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Hepatocellular carcinoma in patients with non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2016年第37期22卷 8294-8303页

作者： Carrie R wong Mindie H Nguyen joseph k Lim Department of Internal Medicine Yale University School of Medicine Division of Gastroenterology and Hepatology Stanford University School of Medicine Yale Liver Center Section of Digestive Diseases Yale University School of Medicine

Nonalcoholic fatty liver disease(NAFLD) is the most common chronic liver disease in the United States and represents an increasingly important etiology of hepatocellular carcinoma(HCC) with annual cumulative incidence rates ranging from 2% to 12% in cohorts of NAFLD cirrhosis. While the risk of progression of NAFLD to HCC remains higher among patients with fibrosis or cirrhosis, an increasing amount of literature describes NAFLD-HCC as a disease that can occur in the absence of cirrhosis. Efforts to characterize the pathogenesis of NAFLD-HCC have suggested mechanisms that strongly associate with states of hyperinsulinemia and chronic inflammation, cellular mechanisms including adaptive immune responses and hepatic progenitor cell populations, and genetic polymorphisms including mutations of PNPLA3. Current literature describes NAFLD-HCC mostly as a disease of late presentation with lower rates of receipt of curative therapy and worse prognosis. However, a growing body of evidence has reported comparable and potentially more favorable disease-free and overall survival rates among patients with NAFLD-HCC after receipt of curative treatment. This review summarizes current evidence of epidemiology, pathophysiology, disease presentation, demand and receipt of curative therapy, post-treatment outcomes, and overall survival of NAFLD-associated HCC.

关键词： Fatty liver Nonalcoholic steatohepatitis Hepatocellular carcinoma Liver cirrhosis Liver cancer

Increasing contribution of non-alcoholic fatty liver disease to hepatocellular carcinoma incidence and mortality in U.S. Medicare

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Hepatobiliary Surgery and Nutrition 2019年第5期8卷 506-508页

作者： Carrie R.wong joseph k.Lim Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at the University of CaliforniaLos AngelesCAUSA Department of Health Policy and Management Jonathan and Karin Fielding School of Public Health at the University of CaliforniaLos AngelesCAUSA Yale Liver Center and Section of Digestive Diseases Yale University School of MedicineNew HavenCTUSA

Hepatocellular carcinoma(HCC)has one of the fastestgrowing rates of cancer-related incidence and mortalityin the United States(U.S.)(1-3).From 2009 to 2013,theaverage annual percent change(AAPC)for liver cancerincidence became the highest among other reported cancersfor both males(+2.9%)and females(+3.8%)(1).In addition,cancer-related mortality rates for liver cancer are the highestamong solid malignancies from 2010 to 2014 for males(+2.6%)and females(+3.0%)(1).

关键词： mortality liver cancer

Phenolic constituents and anticancer properties of Morus alba(white mulberry) leaves

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Journal of Integrative Medicine 2020年第3期18卷 189-195页

作者： Eric Wei Chiang Chan Siu kuin wong joseph Tangah Tomomi Inoue Hung Tuck Chan Faculty of Applied Sciences UCSI University56000 CherasKuala LumpurMalaysia School of Foundation Studies Xiamen University Malaysia43900 SepangSelangorMalaysia Forest Research Centre Sabah Forestry Department90009 SandakanSabahMalaysia Centre for Environmental Biology and Ecosystem Studies National Institute for Environmental Studies(NIES)OnogawaTsukuba 305-0053Japan Secretariat of International Society for Mangrove Ecosystems(ISME) Faculty of AgricultureUniversity of the RyukyusOkinawa 903-0129Japan

Flavonoids are by far the most dominant class of phenolic compounds isolated from Morus alba leaves(MAL). Other classes of compounds are benzofurans, phenolic acids, alkaloids, coumarins, chalcones and stilbenes. Major flavonoids are kuwanons, moracinflavans, moragrols and morkotins. Other major compounds include moracins(benzofurans), caffeoylquinic acids(phenolic acids) and morachalcones(chalcones). Research on the anticancer properties of MAL entailed in vitro and in vivo cytotoxicity of extracts or isolated compounds. Flavonoids, benzofurans, chalcones and alkaloids are classes of compounds from MAL that have been found to be cytotoxic towards human cancer cell lines. Further studies on the phytochemistry and anticancer of MAL are suggested. Sources of information were Pub Med,Pub Med Central, Science Direct, Google, Google Scholar, J-Stage, Pub Chem and China National knowledge Infrastructure.

关键词： Flavonoids Benzofurans Cytotoxic Moracins Morachalcones Chalcomoracin

Endoscopic and non-endoscopic approaches for the management of radiation-induced rectal bleeding

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World Journal of Gastroenterology 2016年第31期22卷 6972-6986页

作者： joseph Paul Weiner Andrew Thomas wong David Schwartz Manuel Martinez Ayse Aytaman David Schreiber Department of Radiation Oncology VA NY Harbor Healthcare System Brooklyn Campus Department of Radiation Oncology SUNY Downstate Medical Center Department of Gastro-enterology VA NY Harbor Healthcare System Brooklyn Campus Department of Gastroenterology SUNY Downstate Medical Center

Pelvic radiation is a commonly utilized treatment for malignancy of the genitourinary and lower gastrointestinal tract. Radiation proctitis and the resultant clinical picture varies from asymptomatic to potentially life threatening. Similarly, treatment options also vary greatly, from medical therapy to surgical intervention. Commonly utilized medical therapy includes sucralfate enemas, antibiotics, 5-aminosalicylic acid derivatives, probiotics, antioxidants, short-chain fatty acids, formalin instillation and fractionated hyperbaric oxygen. More invasive treatments include endoscopic-based, focally ablative interventions such as dilation, heater and bipolar cautery, neodymium/yttrium aluminum garnet argon laser, radiofrequency ablation or argon plasma coagulation. Despite its relatively common frequency, there is a dearth of existing literature reporting headto-head comparisons of the various treatment options via a randomized controlled approach. The purpose of our review was to present the reader a consolidation of the existing evidence-based literature with the goal of highlighting the comparative effectiveness and risks of the various treatment approaches. Finally, we outline a pragmatic approach to the treatment of radiation proctitis. In light of the lack of randomized data, our goal is to pursue as least invasive an approach as possible, with escalation of care tailored to the severity of the patient's symptoms. For those cases that are clinicallyasymptomatic or only mildly symptomatic, observation or medical management can be considered. Once a patient fails such management or symptoms become more severe, invasive procedures such as endoscopically based focal ablation or surgical intervention can be considered. Although not all recommendations are supported by level I evidence, reported case series and single-institutional studies in the literature suggest that successful treatment with cessation of symptoms can be obtained in the majority of cases.

关键词： Prostate cancer Radiation therapy Radiation proctitis Radiation proctopathy Medical treatment Endoscopic treatment Hyperbaric oxygen Neodymium/ yttrium aluminum garnet argon laser Argon plasma coagulation

Indocyanine green lymphangiography-guided liposuction in breast cancer-related lymphedema treatment-patient selection and technique

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Plastic and Aesthetic Research 2020年第2期7卷 30-36页

作者： Hin-Lun Liu Melody Man-kuen wong joseph Hon-Ping Chung Division of Plastic and Reconstructive Surgery Department of SurgeryThe University of Hong KongQueen Mary HospitalHong Kong SARChina

Aim:The rationale of using liposuction to treat lymphedema is that the chronic inflammatory process of lymphedema results in fat *** authors describe the technique of indocyanine green lymphangiography-guided liposuction,its rationale,and our patient selection criteria for better clinical ***:Thirty-two patients underwent liposuction for breast cancer-related *** green lymphangiography was performed prior to *** patients without linear and splash patterns in indocyanine green lymphangiography,circumferential liposuction was performed *** patients who had linear or splash patterns,liposuction was not performed at regions with remaining functional lymphatic *** were assessed using circumferential reduction ***:At a mean follow-up of 24.5±6.5 months,all(100%)patients had a reduction in limb circumferences after *** mean circumference reduction rate was 67.6%±27.9%.Conclusion:Liposuction is a valuable treatment for breast cancer-related *** believe patients with fat predominant lymphedema are the best candidates for liposuction.

关键词： Lymphedema breast cancer-related lymphedema liposuction indocyanine green lymphangiography

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

Surgery in the age of biologics

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Gastroenterology Report 2019年第2期7卷 77-90,I0001页

作者： Daniel J.wong Eve M.Roth joseph D.Feuerstein Vitaliy Y.Poylin Department of Surgery Division of Colon&Rectum SurgeryBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA Department of Medicine Division of GastroenterologyBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA

Since the introduction of the first anti-tumor necrosis factor antibodies in the late 1990s,biologic therapy has revolutionized the medical treatment of patients with inflammatory bowel disease(IBD).Nevertheless,surgery continues to play a significant role in treating IBD *** of intestinal resection in patients with Crohn’s disease or colectomy in ulcerative colitis are reducing but not substantially over the long *** increasing variety of biologic medications are now available to treat IBD patients in various clinical ***,a number of questions persist about how biologic medications affect the need for surgery and overall course in IBD *** the trend for earlier and more frequent use of biologic medications in IBD patients,a working knowledge of the effects of these medications on surgical decision-making and outcomes is essential for the practicing colorectal surgeon and *** review seeks to summarize the relevant literature surrounding biologic use and IBD surgery with a focus on the effect of biologics on the frequency,type and complications of surgery in this‘age of biologics’.

关键词： Biologics inflammatory bowel disease surgery review

Quantum Realities and Observer-Dependent Universes: An Advanced Observer Model

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Journal of Quantum Information Science 2024年第3期14卷 69-121页

作者： joseph Hon Cheung wong Department of Computing The Hong Kong Polytechnic University Hung Hom Kowloon Hong Kong China

This paper presents a novel observer model that integrates quantum mechanics, relativity, idealism, and the simulation hypothesis to explain the quantum nature of the universe. The model posits a central server transmitting multi-media frames to create observer-dependent realities. key aspects include deriving frame rates, defining quantum reality, and establishing hierarchical observer structures. The model’s impact on quantum information theory and philosophical interpretations of reality are examined, with detailed discussions on information loss and recursive frame transmission in the appendices.

关键词： Quantum Mechanics Observer Model Frame Rates Quantum Reality Hierarchical Observers Information Theory Simulation Hypothesis Recursive Frame Transmission Information Loss

A synopsis on flavonoids from the roots of Scutellaria baicalensis with some insights on baicalein and its anti-cancer properties

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Journal of Chinese Pharmaceutical Sciences 2019年第4期28卷 217-228页

作者： Eric Wei Chiang Chan Siu kuin wong joseph Tangah Tomomi Inoue Hung Tuck Chan Faculty of Applied Sciences UCSI University School of Science Monash University Sunway Forest Research Centre Sabah Forestry Department Centre for Environmental Biology and Ecosystem Studies National Institute for Environmental Studies(NIES) Secretariat of the International Society for Mangrove Ecosystems Faculty of Agriculture University of the Ryukyus

Flavones are the most dominant type of flavonoids isolated from the roots of Scutellaria baicalensis(Radix Scutellariae), which is a traditional medicinal plant in East Asian countries, including China, Japan and *** of the flavones are derivatives with methoxyl and hydroxyl groups, and they include baicalein, baicalin, chrysin, norwogonin, oroxylin A and *** possesses anti-cancer activities against a wide spectrum of human cancer cells by inducing apoptosis and cell cycle arrest, and by inhibiting angiogenesis, metastasis and *** examples of the effects of baicalein on apoptosis, cell cycle arrest and metastasis are presented with discussion on the molecular targets and *** on the structure-activity relationships of flavonoid cytotoxicity towards human cancer cells show that the potent cytotoxic activities of baicalein can be attributed to its-OH groupsat C5, C6 and C7(triple hydroxylation) of ring A, carbonyl group at C4 of ring C, and C2–C3 double bond of ring *** on structural modifications of baicalein have shown that the configurations at C6 of ring A are critical factors influencing its anti-proliferative *** the remarkable anti-cancer properties, the future prospects for developing baicalein into an anti-cancer drug are promising.

关键词： Radix Scutellariae Baicalein Flavones Structure-activity relationships