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Consensus scoring systems for nonalcoholic fatty liver disease: an unmet clinical need

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Hepatobiliary Surgery and Nutrition 2021年第3期10卷 388-390页

作者： Yu-Jie Zhou vincent wai-Sun wong Ming-Hua Zheng NAFLD Research Center Department of Hepatologythe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina Division of Gastroenterology and Hepatology Key Laboratory of Gastroenterology and HepatologyMinistry of HealthShanghai Institute of Digestive DiseaseRenji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina Department of Medicine and Therapeutics The Chinese University of Hong KongHong KongChina State Key Laboratory of Digestive Disease The Chinese University of Hong KongHong KongChina Institute of Hepatology Wenzhou Medical UniversityWenzhouChina Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province WenzhouChin

Noninvasive diagnosis of nonalcoholic fatty liver disease(NAFLD)has received increasing attention(1,2).Nowadays,when we search the item‘scoring system and fatty liver’in PubMed,we can see a sharp increase in the number of related papers in the past few *** fact,an era of‘information explosion’of noninvasive tests(NITs)for NAFLD is coming.

关键词： NAFLD diagnosis liver

Intravenous fluid selection rationales in acute clinical management

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World Journal of Emergency Medicine 2018年第1期9卷 13-19页

作者： Wing Yan Shirley Cheung wai Kwan Cheung Chun Ho Lam Yeuk wai Chan Hau Ching Chow Ka Lok Cheng Yau Hang wong Chak Wah kam Accident and Emergency Department Tuen Mun Hospital

BACKGROUND: Intravenous fluid(IVF) is commonly used in acute clinical management. This study aimed to review the choice and primary considerations in IVF prescriptions and to evaluate the adequacy of guidelines and trainings on it in the New Territories West Cluster(NTWC) of Hong ***: This is a descriptive study based on data collected from an online survey. Data were processed by SPSS for statistical analysis. This study focused on a general description and doctor-nurse between group comparison. Participants were asked the choice of IVF for nine acute clinical scenarios and provide reason. A 1–10 scale was used to assess the sufficiency of guideline, training and information, and time for revision on IVF ***: 0.9% sodium chloride was the most familiar IVF(36%), followed by 5% Dextrose solution(26%). In the nine scenarios, the most chosen IVF was 0.9% sodium chloride(37%–61%). There was significant difference in the choice of IVF between doctors and nurses in 7 cases. The second most chosen IVF for doctors was Plasma-Lyte A while that for nurses was Gelofusine. Departmental practice was the most chosen reason to account for the prescription. The adequacy of guideline, information and training, and time for revision was rated 5. Doctors had significantly more time at work than nurses to update knowledge in IVF prescription(5.41 versus 4.57).CONCLUSION: 0.9% sodium chloride was mostly chosen. The choice of IVF was mainly based on departmental practice. Adequacy of guideline, information and training, and time for revision on IVF prescription were average, indicating significant training deficit.

关键词： Intravenous fluid Acute care Resuscitation

Validation model of fibrosis-8 index score to predict significant fibrosis among patients with nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2022年第15期28卷 1563-1573页

作者： Thaninee Prasoppokakorn Wah-Kheong Chan vincent wai-Sun wong Panyavee Pitisuttithum Sanjiv Mahadeva Nik Raihan Nik Mustapha Grace Lai-Hung wong Howard Ho-wai Leung Pimsiri Sripongpun Sombat Treeprasertsuk Department of Medicine Division of GastroenterologyFaculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalThai Red Cross SocietyBangkok 10330Thailand Department of Medicine Division of GastroenterologyDivision of Gastroenterology and Hepatology UnitFaculty of MedicineUniversity of MalayaKuala Lumpur 50603Malaysia Department of Medicine and Therapeutics The Chinese University of Hong KongHong KongChina Department of Medicine Division of General Internal MedicineFaculty of MedicineChulalongkorn University and King Chulalongkorn Memorial HospitalThai Red Cross SocietyBangkok 10330Thailand Department of Pathology Hospital Sultanah BahiyahAlor SetarKedah 05460Malaysia Department of Anatomical and Cellular Pathology The Chinese University of Hong KongHong KongChina Department of Internal Medicine Prince of Songkla UniversityHat Yai 90110Thailand Department of Medicine Division of Gastroenterology and HepatologyStanford University School of MedicinePalo AltoCA 94305United States

BACKGROUND Identifying hepatic fibrosis is crucial for nonalcoholic fatty liver disease(NAFLD)*** fibrosis-8(FIB-8)score,recently developed by incorporating four additional variables into the fibrosis-4(FIB-4)score,showed better performance in predicting significant fibrosis in *** To validate the FIB-8 score in a biopsy-proven NAFLD cohort and compare the diagnostic performance of the FIB-8 and FIB-4 scores and NAFLD fibrosis score(NFS)for predicting significant *** We collected the data of biopsy-proven NAFLD patients from three Asian centers in three *** the patients with available variables for the FIB-4 score(age,platelet count,and aspartate and alanine aminotransferase levels)and FIB-8 score(the FIB-4 variables plus 4 additional parameters:The body mass index(BMI),albumin to globulin ratio,gamma-glutamyl transferase level,and presence of diabetes mellitus)were *** fibrosis stage was scored using nonalcoholic steatohepatitis CRN criteria,and significant fibrosis was defined as at least fibrosis stage *** A total of 511 patients with biopsy-proven NAFLD and complete data were included for *** these 511 patients,271(53.0%)were female,with a median age of 51(interquartile range:41,58)*** median BMI was 29(26.3,32.6)kg/m2,and 268(52.4%)had *** the 511 NAFLD patients,157(30.7%)had significant fibrosis(≥F2).The areas under the receiver operating characteristic curves of the FIB-8 and FIB-4 scores and NFS for predicting significant fibrosis were 0.774,0.743,and 0.680,*** FIB-8 score demonstrated significantly better performance for predicting significant fibrosis than the NFS(P=0.001)and was also clinically superior to FIB-4,although statistical significance was not reached(P=0.073).The low cutoff point of the FIB-8 score for predicting significant fibrosis of 0.88 showed 92.36%sensitivity,and the high cutoff point of the FIB-8 score for predicting significant fibrosis of 1.

关键词： Nonalcoholic fatty liver disease Fibrosis-8 score Fibrosis-4 score Nonalcoholic fatty liver disease fibrosis score

Characterization of available automated external def ibrillators in the market based on the product manuals in 2014

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World Journal of Emergency Medicine 2016年第2期7卷 138-146页

作者： Chik Leung Ho Ka wai Cheng Tze Hang Ma Yau Hang wong Ka Lok Cheng Chak Wah kam Department of Accident and Emergency Medicine Tuen Mun Hospital

BACKGROUND: To popularize the wide-spread use of automated external defi brillator(AED) to save life in sudden cardiac arrest, we compared the strength and weakness of different types of AEDs to enable a sound selection based on regional ***: This was a retrospective descriptive study. Different types of AEDs were compared according to the information of AEDs from manuals and brochures provided by the manufacturers. Fifteen types of AEDs were divided into 3 groups, basic, intermediate and ***: Lifeline? AUTO AED had the best performance in price, portability and user-friendly among AEDs of basic level. It required less time for shock charging. Samaritan PAD defi brillator was superior in price, portability, durability and characteristic among AEDs of intermediate level. It had the longest warranty and highest protection against water and dust. Lifeline? PRO AED had the best performance in most of the criteria among AEDs of advanced level and offered CPR video and manual mode for laypersons and clinicians ***: Lifeline? AUTO AED, Samaritan PAD def ibrillator, Lifeline? PRO AED are superior in AEDs of basic, intermediate and advanced levels, respectively. A feasible AED may be chosen by users according to the regional requirement and the current information about the best available products.

关键词： Automated external defi brillator Electrodes Pads Cardiac arrest

Room temperature Ⅲ–Ⅴ nanolasers with distributed Bragg reflectors epitaxially grown on(001) silicon-on-insulators

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Photonics Research 2019年第9期7卷 1081-1086页

作者： YU HAN wai KIT NG YING XUE kam SING wong KEI MAY LAU Department of Electronic and Computer Engineering Hong Kong University of Science and TechnologyClear Water BayKowloonHong KongChina Department of Physics and William Mong Institute of Nano Science and Technology Hong Kong University of Science and TechnologyClear Water BayKowloonHong KongChina

Efficient, scalable, bufferless, and compact Ⅲ–V lasers directly grown on(001)-oriented silicon-on-insulators(SOIs) are preferred light sources in Si-photonics. In this article, we present the design and operation of Ⅲ–V telecom nanolaser arrays with integrated distributed Bragg reflectors(DBRs) epitaxially grown on industry-standard(001) SOI wafers. We simulated the mirror reflectance of different guided modes under various mirror architectures, and accordingly devised nanoscale DBR gratings to support high reflectivity around1500 nm for the doughnut-shaped TE01 mode. Building from InP/InGaAs nanoridges grown on SOI, we fabricated subwavelength DBR mirrors at both ends of the nanoridge laser cavities and thus demonstrated room-temperature low-threshold InP/InGaAs nanolasers with a 0.28 μm^2 cross-section and a 20 μm effective cavity length. The direct growth of these bufferless nanoscale Ⅲ–V light emitters on Si-photonics standard(001) SOI wafers opens future options of fully integrated Si-based nanophotonic integrated circuits in the telecom wavelength regime.

关键词： InGaAs InP SOI nanolasers with distributed Bragg reflectors epitaxially grown on Room temperature silicon-on-insulators Bragg

Phase Ⅰ/Ⅱ randomized controlled trial of autologous bone marrow-derived mesenchymal stem cell therapy for chronic stroke

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World Journal of Stem Cells 2017年第8期9卷 133-143页

作者： kam Sze Tsang Chi Ping Stephanie Ng Xian Lun Zhu George Kwok Chu wong Gang Lu Anil Tejbhan Ahuja Ka Sing Lawrence wong Ho Keung Ng wai Sang Poon Department of Surgery the Chinese University of Hong Kong Department of Anatomical and Cellular Pathology the Chinese University of Hong Kong Department of Imaging and Interventional Radiology the Chinese University of Hong Kong Department of Medicine and Therapeutics the Chinese University of Hong Kong

AIM To examine the safety and efficacy of mesenchymal stem cell(MSC) therapy for intracerebral haemorrhage with neurological dysfunctions for a *** MSC were ex vivo expanded from 29 mL(17-42 mL) autologous bone marrow. Patients were randomized to have two intravenous injections of autologous MSC or placebos in four weeks apart. Neurological functions and clinical outcomes were monitored before treatment and at 12^(th), 16^(th), 24^(th), 36^(th) and 60^(th) week upon completion of^(th)e treatment. RESULTS A mean of 4.57 × 10~7(range: 1.43 × 10~7-8.40 × 10~7) MSC per infusion was administered accounting to 8.54 × 10~5(2.65 × 10~5-1.45 × 10~6) per kilogram body weight in two occasions. There was neither adverse event at time of administration nor sign of de novo tumour development among patients after monitoring for a year post MSC therapy. Neuro-restoration and clinical improvement in terms of modified Barthel index, functional independence measure and extended Glasgow Outcome Scale were evident among patients having MSC therapy compared to patients receiving placebos. CONCLUSION Intravenous administration of autologous bone marrowderived MSC is safe and has the potential of improving neurological functions in chronic stroke patients with severe disability.

关键词： Stroke Intracerebral haemorrhage Central nervous system Mesenchymal stem cells Cell therapy

Overview of methodologies and statistical strategies in observational studies and meta-analyses on the risk of hepatocellular carcinoma in patients with chronic hepatitis B on entecavir or tenofovir therapy

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Hepatoma Research 2022年第1期8卷 143-156页

作者： Terry Cheuk-Fung Yip vincent wai-Sun wong Mandy Sze-Man Lai Vicki Wing-Ki Hui Yee-KitTse Grace Lai-Hung wong Medical Data Analytics Centre Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong KongChina Department of Medicine and Therapeutics 9/F Lui Che Woo Clinical Sciences BuildingPrince of Wales Hospital30-32 Ngan Shing StreetShatinHong KongChina Institute of Digestive Disease The Chinese University of Hong KongHong KongChina

Entecavir(ETV)and tenofovir disoproxil fumarate(TDF)are first-line antiviral therapies for patients with chronic hepatitis B(CHB)and reduce the risk of disease progression and liver-related complications,as well as improve survival by effectively suppressing viral ***,since the first publication in 2019 on a lower risk of hepatocellular carcinoma(HCC)in Korean patients receiving TDF than those receiving ETV,the topic has remained a hot and unsettled *** studies and meta-analyses have yielded conflicting *** HCC takes time to develop,studies are mainly observational to benefit from a larger sample size and longer follow-up that provides a higher statistical power to compare the two ***,TDF was available to CHB patients a few years later than ETV in most countries,thus leading to a difference in follow-up ***,despite studying the same topic,the difference in data sources and available parameters,inclusion and exclusion criteria,and use of statistical methods complicated the interpretation and comparison of the findings and contributed to between-study heterogeneity in *** review describes some caveats in interpreting and comparing the results from these observational studies and *** studies should explore better designed observational studies with high-quality data sources,and aggregation of patient data in metaanalysis to tackle between-study heterogeneity.

关键词： Bias confounding hepatitis B virus hepatocellular carcinoma liver cancer nucleos(t)ide analogues propensity score

A Traditional Chinese Medicine Approach in Treating Depression by Promoting Liver Qi Circulation: A Western Medicine Perspective

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Chinese Medicine 2015年第4期6卷 187-195页

作者： Raphaella wai Lam So Hoi Shan wong kam Ming Ko Division of Life Science Hong Kong University of Science & Technology Hong Kong China

Depression is a prevalent mental illness in developed countries. In Western medicine, experimental and clinical investigations have demonstrated that depression is associated with the dysregulation of neurotransmitter signaling, and symptoms of depression can be alleviated by therapeutic intervention. However, patients taking antidepressant drugs often experience serious side effects and high relapse rates. On the other hand, traditional Chinese medicine (TCM) views depression as a manifestation of liver qi stagnation. Practitioners of TCM have long been treating depression with herbs that promote qi circulation in the liver. In this article, we offer a hypothesis stating the biochemical basis of the linkage between liver qi stagnation and depression. Liver qi is involved in the processing of macronutrients into molecules to fuel energy metabolism in brain neurons, as well as the synthesis of plasma proteins that maintain blood circulation to the brain, thereby enabling these fuel molecules to be delivered to the brain. In cases of liver qi stagnation, the failure in delivering sufficient fuel molecules to the brain disrupts mitochondrial ATP production in neurons. Because neurotransmitter release and neurotropin transport are driven by ATP, the deficiency in release and transport processes resulting from insufficient ATP production could lead to depression. Therefore, if liver qi stagnation is causally related to the pathogenesis of depression, the promotion of liver qi circulation by Chinese herbs might offer a promising prospect for the effective treatment of depression.

关键词： Mitochondrial ATP Liver “Qi” Stagnation Depression Traditional Chinese Medicine

Non-invasive tests of non-alcoholic fatty liver disease

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Chinese Medical Journal 2022年第5期135卷 532-546页

作者： Guanlin Li Xinrong Zhang Huapeng Lin Lilian Yan Liang Grace Lai-Hung wong vincent wai-Sun wong Department of Medicine and Therapeutics The Chinese University of Hong KongHong KongChina State Key Laboratory of Digestive Disease The Chinese University of Hong KongHong KongChina Medical Data Analytics Centre The Chinese University of Hong KongHong KongChina

For the detection of steatosis,quantitative ultrasound imaging techniques have achieved great progress in past *** resonance imaging proton density fat fraction is currently the most accurate test to detect hepatic *** blood biomarkers correlate with non-alcoholic steatohepatitis,but the accuracy is *** liver fibrosis,liver stiffness measurement by transient elastography(TE)has high accuracy and is widely used across the *** resonance elastography is marginally better than TE but is limited by its cost and *** blood biomarkers of fibrosis have been used in clinical trials and hold promise for selecting patients for treatment and monitoring treatment *** article reviews new developments in the non-invasive assessment of non-alcoholic fatty liver disease(NAFLD).Accumulating evidence suggests that various non-invasive tests can be used to diagnose NAFLD,assess its severity,and predict the *** studies are needed to determine the role of the tests as monitoring *** cannot overemphasize the importance of context in selecting appropriate tests.

关键词： Fatty liver Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Liver fibrosis Cirrhosis Transient elastography FibroScan Magnetic resonance imaging