➥【重點摘要】：
■ 門診：
1. 限制門診，至需要緊急處理的患者或諮詢者，或正在接受治療的患者。
2. 限制醫護人員的人數，以降低全部感染的風險。
3. 考慮限制照護人員至確實需要照顧的病人。
4. 當病患確實有需要時，如有身體或心理上的限制，限制陪病人員一名。
5. 延後所有的追蹤檢查，若資源許可，則轉至遠距問診，直至疫情穩定。
6. 考慮遠距問診，以允許恰當、安全、及快速的分流。
7. 考慮延後所有不必要的介入措施。


■ 對子宮頸癌病人：
1. Pre-invasive疾病：根據ASCCP建議，low-grade篩檢可延後6-12個月，high-grade篩檢應在三個月內檢查。
2. 早期子宮頸癌：若情況允許，可依計畫進行手術。但若手術吃緊，則考慮以下步驟：以CT scan或PET/CT影像，確認疾病期別，延後高風險手術6-8週，或至疫情緩解。對於低風險疾病，在可行的情況下，可考慮簡單的手術。若已可看到腫瘤，則可考慮化療。
3. 中晚期疾病：考慮低分次放射治療已減少患者到醫院治療的次數。對需要每天到醫院的放療患者，除非需要檢查，考慮遠距醫療。


■ 子宮內膜癌：
1. 低風險患者：對grade 1患者可考慮非手術治療，如賀爾蒙療法。
2. 高風險患者：對grade 2 or 3患者，可行的話，應考慮子宮切除術及雙側輸卵管切除術，並依風險進行術後管理。在COVID-19的威脅下，進行腹腔鏡應考慮開腹手術的風險。
3. 晚期疾病：晚期病人應考慮進行切片確診，並作全身性的治療。


■ 卵巢癌：
1. 在疑似早期疾病時，應考慮年齡、家族史、及理學檢查。
2. 在晚期疾病患者，應考慮進行切片確診，並進行化療直至疫情緩解。
3. 對已開始化療的患者，考慮延長治療由3個cycle至6個cycle，但是這些患者仍須考慮手術室的資源，及延長化療時間可能增加感染風險。
4. 對已完成化療的患者，可考慮停止治療。
5. 對需長途旅行已接受治療之患者，考慮至當地腫瘤科接受治療，或考慮接受遠距治療。
6. 對復發患者，應根據臨床判斷已決定是否開始新的化療。


■ 治療計畫：
1. 當地患者：可進行影像學及實驗室檢查，並同意醫師以電話討論後續處置。
2. 遠地患者：考慮在當地進行影像及實驗室檢查並將病歷資料寄給醫師已討論後續處置。
3. 國際患者：考慮延後國際患者的問診。


■ 臨床試驗：
1. 間的互動。
2. 除了有治癒機會、較現行治療有延長或挽救生命機會、或目前沒有標準治療選擇的試驗，其他試驗應限制收案。
3. 對已在試驗中的患者，應持續治療。；但以視訊方式進行毒性評估並以郵件方式寄送藥物。
4. 若試驗患者感染COVID-19，應將患者自試驗排除並進行治療。
5. 所有研究人員應留在家裡，並減少研究人員出現在醫院對病患進行追蹤研究。


■ 學術活動：
1. 藉由視訊方式持續進行學術活動。
2. 持續以視訊會議學習並探索改善照護病患的方式。


■ 安寧照護：
1. 了解病患生活品質的需求、病患生命末期的期待、照顧計畫、疼痛及症狀護理、及照顧者支持仍是醫療團隊的首要目標。
2. 跨領域合作以盡速確保支持及安寧照顧的需求。
3. 對門診及住院患者考慮遠距醫療以減低患者及醫護人員感染風險。
4. 對支持及安寧患者而言，家人的參與是最重要的。
(「財團法人國家衛生研究院」莊淑鈞博士 摘要整理)


📋 COVID-19 Global pandemic: Options for management of gynecological cancers(2020/03/30)+中文摘要轉譯

➥Author：Pedro T Ramirez, Luis Chiva, Ane Gerda Z Eriksson, et al.
➥Link： BMJ
https://ijgc.bmj.com/content/early/2020/03/27/ijgc-2020-001419.full


#2019COVID19Academic
衛生福利部
疾病管制署 - 1922防疫達人
疾病管制署
國家衛生研究院-論壇

希望大家可以幫吓可仁啦😢 我希望個個小朋友都可以健康快樂咁成長，可以一齊去公園玩

【最新消息：募捐行動已於2018年12月3日結束】中大校友慈善基金感謝各界慷慨支持，募捐行動已結束。所得善款將支持張可仁及患上相類疾病需免疫治療的其他6位病童。

詳情請參閱中大校友慈善基金網頁：https://www.facebook.com/cuhkacf.org/posts/589827338133781

-------------------------------------------------------------------------------------
(2018/11/22)

中大醫學院向大家作出緊急呼籲，支持我們2000年的醫科畢業生張俊傑醫生，拯救他只有17個月大的兒子張可仁的性命。

可仁早於出生第4天時已被診斷罹患一種罕有心臟病「主動脈狹窄」(Coarctation of Aorta)，需要接受緊急手術。極之不幸的是，可仁最近再被確診患上「第四期神經母腫瘤」(Stage IV Neuroblastoma)，目前可仁的頭骨至腰椎和盆骨均受到癌細胞擴散，脊髓神經線受到癌細胞壓住，痛楚非常，並有癱瘓的危機，癌細胞更正轉移至骨髓。

可仁現時正住在威爾斯親王醫院兒童癌症中心隔離病房，極容易受到感染。他已開始接受化療，而治療方案將包括化療、手術、放射治療、骨髓移植、免疫治療，治療時間約一年至一年半。他完成化療、手術和放射治療後，會進行骨髓移植，之後需要免疫療法，這可大大提高存活率，由20%升至50%。

然而，免疫治療需要病人自費，所需費用高達港幣200萬元。張醫生另一兒子患有自閉症，太太辭掉小學主任一職，全職照顧兩位小朋友，並要照顧父母親，經濟上未能承擔高昂的醫療費用。

中大醫學院2000年畢業同學會發起是次籌款，目的包括：
1. 為可仁進行骨髓移植後的免疫治療；
2. 引發社會人士及政府對兒童罕有癌症治療的關注。

查詢：
香港中文大學校友慈善基金
電郵：info@cuhkacf.org
電話：2180 4316

-------------------------------------------------------------------------------------

【Fundraising Campaign Completed on 3 December 2018】According to CUHK Alumni Charity Foundation, the fundraising campaign for Mark CHEUNG Ho Yan has completed. The fund raised will be used to support the immunotherapy of Mark and 6 other patients who are suffered from the same disease. Thank you for all your kind-hearted support and generosity.

-------------------------------------------------------------------------------------

(2018/11/22)

This is an urgent appeal for your generosity to save the life of the 17-month-old son of Dr. CHEUNG Chun Kit, our medical alumnus of Class 2000.

Dr. Cheung Chun Kit is a CUHK medical graduate of Year 2000. His younger son, Cheung Ho Yan Mark, has recently been diagnosed to have Stage IV Neuroblastoma in November 2018, and is in an emergency need of donation to provide the necessary funding to support the life-saving yet expensive immunotherapy.

Mark was presented to his paediatrician for fever and cough in late October 2018. His cough resolved with treatment but his fever never completely went away. Two days prior to his diagnosis, Mark was more clingy than usual and did not like to walk. On a video clip, Mark was noted to have foot drop, a very significant red flag which may indicate a compression on the spinal cord. Emergency scans were immediately performed that night, and Mark was found to have a large tumour on the left side of his abdomen. The aggressive tumour had already spread silently to the back of his skull, his spine, his hips and had compressed his nerves which control his lower limbs, resulting in pain on standing and difficulty in walking. Mark is facing an imminent risk of paralysis.

Mark is diagnosed to have a rare childhood cancer which is called Stage IV neuroblastoma, a cancer which typically presents at late stage because it arises deep in the abdomen. To cure his aggressive cancer, Mark needs to survive through rounds of intensive chemotherapy, radiotherapy, surgery, bone marrow transplant, and finally, immunotherapy. The whole treatment duration lasts 1.5 to 2 years. To completely eradicate all cancer cells, immunotherapy will be needed to boost Mark’s survival from 20% to 50%. However, immunotherapy is a self-financed treatment in the public hospital and the treatment costs could be up to 2 million.

Such close encounter with death is not the first time for Mark. At the first week of life, Mark was diagnosed to have a rare heart problem called “Coarctation of Aorta”. Mark had received life-saving surgery to reestablish the blood flow across his aorta, the major blood vessel that allows blood to go from the heart to the brain and the rest of the body. In a report published in 2002, only 67 cases with dual heart condition and neuroblastoma were reported, giving an odd of 1 in 100 million for a child to be hit by these two rare diseases. Scientists have not yet completely understood the mechanisms that may cause the two conditions to appear in a single child.

It never rains but pours that Mark’s elder brother, now 5 years old, was diagnosed to have autism at around age 2. To enable the elder brother to have intensive training to improve his outcome and development, Mark’s mommy quit her job as a primary school teacher since the diagnosis of autism was made for his elder brother. Dr. Cheung, who is a medical doctor for the elderly, became the sole bread-winner of his family.

CUHK Medical Graduates of Year 2000 have initiated a fund-raising campaign for Mark and his family with the following two objectives:

1. To appeal for donation to support the costs of immunotherapy for Mark
2. To increase the public awareness on the grave needs of children with cancers

Enquiries:
CUHK Alumni Charity Foundation Limited
Email: info@cuhkacf.org
Telephone: 2180 4316

🙏🏻🙏🏻🙏🏻

【最新消息：募捐行動已於2018年12月3日結束】中大校友慈善基金感謝各界慷慨支持，募捐行動已結束。所得善款將支持張可仁及患上相類疾病需免疫治療的其他6位病童。

詳情請參閱中大校友慈善基金網頁：https://www.facebook.com/cuhkacf.org/posts/589827338133781

-------------------------------------------------------------------------------------
(2018/11/22)

中大醫學院向大家作出緊急呼籲，支持我們2000年的醫科畢業生張俊傑醫生，拯救他只有17個月大的兒子張可仁的性命。

可仁早於出生第4天時已被診斷罹患一種罕有心臟病「主動脈狹窄」(Coarctation of Aorta)，需要接受緊急手術。極之不幸的是，可仁最近再被確診患上「第四期神經母腫瘤」(Stage IV Neuroblastoma)，目前可仁的頭骨至腰椎和盆骨均受到癌細胞擴散，脊髓神經線受到癌細胞壓住，痛楚非常，並有癱瘓的危機，癌細胞更正轉移至骨髓。

可仁現時正住在威爾斯親王醫院兒童癌症中心隔離病房，極容易受到感染。他已開始接受化療，而治療方案將包括化療、手術、放射治療、骨髓移植、免疫治療，治療時間約一年至一年半。他完成化療、手術和放射治療後，會進行骨髓移植，之後需要免疫療法，這可大大提高存活率，由20%升至50%。

然而，免疫治療需要病人自費，所需費用高達港幣200萬元。張醫生另一兒子患有自閉症，太太辭掉小學主任一職，全職照顧兩位小朋友，並要照顧父母親，經濟上未能承擔高昂的醫療費用。

中大醫學院2000年畢業同學會發起是次籌款，目的包括：
1. 為可仁進行骨髓移植後的免疫治療；
2. 引發社會人士及政府對兒童罕有癌症治療的關注。

查詢：
香港中文大學校友慈善基金
電郵：info@cuhkacf.org
電話：2180 4316

-------------------------------------------------------------------------------------

【Fundraising Campaign Completed on 3 December 2018】According to CUHK Alumni Charity Foundation, the fundraising campaign for Mark CHEUNG Ho Yan has completed. The fund raised will be used to support the immunotherapy of Mark and 6 other patients who are suffered from the same disease. Thank you for all your kind-hearted support and generosity.

-------------------------------------------------------------------------------------

(2018/11/22)

This is an urgent appeal for your generosity to save the life of the 17-month-old son of Dr. CHEUNG Chun Kit, our medical alumnus of Class 2000.

Dr. Cheung Chun Kit is a CUHK medical graduate of Year 2000. His younger son, Cheung Ho Yan Mark, has recently been diagnosed to have Stage IV Neuroblastoma in November 2018, and is in an emergency need of donation to provide the necessary funding to support the life-saving yet expensive immunotherapy.

Mark was presented to his paediatrician for fever and cough in late October 2018. His cough resolved with treatment but his fever never completely went away. Two days prior to his diagnosis, Mark was more clingy than usual and did not like to walk. On a video clip, Mark was noted to have foot drop, a very significant red flag which may indicate a compression on the spinal cord. Emergency scans were immediately performed that night, and Mark was found to have a large tumour on the left side of his abdomen. The aggressive tumour had already spread silently to the back of his skull, his spine, his hips and had compressed his nerves which control his lower limbs, resulting in pain on standing and difficulty in walking. Mark is facing an imminent risk of paralysis.

Mark is diagnosed to have a rare childhood cancer which is called Stage IV neuroblastoma, a cancer which typically presents at late stage because it arises deep in the abdomen. To cure his aggressive cancer, Mark needs to survive through rounds of intensive chemotherapy, radiotherapy, surgery, bone marrow transplant, and finally, immunotherapy. The whole treatment duration lasts 1.5 to 2 years. To completely eradicate all cancer cells, immunotherapy will be needed to boost Mark’s survival from 20% to 50%. However, immunotherapy is a self-financed treatment in the public hospital and the treatment costs could be up to 2 million.

Such close encounter with death is not the first time for Mark. At the first week of life, Mark was diagnosed to have a rare heart problem called “Coarctation of Aorta”. Mark had received life-saving surgery to reestablish the blood flow across his aorta, the major blood vessel that allows blood to go from the heart to the brain and the rest of the body. In a report published in 2002, only 67 cases with dual heart condition and neuroblastoma were reported, giving an odd of 1 in 100 million for a child to be hit by these two rare diseases. Scientists have not yet completely understood the mechanisms that may cause the two conditions to appear in a single child.

It never rains but pours that Mark’s elder brother, now 5 years old, was diagnosed to have autism at around age 2. To enable the elder brother to have intensive training to improve his outcome and development, Mark’s mommy quit her job as a primary school teacher since the diagnosis of autism was made for his elder brother. Dr. Cheung, who is a medical doctor for the elderly, became the sole bread-winner of his family.

CUHK Medical Graduates of Year 2000 have initiated a fund-raising campaign for Mark and his family with the following two objectives:

1. To appeal for donation to support the costs of immunotherapy for Mark
2. To increase the public awareness on the grave needs of children with cancers

Enquiries:
CUHK Alumni Charity Foundation Limited
Email: info@cuhkacf.org
Telephone: 2180 4316