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Objective Drug adherence is crucial to the success of highly active antiretroviral therapy (HAART) in the treatment of HIV disease. Adherence to HAART and its determinants may, however, differ across HIV/AIDS populations. Methods We retrospectively studied drug adherence by self-report in HIV-1 infected Chinese patients who have been on HAART for at least 1 year as at the end of year 2000. HAART is defined as three or more antiretrovirals with at least one protease inhibitor or non-nucleoside analogue reverse transcriptase inhibitor. Results The last drug adherence level assessed by self-report in 161 Chinese patients were: grade A (100%) – 130, 80.7%; grade B (95–99%) – 25, 15.5%; grade C (90–94%) – three, 1.9% and grade D (< 90%) – three, 1.9%. Patients with full adherence were more likely to have undetectable (< 500 copies/mL) plasma virus level (adjusted OR, 4.22; 95% CI, 1.75–12.33). Patients' demographics, HIV disease status and antiretroviral regimen did not affect adherence. Partial drug adherence was, however, independently associated with the psychosocial factors of missing clinic appointments (adjusted OR, 3.13; 95% CI, 1.23–8.33), forgetfulness (adjusted OR, 4.55; 95% CI, 1.64–12.5) and a busy work life (adjusted OR, 6.67; 95% CI, 1.75–25). Conclusion There were similarities and differences in determinants affecting HAART adherence in Chinese compared with other patients. Psychosocial factors rather than HIV disease or treatment were more important factors in our Chinese patients. The relevance of patient populations and care setting for adherence to HAART shall be further studied. [ABSTRACT FROM AUTHOR]

Lipoprotein glomeurulopathy (LPG) is an uncommon cause of end stage kidney disease (ESKD). The long-term outcome of kidney transplantation in patients with LPG remains largely unknown and early recurrence of LPG in the allograft kidney appears to be the rule. Here we report a young Chinese patient with ESKD due to rare coexisting LPG and fibrillary glomerulonephritis, who received deceased kidney transplantation, was diagnosed to have LPG recurrence after 20 years of post-transplant follow-up. With the longest follow-up duration after kidney transplantation in literature, our case shows that the prognosis of kidney transplantation in patients with LPG can still be good. Kidney transplantation should remain a therapeutic option for patients with ESKD due to LPG., (Copyright © 2022. Published by Elsevier Inc.)

The spatial distribution, composition and source of hydrophobic organic compounds (HOCs) including polyaromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and organochlorinated pesticides (OCPs) of the sedimentary microplastics (0.25-5 mm) in Hong Kong were investigated. The concentration of ΣPAHs ranged between 70.8 and 1509 ng g -1 with inter-site differences although the regional difference was insignificant, indicating localised pyrolytic and petrogenic input of PAHs. The concentration of ΣPCBs (13-1083 ng g -1 ) varied with both study sites and regions with higher concentrations obtained in the western waters, possibly due to the input from Pearl River. Significantly higher concentrations of OCPs on eastern shores highlighted fishing and aquaculture activities in South China Sea a potential major source of OCPs. DDT and its metabolites (DDX, ranged from 1.96 to 626 ng g -1 ) were the dominant forms of OCPs (45%-80%). Since most of the DDX existed as DDT, this suggested that there was a fresh input of DDT into the microplastics. As microplastics and HOCs cannot be removed effectively from the environment, reduction of potential ecotoxicological risks should rely on minimizing the use of plastics and HOCs., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Different studies in the past have shown that the risk of cancer development is increased in chronic dialysis patients. However, data concerning the cancer risk in Asian dialysis patients was scarce. More importantly, there was lack of information about the cancer-specific mortality in dialysis patients., Methods: A multicenter retrospective cohort study of 6,254 patients who started either chronic peritoneal dialysis or hemodialysis between 1994 and 2014 in 4 renal units in Hong Kong. Patterns of cancer incidence and mortality in our dialysis patients were compared with those of the general population using standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) respectively., Results: With 14,887 person-years of follow-up, 220 cancers were recorded. The SIR of all cancers was 1.44 (95% CI 1.26-1.65). A trend of an increased SIR was observed in young patients and within the first year of dialysis. Colorectum was the most common site of cancer (20%) while kidney cancer carried the highest risk (SIR 12.28, 95% CI 8.44-17.08). The SMR of all cancers was 0.91 (95% CI 0.72-1.13) and only kidney cancer had higher cancer mortality risk (SMR 4.92, 95% CI 1.80-10.70). SMR was highest in young patients and then decreased with age., Conclusions: The incidence of cancers in our chronic dialysis patients was elevated. Our findings of substantially increased risks in young patients, particularly in relation to kidney cancer, suggest that we can adopt a more individualized approach to cancer screening in chronic dialysis patients., (© 2016 S. Karger AG, Basel.)

Muir-Torre syndrome is a rare, autosomal dominant condition characterized by the presence of a skin tumor of sebaceous differentiation and visceral malignancies. We reviewed the case of a 46-year-old Chinese man who had a bleeding mass over the right upper eyelid. He had a history of colon cancer and a family history satisfying the Amsterdam criteria for hereditary non-polyposis colorectal cancer syndrome with germline mutation in the MutS homolog-2 gene. The eyelid lesion was excised completely and submitted for histopathologic examination which showed sebaceous carcinoma. Frozen section and conjunctival map biopsy showed no residual malignancy or local metastasis. Post-operative positron-emission tomography with combined computed tomography did not reveal any residual or visceral malignancy. He had no recurrence in the 32-month follow-up period. We should consider Muir-Torre syndrome in patients with sebaceous carcinoma, especially in the presence of personal and/or family history of visceral malignancies.

To evaluate the clinical efficacy of transcutaneous everting sutures for lower eyelid involutional entropion in Chinese patients. A retrospective, non-comparative, interventional case series. This retrospective study consecutively reviewed the medical records of all patients with involutional lower eyelid entropion who underwent transcutaneous everting suture for entropion correction at the Department of Ophthalmology, Caritas Medical Centre, from 1st January 2010 to 31st October 2013. Exclusion criteria included concurrent eyelid pathologies such as malignant tumor, infection, cicatricial entropion, post-operative follow-up period of <3 months, significant horizontal lid laxity, and aged <60 years at the time of surgery. The primary outcome measures were recurrence rate and complications. Secondary outcome measures included patient demographic data, type and number of everting sutures, duration of operation, timing of stitch removal, duration of follow-up, as well as each patient's medical history and current medications. Thirty-four eyelids of 28 patients were included. The average age was 78.2 ± 7.3 years and the male to female ratio was 4:3. In this series, 26.5 and 2.9 % of eyelids underwent entropion correction whilst receiving aspirin and warfarin, respectively. The mean duration of post-operative follow-up was 13.2 ± 10.5 months. The recurrence rate was 11.8 % at a mean of 9.0 ± 6.0 months. There were no peri-operative or post-operative complications observed. A transcutaneous everting suture was found to be a quick and effective means to correct senile involutional lower lid entropion in Chinese patients with no complications despite the continued use of anti-coagulation therapy in >25 % of our cases.

Angelica Radix, the roots of the genus Angelica, has been used for more than 2,000 years as a traditional medicine in Eastern Asia. The Chinese Pharmacopoeia records more than 100 herbal formulae containing Angelica roots. There are two common sources of Angelica roots, Angelica sinensis from China and A. gigas from Korea. The two species of Angelica roots differ in their chemical compositions, pharmacological properties and clinical efficacy. ¹H-NMR metabolic profiling has recently emerged as a promising quality control method for food and herbal chemistry. We explored the use of ¹H-NMR metabolic profiling for the quality control of Angelica Radix. Unlike previous work, we performed the metabolic profiling on hot water extracts, so as to mimic the clinically relevant preparation method. Unsupervised principle component analyses of both the full spectral profile and a selection of targeted molecules revealed a clear differentiation of three types of Angelica roots. In addition, the levels of 13 common metabolites were measured. Statistically significant differences in the levels of glucose, fructose and threonine were found between different sources of Angelica. Ferulic acid, a marker commonly used to evaluate Angelica root, was detected in our samples, but the difference in ferulic acid levels between the samples was not statistically significant. Overall, we successfully applied ¹H-NMR metabolic profiling with water extraction to discriminate all three sources of Angelica roots, and obtained quantitative information of many common metabolites.

Aim: There is limited data concerning the impact of recipient body mass index (BMI) on graft outcome in Asian renal transplant recipients. The aim of this study is to identify whether obesity (BMI > or =25 kg/m(2)) and overweight (BMI > or =23 kg/m(2)) can predict graft outcome., Methods: This is a single-centre retrospective study. All patients who received kidney transplantation between 1997 and 2005 were recruited. Patients were categorized according to two different designated BMI cut-off values., Results: One hundred and thirty-one patients were recruited with a median follow-up duration of 73 months. If a BMI cut-off value of 25 kg/m(2) was used, 86.3% patients were classified as non-obese and 13.7% as obese. Obesity was significantly associated with poor renal graft function and decreased patient and graft survival. On the other hand, 34.3% patients were classified as overweight and 65.7% patients as normal if a BMI cut-off value of 23 kg/m(2) was used. Overweight was significantly associated with a lower glomerular filtration rate only. Cox regression analysis showed that obesity (odds ratio (OR) = 3.09), acute rejection (OR = 5.68), pre-transplant diabetes mellitus (OR = 3.21) and age of recipient (OR = 1.06) were all significant independent risk factors associated with graft failure., Conclusion: Recipient BMI > or =25 kg/m(2) is a significant predictive factor for long-term renal graft outcome in the Asian population.

Background: To evaluate the prevalence of chronic kidney disease (CKD) in Chinese HIV-infected population., Methods: This was a cross-sectional point prevalence study. All Chinese HIV-infected patients who were followed up in a tertiary referral center in Hong Kong were recruited. Spot urine was saved for each patient to calculate urine protein-to-creatinine ratio (urine P/Cr). Those with urine P/Cr > 0.3 would have 24-h urine collection to determine the exact amount of proteinuria. Glomerular filtration rate (GFR) was estimated using MDRD formula. CKD was defined as GFR <60 ml/min/1.73 m2 and/or urine P/Cr > 0.3. Baseline demographic and clinical data were extracted from patients' records., Results: In total 322 patients were recruited. The mean age was 45.2 +/- 11.7 years. The duration of follow up was 6.0 +/- 4.0 years. There were 264 male and 58 female patients. The prevalence of hypertension, diabetes mellitus and CKD were 7.4%, 10.6% and 16.8%, respectively. Eighteen patients (5.6%) had GFR < 60 ml/min/1.73 m2 while 44 patients (13.7%) had spot urine P/Cr > 0.3. Among those with urine P/Cr > 0.3, 38 patients had 24-h urine collection. Using univariate analysis, CKD was found to be significantly (P < 0.05) associated with age, hypertension, diabetes, use of indinavir, lower CD4 count and peak viral load. Multivariate logistic regression revealed older age (P < 0.001), lower CD4 count (P = 0.02) and use of indinavir therapy (P = 0.04) were associated with development of CKD., Conclusion: CKD is prevalent in Chinese HIV-infected patients. Patients with CKD were more likely to be older, associated with use of indinavir and CD4 nadir less than 100 cells/mul.

Few studies used paired kidneys for comparison between tacrolimus and cyclosporine in renal transplantation. Most of the published data used whole blood trough levels for drug monitoring. However, the use of limited sampling strategy and abbreviated formula to estimate the 12-h area under concentration-time curve (AUC(0-12)) allowed better prediction of drug exposure. Sixty-six first cadaveric renal transplant recipients receiving paired kidneys were randomized to receive either tacrolimus-based (n = 33) or cyclosporine microemulsion (Neoral)-based therapies (n = 33). Abbreviated AUC(0-12) was used for drug monitoring and dose titration. Mean follow-up duration was 2.8 +/- 2 years. The patient and graft survival were comparable. Fewer incidence of acute rejection was observed in tacrolimus group (15% vs. 27.3%) though the difference was not significant (P = 0.23). The absolute value and the rate of decline of creatinine clearance were both significantly better in tacrolimus-treated patients. Prevalence of hypertension, post-transplant diabetes mellitus, infection, and malignancy were similar in both groups. Prevalence of hypercholesterolemia (11/33 vs. 4/33) and gum hypertrophy (6/33 vs. 1/33) was more common in cyclosporine-treated patients (P = 0.04 in both parameters). This was the first prospective, randomized study with paired kidney analysis showing the renal function was significantly better in tacrolimus-treated patients than in cyclosporine-treated patients.