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| 1 | Use of portal pressure studies in the management of variceal haemorrhage显示文摘Portal hypertension occurs as a complication of liver cirrhosis and complications such as variceal bleeding lead to significant demands on resources. Endoscopy is the gold standard method for screening cirrhotic patients however universal endoscopic screening may mean a lot of unnecessary procedures as the presence of oesophageal varices is variable hence a large time and cost burden on endoscopy units to carry out both screening and subsequent follow up of variceal bleeds. A less invasive method to identify those at high risk of bleeding would allow earlier prophylactic measures to be applied. Hepatic venous pressure gradient (HVPG) is an acceptable indirect measurement of portal hypertension and predictor of the complications of portal hypertension in adult cirrhotics. Varices develop at a HVPG of 10-12 mmHg with the appearance of other complications with HPVG > 12 mmHg. Variceal bleeding does not occur in pressures under 12 mmHg. HPVG > 20 mmHg measured early after admission is a significant prognostic indicator of failure to control bleeding varices, indeed early transjugular intrahepatic portosystemic shunt (TIPS) in such circumstances reduces mortality significantly. HVPG can be used to identify responders to medical therapy. Patients who do not achieve the suggested reduction targets in HVPG have a high risk of rebleeding despite endoscopic ligation and may not derive significant overall mortality benefit from endoscopic intervention alone, ultimately requiring TIPS or liver transplantation. Early HVPG measurements following a variceal bleed can help to identify those at risk of treatment failure who may benefit from early intervention with TIPS. Therefore, we suggest using HVPG measurement as the investigation of choice in those with confirmed cirrhosis in place of endoscopy for intitial variceal screening and, where indicated, a trial of B-blockade, either intravenously during the initial pressure study with assessment of response or oral therapy with repeat HVPG six weeks later. In those with elevated pressures, primary medical prophylaxis could be commenced with subsequent close monitoring of HVPG thus negating the need for endoscopy at this point. All patients presenting with variceal haemorrhage should undergo HVPG measurement and those with a gradient greater than 20 mmHg should be considered for early TIPS. By introducing portal pressure studies into a management algorithm for variceal bleeding, the number of endoscopies required for further intervention and follow up can be reduced leading to significant savings in terms of cost and demand on resources. | Jennifer Addley Tony CK Tham William Jonathan Cash | 2012 | World Journal of Gastrointestinal Endoscopy2012，4，7： | 37 |
| 2 | Risk factors and natural history of breast cancer in younger Chinese women显示文摘AIM: To investigate the age differences in the risk factors, clinicopathological characteristics and patterns of treatment of female breast cancer patients. METHODS: Seven thousand one hundred and fiftytwo women with primary breast cancer from the Hong Kong Breast Cancer Registry were recruited after receiving patients' consent, they were asked to complete standardized questionnaires which captured their sociodemographic characteristics and risk factors associated with breast cancer development. Among them, clinicopathological data and patterns of treatment were further collected from medical records of 5523 patients with invasive breast cancers. Patients were divided into two groups according to the age at diagnosis: younger(< 40 years old) vs older patients(≥ 40 years old) for subsequent analyses.RESULTS: Analysis on the sociodemographic characteristics and exposure to risk factors were performed on 7152 women with primary breast cancer and the results revealed that younger patients were more likely to have unhealthy lifestyles; these include a lack of exercise(85.4% vs 73.2%, P < 0.001), having high stress in life(46.1% vs 35.5%, P < 0.001), having dairy/meat-rich diets(20.2% vs 12.9%, P < 0.001),having alcohol drinking habit(7.7% vs 5.2%, P = 0.002). Younger patients were also more likely to have hormone-related risk factors including nulliparity(43.3% vs 17.8%, P < 0.001) and an early age at menarche(20.7% vs 13.2%, P < 0.001). Analyses on clinicopathological characteristics and patterns of treatment were performed on 5523 women diagnosed with invasive breast cancer. The invasive tumours in younger patients showed more aggressive pathological features such as having a higher percentage of grade 3 histology(45.7% vs 36.5%, P < 0.001), having a higher proportion of tumours with lymphovascular invasion(39.6% vs 33.2%, P = 0.003), and having multifocal disease(15.7% vs 10.3%, P < 0.001); they received different patterns of treatment than their older counterparts.CONCLUSION: Younger patients in Hong Kong are more likely to encounter risk factors associated with breast cancer development and have more aggressive tumours than their older counterparts. | Winnie Yeo Hang-Mei Lee Amy Chan Emily YY Chan Miranda CM Chan Keeng-Wai Chan Sharon WW Chan Foon-Yiu Cheung Polly SY Cheung Peter HK Choi Josette SY Chor William WL Foo Wing-Hong Kwan Stephen CK Law Lawrence PK Li Janice WH Tsang Yuk Tung Lorna LS Wong Ting-Ting Wong Chun-Chung Yau Tsz-Kok Yau Benny CY Zee | 2014 | World Journal of Clinical Oncology2014，5，5： | 4 |
| 3 | 脂质组学改善传统危险因素预测的2型糖尿病患者的心血管事件显示文摘临床脂质测定并未显示出糖尿病或心血管病相关的脂质代谢改变的复杂性。脂质组学则能够评估可作为疾病风险潜在标志物的数百种脂质种类。方法:纳入来自糖尿病治疗和血管保护行动。 | 刘莉 叶鹏 Alshehry ZH Mundra PA Barlow CK Mellett NA Wong G McConville MJ Simes J Tonkin AM Sullivan DR Barnes EH Nestel PJ Kingwell BA Marre M Neal B Poulter NR Rodgers A Williams B Zoungas S Hillis GS Chalmers J Woodward M Meikle PJ | 2016 | 中华高血压杂志2016，24，10： | 3 |
| 4 | EECP in the treatment of endothelial dysfunction: preventing progression of cardiovascular disease显示文摘 | John CK Hui William E Lawson Gregory W Barsness | 2010 | Journal of Geriatric Cardiology2010，7，2： | 3 |
| 5 | The digital di vide in adoption and use of a personal health record显示文摘 | Yamin CK Emani S Williams DH | 2011 | Arch Intern Med2011，171，6： | 1 |
| 6 | Effects of food and antacids on the pharmacokinetics of eltrombopag in healthy adult subjects:two single-dose, open-label, randomized-sequence, crossover studies 显示文摘 | Williams DD Peng B Bailey CK | 2009 | Clin Ther2009，31，4： | 1 |
| 7 | Regulation of multiple angiogenic pathways by DLIA and Notch in human umbilical vein endothelial cells显示文摘 | Harrington LS Sainson RC Williams CK | 2008 | Microvasc Res2008，75，2： | 1 |
| 8 | Development of questionnaire to examine relationship of physicalssc activity and diabetes in Pima Indians显示文摘 | Andrea MK William CK Ronald EL | 1990 | Diabetes Care1990，13，： | 1 |
| 9 | The path forward for biofuels and biomaterials显示文摘 | RAGAUAKAS AJ WILLIAMS CK DAVISION BH | | 0，，5760： | 1 |
| 10 | DLL4 activation of Notch signaling reduces tumor vascularity and inhibits tumor growth 显示文摘 | Segarra M Williams CK Sierra Mde L | 2008 | Blood2008，112，5： | 1 |
| 11 | Up-regulation of the Notch ligand Delta-like 4 inhibits VEGF-induced endothelial cell function 显示文摘 | Williams CK Li JL Murga M | 2006 | Blood2006，107，3： | 1 |
| 12 | Up-regulation of the Notch lig-and Delta-like4inhibits VEGF-induced endothelial cell function显示文摘 | Williams CK Li JL Murga M | 2006 | Blood2006，107，3： | 1 |
| 13 | Derivation and validation of a clinical system for predicting pneumonia in acute stroke显示文摘 | Chumbler NR Williams LS Wells CK | 2010 | Neuroepidemio2010，34，3： | 1 |
| 14 | Promising antituberculosis activity of the oxazolidinone PNU-100480 relative to that of linezolid in a murine model 显示文摘 | Williams KN Stover CK Zhu T | 2009 | Antimicrob Agents C hemother2009，53，4： | 1 |
| 15 | The design of an Internet-based system to maintain home monitoring adherence by lung transplant recipients显示文摘 | Bernd CK Stanley MF William NR | 2006 | IEEE Transactions on Information Technology in Biomedicine2006，10，1： | 1 |
| 16 | Detection of human parvovirus B19 DNA by using the polymerase chain reaction显示文摘 | William CK Stuart PA | 1990 | J Clin Micro1990，28，1： | 1 |
| 17 | The path forward for biofuels and biomaterials显示文摘 | Ragauskas AJ Williams CK Davison BH | 2006 | Science2006，311，： | 1 |
| 18 | Regulation of multiple angiogenic pathways by Dll4 and Notch in human umbilical vein endothelial cells显示文摘 | Harrington LS Sainson RC Williams CK | | 0，，02： | 1 |
| 19 | Interacting brain systems modulate memory consolidation显示文摘 | McIntyre CK McGaugh JL Williams CL | 2012 | Neurosci Biobehav Rev2012，36，7： | 1 |
| 20 | Lack of Medication Dose Uniformity in Commonly Split Tablets显示文摘 | Teng J Song CK Williams RL | 2002 | Journal of the American Pharmaceutical Association2002，42，： | 1 |
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