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Clinical significance of hepatic derangement in severe acute respiratory syndrome

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World Journal of Gastroenterology 2005年第14期11卷 2148-2153页

作者： Henry Lik-Yuen Chan Ambrose Chi-Pong Kwan Ka-Fai To Sik-To Lai Paul Kay-Sheung Chan Wai-Keung Leung Nelson Lee Alan Wu joseph jao-yiu sung Department of Medicine and Therapeutics Chinese University of Hong Kong Hong Kong SARChina Department of Medicine Princess Margaret Hospital Hong Kong SARChina Department of Anatomical and Cellular Pathology Chinese University of Hong Kong Hong Kong SARChina Department of Microbiology Chinese University of Hong Kong Hong Kong SARChina

AIM:Elevation of alanine aminotransferase (ALT) level is commonly seen among patients suffering from severe acute respiratory syndrome (SARS). We report the progression and clinical significance of liver derangement in a large cohort of SARS patient. METHODS: Serial assay of serum ALT was followed in patients who fulfilled the WHO criteria of SARS. Those with elevated ALT were compared with those with normal liver functions for clinical outcome. Serology for hepatitis B virus (HBV) infection was checked. Adverse outcomes were defined as oxygen desaturation, need of intensive care unit (ICU) and mechanical ventilation and death. RESULTS: Two hundred and ninety-four patients were included in this study. Seventy (24%) patients had elevated serum ALT on admission and 204 (69%) patients had elevated ALT during the subsequent course of illness. Using peak ALT >5xULN as a cut-off and after adjusting for potential confounding factors, the odds ratio of peak ALT >5x ULN for oxygen desaturation was 3.24 (95%CI 1.23-8.59, P= 0.018), ICU care was 3.70 (95%CI 1.38-9.89, P= 0.009), mechanical ventilation was 6.64 (95%CI 2.22-19.81, P = 0.001) and death was 7.34 (95%CI 2.28-24.89, P= 0.001). Ninety-three percent of the survived patients had ALT levels normalized or were on the improving trend during follow-up. Chronic hepatitis B was not associated with worse clinical outcomes. CONCLUSION: Reactive hepatitis is a common complication of SARS-coronavirus infection. Those patients with severe hepatitis had worse clinical outcome.

关键词： SARS Hepatitis Hepatitis B virus Coronavirus

Follow up of serial urea breath test results in patients after consumption of antibiotics for non-gastric infections

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World Journal of Gastroenterology 2002年第4期8卷 703-706页

作者： Wai-Keung Leung Lawrence Cheung-Tsui Hung Carrie Ka-Li Kwok Rupert Wing-Loong Leong Daniel Kwok-Keung Ng joseph jao-yiu sung Department of Medicine & Therapeutics Prince of Wales Hospitalthe Chinese University of Hong KongShatinHong KongChina Department of Paediatrics Kwong Wah HospitalKowloonHong KongChina

AIM: The widespread use of antibacterial therapy hasbeen suggested to be the cause for the decline in theprevalence of Helicobacter pyloriinfection. This studyexamine the serial changes of urea breath test resultsin a group of hospitalized patients who were givenantibacterial therapy for non-gastric ***: Thirty-five hospitalized patients who weregiven antibacterial therapy for clinical infections,predominantly chest and urinary infections, werestudied. Most (91%) patients were given singleantibiotic of either a penicillin or cephalosporin *** 13C-urea breath tests were performed within 24hours of initiation of antibiotics, at one-week and atsix-week post-therapy. H. pylori infection wasdiagnosed when one or more urea breath tests ***: All 35 patients completed three serial ureabreath tests and 26 (74 %) were H. pylori-positive. Ten(38 %) H. pylori-infected patients had at least onenegative breath test results during the study *** medium delta 13C values were significantly lowerat baseline (8.8) than at one-week (20.3) and six-week(24.5) post-treatment in H. pylori-positive individuals(P=0.022). Clearance of H. pyloriat six-week was onlyseen in one patient who had received anti-helicobactertherapy from another ***: Our results suggested that one-third ofH. pylori-infected individuals had transient false-negative urea breath test results during treatment withantibacterial agent. However, clearance of H. pyloriinfection by regular antibiotic consumption is rare.

关键词：抗生素 HP感染连续尿素呼吸试验耐药

Hepatitis B virus genotype has no impact on hepatitis B e antigen seroconversion after lamivudine treatment

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World Journal of Gastroenterology 2003年第12期9卷 2695-2697页

作者： Henry Lik-Yuen Chan May-Ling Wong Alex Yui Hui Angel Mei-Ling Chim Ada Mei-Ling Tse Lawrence Cheung-Tsui Hung Francis Ka-Leung Chan joseph jao-yiu sung Department of Medicine and Therapeutics Chinese University of Hong KongHong Kong

AIM: To investigate the association of hepatitis B virus (HBV) genotype and HBeAg seroconversion after nucleotide analogue ***: Chronic hepatitis B patients receiving lamivudine followed up for at least 6 months post-treatment were studied. Consecutive treatment-naive patients who were prospectively followed up in the clinic for at least 18 months were studied as controls. HBeAg seroconversion was defined as loss of HBeAg, appearance of anti-HBe and normalization of alanine aminotransferase for at least 6 ***: Thirty-five patients on lamivudine and 96 control patients followed up for 39 (18-49) months were *** was given for 12 (10-18) months, and patients were followed up for 15 (6-34) months after drug *** B and C HBV were found in 43 and 88 patients and HBeAg seroconversion occurred in 12 (28 %) and 16(18 %) patients, respectively (P=0.30). There was no difference in HBeAg seroconversion between patients infected by genotype B and C HBV in the control (35 % vs 21%, P=0.25) and lamivudine-treated (14 % vs 10 %,P=1.00) ***: HBeAg seroconversion after treatment by lamivudine was not influenced by the HBV genotype.

关键词：乙型肝炎乙型肝炎病毒拉米夫定 HBeAg 基因型抗病毒治疗

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Cellular & Molecular Immunology 2021年第4期18卷 1005-1015页

作者： Xuezhen Zeng Jingying Zhou Zhewen Xiong Hanyong Sun Weiqin Yang Myth T.S.Mok Jing Wang Jingqing Li Man Liu Wenshu Tang Yu Feng Hector Kwong-Sang W ang Shun-Wa Tsang King-Lau Chow Philip Chun Yeung John Wong Paul Bo-San Lai Anthony Wing-Hung Chan Ka Fai To Stephen Lam Chan Qiang Xia Jing Xue Xiao Chen Jun Yu Sui Peng joseph jao-yiu sung Ming Kuang Alfred Sze-Lok Cheng School of Biomedical Sciences The Chinese University of Hong KongHong Kong SARChina lnstitute of Precision Medicine The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina Department of Liver Surgery The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina Department of Pharmacy The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina Department of Anatomical and Cellular Pathology The Chinese University of Hong KongHong Kong SARChina Department of Liver Surgery Ren Ji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina Department of Gastroenterology The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina Division of Life Science Hong Kong University of Science and TechnologyHong Kong SARChina Department of Surgery The Chinese University of Hong KongHong Kong SARChina State Key Laboratory of Translational Oncology The Chinese University of Hong KongHong Kong SARChina Department of Clinical Oncology The Chinese University of Hong KongHong Kong SARChina State Key Laboratory of Oncogenes and Related Genes Stem Cell Research CenterRen Ji HospitalSchool of MedicineShanghai Cancer InstituteShanghai Jiao Tong UniversityShanghaiChina Department of Medicine and Therapeutics The Chinese University of Hong KongHong Kong SARChina State Key Laboratory of Digestive Disease The Chinese University of Hong KongHong Kong SARChina Clinical Trial Unit The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina Cancer Center The First Affiliated HospitalSun Yat-sen UniversityGuangzhouChina

The liver is an immunologically tolerant organ and a common metastatic site of multiple cancer *** a role for cancer cell invasion programs has been well characterized,whether and how liver-intrinsic factors drive metastatic spread is incompletely ***,we show that aberrantly activated hepatocyte-intrinsic cell cycle-related kinase(CCRK)signaling in chronic liver diseases is critical for cancer metastasis by reprogramming an immunosuppressive *** an inducible liverspecific transgenic model,we found that CCRK overexpression dramatically increased both B16F10 melanoma and MC38 colorectal cancer(CRC)metastasis to the liver,which was highly infiltrated by polymorphonuclear-myeloid-derived suppressor cells(PMNMDSCs)and lacking natural killer T(NKT)*** of PMN-MDSCs in CCRK transgenic mice restored NKT cell levels and their interferon gamma production and reduced liver metastasis to 2.7% and 0.7%(metastatic tumor weights)in the melanoma and CRC models,***,CCRK activated nuclear factor-kappa B(NF-κB)signaling to increase the PMN-MDSC trafficking chemokine C-X-C motif ligand 1(CXCL1),which was positively correlated with liver-infiltrating PMN-MDSC levels in CCRK transgenic ***,CRC liver metastasis patients exhibited hyperaaivation of hepatic CCRK/NF-κB/CXCL1 signaling,which was associated with accumulation of PMN-MDSCs and paucity of NKT cells compared to healthy liver transplantation *** summary,this study demonstrates that immunosuppressive reprogramming by hepatic CCRK signaling undermines antimetastatic *** findings offer new mechanistic insights and therapeutic targets for liver metastasis intervention.

关键词： Cell cycle related kinase liver metastasis liver immune microenvironment myeloid-derived suppressor cell natural killer T cell

COVID-19 risk prediction scores for mortality:A validation study from the National Registry of COVID-19 in China

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Chinese Medical Journal 2024年第6期137卷 743-745页

作者： Sui Peng Kelvin KF Tsoi Jianfeng Wu Steve HL Yim Haibo Wang Qian Zhou Han Xiao Zongpeng Weng Bin Li Ming Kuang Jianyan Long joseph JY sung Haipeng Xiao Clinical Trials Unit The First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouGuangdong 510080China Stanley Ho Big Data Decision Analytics Research Centre The Chinese University of Hong KongHong Kong 999077China JC School of Public Health and Primary Care The Chinese University of Hong KongHong Kong 999077China Department of Critical Care Medicine The First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouGuangdong 510080China Department of Geography and Resource Management The Chinese University of Hong KongHong Kong 999077China Department of Medical Ultrasonics Institute of Diagnostic and Interventional UltrasoundThe First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouGuangdong 510080China Department of Liver Surgery The First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouGuangdong 510080China Department of Medicine and Therapeutics The Chinese University of Hong KongHong Kong 999077China Department of Endocrinology Precision Medicine InstituteThe First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouGuangdong 510080China

To the Editor:Coronavirus disease 2019(COVID-19)has evolved into a global pandemic,with over 700 million confirmed cases worldwide and still mounting.^([1])The clinical impact of this pandemic is immense,given the wide spectrum of disease manifestation,ranging from mild respiratory symptoms to severe pulmonary *** high-risk individuals,especially during their initial encounters in clinics and hospital emergency services,is crucial to provide timely effective ***,the timely risk stratification of COVID-19 patients in the emergency room can greatly benefit both infected individuals and healthcare professionals.^([2])This study aims to identify features of serious COVID-19 infection at presentation that may lead to mortality of the patients.

关键词： mortality respiratory prediction

Analgesic effects of JCM-16021 on neonatal maternal separation-induced visceral pain in rats

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World Journal of Gastroenterology 2010年第7期16卷 837-845页

作者： joseph JY sung Faculty of Medicine The Chinese University of Hong Kong

AIM:To investigate the pharmacological effect of JCM-16021,a Chinese herbal formula,and its underlying ***:JCM-16021 is composed of seven herbal plant *** raw materials of the formula were examined according to the quality control criteria listed in the Chinese Pharmacopeia(2005).In a neonatal maternal separation(NMS)model,male SpragueDawley rats were submitted to daily maternal separation from postnatal day 2 to day 14,or no specific handling(NH).Starting from postnatal day 60,rats were administered JCM-16021(2,4,8 g/kg per day)orally twice a day for 28 *** threshold pressure and electromyographic activities of external oblique muscles in response to colorectal distention recorded with a Power Lab System(AD Instruments International),were tested as pain *** in serotonin(5-HT)and 5-hydroxyindoleacetic acid(5-HIAA)concentrations in the colon of rats were analyzed;the enterochromaffin cell numbers and serotonin transporter in the colon of rats were also evaluated with an immunohistochemistry ***:NMS treatment significantly reduced pain threshold pressure(37.4±1.4 mmHg),as compared to that of NH rats(57.7±1.9 mmHg,P<0.05).After JCM-16021 treatment,the pain threshold pressure significantly increased when compared to that before treatment(34.2±0.9 mmHg vs 52.8±2.3 mmHg in the high dose group,40.2±1.6 mmHg vs 46.5±1.3 mmHg in the middle dose group,and 39.3±0.7 mmHg vs 46.5±1.6 mmHg in the low dose group,P<0.05).Also JCM-16021 significantly and dose-dependently decreased electromyographic activity to the graded colorectal distension(CRD),(the meanΔAUC values were:0.17±0.03,0.53±0.15,1.06±0.18,1.22±0.24 in the high dose group;0.23±0.04,0.68±0.17,1.27 ±0.26,1.8±0.3 in the middle dose group;and 0.29 ±0.06,0.8±0.16,1.53±0.24,2.1±0.21 in the low dose group for the pressures 20,40,60,80 mmHg),as compared to the NMS vehicle *** meanΔAUC values were:0.57±0.12,1.33±0.18,2.57±0.37,3.08±0.37 for the pressures 20,40,60,80 mmHg(P

关键词： Analgesia effect Neonatal maternal separation Visceral hyperalgesia Herbal medicine Serotonin pathway

Artificial intelligence in gastroenterology:where are we heading?

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Frontiers of Medicine 2020年第4期14卷 511-517页

作者： joseph JY sung Nicholas CH Poon Institute of Digestive Disease Faculty of MedicineThe Chinese University of Hong KongHong KongChina Big Data Decision Analytic Cancer The Chinese University of Hong KongHong KongChina

Artificial intelligence(AI)is coming to medicine in a big *** making diagnosis in various medical conditions,following the latest advancements in scientific literature,suggesting appropriate therapies,to predicting prognosis and outcome of diseases and conditions,AI is offering unprecedented possibilities to improve care for *** is a field that AI can make a significant *** is partly because the diagnosis of gastrointestinal conditions relies a lot on image-based investigations and procedures(endoscopy and radiology).AI-assisted image analysis can make accurate assessment and provide more information than conventional *** integration of genomic,epigenetic,and metagenomic data may offer new classifications of gastrointestinal cancers and suggest optimal personalized *** managing relapsing and remitting diseases such as inflammatory bowel disease,irritable bowel syndrome,and peptic ulcer bleeding,convoluted neural network may formulate models to predict disease outcome,enhancing treatment *** and surgical robots can also assist surgeons in conducting gastrointestinal *** the advancement and new opportunities are exciting,the responsibility and liability issues of AI-assisted diagnosis and management need much deliberations.

关键词： artificial intelligence endoscopy robotics gastrointestinal diseases

Dieulafoy's lesion:A case series study

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World Journal of Gastroenterology 2005年第23期11卷 3574-3577页

作者： RS Walmsley Yuk-Tong Lee joseph JY sung Department of Gastroenterology Department of Medicine and Therapeutics

AIM: Dieulafoy's lesion (DL) accounts for 1-5.8% of cases of acute upper gastrointestinal bleeding (GIB). Its mortality is high, approaching 20%, despite recent advances in endoscopic therapy. We aimed to report our experience in the treatment of ***: A retrospective case study of all patients with DL between January 1993 and January 2003 was done. Characteristics, treatment methods, success rates and 30-d mortality of the patients were analyzed. RESULTS: Thirty-six patients were noted to have DL in the study period. Thirty-three records were available for assessment in which 35 DL were identified. The median age of the patients was 67 years with male to female ratio of 5.6:1. Significant comorbidities existed in 69% of the patients. Eighty-nine percent of the DL was found at first endoscopy, three DL at laparotomy. Significant coexistent endoscopic findings existed in 23%. Hemostasis was achieved in 88% by using adrenaline injection, or in combination with heater probe application at first endoscopy. Four cases had re-bleeding, all were successfully treated endoscopically. The 30-d mortality rate was 23%.CONCLUSION: Successful endoscopic hemostasis could be achieved in 100% of cases of DL. The overall mortality may still remain high, mainly due to the comorbidities and age of these patients.

关键词： Dieulafoy Gastrointestinal bleeding

Virtual colonoscopy-induced perforation in a patient with Crohn's disease

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World Journal of Gastroenterology 2007年第6期13卷 978-979页

作者： Sunny H Wong Vincent WS Wong joseph JY sung Institute of Digestive Disease and Department of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong China

We report a case of sigmoid colon perforation in a patient with Crohn's disease undergoing computed-tomographic (CT) colonography. A 70-year-old patient with Crohn's disease with terminal ileitis and sigmoid stricture underwent CT colonography after incomplete conventional colonoscopy. During the procedure, the colon was inflated by air insufflation and the patient developed abdominal pain with radiological evidence of retroperitoneal and intraperitoneal free gas. Hartmann's operation was performed. This case highlights that CT colonography is not risk-free. The risk of perforation may be higher in patients with inflammatory bowel disease.

关键词： Perforation Colonography Crohn's disease Stricture Hartmann's Inflammatory bowel disease