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Rifaximin vs conventional oral therapy for hepatic encephalopathy:A meta-analysis

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World Journal of Gastroenterology 2012年第8期18卷 767-777页

作者： Karim M Eltawil Marie Laryea Kevork Peltekian Michele Molinari Department of Surgery and Transplantation Queen Elizabeth Ⅱ Health Sciences Center Dalhousie University Department of Medicine Hepatology and Transplantation Queen Elizabeth Ⅱ Health Sciences Center Dalhousie University

AIM: To characterize the efficacy of rifaximin in the management of hepatic encephalopathy (HE) as several randomized controlled studies have shown contradictory results on its effectiveness in comparison to other oral agents. METHODS: We performed a systematic review and random effects meta-analysis of all eligible trials identifi ed through electronic and manual searches. Twelve randomized controlled trials met the inclusion criteria with a total of 565 patients. RESULTS: The clinical effectiveness of rifaximin was equivalent to disaccharides or other oral antibiotics[odds ratio (OR) 0.96; 95% CI: 0.94-4.08] but with a better safety profi le (OR 0.27; 95% CI: 0.12-0.59). At the completion of treatment protocols, patients receiving rifaximin showed lower serum ammonia levels [weighted mean difference (WMD) = -10.65; 95% CI: -23.4-2.1; P = 0.10], better mental status (WMD = -0.24; 95% CI: -0.57-0.08; P = 0.15) and less asterixis (WMD -0.1; 95% CI -0.26-0.07; P = 0.25) without reaching statistical signifi cance. On the other hand, other psychometric outcomes such as electroencephalographic response and grades of portosystemic encephalopathy were superior in patients treated with rifaximin in comparison to the control group (WMD = 0.21, 95% CI: -0.33-0.09, P = 0.0004; and WMD = -2.33, 95% CI: -2.68-1.98, P = 0.00001, respectively). Subgroup and sensitivity analysis did not show any signifi cant difference in the above fi ndings. CONCLUSION: Rifaximin appears to be at least as effective as other conventional oral agents for the treatment of HE with a better safety profi le.

关键词： Hepatic encephalopathy Lactulose Neo-mycin Non-absorbable disaccharides Rifaximin

Prevention of recurrent hepatitis B infection after liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2013年第5期12卷 465-472页

作者： Tiffany CL Wong James YY Fung Chung Mau Lo Department of Surgery queen Mary hospital The University of Hong Kong102 Pokfulam Road Department of Medicine queen Mary hospital The University of Hong Kong102 Pokfulam Road

BACKGROUND:Recurrence of hepatitis B virus(HBV) infection after liver transplantation can lead to graft loss and a reduction in long-term *** purpose of this review is to summarize the current therapeutic options for preventing HBV recurrence in liver transplant *** SOURCES:Up to January 2013,studies that were published in MEDLINE and EMBASE on prevention of HBV recurrence after liver transplantation were ***:There have been remarkable advancements in the past two decades on the prevention of HBV recurrence after liver transplantation,from the discovery of hepatitis B immune globulin(HBIG) and lamivudine monotherapy to the combination therapy using HBIG and *** the development of newer and stronger antiviral agents,the need for life-long HBIG is *** their low resistance profile,oral antiviral prophylaxis using these new agents alone is sufficient and is associated with excellent ***:Restoration of host HBV immunity with adoptive immunity transfer and vaccination may represent the ultimate strategy to withdraw prophylactic treatment and to achieve a drug free regimen against HBV recurrence after liver transplantation.

关键词： hepatitis B liver transplantation hepatitis B immune globulin antiviral therapy adoptive immunity transfer HBV vaccination

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MicroRNAs: Mechanisms, Functions and Progress

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Genomics, Proteomics & Bioinformatics 2012年第5期10卷 237-238页

作者： Tongbin Li William C.S.Cho *** Research Group LC SciencesHoustonTX 77054USA Department of Clinical Oncology Queen Elizabeth HospitalHong Kong SARChina

In 1993 when Ambros and co-workers [1] discovered that a mysterious Caenorhabditis elegans gene, lin-4, does not encode a protein, but acts in the form of a small RNA and represses the expression of its target gene, lin-14, through base-pairing with its 3＇ untranslated region （3tUTR）, nobody would imagine that 20 years later, this category of small RNAs - now widely known as microR- NAs （or miRNAs）, has ～2000 known members in the human genome （and counting）, and that miRNA-mediated gene regulation is deeply involved in virtually all important biological processes in animals and plants.

关键词： Caenorhabditis elegans biological processes gene regulation human genome target gene small RNA form of

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Interferon-free regimens in patients with hepatitis C infection and renal dysfunction or kidney transplantation

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World Journal of Hepatology 2017年第4期9卷 180-190页

作者： Evangelos Cholongitas Chrysoula Pipili George V Papatheodoridis 4th Department of Internal Medicine Medical School of Aristotle University Hippokration General Hospital of Thessaloniki Division of Nephrology Queen Elizabeth University Hospital Department of Gastroenterology Medical School of National and Kapodistrian University of Athens Laiko General Hospital

Treatment of patients with chronic kidney disease(CKD) and chronic hepatitis C(CHC) differs from that used in the general CHC population mostly when glomerular filtration rate(GFR) is below 30 m L/min, as sofosbuvir, the backbone of several current regimens, is officially contraindicated. Given that ribavirin free regimens are preferable in CKD, elbasvir/grazoprevir is offered in CHC patients with genotype 1 or 4 and ombitasvir/paritaprevir and dasabuvir in genotype 1b for 12 wk. Although regimens containing peginterferon with or without ribavirin are officially recommended for patients with CKD and genotype 2, 3, 5, 6, such regimens are rarely used because of their low efficacy and the poor safety and tolerance profile. In this setting, especially in the presence of advanced liver disease, sofosbuvirbased regimens are often used, despite sofosbuvir contraindication. It seems to have good overall safety with only 6% or 3.4% of CKD patients to discontinue therapy or develop serious adverse events without drug discontinuation. In addition, sustained virological response(SVR) rates with sofosbuvir based regimens in CKD patients appear to be comparable with SVR rates in patients with normal renal function. Treatment recommendations for kidney transplant recipients are the same with those for patients with CHC, taking into consideration potential drug-drug interactions and baseline GFR before treatment initiation. This review summarizes recent data on the current managementof CHC in CKD patients highlighting their strengths and weaknesses and determining their usefulness in clinical practice.

关键词： Chronic hepatitis C virus infection Kidney Renal Kidney transplantation Direct acting antiviral agents Glomerular filtration rate Hepatitis C

Prospective randomized controlled trial evaluating cap-assisted colonoscopy vs standard colonoscopy

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World Journal of Gastroenterology 2010年第31期16卷 3905-3910页

作者： Hoi-Poh Tee Crispin Corte Hamdan Al-Ghamdi Emilia Prakoso John Darke Raman Chettiar Wassim Rahman Scott Davison Sean P Griffin Warwick S Selby Arthur J Kaffes Gastroenterology Unit Medical DepartmentHospital Tengku Ampuan AfzanJalan Tanah Putih25100 KuantanPahang Malaysia AW Morrow Gastroenter-ology and Liver Centre Royal Prince Alfred HospitalMissen-den RoadCamperdownNSW 2050Australia Gastroenterology Unit Medical DepartmentQueen Elizabeth HospitalKarung Berkunci No.202988586 Kota KinabaluMalaysia

AIM: To study the significance of cap-fitted colonoscopy in improving cecal intubation time and polyp detection rate. METHODS: This study was a prospective randomized controlled trial conducted from March 2008 to February 2009 in a tertiary referral hospital at Sydney. The primary end point was cecal intubation time and the secondary endpoint was polyp detection rate. Consecutive cases of total colonoscopy over a 1-year period were recruited. Randomization into either standard colonoscopy (SC) or cap-assisted colonoscopy (CAC) was performed after consent was obtained. For cases randomized to CAC, one of the three sizes of cap was used: D-201-15004 (with a diameter of 15.3 mm), D-201-14304 (14.6 mm) and D-201-12704 (13.0 mm). All of these caps were produced by Olympus Medical Systems, Japan. Independent predictors for faster cecal time and better polyp detection rate were also determined from this study. RESULTS: There were 200 cases in each group. There was no signif icant difference in terms of demographic characteristics between the two groups. CAC, when compared to the SC group, had no signif icant difference in terms of cecal intubation rate (96.0% vs 97.0%, P = 0.40) and time (9.94 ± 7.05 min vs 10.34 ± 6.82 min, P = 0.21), or polyp detection rate (32.8% vs 31.3%, P = 0.75). On the subgroup analysis, there was no significant difference in terms of cecal intubation time by trainees (88.1% vs 84.8%, P = 0.40), ileal intubation rate (82.5% vs 79.0%, P = 0.38) or total colonoscopy time (23.24 ± 13.95 min vs 22.56 ± 9.94 min, P = 0.88). On multivariate analysis, the independent determinants of faster cecal time were consultant-performed procedures (P < 0.001), male patients (P < 0.001), non-usage of hyoscine (P < 0.001) and better bowel preparation (P = 0.01). The determinants of better polyp detection rate were older age (P < 0.001), no history of previous abdominal surgery (P = 0.04), patients not having esophagogastroduodenoscopy in the same setting (P = 0.003),

关键词： Cap Hood Cecum Colonoscopy Cecal intubation Colonic polyps

Androgen and bone mass in men

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Asian Journal of Andrology 2003年第2期5卷 148-154页

作者： Annie W.C.Kung Department of Medicine University of Hong Kong Queen Mary Hospital Hong Kong China

Androgens have multiple actions on the skeleton throughout life. Androgens promote skeletal growth and accumulation of minerals during puberty and adolescence and stimulate osteoblast but suppress osteoclast function, activity and lifespan through complex mechanisms. Also androgens increase periosteal bone apposition, resulting in larger bone size and thicker cortical bone in men. There is convincing evidence to show that aromatization to estrogens was an important pathway for mediating the action of testosterone on bone physiology. Estrogen is probably the dominant sex steroid regulating bone resorption in men, but both testosterone and estrogen are important in maintaining bone formation.

关键词： bone of as et Androgen and bone mass in men in

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Anti-osteoporosis properties of phosphorylated collagen peptidemagnesium chelates in osteoblast MC3T3-E1 cells and ovariectomized mice

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中华医学杂志(英文版) 2024年第14期137卷 1762-1764页

作者： Zhang Chao Du Bowei Deng Guiya Zhang Shuai Yu Tengfei Guan Yuepeng Huang Yaqin College of Materials Science and Engineering Beijing University of Chemical Technology Beijing China School of Pharmacy Queen’s University Belfast Belfast BT7BL UK Department of Ultrasound Beijing Tian Tan Hospital Capital Medical University Beijing China Beijing Key Laboratory of Clothing Materials R& D and Assessment Beijing Engineering Research Center of Textile Nano Fiber Beijing Institute of Fashion Technology Beijing China

To the Editor: Postmenopausal osteoporosis is a typical bone metabolic disruption disease caused by estrogen deficiency, characterized by deteriorated bone structure, reduced bone mineral density (BMD), and thinned sclerotin, which has troubled millions of menopausal women worldwide. Additionally, estrogen deficiency is accompanied by oxidative stress and inflammation, thus causing the occurrence and deterioration of osteoporosis. Conventional treatment options have limited efficacy and cannot meet the requirements of long-term treatment. Therefore, in order to alleviate the problem of osteoporosis in human health, innovative strategies should explore the possibilities and alternatives to current ones. In this study, collagen peptides (CP) were phosphorylated and then chelated with magnesium ions to produce phosphorylated collagen peptide magnesium chelates (PCP-Mg). The anti-osteoporosis properties of PCP-Mg were investigated by exploring the osteogenic function of osteoblasts, the preventive effect of ovariectomy (OVX)-induced bone loss in mice, and the potential mechanism underlying the effects on osteoporosis prevention. The results could provide a theoretical basis for the research and development of PCP-Mg in the food and pharmaceutical fields for the prevention and treatment of osteoporosis in the future.

关键词： BONE

COVID-19:Effect on gastroenterology and hepatology service provision and training:Lessons learnt and planning for the future

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World Journal of Gastroenterology 2021年第44期27卷 7625-7648页

作者： Muhammad Raheel Anjum Jodie Chalmers Rizwana Hamid Neil Rajoriya Department of Gastroenterology The Royal Wolverhampton NHS TrustWolverhampton WV100QPUnited Kingdom Department of Medicine Queen Elizabeth HospitalUniversity Hospitals Birmingham NHS Foundation TrustBirmingham B152WBUnited Kingdom Department of Gastroenterology Royal Alexandria HospitalPaisley PA29PJScotlandUnited Kingdom queen elizabeth hospital University Hospitals Birmingham NHS Foundation TrustBirmingham B152WBUnited Kingdom Institute of Immunology and Immunotherapy University of BirminghamBirmingham B152TTUnited Kingdom

In late 2019,reports arose of a new respiratory disease in China,identified as a novel coronavirus,severe acute respiratory syndrome coronavirus *** World Health Organisation named the disease caused by the virus‘coronavirus disease 2019(COVID-19)’.It was declared a pandemic in early 2020,after the disease rapidly spread across the ***-19 has not only resulted in substantial morbidity and mortality but also significantly impacted healthcare service provision and training across all medical specialties with gastroenterology and Hepatology services being no ***,most,if not all‘nonurgent’services have been placed on hold during surges of *** a result there have been delayed diagnoses,procedures,and surgeries which will undoubtedly result in increased morbidity and *** services have been converted to remote consultations where possible in many *** have been redeployed to help care for COVID-19 patients in other settings,resulting in disruption to their training-particularly endoscopy and outpatient *** has led to significant anxiety amongst trainees,and risks prolongation of *** is of the utmost importance to develop strategies that continue to support COVID-19-related service provision,whilst also supporting existing and future gastroenterology and Hepatology services and *** to healthcare provision during the pandemic have generated new and improved frameworks of service and training delivery,which can be adopted in the post-COVID-19 world,leading to enhanced patient care.

关键词： COVID-19 Gastroenterology Hepatology Training Service provision

Ten-Year Outcomes of Transobturator Mid-Urethral Sling for Treatment of Stress Urinary Incontinence in Hong Kong Chinese Women with or without Reconstructive Pelvic Floor Surgery

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Open Journal of Obstetrics and Gynecology 2021年第11期11卷 1639-1649页

作者： Toby Yuen Mei Chan Willy Cecilia Cheon Yuk Sheung Fan Urogynaecology Team Department of Obstetrics & Gynecology Queen Elizabeth Hospital Hong Kong China

Objective: To evaluate the outcomes of transobturator mid-urethral sling (TO-MUS) with or without reconstructive pelvic floor surgery (RPFS) in Chinese women with stress urinary incontinence (SUI) after 10 years. Methods: This was a prospective observational study on Chinese women undergoing the insertion of TO-MUS with or without RPFS. All patients were assessed at 1-year and 10-year by urodynamic study (UDS). Objective cure was defined as the absence of urine leakage during provocative maneuvers on filling cystometry. Data regarding subjective outcome (patient perception), quality of life changes (Urogenital Distress Inventory-short form (UDI-6), Incontinence Impact Questionnaire-short form (IIQ-7)) and adverse events were also collected. Results: Of 104 eligible patients, 99 patients completed the 10-year evaluation. 57 patients (57.6%) underwent TO-MUS only and 42 patients (42.4%) underwent TO-MUS with concomitant RPFS. At 10-year follow-up, the overall objective cure rate was 86.9% and ov

关键词： Stress Urinary Incontinence Urodynamic Stress Incontinence Mid-Urethral Sling Transobturator