Mammography screening in general practice - a pilot study

Objectives: To evaluate the acceptability, feasibility and performance of a mammography screening programme for female patients in general practice. Design: A cross sectional study. Setting: A general practice clinic and a resiona/ hospital in Hong Kong. Subjects: 500 Chinese women aged 45 years or older attending a university teaching general practice clinic on Hong Kong Island. Main outcome measures: The rates of uptake of screening, retakes, recall for further evaluation and fine needle aspiration (FNA), and participants' opinion on mammography. Results: The uptake rate of screening was 37%. Mammography was feasible for all participants, 12% had additional films and 7% required retakes. Sixteen percent were recalled for further evaluation, 4% had FNA, one had an excisional biopsy which revealed no cancer. Most women rated pain of mammography mild to moderate and did not find it embarrassing, 98% said that they would recommend it to their friends and 87% indicated that they would do it again. Conclusions: Mammography screening for Chinese women presenting to general practice was technically feasible. Most women found the experience of mammography screening acceptable. The uptake rate of mammography screening was much lower than what would be required to benefit the overall breast cancer mortality. There was also room for improvement in our retake and recall rates. We need to weigh the possible benefit of mammography screening against the stress and resources associated with additional films, retakes, recalls for further evaluation, FNA and excisional biopsy in individuals with false positive results.published_or_final_versio

A pregnant woman with a rapidly growing breast lump

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Associations of perceived interparental relationship, family harmony and family happiness with smoking intention in never-smoking Chinese children and adolescents: a cross-sectional study

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Recurrent pneumothorax in pregnancy: What should we do after placing an intercostal drain

Recurrent pneumothorax is rare during pregnancy. We describe a Chinese woman, with a history of spontaneous pneumothorax managed with an intercostal drain, who developed a recurrent pneumothorax during her 32nd week of pregnancy. There is no consensus on management in this situation. We review the literature and discuss different management approaches. Thirty-six cases of antepartum pneumothorax have been reported in 31 case reports. An intercostal drain only (n=11) or surgeries (thoracotomy, n=9; or video-assisted thoracoscopy, n=2) were common treatment options with no surgical complications reported. Twenty-two (61%) patients progressed to a normal vaginal delivery, while the rest required forceps delivery (22%) or Caesarean section (14%). No single treatment option outweighed the others. There were no maternal or foetal complications reported in those who underwent antepartum surgical intervention. Surgical management of recurrent pneumothorax during pregnancy is well tolerated.published_or_final_versio

A 'Radical' Approach to Reading Development in Chinese: The Role of Semantic Radicals and Phonetic Radicals

Two studies investigating the significance of radical knowledge in Chinese reading development are reported in this paper. Study 1 examined the semantic radical knowledge of 20 Grade 1, 20 Grade 3, and 20 Grade 5 Chinese children in Hong Kong. It was found that various types of semantic radical knowledge, including the position and semantic category of semantic radicals, correlated significantly with Chinese word reading and sentence comprehension. Study 2 examined phonetic radical knowledge with another three groups of 20 Chinese children in Grades 1, 3, and 5 respectively. It was found that various measures of phonetic radical knowledge, including the function and sound value of phonetic radicals, correlated significantly with Chinese word reading. These studies found that, developmentally, the children started acquiring the knowledge of character structure, position, semantic category, and sound value of radicals from about Grade 1. However, they did not understand that the function of semantic radicals is to provide meaning cues in reading until Grade 3. The authors concluded that the radical is an important orthographic processing unit in reading development in Chinese.published_or_final_versio

Immunoglobulin G4–related disease in Hong Kong: clinical features, treatment practices, and its association with multisystem disease

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Design, Synthesis and Biological Evaluation of N-Sulfonylphenyl glyoxamide-Based Antimicrobial Peptide Mimics as Novel Antimicrobial Agents

© 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim Antibiotic resistance is a major global health concern. There is an urgent need for the development of novel antimicrobials. Recently, phenylglyoxamide-based small molecular antimicrobial peptide mimics have been identified as potential new leads to treat bacterial infections. Here, we describe the synthesis of novel phenylglyoxamide derivatives via the ring-opening reaction of N-sulfonylisatins with primary amines, followed by conversion into hydrochloride, quaternary ammonium iodide or gunidinium salts. The antibacterial activity of the compounds against Staphylococcus aureus was evaluated by in vitro assays. Structure-activity relationship studies revealed that 5-bromo-substituent at the phenyl ring, octyl group appended to the ortho sulfonamide group or guanidine hydrochloride salt as the terminal group significantly contributed to potency. The most potent compound, the gunidinium salt 35 d, exhibited a minimum inhibitory concentration value of 12 μM and a therapeutic index of 15. It also demonstrated its potential to act as antimicrobial pore-forming agent. Overall, the results identified 35 d as a new lead antimicrobial compound

Characterisation and expression of SPLUNC2, the human orthologue of rodent parotid secretory protein

We recently described the Palate Lung Nasal Clone (PLUNC) family of proteins as an extended group of proteins expressed in the upper airways, nose and mouth. Little is known about these proteins, but they are secreted into the airway and nasal lining fluids and saliva where, due to their structural similarity with lipopolysaccharide-binding protein and bactericidal/permeability-increasing protein, they may play a role in the innate immune defence. We now describe the generation and characterisation of novel affinity-purified antibodies to SPLUNC2, and use them to determine the expression of this, the major salivary gland PLUNC. Western blotting showed that the antibodies identified a number of distinct protein bands in saliva, whilst immunohistochemical analysis demonstrated protein expression in serous cells of the major salivary glands and in the ductal lumens as well as in cells of minor mucosal glands. Antibodies directed against distinct epitopes of the protein yielded different staining patterns in both minor and major salivary glands. Using RT-PCR of tissues from the oral cavity, coupled with EST analysis, we showed that the gene undergoes alternative splicing using two 5' non-coding exons, suggesting that the gene is regulated by alternative promoters. Comprehensive RACE analysis using salivary gland RNA as template failed to identify any additional exons. Analysis of saliva showed that SPLUNC2 is subject to N-glycosylation. Thus, our study shows that multiple SPLUNC2 isoforms are found in the oral cavity and suggest that these proteins may be differentially regulated in distinct tissues where they may function in the innate immune response

SENP1 promotes hypoxia-induced cancer stemness by HIF-1α deSUMOylation and SENP1/HIF-1α positive feedback loop

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TSC1/2 mutations define a molecular subset of HCC with aggressive behaviour and treatment implication

Objective We investigated the mutational landscape of mammalian target of rapamycin (mTOR) signalling cascade in hepatocellular carcinomas (HCCs) with chronic HBV background, aiming to evaluate and delineate mutation-dependent mechanism of mTOR hyperactivation in hepatocarcinogenesis. Design We performed next-generation sequencing on human HCC samples and cell line panel. Systematic mutational screening of mTOR pathway-related genes was undertaken and mutant genes were evaluated based on their recurrence. Protein expressions of tuberous sclerosis complex (TSC)1, TSC2 and pRPS6 were assessed by immunohistochemistry in human HCC samples. Rapamycin sensitivity was estimated by colony-formation assay in HCC cell lines and the treatment was further tested using our patient-derived tumour xenograft (PDTX) models. Results We identified and confirmed multiple mTOR components as recurrently mutated in HBV-associated HCCs. Of significance, we detected frequent (16.2%, n=18/111) mutations of TSC1 and TSC2 genes in the HCC samples. The spectrum of TSC1/2 mutations likely disrupts the endogenous gene functions in suppressing the downstream mTOR activity through different mechanisms and leads to more aggressive tumour behaviour. Mutational disruption of TSC1 and TSC2 was also observed in HCC cell lines and our PDTX models. TSC-mutant cells exhibited reduced colony-forming ability on rapamycin treatment. With the use of biologically relevant TSC2-mutant PDTXs, we demonstrated the therapeutic benefits of the hypersensitivity towards rapamycin treatment. Conclusions Taken together, our findings suggest the significance of previously undocumented mutation-dependent mTOR hyperactivation and frequent TSC1/2 mutations in HBV-associated HCCs. They define a molecular subset of HCC having genetic aberrations in mTOR signalling, with potential significance of effective specific drug therapy.published_or_final_versio