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Venous thromboembolism prophylaxis in hospitalized elderly patients： Time to consider a ＇mUST＇ strategy

Journal of Geriatric Cardiology 2011年第2期8卷 114-120页

作者： kwok m.ho edward litton Department of Intensive Care medicine Royal Perth Hospital and School of Population Health University of Western Australia Perth WA 6000 Australia

Venous thromboembolism （VTE） is the commonest cause of preventable death in hospitalized patients. Elderly patients have higher risk of VTE because of the high prevalence of predisposing co-morbidities and acute illnesses. Clinical diagnosis of VTE in the elderly patient is particularly difficult and, as such, adequate VTE prophylaxis is of pivotal importance in reducing the mortality and morbidities of VTE. Omission of VTE prophylaxis is, however, very common despite continuous education. A simple way to overcome this problem is to implement universal VTE prophylaxis for all hospitalized elderly patients instead of selective prophylaxis for some patients only according to individual＇ s risk of VTE. Although pharmacological VTE prophylaxis is effective for most patients, a high prevalence of renal impairment and drug interactions in the hospitalized elderly patients suggests that a multimodality approach may be more appropriate. mechanical VTE prophylaxis, including calf and thigh compression devices and/or an inferior vena cava filter, are often underutilized in hospitalized elderly patients who are at high-risk of bleeding and VTE. Because pneumatic compression devices and thigh length stockings are virtually risk free, mechanical VTE prophylaxis may allow early or immediate implementation of VTE prophylaxis for all hospitalized elderly patients, regardless of their bleeding and VTE risk. Although the cost-effectiveness of this multimodality Universal STat （＇mUST＇） VTE prophylaxis approach for hospitalized elderly patients remains uncertain, this strategy appears to offer some advantages over the traditional ＇selective and single-modal＇ VTE prophylaxis approach, which often becomes ＇hit or miss＇ or not implemented promptly in many hospitalized elderly patients. A large clustered randomized controlled trial is, however, needed to assess whether early, multimodality, universal VTE prophylaxis can improve important clinical outcomes of hospitalized elderly patients.

关键词： age bundle of care deep vein thrombosis prevention pulmonary embolism

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Flattening the biological age curve by improving metabolic health:to taurine or not to taurine,that’s the question

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Journal of Geriatric Cardiology 2023年第11期20卷 813-823页

作者： kwok m.ho Anna Lee William Wu matthew T.V.Chan Lowell Ling Jeffrey Lipman Jason Roberts edward litton Gavin m.Joynt martin Wong Department of Intensive Care medicine Fiona Stanley HospitalPerthAustralia medical School The University of Western AustraliaPerthAustralia School of Veterinary&Life Sciences Murdoch UniversityPerthAustralia Department of Anaesthesia&Intensive Care Prince of Wales HospitalChinese University of Hong KongHong KongChina Jamieson Trauma Institute Royal Brisbane and Women’s HospitalBrisbaneQueenslandAustralia Division of Anaesthesiology Critical Care Emergency and Pain medicine Nîmes University HospitalUniversity of MontpellierNîmesFrance University of Queensland Centre for Clinical Research Faculty of MedicineThe University of QueenslandBrisbaneAustralia Herston Infectious Diseases Institute(HeIDI) Metro North HealthBrisbaneAustralia Departments of Pharmacy and Intensive Care medicine Royal Brisbane and Women’s HospitalBrisbaneAustralia JC School of Public Health and Primary Care Centre for Health Education and Health PromotionChinese University of Hong KongHong KongChina School of Public Health Peking UniversityBeijingChina School of Public Health Fudan UniversityShanghaiChina

The aging population is an important issue around the world especially in developed *** med-ical advances have substantially extended life span,the same cannot be said for the duration of health *** are seeing in-creasing numbers of elderly people who are frail and/or have multiple chronic conditions;all of these can affect the quality of life of the elderly population as well as increase the burden on the healthcare *** is mechanistically related to common medical conditions such as diabetes mellitus,ischemic heart disease,cognitive decline,and frailty.A recently accepted concept termed‘Accelerated Biological Aging’can be diagnosed when a person’s biological age—as measured by biomarkers of DNA methylation—is older than their corresponding chronological ***,a conditionally essential amino acid,has received much attention in the past few years.A substantial number of animal studies have provided a strong scientific foundation sug-gesting that this amino acid can improve cellular and metabolic health,including blood glucose control,so much that it has been labelled one of the‘longevity amino acids’.In this review article,we propose the rationale that an adequately powered random-ized-controlled-trial(RCT)is needed to confirm whether taurine can meaningfully improve metabolic and microbiome health,and biological *** trial should incorporate certain elements in order to provide the much-needed evidence to guide doctors,and also the community at large,to determine whether this promising and inexpensive amino acid is useful in improving human metabolic health.

关键词： rational meaningful Taurine

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安全有效的静脉补铁治疗可减少异体输血需求：随机临床试验的系统性综述和荟萃分析

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英国医学杂志中文版 2014年第2期17卷 73-74页

作者： edward litton JingXiao kwok m.ho 王倩(译) 许小平(校) Department ofIntensive Caremedicine Royal PerthHospital PerthWestern Australia6000 School of medicineand Pharmacology University of WesternAustralia PerthWestern Australia6OO9 School of PopulationHealth University ofWestern AustraliaPerth WesternAustralia 6009 复旦大学附属上海华山医院血液科

目的为了评价静脉补铁治疗的有效性和安全性，主要对患者血红蛋白浓度的改善、输血需求及感染风险进行评估。研究设计对评价静脉补铁治疗的安全性及有效性的随机对照临床研究进行系统性综述和荟萃分析。

关键词：静脉补铁治疗系统性综述荟萃分析异体输血随机临床试验安全性随机对照临床研究血红蛋白浓度

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Very long survival in pediatric cancer between 1944 and 1993

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Chinese medical Journal 1999年第7期112卷 39-43页

作者： Zhao Guolong, Cathy D Boysen, edward F Brown, Khatab m Hassanein, Frederic k F holmes and Grace E Foege holmes Henan Institute of medical Sciences Henan Medical University Henan 450052 China Department of Internal medicine University of Kansas Medical Center Kansas City Kansas 66160 USA Department of Biometry University of Kansas Medical Center Kansas City Kansas 66160 USA Department of Preventive medicine and Pediatrics University of Kansas Medical Center Kansas City Kansas 66160 USA

Objective To identify factors associated with very long survival among all cancer cases di agnosed at age 19 years or younger registered by the Cancer Data Service at the University of Kansas medical Center in Kansas City, Kansas, USA in the 40 year period between 1944 and 1983, with followup to 1993 methods There were 2720 pediatric patients with 2750 cancers who were studied Forty f our types of cancer were grouped into 11 diagnostic categories Diagnosis years spanned four eras: 1944-1953, 1954-1963, 1964-1973, and 1974-1983 Cases were c ompared u sing specific characteristics and were divided into shortterm and longterm s urvivors with the division generously set at seven years The proportions of t h e longterm survivors were compared by specific characteristics Results Among the diagnostic categories, leukemias were the most common (298%), follow e d by CNS tumors (152%), and hodgkin's disease (90%) male to female ratio was 43; average age at diagnosis was 883608 years Longterm survivors to tal ed 1148 (417%) Prognosis was better in cases diagnosed in earlier stages and i n later eras Proportion of longterm survivors increased from 187% in era to 526% in era Improvement of survival was statistically significant in mo st diagnostic categories Conclusions This study shows continuing improvement of survival during four consecutive eras for childhood and adolescent cancer Early diagnosis was associated with bett e r survival Unstaged cases decreased over time reflecting progress in diagnost i c techniques many patients died before seven years after diagnosis Those w ho survived more than seven years had excellent survival Pediatricians can expe c t to participate in the care of these patients long after the original diagnosis and treatment

关键词： cancer survial longterm children

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multinational survey on the preferred approach to management of Barrett’s esophagus in the Asia-Pacific region

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World Journal of Gastrointestinal Oncology 2021年第4期13卷 279-294页

作者： Guan Sen Kew Alex Yu Sen Soh Yeong Yeh Lee Takuji Gotoda Yan-Qing Li Yan Zhang Yiong Huak Chan Kewin Tien ho Siah Daniel Tong Simon Ying Kit Law Andrew Ruszkiewicz Ping-Huei Tseng Yi-Chia Lee Chi-Yang Chang Duc Trong Quach Chika Kusano Shobna Bhatia Justin Che-Yuen Wu Rajvinder Singh Prateek Sharma Khek-Yu ho Department of Gastroenterology and Hepatology University Medicine ClusterNational University Health SystemSingapore 119228Singapore Department of Gastroenterology and Hepatology National University HospitalNational University Health SystemSingapore 119074Singapore School of medical Sciences Universiti Sains MalaysiaPenang 11800Malaysia Division of Gastroenterology and Hepatology Department of MedicineNihon University School of MedicineTokyo 173-8610Japan Department of Gastroenterology Laboratory of Translational GastroenterologyQilu Hospital of Shandong UniversityJinan 250012Shandong ProvinceChina Yong Loo Lin School of medicine National University of SingaporeSingapore 119228Singapore Department of Surgery The University of Hong KongHong Kong PokfulamHong KongChina Department of Pathology SA PathologyAdelaide 5112Australia Department of Internal medicine National Taiwan University HospitalTaipei 100Taiwan Department of Internal medicine Fu Jen Catholic University HospitalTaipei 24352Taiwan Department of Internal medicine University of Medicine and Pharmacy at Hochiminh CityVietnamHochiminh 70000Viet Nam Department of Gastroenterology Seth GS Medical College and King Edward Memorial HospitalMumbai 400012India Department of medicine and Therapeutics The Chinese University of Hong KongHong KongChina Department of Gastroenterology Lyell McEwin HospitalUniversity of AdelaideAdelaide 64128Australia Department of Gastroenterology and Hepatology Kansas City VA Medical CenterKansas CityKS 64128United States Department of medicine National University HospitalSingapore 119074Singapore

BACKGROUND major societies provide differing guidance on management of Barrett’s esophagus(BE),making standardization *** To evaluate the preferred diagnosis and management practices of BE among Asian *** Endoscopists from across Asia were invited to participate in an online questionnaire comprising eleven questions regarding diagnosis,surveillance and management of *** Five hundred sixty-nine of 1016(56.0%)respondents completed the survey,with most respondents from Japan(n=310,54.5%)and China(n=129,22.7%).Overall,the preferred endoscopic landmark of the esophagogastric junction was squamocolumnar junction(42.0%).Distal palisade vessels was preferred in Japan(59.0%vs 10.0%,Pmo-columnar junction was preferred(59.5%vs 27.4%,Pm criteria all the *** was never used by 46.1%of Japanese,whereas 84.2%outside Japan,endoscopists used it to varying extents(Pmost Asian endoscopists(70.8%)would survey long-segment BE without dysplasia every two *** to Seattle protocol was poor with only 6.3%always performing it.73.2%of Japanese never did it,compared to 19.3%outside Japan(Pmost preferred(74.0%)treatment of non-dysplastic BE was proton pump inhibitor only when the patient was symptomatic or had *** BE with low-grade dysplasia,6-monthly surveillance was preferred in 61.9%within Japan vs 47.9%outside Japan(Pmanagement of BE varied within Asia,with stark contrast between Japan and outside *** Asian endoscopists chose squamo-columnar junction to be the landmark for esophagogastric junction,which is *** also did not consistently use Prague criteria,and Seattle *** of standardization,education and research are possible reasons.

关键词： Barrett's esophagus Survey Asia-Pacific Asian Barrett's consortium Prague criteria Seattle protocol

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Transcriptomic analyses of localized prostate cancers of East Asian and North American men reveal race-specific luminal-basal and microenvironmental differences

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Cancer Communications 2023年第10期43卷 1164-1168页

作者： melvin L.K.Chua Alexander K.Hakansson Enya H.W.Ong Boon Hao hong Jing Jing miao Adelene Y.L.Sim Janice S.H.Tan Kah min Tan Gabrielle C.J.Lee Kar Perng Low Jeffrey K.L.Tuan Terence W.K.Tan michael L.C.Wang Joe P.S.Yeong michael C.S.Tan Lui Shiong Lee Ravindran Kanesvaran Xin Zhao Julian ho Daniel E.Spratt edward m.Schaeffer Kae-Jack Tay Yang Liu Elai Davicioni Li Yan Khor Division of Radiation Oncology National Cancer Centre SingaporeSingaporeSingapore Duke-NUS medical School SingaporeSingapore Division of medical Sciences National Cancer Centre SingaporeSingaporeSingapore Veracyte IncSan DiegoCAUSA Department of Nasopharyngeal Carcinoma State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat-sen University Cancer CenterGuangzhouGuangdongP.R.China Faculty of medicine Nursing and Health SciencesMonash UniversityVictoriaAustralia Department of Anatomical Pathology Singapore General HospitalSingaporeSingapore Department of Pathology Changi General HospitalSingaporeSingapore Department of Urology Sengkang General HospitalSingaporeSingapore Division of medical Oncology National Cancer Centre SingaporeSingaporeSingapore Department of Radiation Oncology University Hospitals Seidman Cancer CenterCase Comprehensive Cancer CenterClevelandOHUSA Department of Urology Northwestern University Feinberg School of MedicineChicagoILUSA Department of Urology Singapore General HospitalSingaporeSingapore

Dear editor,Prostate cancer(PCa)remains a major healthcare burden in men globally[1].most patients present with localized disease,and treatment is recommended based on risk classification systems like the National Comprehensive Cancer Network(NCCN)[2].however,these methods are imprecise for estimating metastasis-free survival and prostate cancer-specific mortality and thus biomarkers that can predict tumor aggression are needed[3–5].Several studies have since characterized the molecular landscape of localized PCa in White[4,5]and Black/African-American men[6],but data is lacking in Asian *** Chinese Prostate Cancer Genome and Epigenome Atlas(CPGEA)reported on the genomic and epigenomic landscape of 208 PCa of men from China[7].Comparative analyses between the CPGEA cohort and data from The Cancer Genome Atlas(TCGA)revealed higher frequencies of Forkhead box A1(FOXA1)and chromodomain-helicase DNA-binding 1(CHD1)mutations,and lower frequencies of phosphatase and tensin homolog(PTEN)mutations and transmembrane protease serine 2-E26 transformationspecific related gene(TmPRSS2-ERG)fusion in Chinese compared with White men[7].These preliminary findings highlight the presence of race-specific differences in molecular phenotypes of PCa.

关键词： landscape Atlas editor

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人源大麻素受体CB1晶体结构

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科学新闻 2017年第4期 39页

作者： Tian Hua Kiran Vemuri mengchen Pu Lu Qu Gye Won Han Yiran Wu Suwen Zhao Wenqing Shui Shanshan Li Anisha Korde Robert B.Laprairie edward L.Stahl Jo-Hao ho Nikolai Zvonok Han Zhou Irina Kufareva Beili Wu Qiang Zhao michael A.Hanson Laura m.Bohn Alexandros makriyannis Raymond C.Stevens 刘志杰上海科技大学上海科技大学iHuman研究所国际生物结晶组织亚洲晶体学会中国晶体学会中国生物物理学会

文章简介人源大麻素受体(human Cannabinoid Receptor 1,CB1)是G蛋白偶联受体(G protein coupled receptor,GPCR)Class A家族的一员,其主要分布在中枢神经系统,尤其是大脑皮层、基底核、海马和小脑区域,是人类大脑中表达量最高的GPCR之... 详细信息

文章简介人源大麻素受体(human Cannabinoid Receptor 1,CB1)是G蛋白偶联受体(G protein coupled receptor,GPCR)Class A家族的一员,其主要分布在中枢神经系统,尤其是大脑皮层、基底核、海马和小脑区域,是人类大脑中表达量最高的GPCR之一。CB1是大麻的主要有效成分——四氢大麻酚(?9-tetrahydrocannabinol,THC)的主

关键词：大麻素受体 CB1 晶体结构结晶构造固体结构

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