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        Impact of fatty liver on long-term outcomes in chronic hepatitis B: a systematic review and matched analysis of individual patient data meta-analysis

        Yu Jun Wong,Vy H. Nguyen,Hwai-I Yang,Jie Li,Michael Huan Le,Wan-Jung Wu,Nicole Xinrong Han,Khi Yung Fong,Elizabeth Chen,Connie Wong,Fajuan Rui,Xiaoming Xu,Qi Xue,Xin Yu Hu,Wei Qiang Leow,George Boon-B 대한간학회 2023 Clinical and Molecular Hepatology(대한간학회지) Vol.29 No.3

        Background/Aims: Chronic hepatitis B (CHB) and fatty liver (FL) often co-exist, but natural history data of this dual condition (CHB-FL) are sparse. Via a systematic review, conventional meta-analysis (MA) and individual patient-level data MA (IPDMA), we compared liver-related outcomes and mortality between CHB-FL and CHB-no FL patients. Methods: We searched 4 databases from inception to December 2021 and pooled study-level estimates using a random- effects model for conventional MA. For IPDMA, we evaluated outcomes after balancing the two study groups with inverse probability treatment weighting (IPTW) on age, sex, cirrhosis, diabetes, ALT, HBeAg, HBV DNA, and antiviral treatment. Results: We screened 2,157 articles and included 19 eligible studies (17,955 patients: 11,908 CHB-no FL; 6,047 CHB-FL) in conventional MA, which found severe heterogeneity (I2=88–95%) and no significant differences in HCC, cirrhosis, mortality, or HBsAg seroclearance incidence (P=0.27–0.93). IPDMA included 13,262 patients: 8,625 CHB-no FL and 4,637 CHB-FL patients who differed in several characteristics. The IPTW cohort included 6,955 CHB-no FL and 3,346 CHB-FL well-matched patients. CHB-FL patients (vs. CHB-no FL) had significantly lower HCC, cirrhosis, mortality and higher HBsAg seroclearance incidence (all P≤0.002), with consistent results in subgroups. CHB-FL diagnosed by liver biopsy had a higher 10-year cumulative HCC incidence than CHB-FL diagnosed with non-invasive methods (63.6% vs. 4.3%, P<0.0001). Conclusions: IPDMA data with well-matched CHB patient groups showed that FL (vs. no FL) was associated with significantly lower HCC, cirrhosis, and mortality risk and higher HBsAg seroclearance probability.

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        Mapping the interrelationships between self-concept, motivation and university experience among students of self-financing higher education institutions in Hong Kong

        Phoebe Wong,Connie Mak,Peggy M. L. Ng,Jessie Zhao 서울대학교 교육연구소 2017 Asia Pacific Education Review Vol.18 No.1

        This study explores the interrelationships between self-concept, motivation and academic and social experience among students from self-financing higher education institutions in Hong Kong. Although prior studies have investigated different aspects of self that drive various types of motivation in students’ academic and social experience, most of them are related to publicly funded universities only. This study aims to extend our current understanding to the context of self-financing higher education, which is an alternative to students whose academic results are not good enough to secure tertiary placements at publicly funded universities. Using qualitative approach and the technique of friendship pair, 26 students from 12 self-financing higher education institutions in Hong Kong were recruited for semi-structured interviews. Data analysis revealed that participants constructed two dimensions of the self: the personal (i.e. the actual academic self, the possible academic self, the spiritual self and the extended self) and relational (i.e. the familial self and the social self) dimensions in the light of their university experience. The findings provide a better understanding of the contemporary university experience in relation to self and motivation among students studying at self-financing higher education institutions.

      • Triple Negative Status is a Poor Prognostic Indicator in Chinese Women with Breast Cancer: a Ten Year Review

        Ma, K.K.,Chau, Wai Wang,Wong, Connie H.N.,Wong, Kerry,Fung, Nicholas,Lee, J.T. Andrea,Choi, L.Y. Catherine,Suen, Dacita T.K.,Kwong, Ava Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.5

        Background: Ethnic variation in tumor characteristics and clinical presentation of breast cancer is increasingly being emphasized. We studied the tumor characteristics and factors which may influence the presentation and prognosis of triple negative breast cancers (TNC) in a cohort of Chinese women. Methods: A prospective cohort of 1800 Chinese women with breast cancer was recruited in a tertiary referral unit in Hong Kong between 1995 and 2006 and was followed up with a median duration of 7.2 years. Of the total, 216 (12.0%) had TNC and 1584 (88.0%) had non-TNC. Their clinicopathological variables, epidemiological variables and clinical outcomes were evaluated. Results: Patients with TNC had similar age of presentation as those with non-TNC, while presenting at earlier stages (82.4% were stage 1-2, compared to 78.4% in non-TNC, p=0.035). They were likely to be associated with grade 3 cancer (Hazard Ratio(HR)=5.8, p<0.001). TNC showed higher chance of visceral relapse (HR=2.69, p<0.001), liver metastasis (HR=1.7, p=0.003) and brain metastasis (HR=1.8, p=0.003). Compared with non-TNC group, TNC had similar 10-year disease-free survival (82% vs 84%, p=0.148), overall survival (78% vs 79%, p=0.238) and breast cancer-specific mortality (18% vs 16%, p=0.095). However, TNC showed poorer 10-year stage 3 and 4 specific survival (stage 3: 53% vs. 67%, p=0.010; stage 4: 0% vs. 40%, p=0.035). Conclusions: Chinese women with triple negative breast cancer do not have less aggressive biological behavior compared to the West and presentation at a later stage results in worse prognosis compared with those with non triple negative breast cancer.

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