tbuckley/cabot-search huggingface dataset:
大气环境变化对人体亚健康状态的影响
Authors: 钱晶, 陈莉, 童静霞
Journal: BMJ (2005)

许多研究表明,人类的亚健康状态和多种疾病的诱发、复发、加重在很大程度上与生存环境有关,气象条件是组成人类生存环境的重要要素,其变化不仅影响人的生理健康,也明显影响心理健康[1-4].本文简述了大气环境变化与人体亚健康的关系。
老年急性心肌梗死患者经皮冠状动脉腔内成形术后QT离散度改变46例分析
Authors: 张文
Journal: BMJ (2004)

来愈多的老年冠心病患者接受介入治疗,极大地改善了其预后[1].QT离散度(QTd)代表了心室肌复极的不稳定性和不同步性,是一种预测室性心动过速、心室颤动和心脏猝死的指标[2].本研究旨在回顾性分析老年急性心肌梗死患者经皮冠状动脉腔内成形术(PTCA)术后QT离散度改变及其与恶性心律失常的关系。
Role of glyoxalase-1 in trabectedin-resistant myxoid liposarcoma.
Authors: Sonia Simonetti, Michele Iuliani, Francesco Pantano, Giulia Ribelli, Andrea Napolitano, Daniele Santini, Giuseppe Tonini, Bruno Vincenzi
Journal: Journal of Clinical Oncology (2020)

e23566 Background: Glyoxalase-1 (Glo1) is involved in the detoxification of the endogenous reactive metabolite, methylglyoxal (MG), whose abnormal accumulation increases adduct levels and induce cell apoptosis. Previous studies demonstrated that increased Glo-1 expression was associated with cancer chemotherapy resistance. We performed bioinformatics analyses finding that Glo-1 mRNA over-expression was correlated with worse prognosis in patients affected by Soft Tissue Sarcoma (STS). On the bases of these evidences, we investigated the potential role of Glo1 expression as biomarker of tumor growth and drug resistance in STS. Methods: Trabectedin and MG cytoxicity was evaluated by MTT viability assay measured at spectrofluorometer. Apoptosis was analyzed by flow cytometry using Annexin V antibody and propidium iodide. Glo-1 expression analysis was performed by Western Blot using a mouse monoclonal anti-human Glo-1 antibody (NBP1-19015). Synergy analysis was calculated using Combenefit software and statistical analysis was performed by Student-t test using the program GraphPad-Prism. Results: As STS trabectedin resistant model, we used a myxoid-liposarcoma cell line (402-91 ET cells) that are not responsive to clinical doses of trabectedin contrary to the parental sensitive cell line (402-91 WT cells). Intriguingly, we found higher Glo-1 protein levels in 402-91 ET cells compared to 402-91 WT cells. The treatment of 402-91 ET cells with the specific Glo1 inhibitor S-p-bromobenzylglutathione cyclopentyl diester (BBGC), in combination with trabectedin (PharmaMar), significantly inhibited cell viability and increased apoptosis than trabectedin alone. In particular, the addition of BBGC reduced trabectedin EC50 (half-maximal effective concentration) from 20.4nM to 5.92nM in 402-91 ET cells, similar to that observed in 402-91 WT cells (4.92nM). To investigate if cell death was induced by MG accumulation following Glo1 inhibition, we evaluated 402-91 ET cell viability after treatment with different doses of MG in combination with trabectedin. The addition of MG restored sensitivity to trabectedin in 402-91 ET cells as well as BBGC. Conclusions: Our results highlight a new potential mechanism of trabectedin resistance mediated by Glo-1 over-expression. The use of the specific Glo-1 inhibitor, BBGC, restores trabectedin sensitivity in resistant cells leading to MG accumulation that, in turn, promotes cell death and apoptosis. These data provide a strong rationale to investigate Glo-1 inhibition strategy, in combination with trabectedin, in STS in vivo models.
Laparoscopic resection combined with colonoscopy in treatment of colon carcinoid tumors: a report of 12 cases
Authors: 葛恒发, 刘卫东, 姜宝飞, 周光荣
Journal: BMJ (2011)

Twelve cases of colon carcinoid were treated by laparoscopic resection combined with colonoscopy from January 2003 to November 2009 in the First Huai'an Hospital. The tumors presented as submucosal lesions in colonoscopy with the size of 1.5 - 3.0 cm in diameter, which were difficult to be found by laparoscopy. All tumors were locally resected under laparoscopy with the assistance of colonoscopy successfully. Patients were followed up for 6 - 72 months, one case died 30 months after operation due to liver metastases. Colon carcinoid tumors with diameter from 1.5 - 3.0 cm often have muscular invasion and lymph node metastasis. The results indicate that laparoscopic resection combined with colonoscopy is a safe and effective procedure for colon carcinoid tumor.

Key words: 
Colonic neoplasms ;  Digestive system surgical procedures ;
对宁夏地区全科医学培训学员情况的分析
Authors: 蔡慧珍, 朱凤萍
Journal: BMJ (2009)

宁夏地区全科医学培训工作已开展多年,为了掌握总体情况、分析培训工作的结构和状况,找出制约宁夏地区全科医学发展的因素,我们对宁夏地区2005年至2007年全科医学培训情况进行了回顾性调查和分析.1.资料与方法:290名医生的资料来源于2005年至2007年宁夏医科大学全科医学培训中心学员登记资料;根据学员留下的联系方式进行电话采访调查,除45人联系方式改变没能联系上外,共电话回访245人.回访内容:目前是否还从事社区卫生工作,工作满意度,对全科培训工作的意见和建议.并做一般描述性分析。
Atrioventricular Dissociation during Ventricular Fibrillation
Authors: Jonathan R Salik, Sunu S Thomas
Journal: New England Journal of Medicine (2020)

A 50-year-old woman with a history of cardiac transplantation had acute cellular rejection of the transplanted heart. Transthoracic echocardiography, shown in a video, was performed while she was receiving venoarterial extracorporeal membrane oxygenation and revealed ventricular fibrillation with preserved atrial contractility, consistent with atrioventricular dissociation.
Sequential chemoradiation versus radiation alone or concurrent chemoradiation in adjuvant treatment after radical hysterectomy for stage IB1-IIA2 cervical cancer (STARS Study): A randomized, controlled, open-label, phase III trial.
Authors: He Huang, Yanling Feng, Ting Wan, Yanna Zhang, Xinping Cao, Yongwen Huang, Ying Xiong, Xin Huang, Min Zheng, Yanfang Li, Jundong Li, Guandi Chen, Hu Li, Yile Chen, Liguo Ma, Hongying Yang, Li Li, Shuzhong Yao, Qing Liu, Jihong Liu
Journal: Journal of Clinical Oncology (2020)

6007 Background: There are limited data from previous studies regarding whether the addition of chemotherapy to adjuvant radiation after radical surgery improves outcomes among patients with early-stage cervical cancer and adverse pathological factors. Methods: This was a prospective randomized trial including patients with FIGO 2009 stage IB1-IIA2 cervical cancer and squamous-cell, adenocarcinoma, or adenosquamous carcinoma with at least one adverse factor after radical hysterectomy. Patients were randomized 1:1:1 to receive adjuvant radiation alone, concurrent chemoradiation with weekly cisplatin (30-40 mg/m 2 ), or sequential chemoradiation with cisplatin (60-75 mg/m 2 ) plus paclitaxel (135-175 mg/m 2 ) in 21 day cycles, given 2 cycles before and 2 cycles after radiotherapy respectively. The primary outcome was the rate of disease-free survival at 3 years. Results: A total of 1,048 patients were included in the study (350, radiation alone; 345, concurrent chemoradiation; and 353, sequential chemoradiation). Overall, the median follow-up was 56 months and the median age of patients was 48 years. Most patients (75%) had stage IB1 or IIA1 disease. The three groups were similar with respect to histologic subtypes, the rate of lymphovascular invasion, parametrial, surgical margin and deep stromal involvement, tumor grade, rate of use of minimally invasive surgery, and neoadjuvant chemotherapy, except for lymph-node involvement that was lowest in radiation alone arm. In the intention-to-treat population, sequential chemoradiation was associated with a higher rate of disease-free survival than radiation alone (3-year rate, 90·0% vs. 82·0%; HR 0·52; 95% CI, 0·35 to 0·76) and concurrent chemoradiation (90·0% vs. 85·0%; HR 0·65; 95% CI, 0·44 to 0·96), differences remained after adjustment for lymph-node involvement. Sequential chemoradiation was also associated with a higher rate of overall survival than radiation alone (5-year rate, 92·0% vs. 88·0%; HR for death from cancer, 0·58; 95% CI, 0·35 to 0·95). However, neither disease-free survival nor cancer death risk was different between patients treated with concurrent chemoradiation or radiation alone. Conclusions: In this trial, sequential chemoradiation, rather than concurrent chemoradiation, resulted in a higher disease-free survival and lower risk of cancer death than radiation alone among women with early-stage cervical cancer after radical surgery. Clinical trial information: NCT00806117.
输尿管镜下双频激光碎石术临床分析
Authors: 袁涛, 廖国强, 姜启全, 桂亚平, 卞崔冬, 章劲夫, 王天如
Journal: BMJ (2006)

回顾性分析268例输尿管结石行输尿管镜下双频激光碎石术治疗患者的临床资料.268例中,上段结石73例,中段结石31例,下段结石164例,双侧结石11例,单次治疗成功率为92.9%(249/268).手术时间15～95 min,平均30 min.术后除出现不同程度血尿外,无严重并发症.术后平均住院时间3.5 d.结果说明,输尿管镜下双频双脉冲激光碎石术治疗输尿管结石高效、安全、微创,是目前治疗输尿管结石的理想方法,可作为输尿管中下段结石首选的疗法。
Effect of antithrombotic strategies on cerebrovascular events in aged patients with atrial fibrillation
Authors: Jing Li, Jing Shi, Wenbin Wu, Ji Shen
Journal: BMJ (2019)

Objective
To investigate the effect of antithrombotic strategies on cerebrovascular events in aged patients with nonvalvular artial fibrillation(nvAF).


Methods
The clinic data of 101 patients aged 80 years and over with nvAF admitted from January 2005 to June 2016 were retrospectively analyzed. The stroke and transient ischemic attack (TIA) occurred in 29 patients (28.7%, stroke/TIA group) and the remaining 72 patients were assigned in non-stroke/TIA group. The antithrombotic schemes and the antithrombotic drug-related bleeding were compared between two groups.


Results
Among 101 patients, there were 70 cases receiving antiplatelet therapy, 19 cases receiving anticoagulation therapy and 12 cases receiving no antithrombotic therapy. The nvAF history was longer in the stroke/TIA group than that in non-stroke/TIA group [15.0(8.0,17.5) vs. 6.0(3.0,12.8),Z=-3.645,P<0.01]; the proportion of anticoagulation therapy was higher in non-stroke/TIA group than that in stroke/TIA group (18/72 vs. 1/29,χ2=5.778,P<0.01). The occurrence of medication-related bleeding was 15.6%(14/90) in patients with antiplatelet therapy and 12.0%(3/25) in patients with anticoagulation therapy (χ2=0.196, P=0.658).There was no significant difference in the first time of stroke/TIA attack among patients with different antithrombotic schemes(χ2=0.859, P=0.651).


Conclusion
The aged patients with nvAF are in a high risk of thromboembolism, but the proportion of using antithrombotic therapy is low. Anticoagulation therapy has a protective effect against the occurrence of stoke/TIA without increasing the risk of bleeding, which makes anticoagulation therapy advisable in the elderly patients.


Key words: 
Atrial fibrillation; Stroke; Anticoagulants
シェーグレン症候群,気管支拡張症に合併したAustrian Syndromeの1例
Authors: 本田健, 平野能文, 公受伸之, 石橋豊, 徳丸睦, 小谷暢啓, 菅森峰, 國澤良嗣, 高橋伸幸, 坂根健志, 佐藤秀俊, 吉冨裕之, 若林景子, 安達和子, 島田俊夫
Journal: Circulation (2007)
Venous thromboembolic events in glioblastoma patients: Common complication but not a major reason for death.
Authors: Dorothee Gramatzki, Amanda Eisele, Katharina Seystahl, Emilie Le Rhun, Elisabeth Jane Rushing, Patrick Roth, Rolf A. Stahel, Michael Weller
Journal: Journal of Clinical Oncology (2020)

e14530 Background: Venous thromboembolic events (VTE) are a major complication in cancer patients. Anticoagulant use is the appropriate treatment for acute VTE in cancer patients, although associated with increased risk for bleeding, especially in brain tumor patients. In glioblastoma patients it remains unclear whether occurrence of VTE is associated with survival and to what extent thromboprophylaxis is necessary and efficient. Methods: Frequency, risk factors, and treatment of VTE as well as its complications were assessed in an epidemiological glioblastoma cohort in the Canton of Zurich, Switzerland, in the years 2005 to 2014. Association of clinical data with survival were retrospectively analyzed using the log rank test. Results: Four-hundred-nineteen patients diagnosed with isocitrate dehydrogenase wildtype glioblastoma were identified in the 10-year time-frame. Median overall survival (OS) was 12.4 months (95% CI 11.4-13.4) with a median follow up of 64.5 months (95% CI 46.6-82.4).VTE were seen in 65 patients (15.7%; 5 patients with missing information on VTE).Median time from diagnosis of glioblastoma to occurrence of VTE was 2.0 months (95% CI 0.8-3.1). A history of VTE was found in 6 patients (9.2%). Thirty-nine patients were on steroids (62.5%; 1 patient with missing data) at time of diagnosis of VTE, and 35 patients (56%; 3 patients with missing data) had a Karnofsky Performance Score of less than 70%. At the time patients were diagnosed with VTE the majority of patients (93.8%) were treated with therapeutic anticoagulation. Complications resulting in stop of anticoagulation occurred in 11 patients (18.0%; 4 patients had no anticoagulation) mainly because of intracranial bleedings (9 patients). OS was not different (p = 0.355) between patients who were diagnosed with VTE and those who were not. Tumor progression (283 patients, 77.3%) was the major reason for death (366 patients with confirmed death) in this patient cohort, only 3 patients (0.8%) died because of confirmed VTE and another 5 patients (1.4%) had an unexpected sudden death. Conclusions: Although VTE was identified in 65 patients (16%) diagnosed with glioblastoma, VTE was no major reason for death. On a population-based level these data do not support the implementation of primary thromboprophylaxis in this cohort of patients.
Impact of carbon dioxide pneumoperitoneum on laparoseopic cholecystectomy for patients with chronic renal failure
Authors: Hui-zhong Yuan, Yan-sheng Cao, Chun-hua Yu, Jian Cheng, Fang Xie, Wei-ming Mo
Journal: BMJ (2008)

Fifteen patients with chronic renal failure(CRF)underwent laparoscopic cholecystectomy(LC)at carbon dioxide(CO2)pneumoperitoneum pressure of 10-12 mm Hg(Group A,n=9)or 13-15 mm Hg(Group B,n=6).Renal function and urinary volume(UV)of Group A showed no remarkable change following the operation.But in Group B,the levels of blood urine nitrogen(BUN)and serum creatine(Scr)were increased significantly,and creatinine clearance rate(Ccr)and UV were remarkably decreased(P＜0.05).These variants gradually retumed tO the preoperative levels after 1 week.The analysis showed that laparoscopic choleeystectomy at CO2 pneumoperitoneum pressure of 10-12 mm Hg in CRF patients might be safe.Higher CO2 pneumoperitoneum pressure could result in reversible renal Email:yuanhuizhong2000@yahoo.com.cnfunction change.

Key words: 
Renal failure,chronic; Pneumoperitoneum,artificial
Activity of decitabine as maintenance therapy in core binding factor acute myeloid leukemia.
Authors: Mahran Shoukier, Hagop M. Kantarjian, Guillermo Garcia-Manero, Keyur P. Patel, Tapan M. Kadia, Farhad Ravandi, Maro Ohanian, Naval Guastad Daver, Ghayas C. Issa, Jeffrey Aldrich, Gautam Borthakur
Journal: Journal of Clinical Oncology (2020)

7522 Background: Real-time quantitative (RTPCR) based minimal residual disease (MRD) monitoring provides prognostic information in core binding factor acute myeloid leukemia (CBF-AML). Earlier we reported on the activity of decitabine (DAC) as maintenance therapy in a smaller cohort of patients with CBF AML. Methods: We have summarized the results in patients (pts) with CBF who received DAC maintenance for persistent RTPCR positivity or because of inability to complete all planned consolidation in a fludarabine, GCSF, cytarabine (FLAG) based regimen. The planned number of DAC cycles was 12 but could be adjusted at the discretion of the treating physician based on RTPCR response. Serial RTPCR was obtained approximately every 2-3 months. Results: Thirty-four pts with CBF-AML [t(8;21)=14 and inv(16)=20] received DAC as maintenance. Eighteen pts (53%) completed a full course (7 cycles) of FLAG based regimen before DAC for persistent PCR positivity (group 1). Sixteen pts (47%) were switched to DAC as they did not complete planned consolidation (group 2). In group 2, 9 pts (56%) had negative PCR (group 2A) and 7 pts (46%) had positive PCR (group 2B) prior to starting DAC. Patient characteristics are summarized in table. The median follow up was 59.2 [15.4-107.2] and 32.47 [8.5-86.3] months for group 1 and 2, respectively. In Group 1 and group 2A only 1 patient each had relapse, while 5 pts (72%) from group 2B had relapse. All the patients in group 2B with relapse were at suboptimal RTPCR response (&gt;0.1%). Conclusions: Our study shows DAC is an effective maintenance for CBF-AML pts who have persistent PCR positively after FLAG based induction consolidation and those unable to tolerate a full course, but have negative PCR. However patients with high levels of MRD persistence should be considered for stem cell transplant. [Table: see text]
Pre- versus postoperative CAPOX plus bevacizumab (CAPOX-Bev) for resectable liver metastases from colorectal cancer (CLM): A randomized phase II/III trial (HiSCO-01).
Authors: Yuji Takakura, Katsunori Shinozaki, Satoshi Ikeda, Hiroyuki Egi, Yuzo Hirata, Manabu Shimomura, Takafumi Oshiro, Takao Hinoi, Daisuke Sumitani, Masahiro Nakahara, Masanori Yoshimitsu, Naruhiko Honmyo, Tsuyoshi Kobayashi, Hideki Ohdan
Journal: Journal of Clinical Oncology (2020)

4021 Background: The role of neoadjuvant chemotherapy, particularly for those with initially resectable CLM, is controversial. And the optimal regimen and duration to be used in the neoadjuvant setting is not established. We conducted prospective, multicenter, randomized phase II/III study to assess pre-operative 8 cycles of CAPOX-Bev (arm A) plus radical surgery compared with post-operative 8 cycles of CAPOX-Bev (arm B) for patients (pts) with resectable CLM. Methods: The primary endpoint in the Phase II was completion rate of protocol treatment (more than 6 cycles of CAPOX-Bev plus R0 surgical resection) and PFS in the Phase III. The secondary endpoints were OS, ORR (arm A), liver damage (arm A), safety. The Phase III part was terminated due to slow enrollment. Results: 81 pts were enrolled from 10 centers between November 2010 and November 2017. The full analysis set consisted of 76 pts who started protocol treatment (arm A 37 vs. arm B 39). 76 pts had the following characteristics: median age 66 (27-80), median number of liver metastases 2 (1-14), 69.7% male, 67.1% synchronous and 94.7% primary resected. Completion rate of protocol treatment was 89.2% in arm A and 71.8% in arm B (p = .06). ORR was 63.9%, including 2 pts who had pathologically complete response (5.6%). Only 1 pts in arm A could not undergo surgery due to progression of disease. In the chemotherapy safety population, arm B was associated with more grade 3 neutropenia and grade 3 gastrointestinal disorder than arm A. The most frequent surgical adverse event was biliary fistula, with an incidence of 0% in arm A and 10.3% in arm B (p = .02). No patient died from treatment-related adverse events. The median follow-up time was 40 months. The rate of PFS at 3 years was 32.2% in arm A versus 38.5% in arm B (p = .99). Conclusions: Pre-operative 8 cycles of CAPOX-Bev is compatible with radical surgery, but may have no impact on progression-free survival compared with post-operative chemotherapy. Clinical trial information: UMIN000003783 .
RELAY+: Exploratory study of ramucirumab plus gefitinib in untreated patients (pts) with <i>epidermal growth factor receptor</i> (<i>EGFR</i>)-mutated metastatic non-small cell lung cancer (NSCLC).
Authors: Makoto Nishio, Kazuto Nishio, Martin Reck, Edward B. Garon, Fumio Imamura, Tomoya Kawaguchi, Hiroyuki Yamaguchi, Satoshi Ikeda, Katsuya Hirano, Carla M Visseren-Grul, Ryan C Widau, Annamaria H. Zimmermann, Gosuke Homma, Sotaro Enatsu, Kazuhiko Nakagawa
Journal: Journal of Clinical Oncology (2020)

9564 Background: The phase III randomized part of the RELAY study (Part B; RELAY; NCT02411448) showed a significant improvement in progression-free survival (PFS) for ramucirumab (RAM) plus erlotinib (ERL) vs placebo plus ERL in 449 untreated pts with EGFR-mutated metastatic NSCLC (median PFS: 19.4 vs 12.4 months; stratified hazard ratio: 0.59, 95% CI: 0.46–0.76, p&lt;0.0001; 1-year PFS rate: 71.9% vs 50.7%). Here we report initial results from RELAY+ (additional cohort of RELAY; Part C), an open-label, single-arm, exploratory study evaluating RAM plus gefitinib (GEF) in East Asian pts. Methods: Previously untreated East Asian pts with metastatic NSCLC and EGFR exon 19 deletions (Ex19del) or exon 21 substitution mutation (Ex21.L858R) received RAM (10 mg/kg Q2W) plus GEF (250 mg/day) until disease progression or unacceptable toxicity. The 1-year PFS rate (primary endpoint, assuming a 1-year PFS rate of 55% for RAM+GEF), tumor response, biomarkers, and safety were assessed. EGFR T790M status (baseline/30-day follow-up) was assessed in liquid biopsy samples by Guardant360 NGS. Results: In total, 82 pts were enrolled (Japan: 68; Taiwan: 8; Korea: 6); 65.9% were female, 65.9% were never-smokers, and 43.9% had Ex19del. With median follow-up of 13.8 months (range: 2.6–20.2; censoring rate: 58.5%), the overall 1-year PFS rate (95% CI) was 65.0% (52.4–75.1), 67.2% (48.6–80.3) in pts with Ex19del (n=36), and 63.4% (45.0–77.1) in pts with Ex21.L858R (n=46). The objective response rate was 70.7% (95% CI: 59.6–80.3), disease control rate was 98.8% (95% CI: 93.4–100.0), and duration of response was immature at this point in time with a censoring rate of 56.9% where the median point estimate was 13.6 months (95% CI: 11.1–18.2). Post-progression EGFR T790M was seen in 7 of 9 (78%; 95% CI: 45.3–93.7) pts with 30-day follow-up NGS results in which EGFR activating mutation was detected. Grade ≥3 treatment-emergent adverse events reported in &gt;5% of pts were ALT increased (23.2%), hypertension (22.0%), and AST increased (12.2%). Conclusions: With a 1-year PFS rate of 65.0%, the primary endpoint of RELAY+ was met. The efficacy of RAM+GEF in RELAY+ was similar to that of RAM+ERL in RELAY, and the safety profile of the combination was similar to that of the individual drugs. Clinical trial information: NCT02411448 .
Practice and exploration of the model of general practice alliance in general hospital
Authors: Juanjuan Liu, Xiancheng Zhu, Jingjing Ren
Journal: BMJ (2019)

The article introduces the implementation of the general practice alliance model in the First Affiliated Hospital of Zhejiang University School of Medicine. Based on the high-quality resources of a tertiary university hospital the general practice alliance has upgraded the clinical, research and teaching abilities of primary care and promoted two-way referral system. Our experience shows that the alliance would improve the effectiveness of health care system and facilitate to form a rational medical service ecosystem.


Key words: 
General medical alliance; Practice; Exploration
Abstract 13625: Meta- Analysis of Lowering Apolipoprotein B With Mortality and Cardiovascular Outcomes Across Various Lipid Lowering Therapies
Authors: Safi U Khan, Muhammad U Khan, Shahul Valavoor, Muhammad S Khan, Victor Okunrintemi, Mamas A Mamas, Thorsten M Leuker, Michael J Blaha, Erin D Michos
Journal: Circulation (2019)

Introduction: Apolipoprotein B (apoB) concentration is reflective of the total burden of atherogenic lipoprotein particles, including low-density lipoprotein (LDL). Hypothesis: Association between ...
Novel biological therapies for systemic lupus erythematosus
Authors: 刘湘源, 李胜光, 黄烽
Journal: BMJ (2006)

系统性红斑狼疮(SLE)是一种常见的、以多脏器损害为主的自身免疫性疾病.从20世纪50年代应用糖皮质激素及70年代应用免疫抑制剂以来,SLE患者的预后得到较大改善,但仍有相当一部分患者对常规治疗无效.近年来的研究显示,新的生物制剂治疗SLE具有广阔的应用前景.生物制剂就是主要作用于巨噬细胞、T淋巴细胞及B淋巴细胞等相互作用的某些环节,以阻断免疫反应继续并发挥疗效的一类产品,其品种繁多,目前治疗SLE的生物制剂主要是针对下列环节:①阻断或降低致病性自身抗体的产生;②阻止致病性自身抗体与靶组织的结合及其与免疫复合物在靶组织的沉积;③抑制免疫复合物引起的炎症反应。
Clinical reasoning of internal medicine in Gastroenterology
Authors: 钱家鸣, 吴东
Journal: BMJ (2010)

消化疾病是内科的常见病,消化病学是内科学的重要分支.随着影像和内镜技术的不断发展,消化科已成为一个具有鲜明特色,而又与大内科密切联系的三级临床学科.有些读者也许会问,既然已经成了一门专科,消化医生只需要掌握本专业的知识和技能就足够了,为什么还要强调大内科临床思维?大内科思维对于消化疾病的诊治究竟有何价值?
Abstract 16227: Does Smoker’s Paradox Exist in Resuscitated Patients With and Without Coronary Artery Disease?
Authors: Eisuke Kagawa, Keigo Dote, Masaya Kato, Shota Sasaki, Noboru Oda, Eiji Kunita, Michiaki Nagai
Journal: Circulation (2017)

Introduction: Smoking status is well known to affect the prognosis of patients with acute coronary syndrome (ACS), such as the smoker’s paradox that current smokers have better prognosis than non-s...