old Chinese man with treatment-naive chronic hepatitis B presented with a one-week history of jaundice when admitted to our *** admission,his bilirubin was 704μmol/L,alanine aminotransferase 180 U/L,international normalized ratio 2.4,creatinine 140μmol/L,and Model for End-stage Liver Disease(MELD)score *** serum HBV DNA was 64.7 IU/mL,and he was commenced on ***,he developed acute-onchronic liver failure on day 28 with grade 2 hepatic encephalopathy and a MELD score of 40(bilirubin 709μmol/L,international normalized ratio 3.3,creatinine 181μmol/L).

关键词： Editor hospital

Endoscopic ultrasound in chronic liver disease

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World Journal of Hepatology 2020年第6期12卷 262-276页

作者： Brian M fung Alexander P Abadir Armen Eskandari Michael J Levy james H Tabibian Department of Medicine Olive View-UCLA Medical CenterSylmarCA 91342United States Department of Medicine University of California Irvine Medical CenterOrangeCA 92868United States Division of Gastroenterology and Hepatology University of California Davis Medical CenterSacramentoCA 95817United States Division of Gastroenterology and Hepatology Mayo ClinicRochesterMN 55905United States Division of Gastroenterology Department of MedicineOlive View-UCLA Medical CenterSylmarCA 91342United States

Endoscopic ultrasound(EUS)is a minimally invasive diagnostic and therapeutic modality with a number of established as well as evolving uses in patients with chronic liver *** to other diagnostic tools such as cross-sectional imaging or conventional endoscopy,EUS has been shown to increase diagnostic sensitivity and therapeutic success for many clinical scenarios and applications with a low rate of adverse *** this review,we discuss and focus on the current and growing role of EUS in the evaluation and/or treatment of hepatobiliary masses,hepatic parenchymal disease,portal hypertension,esophageal and other varices,and indeterminate biliary strictures.

关键词： Endoscopy Cirrhosis Liver mass Liver biopsy Variceal bleeding

The utility of coronary computed tomography angiography in elderly patients

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Journal of Geriatric Cardiology 2019年第7期16卷 507-513页

作者： Jordan Laggoune Nitesh Nerlekar Kiran Munnur Brian SH Ko james D Cameron Sujith Seneviratne Dennis TL wong Monash Cardiovascular Research Centre Monash University and MonashHeartMonash HealthClaytonVictoriaAustralia South Australian Health Medical Research Institute AdelaideAustralia

Background Coronary computed tomography angiography(CCTA)is often avoided in elderly patients due to a presumption that a high proportion of patients will have heavily calcified plaque limiting an accurate *** sought to assess the image quality,luminal stenosis and utility of CCTA in elderly patients with suspected coronary artery disease(CAD)and stable chest *** Retrospective analysis of elderly patients(>75 years)who underwent 320-detector row CCTA between 2012–2017 at *** CCTA was analysed for degree maximal coronary stenosis by CAD-RADS classification,image quality by a 5-point Likert score(1-poor,2-adequate,3-good,4-very good,5-excellent)and presence of artefact limiting *** 1011 elderly patients(62%females,78.8±3.3 years)were *** risk factor prevalence included:hypertension(65%),hyperlipidaemia(48%),diabetes(19%)and smoking(21%).The CCTA was evaluable in 68%of patients which included 52%with non-obstructive CAD(50%)*** Likert score was 3.1±0.6 corresponding to good image *** the 323(32%)of patients with a non-interpretable CCTA,80%were due to calcified plaque and 20%due to motion *** gender(P=0.009),age(P=0.02),excess motion(P78 years of age are significantly less likely to have interpretable scans.

关键词： Coronary artery calcium Coronary CT angiography Multi-detector row CT The elderly

Survival outcomes of right-lobe living donor liver transplantation for patients with high Model for End-stage Liver Disease scores

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Hepatobiliary & Pancreatic Diseases International 2013年第3期12卷 256-262页

作者： Kenneth SH Chok See Ching Chan james YY fung Tan To Cheung Albert CY Chan Sheung Tat Fan Chung Mau Lo Department of Surgery The University of Hong Kong State Key Laboratory for Liver Research The University of Hong Kong Department of Medicine The University of Hong Kong

BACKGROUND: Controversy exists over whether living donor liver transplantation (LDLT) should be offered to patients with high Model for End-stage Liver Disease (MELD) scores. This study tried to determine whether a high MELD score would result in inferior outcomes of right-lobe LDLT. METHODS: Among 411 consecutive patients who received right-lobe LDLT at our center, 143 were included in this study. The patients were divided into two groups according to their MELD scores: a high-score group (MELD score ≥25; n=75) and a low-score group (MELD score <25; n=68). Their demographic data and perioperative conditions were compared. Univariable and multivariable analyses were performed to identify risk factors affecting patient survival. RESULTS: In the high-score group, more patients required preoperative intensive care unit admission (49.3% vs 2.9%; P<0.001), mechanical ventilation (21.3% vs 0%; P<0.001), or hemodialysis (13.3% vs 0%; P=0.005); the waiting time before LDLT was shorter (4 vs 66 days; P<0.001); more blood was transfused during operation (7 vs 2 units; P<0.001); patients stayed longer in the intensive care unit (6 vs 3 days; P<0.001) and hospital (21 vs 15 days; P=0.015) after transplantation;more patients developed early postoperative complications (69.3% vs 50.0%; P=0.018); and values of postoperative peak blood parameters were higher. However, the two groups had comparable hospital mortality. Graft survival and patient overall survival at one year (94.7% vs 95.6%; 95.9% vs 96.9%), three years (91.9% vs 92.6%; 93.2% vs 95.3%), and five years (90.2% vs 90.2%; 93.2% vs 95.3%) were also similar between the groups. CONCLUSIONS: Although the high-score group had signifi-cantly more early postoperative complications, the two groups had comparable hospital mortality and similar satisfactory rates of graft survival and patient overall survival. Therefore, a high MELD score should not be a contraindication to right-lobe LDLT if donor risk and recipi

关键词： Model for End-stage Liver Disease living donor liver transplantation survival right-lobe

Acidic domains differentially read histone H3 lysine 4 methylation status and are widely present in chromatin-associated proteins

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Science China(Life Sciences) 2017年第2期60卷 138-151页

作者： Meng Wu Wei Wei Jiwei Chen Rong Cong Tieliu Shi Jiwen Li Jiemin wong james X.Du Shanghai Key Laboratory of Regulatory Biology the Institute of Biomedical Sciences and School of Life SciencesEast China Normal UniversityShanghai 200241China Collaborative Innovation Center for Cancer Medicine Sun Yat-Sen University Cancer CenterGuangzhou 510060China University de Lyon Ecole Normale Supdrieure de LyonCNRS USR 3010Laboratoire Joliot-CurieLyon 69364France

Histone methylation is believed to provide binding sites for specific reader proteins, which translate histone code into biological function. Here we show that a family of acidic domain-containing proteins including nucleophosmin （NPM 1）, pp32, SET/TAF 113, nucleolin （NCL） and upstream binding factor （UBF） are novel H3K4me2-binding proteins. These proteins exhibit a unique pattern of interaction with methylated H3K4, as their binding is stimulated by H3K4me2 and inhibited by H3K4mel and H3K4me3. These proteins contain one or more acidic domains consisting mainly of aspartic and/or glutamic residues that are necessary for preferential binding of H3K4me2. Furthermore, we demonstrate that the acidic domain with sufficient length alone is capable of binding H3K4me2 in vitro and in vivo. NPM1, NCL and UBF require their acidic domains for association with and transcriptional activation ofrDNA genes. Interestingly, by defining acidic domain as a sequence with at least 20 acidic residues in 50 continuous amino acids, we identified 655 acidic domain-containing protein coding genes in the human genome and Gene Ontology （GO） analysis showed that many of the acidic domain proteins have chromatin-related functions. Our data suggest that acidic domain is a novel histone binding motif that can differentially read the status of H3K4 methylation and is broadly present in chromatin-associated proteins.

关键词： histone methylation H3K4mel H3K4me2 H3K4me3 acidic domain histone code transcription chromatin

Current and future molecular diagnostics in colorectal cancer and colorectal adenoma

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World Journal of Gastroenterology 2014年第14期20卷 3847-3857页

作者： Andy Hin-fung Tsang Ka-Ho Cheng Apple Siu-Ping wong Simon Siu-Man Ng Brigette Buig-Yue Ma Charles Ming-Lok Chan Nancy Bo-Yin Tsui Lawrence Wing-Chi Chan Benjamin Yat-Ming Yung Sze-Chuen Cesar wong Department of Health Technology and Informatics Faculty of Health and Social SciencesHong Kong Polytechnic University Department of Surgery Prince of Wales Hospital State Key Laboratory in Oncology in South China Sir Y K Pao Centre for CancerDepartment of Clinical OncologyHong Kong Cancer Institute and Prince of Wales HospitalThe Chinese University of Hong Kong

Colorectal cancer(CRC)is one of the most prevalent cancers in developed *** the other hand,CRC is also one of the most curable cancers if it is detected in early stages through regular colonoscopy or *** CRC develops slowly from precancerous lesions,early detection can reduce both the incidence and mortality of the *** occult blood test is a widely used non-invasive screening tool for *** fecal occult blood test is simple and cost-effective in screening CRC,there is room for improvement in terms of the accuracy of the *** dysregulations have been found to play an important role in CRC *** better understanding of the molecular basis of CRC,there is a growing expectation on the development of diagnostic tests based on more sensitive and specific molecular markers and those tests may provide a breakthrough to the limitations of current screening tests for *** this review,the molecular basis of CRC development,the characteristics and applications of different non-invasive molecular biomarkers,as well as the technologies available for the detection were *** review intended to provide a summary on the current and future molecular diagnostics in CRC and its pre-malignant state,colorectal adenoma.

关键词： Colorectal cancer Colorectal adenoma Molecular diagnostics Fecal occult blood test Non-invasive

Donor ductal anomaly is not a contraindication to right liver lobe donation

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Hepatobiliary & Pancreatic Diseases International 2019年第4期18卷 343-347页

作者： Kenneth SH Chok james YY fung Wing Chiu Dai Sui Ling Sin Ka Wing Ma Albert CY Chan Tan To Cheung Chung Mau Lo Department of Surgery The University of Hong Kong102 Pok Fu Lam RoadHong KongChina State Key Laboratory for Liver Research The University of Hong Kong102 Pok Fu Lam RoadHong KongChina Department of Medicine The University of Hong Kong102 Pok Fu Lam RoadHong KongChina

Background:Data of living-donor liver transplantation(LDLT)suggested that donor ductal anomaly may contribute to postoperative biliary complications in recipients and in *** retrospective study aimed to determine if the occurrence of postoperative biliary stricture in donors or recipients in rightlobe LDLT(RLDLT)is related to donor biliary anatomy ***:We analyzed our RLDLT recipients’clinical data and those of their graft *** recipients were divided into 2 groups:with and without postoperative biliary *** 2 groups were *** primary endpoints were donor biliary anatomy type and postoperative biliary complication incidence;the secondary endpoints were 1-,3-and 5-year graft and patient survival ***:Totally 127 patients were included in the study;25(19.7%)of them developed biliary anastomotic *** these 25 patients,16 had type A biliary anatomy,3 had type B,2 had type C,3 had type D,and 1 had type *** the 127 donors,96(75.6%)had type A biliary anatomy,13(10.2%)had type B,6(4.7%)had type C,10(7.9%)had type D,and 2(1.6%)had type *** stricture was seen in 2 donors,who had type A biliary *** of the recipients or donors developed bile *** association between the occurrence of postoperative biliary stricture and donor biliary anatomy type was found(P=0.527).Conclusions:The incidence of biliary stricture in donors or recipients after RLDLT was not related to donor biliary anatomy *** postoperative complications were similar in whatever type of donor bile duct anatomy,donor ductal anomaly should not be considered a contraindication to donation of right liver lobe.

关键词： Living donor liver transplantation Right liver donation Biliary complications Cholangiograms Ductal anomaly

A Quantum Representation of the Homogeneous 5D Manifold and the Perelman Mappings of 5D onto Non-Homogeneous Lorentz 4D Manifolds

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Journal of Modern Physics 2019年第5期10卷 557-575页

作者： Kai Wai wong Peter Chin Wan fung Wan Ki Chow Department of Physics and Astronomy University of Kansas Lawrence USA Department of Physics and Centre on Behavioral Health University of Hong Kong Hong Kong China Department of Building Services Engineering The Hong Kong Polytechnic University Hong Kong China

The expression of the Maxwell magnetic monopole was employed to correlate the space to space projection that gives rise to the Gell-Mann standard model, and space to time projection which gives the leptons;and how does it correlate to the Perelman mappings from the homogeneous 5D manifold to the Lorentz 4D manifold, together with correlating the physical consequences caused by the breaking of the Diagonal Long Range Order [DLRO] of the monopoles quantum states affected by the motion of massive particles in the Lorentz 4D boundary of the 5D manifold, which leads to gravitons and the gravity field via the General Relativity covariant Riemannian 4D curvatures metric equation.

关键词： 5D Homogeneous Manifold Perelman Mappings Magnetic Monopoles Space Projections and Topological Symmetries Covariant Riemannian Curvature and Gravity

Partial portal vein arterialization using right gastroepiploic artery:A novel solution for portal hypoperfusion

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Hepatobiliary & Pancreatic Diseases International 2018年第4期17卷 367-370页

作者： Kin Pan Au Kenneth Siu Ho Chok Sui Ling Sin james Yan Yue fung Chung Mau Lo Vivian Way Kay Mok Division of Liver Transplantation Department of SurgeryQueen Mary HospitalThe University of Hong KongPokfulamHong KongChina Division of Plastic and Reconstructive Surgery Department of SurgeryQueen Mary HospitalThe University of Hong KongHong KongChina

To the Editor:Establishing dual arterial and portal inflow is essential for liver transplantation[1].Inadequate portal inflow compromises graft function and graft survival[2].Portal hypoperfusion is usually a conseque... 详细信息

关键词： In PVA Partial portal vein arterialization using right gastroepiploic artery