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| 1 | Clinical applications, limitations and future role of transient elastography in the management of liver disease显示文摘Transient elastography(TE) is a reliable tool for the non-invasive assessment of liver fibrosis in routine clinical practice. TE is currently approved for use in Europe, Asia and the United States. The widespread adoption of this technology is certain to increase the use of TE worldwide. Although TE has been well validated in chronic viral hepatitis, its clinical role in other liver diseases remains less clear. The advent of new treatment for chronic hepatitis C and emerging prevalence of non-alcoholic steatohepatitis raises new questions on the role of TE in current clinical practice. This review aims to examine the clinical applications, limitations and future role of TE in current clinical practice in light of the changing epidemiology of liver diseases and new clinical management paradigms. In current clinical practice, TE is the most accurate noninvasive method for diagnosis of liver cirrhosis. TE is useful to rule out fibrosis and cirrhosis but does not have sufficient accuracy to discern between various stages of fibrosis. The clinical role of TE has evolved from cross-sectional point-in-time assessment of fibrosis and cirrhosis to the more relevant role of prediction of vital clinical end-points. This provides clinicians with the ability to modify treatment strategies based on the information provided by TE. TE has evolved over the past decade to become an essential tool to assist the clinician in the management of chronic liver disease. | Pik Eu Chang George Boon-Bee Goh Jing Hieng Ngu Hiang Keat Tan Chee Kiat Tan | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016，7，1： | 5 |
| 2 | Immunoglobulin G in non-alcoholic steatohepatitis predicts clinical outcome:A prospective multi-centre cohort study显示文摘BACKGROUND Autoimmune markers including plasma cells(PC),anti-smooth-muscle antibody(ASMA),anti-nuclear antibody(ANA),and raised immunoglobulin G(IgG)are commonly observed in non-alcoholic steatohepatitis(NASH),however their clinical significance is unknown.AIM To determine if autoimmune markers in NASH patients are independently associated with poorer clinical outcomes.METHODS Consecutive patients with biopsy proven NASH from Christchurch Hospital,New Zealand and Singapore General Hospital(SGH)were included between 2005 to 2016 in a prospective multi-centre cohort study.Patients with other causes of chronic liver disease were excluded.IgG>14 g/L or globulin fraction>50%,ANA≥1:40,SMA≥1:40 were considered positive.Multivariate analysis was performed to assess which markers were independently associated with mortality and hepatic decompensation.RESULTS Total 261 patients were included of which 201 were from SGH.The median age was 53 and 51.9%were male.Advanced fibrosis was present in 31.4%at diagnosis.PC,ASMA,ANA and raised IgG were observed in 13.1%,4.9%,27.8%and 30.1%of patients respectively.After multivariate analysis,elevated IgG[Hazard Ratio(HR)6.79,95%CI:2.93-17.15]and fibrosis stage(HR 1.37,95%CI:1.03-1.87)were found to be independently associated with increased risk of liver decompensation.Age(HR 1.06,95%CI:1.02-1.10)and elevated IgG(HR 3.79,95%CI:1.90-7.68)were independent factors associated with higher mortality risk.CONCLUSION Elevated IgG,rather than ANA,ASMA or plasma cells,is independently associated with increased risk of hepatic decompensation and mortality in NASH.It could hence be important for prognostication. | Marianne Anastasia De Roza Mehul Lamba George Boon-Bee Goh Johnathan Huey-Ming Lum Mark Chang-Chuen Cheah Jing Hieng Jeffrey Ngu | 2021 | World Journal of Gastroenterology2021，27，43： | 2 |
| 3 | Initial leucocytosis and other significant indicators of poor outcome in severe traumatic brain injury: an observational study显示文摘Background:Globally,severe traumatic brain injury(TBI)has been the principal cause of mortality among individuals aged 45 and below.The incidence of road traffic accidents in Malaysia is one of the highest in the world with thousands of victims sustaining severe disabilities.The aim of this study is to determine the association between leucocytosis and extended Glasgow Outcome Scale(GOSE)scores as well the relationship of other factors and the outcomes of severe TBI.Methods:This was a retrospective observational study.A total of 44 consecutive patients who were admitted to Sarawak General Hospital from January 1,2018,to September 30,2018,with severe TBI were included.Data were collected from discharge summaries and hospital medical records.Chi-square and t test were used.SPSS was employed.Results:Of a total of 44 patients with severe TBI,18 patients(41%)died during the same admission.The mean age of patients was 37.1 years with 93.2%of affected patients being male.56.9%of patients presented with a Glasgow Coma Scale(GCS)of 6 and less.A large percentage(86.3%)were discharged with a GOSE of less than 7.Older age and low admission GCS(6 and less)were significantly associated with poor GOSE scores on discharge and after 6 months(p<0.05)on multivariate analysis.Leucocytosis on admission was also associated with poor outcomes where patients with higher total white counts on presentation attaining lower GOSE scores(p<0.05).Conclusion:We concluded that leucocytosis was significantly associated with poor outcomes in severe TBI patients in addition to other factors such as advanced age and poor GCS on arrival. | Kugan Vijian Eu Gene Teo Davendran Kanesen Albert Sii Hieng Wong | 2020 | Chinese Neurosurgical Journal2020，6，4： | 2 |
| 4 | Predictors of poor outcome in patients w ith autoimmune hepatitis: A population‐based study显示文摘 | Jing Hieng Ngu Richard Blair Gearry Chris Miles Frampton Catherine A.M. Stedman | 2013 | Hepatology2013，，： | 1 |
| 5 | Regulation of hepatitis B virus ENI enhancer activity by hepatocyte-enriched transcription factor HNF3显示文摘 | Chen M Hieng S Qian X | 1994 | Virology1994，205，1： | 1 |
| 6 | In the Absence of Endogenous IL-10, Mice Acutely Infected with Toxoplasma Gondii Succumb to a Lethal Immune Respond Dependent on CD+4 T Cells and Accompanied by Overproduction of IL-2, IFN-γand TNF-α 显示文摘 | Wysocka M Hieng S | 1996 | Immunol1996，157，： | 1 |
| 7 | Effects of jet -grouting on adjacent ground and structures 显示文摘 | Ing Hieng Wong Teoh Yaw Poh | 2000 | Journal of Geotechnical and Geoenvironmental Engineering2000，126，3： | 1 |
| 8 | Behavior of model rafts resting on pile-reinforced sand 显示文摘 | Xiao dong Cao Lng Hieng Wong Ming-Fang Chang | 2004 | Journal of Geotechnical and Geoenvironmental Engineering2004，130，2： | 1 |
| 9 | Effects of jet grouting on adjacent ground and structures 显示文摘 | Wong Hieng | 2000 | Journal of Geotechnical and Geoenvironment Engineering2000，126，3： | 1 |
| 10 | Review of an ll-year experience in retrosigmoid approach for treatment of acoustic neuromas 显示文摘 | Lim SIJ Hieng AWS | 2013 | MedJ Malaysia2013，68，3： | 1 |
| 11 | The metabolite chemotype of N icotiana benthamiana transiently expressing artemisinin biosynthetic pathway genes is a function of CYP 71 AV 1 type and relative gene dosage显示文摘 | Hieng‐Ming Ting Bo Wang Anna‐Margareta Rydén Lotte Woittiez Teun Herpen Francel W. A. Verstappen Carolien Ruyter‐Spira Jules Beekwilder Harro J. Bouwmeester Alexander Krol | 2013 | New Phytol2013，，2： | 1 |
| 12 | Inflammatory Bowel Disease Is Associated With Poor Outcomes of Patients With Primary Sclerosing Cholangitis显示文摘 | Jing Hieng Ngu Richard Blair Gearry Andrew Jeffrey Wright Catherine Ann Malcolm Stedman | 2011 | Clinical Gastroenterology and Hepatology2011，，12： | 1 |
| 13 | Lipoxin-mediated inhibition of IL-12 production by DCs: a mechanism for regulation of microbial immunity显示文摘 | Aliberti J Hieng S Reise-Sousa G | 2002 | Nat Immunol2002，3，1： | 1 |
| 14 | Effects of jet grouting on adjacent ground and structures显示文摘 | Ing Hieng wong Teoh Yaw Poh | 2000 | Journal of Geotechnical and Geoenvironmental Engineering2000，126，3： | 1 |
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