tbuckley/cabot-search huggingface dataset:
Standard-dose salvage chemotherapy in patients with refractory metastatic germ-cell tumors (mGCT) progressing after high-dose chemotherapy (HDCT) and peripheral-blood stem-cell transplant (PBSCT).
Authors: Vaibhav Agrawal, Sandra K. Althouse, Nasser H. Hanna, Lawrence H. Einhorn, Nabil Adra
Journal: Journal of Clinical Oncology (2020)

e17061 Background: About 40% of patients with relapsed GCT will progress after HDCT and PBSCT and are generally incurable with further standard dose chemotherapy. We previously evaluated standard dose cisplatin combination chemotherapy in 15 patients following progression from HDCT and observed only a single brief PR ( JCO 18(6), 1181-1186.). We report results of non-platinum standard-dose chemotherapy regimens in refractory mGCT. Methods: Pts with mGCT who progressed after HDCT+PBSCT at Indiana University from 2004-2019 were evaluated. Kaplan-Meier methods and log-rank tests were used to analyze PFS and OS for the regimen directly following HDCT. Results: 78 pts with refractory mGCT were reviewed. 64 pts. (82%) received paclitaxel+gemcitabine (TG), 10 pts. (13%) received daily oral etoposide (E), and 4 pts. (5%) received oxaliplatin-based (O) regimens (oxaliplatin+gemcitabine or oxaliplatin+bevacizumab). Median age was 29 (range, 16-57). Primary site was testis in 62, retroperitoneum in 6, mediastinum in 9. Metastatic sites included retroperitoneal LNs (62), pulmonary (58), liver (23), bone (6), and brain (21). IGCCCG risk was good in 16, intermediate in 5, and poor in 57. HDCT was utilized as 2 nd line setting in 72 pts, and ≥3 rd line in 6 pts. Median time from HDCT to progression was 4 months (upper limit 16.6 months). PS and OS data is shown in the table, with superior outcomes in TG compared to O and E (p &lt; 0.001). Maintenance oral etoposide after HDCT was administered in 44% (n = 28) of all patients who later progressed and received TG. Among 12 patients (19%) with 12-month PFS on TG, the median overall PFS was 18.3 months with 2 patients alive at the time of last follow-up. The primary site was testis in 11 patients, 67% (n = 8) were platinum refractory, and 83% (n = 10) were IGCCCG poor risk. 10 patients achieved a PR to TG, and two patients achieved CR. Conclusions: Salvage standard-dose chemotherapy with paclitaxel+gemcitabine after progression on HDCT is superior to oral etoposide or oxaliplatin-based regimens and should be the preferred regimen in patients with refractory mGCT. [Table: see text]
Diabetes, plasma glucose and incidence of colorectal cancer in Chinese adults: a prospective study of 0.5 million people
Authors: Pang Yuanjie, Kartsonaki Christiana, Guo Yu, Chen Yiping, Yang Ling, Bian Zheng, Bragg Fiona, Millwood Iona Y, Shen Leijia, Zhou Songgen, Liu Jiben, Chen Junshi, Li Liming, Holmes Michael, Chen Zhengming, 霍永丰
Journal: BMJ (2019)

背景
糖尿病可致结直肠癌（CRC）的发病风险升高。糖尿病病程和非糖尿病患者的血糖与CRC发病风险之间的相关性仍不清楚。


方法
2004至2008年前瞻性中国Kadoorie Biobank研究从10个不同地区纳入了512 713名受试者。在10年随访期间，在基线无癌症史的510 136名受试者中共记录有3 024例新发CRC病例（1 745例结肠癌，1 716例直肠癌）。应用Cox回归分析对糖尿病（入组前诊断或筛查发现的）或无糖尿病病史者随机血糖（RPG）水平与CRC发病相关性的校正风险比(HR)进行估计。


结果
基线时，共有5.8%的受试者患有糖尿病。糖尿病患者发生CRC的校正HR为1.18（95%可信区间1.04~1.33），且发生结肠癌与直肠癌的风险相当[1.19(1.01~1.39)比1.14(0.96~1.35)]。这些患者发生CRC的HR随糖尿病病程的延长而下降（趋势P值为0.03）。在入组前无糖尿病的受试者中，其RPG水平与CRC发病呈正相关，基线RPG每升高1 mmol/L其发生CRC的校正HR为1.04（1.02~1.05），且发生结肠癌与直肠癌的风险亦相当[1.03（1.01~1.05）比1.04（1.02~1.06）]。在男性中，糖尿病和RPG与CRC发病风险的相关性高于女性，但其差异无统计学意义（异质性检验的P值分别为0.3和0.2）。


讨论
在中国成年人中，未诊断糖尿病者其糖尿病和升高的血糖水平与CRC发病风险升高相关。
白细胞疾病
Authors: 吴东, 陈嘉林, 庄俊玲
Journal: BMJ (2012)

一、白细胞(WBC)升高未必是感染,感染时WBC未必升高血液中的WBC包括中性粒细胞、单核细胞、淋巴细胞、嗜酸性粒细胞、嗜碱性粒细胞.各类WBC的生理功能有所区别,不同疾病可引起不同类型的WBC数量发生变化.临床常用血WBC总数升高(主要是中性粒细胞升高)来判断感染存在,但二者关系并不绝对.WBC升高还见于很多非感染性炎症疾病,例如急性胰腺炎、烧伤、吸入性肺炎,还可见于非炎症性疾病,包括剧烈运动、中暑、急性失血等.某些药物也可造成WBC升高,例如糖皮质激素、儿茶酚胺等。
Immune checkpoint inhibitor toxicity and associated outcomes in a geriatric population.
Authors: Peter James Polewski, Yacki Hayashi-Tanner, Mamatha Gaddam, Nancy R Fisher, Attila J Kovacs, David E. Marinier
Journal: Journal of Clinical Oncology (2020)

e24014 Background: Increased use of immune checkpoint inhibitor (ICI) therapy over various cancer types has resulted in a parallel rise in immune-related adverse events (irAEs). There is limited data with regards to understanding irAEs in the elderly population despite its widespread use. We aimed to investigate irAEs in elderly patients receiving checkpoint inhibitor immunotherapy in a community oncology practice setting. Methods: Our retrospective study included patients ≥65 years old treated at a community oncology practice setting from January 1, 2011 through September 30, 2019 who received at least one treatment of a PD-1 or PDL-1 inhibitor (PDI) and/or CTLA-4 checkpoint inhibitor. We evaluated the prevalence of irAEs, determined if age, class of ICI, or oncologic response (clinical and radiographic) was associated with higher grades of irAE. The impact of irAEs on progression-free survival (PFS) and overall survival (OS) was also analyzed. Results: A total of 210 patients were identified, of which 76 developed irAEs. The overall mean age was 75.0 ± 7.2 years. Males accounted for 58% and the overall majority were Caucasian. The most common cancers were lung (56.7%), melanoma (20.0%) and genitourinary (14.8%). The prevalence of irAEs was 36.2% with a distribution of grades 1-2-3-4-5 being 31.6% - 43.4% - 17.1% - 6.6% and 1.3%, respectively. Hazard ratio adjusted for number of cycles for OS was 1.47 (95% CI, 0.98 to 2.19; p = 0.058) and PFS was 1.11 (95% CI, 0.72 to 1.71). Conclusions: To our knowledge, this is one of the few studies that has explored irAEs in the geriatric population. There was no association between ICI-associated higher-grade toxicities and oncologic response in our elderly population. Although there was a trend in OS, we found no statistical differences between elderly patients with irAEs and those without for OS and PFS. Further study is needed to explore the occurrence irAEs in the elderly to improve management of these patients.
ENGOT-cx11/KEYNOTE-A18: A phase III, randomized, double-blind study of pembrolizumab with chemoradiotherapy in patients with high-risk locally advanced cervical cancer.
Authors: Domenica Lorusso, Nicoletta Colombo, Robert L. Coleman, Leslie M. Randall, Linda R. Duska, Yang Xiang, Kosei Hasegawa, Angelica Nogueira Rodrigues, David Cibula, Mansoor Raza Mirza, Benoit You, Ana Oaknin, Melissa Christiaens, Cagatay Taskiran, Elena Ioana Braicu, Jacob Korach, Christian Marth, Stephen Michael Keefe, Martina Puglisi, Sandro Pignata
Journal: Journal of Clinical Oncology (2020)

TPS6096 Background: High-risk locally advanced cervical cancer has a poor prognosis, and more than half of patients recur in 2 y. External beam radiotherapy (EBRT) with concurrent chemotherapy followed by brachytherapy is the standard of care for locally advanced cervical cancer. The immunostimulatory activity of the PD-1 inhibitor pembrolizumab (pembro) may be enhanced by concurrent chemoradiotherapy (CRT). After the KEYNOTE-158 study, in which pembro showed durable antitumor activity, pembro monotherapy was approved for patients with PD-L1–positive recurrent or metastatic cervical cancer who progressed during or after chemotherapy. ENGOT-cx11/KEYNOTE-A18 (NCT04221945) is a phase III, randomized, placebo-controlled study evaluating pembro with concurrent CRT for the treatment of locally advanced cervical cancer. Methods: Approximately 980 patients with high-risk (FIGO 2014 stage IB2-IIB with node-positive disease or stage III-IVA), locally advanced, histologically confirmed cervical cancer who have not received systemic therapy, immunotherapy, definitive surgery, or radiation will be randomized 1:1 to receive either 5 cycles of pembro 200 mg every 3 wk (Q3W) + CRT followed by 15 cycles of pembro 400 mg Q6W or 5 cycles of placebo Q3W + CRT followed by 15 cycles of placebo Q6W. The CRT regimen includes 5 cycles (with optional 6th dose) of cisplatin 40 mg/m 2 Q1W + EBRT followed by brachytherapy. Randomization is stratified by planned EBRT type (intensity-modulated radiotherapy [IMRT] or volumetric-modulated arc therapy [VMAT] vs non-IMRT or non-VMAT), cancer stage at screening (stage IB2-IIB vs III-IVA), and planned total radiotherapy dose. Treatment will continue until the patient has received 20 cycles of pembro (5 cycles 200 mg Q3W, 15 cycles 400 mg Q6W) vs placebo (~2 y) or until disease progression, unacceptable toxicity, or withdrawal. Primary endpoints are PFS per RECIST v1.1 by blinded independent central review and OS. Secondary endpoints are PFS at 2 y, OS at 3 y, complete response at 12 wk, ORR, PFS and OS in PD-L1–positive patients, EORTC QLQ-C30 and QLQ-CX24, and safety. Enrollment is ongoing. Clinical trial information: NCT04221945.
二甲双胍联合复方醋酸环丙孕酮治疗难治性多囊卵巢综合征的临床研究
Authors: 王秀萍, 谢玲
Journal: BMJ (2007)

多囊卵巢综合征(PCOS)以持续性无排卵和高雄激素血症为特征,是无排卵性不孕症最重要的原因之一.目前,越来越多的研究表明,PCOS患者无论肥胖与否,都存在不同程度的胰岛素抵抗,而且胰岛素水平和雄激素水平呈正相关.口服避孕药能抑制促性腺激素分泌而减少卵巢雄激素的生成.本研究探讨应用胰岛素增敏剂二甲双胍联合复方醋酸环丙孕酮(达英-35)治疗克罗米酚耐药的PCOS患者,观察其雄激素及胰岛素水平的变化以及对排卵的改善情况。
Prospective validation of a machine learning algorithm to predict short-term mortality among outpatients with cancer.
Authors: Chris Manz, Corey Chivers, Manqing Liu, Susan B Regli, Sujatha Changolkar, Chalanda N. Evans, Charles A.L. Rareshide, Michael Draugelis, Jennifer Braun, Amol S. Navathe, Pallavi Kumar, Justin E. Bekelman, Mitesh S. Patel, Nina O'Connor, Lynn Mara Schuchter, Lawrence N. Shulman, Ravi Bharat Parikh
Journal: Journal of Clinical Oncology (2020)

2009 Background: Oncologists accurately identify only 35% of patients with cancer who will die in six months. There is an urgent need for automated, accurate prognostic systems to inform treatment and advance care planning in oncology. We assessed the prospective performance of a previously described ML algorithm (Parikh et al, JAMA Netw Open, 2019) to predict short-term mortality in a cohort of general oncology outpatients. Methods: Our prospective cohort consisted of patients aged ≥18 years who had a medical or gynecologic oncology encounter between March 1 and April 30, 2019 in either a tertiary academic practice or one of twelve community practices within a large academic cancer system. We used a retrospectively validated gradient-boosting ML algorithm, based on 559 structured electronic health record (EHR) variables, to predict 180-day mortality prior to each oncology encounter. For patients with multiple encounters, we selected the last encounter to assess performance. We assessed several performance metrics, including area under the receiver operating curve (AUC), area under the precision-recall curve (AUPRC), scaled Brier score (sBrier; a measure of calibration ranging from 0 [random] to 1 [perfect]), and positive predictive value (PPV). Results: Of 25,537 unique patients, median age was 64.4 (interquartile range 53.3 – 73.0), 76.8% were White, 56.5% were treated at a community center, and 4.1% died within 180 days. The ML algorithm had an AUC of 0.89 (95% confidence interval [CI] 0.88-0.90), AUPRC 0.34, and sBrier 0.29. At a prespecified threshold of 40%, observed 180-day mortality was 44.5% (95% CI 40.7 – 48.4%) in the high-risk group vs. 3.0% (95% CI 2.8% – 3.3%) in the low-risk group. There was an 85-fold difference in mortality (13.6% vs. 0.16%) in the top vs. bottom risk quartiles. The model was well-calibrated for mortality risks ≤40% and slightly under-calibrated for mortality risks &gt; 40%. Performance varied across cancer types in the tertiary hospital but did not vary by race or practice type (Table). Conclusions: In this prospective cohort study among outpatients with cancer, a ML prognostic algorithm based on EHR data had better discrimination and calibration that published cancer-specific models. This is one of the first ML prognostic models to be prospectively validated in oncology. [Table: see text]
Nasal vestibulitis: An MNCCTN natural history trial—Nasal vestibulitis symptoms associated with paclitaxel, docetaxel, and other chemotherapy agents.
Authors: Elizabeth Jane Cathcart-Rake, David Zahrieh, Deanne s. Smith, Susan Young, Eric G. Wolfe, Amanda O'Connor, Stephan Thome, Mario E. Lacouture, Terra Register, Jill Piens, Shaylene McCue, Charles L. Loprinzi
Journal: Journal of Clinical Oncology (2020)

e24086 Background: Nasal vestibulitis has been infrequently described as a side effect of cancer-directed therapy; however, a preliminary study reported that 71% of patients undergoing taxane chemotherapy experienced nasal vestibulitis symptoms. This natural history trial describes the incidence, characteristics, and severity of nasal vestibulitis symptoms among patients undergoing paclitaxel, docetaxel, and non-taxane chemotherapy. Methods: Eligible participants who reported baseline (prior to starting chemotherapy) nasal symptoms ≤ 2 on a 10-point scale were enrolled in this trial upon initiation of a new treatment regimen, involving paclitaxel or docetaxel, or non-taxane chemotherapy. Participants completed nasal symptom logs each time they received a dose of therapy until either the regimen was stopped or four months had passed. The proportion of patients reporting new nasal symptoms was estimated within each cohort with the 95% exact confidence interval (CI). A cumulative incidence model was utilized to quantify the incidence of treatment-emergent nasal symptoms within each cohort, while controlling for age, sex, smoking history, and history of asthma or allergies. Results: Thirty-five participants received paclitaxel, 21 received docetaxel, and 25 received other types of chemotherapy. 86.4% of participants were female, mean age was 60.2 ± 11.2 years; 93.8% of participants completed 2 or more surveys. A higher percentage of participants in the paclitaxel cohort experienced new nasal vestibulitis symptoms than participants in the other two cohorts. The percentage (95% CI) of participants with nasal symptoms, for patients receiving paclitaxel, docetaxel, and non-taxane chemotherapy were 74.3% (56.7%, 87.5%), 47.6% (25.7%, 70.2%), and 44.0% (24.4%, 65.1%), respectively. Epistaxis was reported by 60% of participants in the paclitaxel cohort. Paclitaxel-receiving participants also reported nasal dryness (48.6%), scabbing (40.0%), and pain (20.0%). Nearly half of participants reported moderate symptoms (4-7 out of a 10-point scale), with 8.6% reporting symptoms as severe (8-10 on a 10-point scale). Conclusions: Nasal vestibulitis is a common side effect of chemotherapy, especially paclitaxel chemotherapy.
Cost-effectiveness analysis of clinical pathway for different TOAST subtypes of patients with acute cerebral infarction
Authors: Xian-xian Zhang, Lu Xiao, Qiong Yi, Lan-lan Chen, Yan Zhu, Jian Wu, Long Yu
Journal: BMJ (2013)

Objective
To evaluate the cost-effectiveness of clinical pathway for different Trial of Org 10172 in Acute Stroke Treatment (TOAST) subtypes of patients with acute cerebral infarction (ACI).


Methods
ACI clinical pathway was developed according to the characteristics of our hospital. A total of 1036 ACI patients were recruited. They were divided into control (n=472) and pathway (n=564) groups. The hospitalization time, hospitalization expenses and clinical outcomes between two groups of different TOAST subtypes were compared. Good clinical outcome was defined as a modified Rankin Score (mRS) of 0-2.


Results
Compared to control group, the lengths of stay for ACI patients in pathway group were significantly shorter (P=0.004) while those with good clinical outcomes were significantly higher (P=0.002). Furthermore, the lengths of stay for large artery atherosclerosis (LAA) subtype patients in pathway group were shorter (P=0.000), both total hospital charges and medication costs were significantly reduced (P=0.044, 0.036) while those with good clinical outcome were significantly higher (P=0.002); the differences among other four subtypes of small artery occlusion (SAO), cardioembolism (CE), stroke of other etiology (SOE) and stroke of undetermined etiology (SUE) were not statistically significant.


Conclusion
The implementation of clinical pathway may offer more benefits to LAA subtype ACI patients than other subtypes.


Key words: 
Cerebrovascular Accident; Clinical pathways; Prognosis
IgA肾病红细胞免疫功能测定与肾小管间质病变研究
Authors: 张丽萍, 闫喆, 杨林, 傅淑霞
Journal: BMJ (2012)

对46例IgA肾病患者肾小管间质病变及相关细胞因子检测结果显示,随着肾小管间质病变逐渐加重,CD35活性水平越低,肾小管间质转化生长因子(TGF-β1)表达及尿β2微球蛋白活性水平越高(P＜0.05).红细胞免疫功能紊乱可能加重IgA肾病肾小管间质损害。
Effects of very-low-carbohydrate diet on body and function index in overweight or obese subjects
Authors: Huanli Jiao, Qing Zhang
Journal: BMJ (2015)

Objective
To assess the effects of very-low-carbohydrate diet (VLCD) on body function and body composition in obese or overweight subjects.


Methods
Thirty five overweight or obese subjects were enrolled in the study, including 10 males and 25 females with a mean age of (43±10) years.All subjects received VLCD intervention and 30 min moderate-intensity exercise daily for 3 months.The height, weight, blood pressure, heart rate, blood lipids and body composition were measured before and 1, 3 months after intervention.ANOVA or nonparametric test was used for statistical analysis.


Results
After 3-month intervention, compared to baseline, the average body weight was decreased by 17.2 and 5.9 kg, waist circumference was decreased by 15.1 and 4.5 cm, BMI index decreased by 4.3 and 3.4 kg/cm2, waist to hip ratio was decreased by 0.1 and 0.1, for males and females, respectively (F=11.65 and 5.28, 8.36 and 3.73, 9.28 and 12.06, 3.32 and 19.43, all P<0.05). Compared with the baseline, the systolic pressure was decreased by 12.2 and 9.2 mmHg(1 mmHg=0.133 kPa), triglycerides were decreased by 0.25 and 0.42 mmol/L, fasting blood glucose was decreased by 0.13 and 0.43 mmol/L after 1 month and 3 months of intervention, respectively.The proportion of patients with fatty liver was decreased from 69%(24/35) at baseline to 49%(17/35) at 1 month after intervention and further to 6%(2/32) at 3 months after intervention (χ2=27.52, P<0.05).


Conclusion
The results indicate that VLCD can effectively control the body weight, and significantly improve the state of body function disorder.


Key words: 
Obesity; Low carbohydrate diet; Blood glucose; Fatty liver
Clinical study of osteoporosis in patients with liver cirrhosis following hepatitis B virus infection
Authors: 王义国, 刘倩, 王文奇, 陈自平, 闫明先
Journal: BMJ (2006)

目的 探讨乙型肝炎肝硬化患者骨代谢异常的发病机制.方法用NM-300单光子骨密度测量系统检测61例乙型肝炎肝硬化患者的骨密度;抽取空腹血检测血清钙调节激素:1,25 二羟维生素D3[1,25(OH)2D3]、甲状旁腺素、降钙素、骨钙素、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、尿骨胶原交联水平.根据尺桡骨密度将肝硬化患者分为骨质疏松组和非骨质疏松组,分别与30例健康者的各项检测指标做对照.结果肝硬化组尺骨密度、桡骨密度、尺桡密度均较对照组明显降低;肝硬化组血清1,25(OH)2D3、骨钙素水平较对照组明显降低,其中骨质疏松组较非骨质疏松组降低更明显;尿骨胶原交联水平肝硬化组较对照组明显升高,其中骨质疏松组较非骨质疏松组升高更明显.对血清1,25(OH)2D3、骨钙素、尿骨胶原交联水平与尺桡密度进行了统计学处理,发现血清1,25(OH)2D3、骨钙素水平与尺桡密度呈正相关.骨质疏松组尿骨胶原交联水平与尺桡密度呈负相关,而与非骨质疏松组无相关性.肝硬化组血清IL-1β、IL-6、TNF-α水平较对照组明显升高,骨质疏松组较非骨质疏松组升高显著;肝硬化组IL-1β、IL-6、TNF-α水平与尺桡密度呈负相关;其中骨质疏松组较非骨质疏松组相关性更明显.结论乙型肝炎肝硬化患者存在骨形成减少和骨破坏过多两种因素,从而引起肝性骨病;在骨形成减弱的过程中1,25(OH)2D3起着主要作用,在骨吸收增强的过程中IL-1β、IL-6、TNF-α起着重要的作用.适当补充维生素D3、降低体内IL-1β、IL-6和TNF-α水平,对防治肝性骨病可能具有重要意义。
Clinical outcome of patients diagnosed with testicular sex cord stromal tumors.
Authors: Syed Abdullah Javaid Bukhari, Maira Iqbal Malik, Paul Hutton, Emilio Porfiri, Mariam Jafri
Journal: Journal of Clinical Oncology (2020)

e17055 Background: Testicular Sex Cord Stromal Tumors (TSCST) are rare representing approximately 5% of testicular cancers. Leydig Cell Tumours (LCT) constitute 1-3% of testicular tumours, occur commonly in third to sixth decade and are up to 50mm in diameter. Sertoli Cell Tumours(SCT) constitute less than 1%, occur commonly in the fourth decade and have an average diameter of 35mm. High-risk histological features include; tumour size, increased mitotic activity, pleomorphic nuclei, necrosis, vascular invasion and rete testis invasion. Management is surgical with no standard chemotherapy or radiotherapy in adjuvant or metastatic setting. Methods: A retrospective review of epidemiology, radiological staging, histopathological features, relapse rate and treatment in 82 patients diagnosed with TSCST between 4/12/2001 -27/12/2018 at a tertiary referral centre. Results: 2,170 testicular cancer patients were diagnosed in this period of whom 82 patients (3.8%) had TSCST. 65 patients (2.9% ) had LCT,13 patients (0.59%) had SCT, 3 patients had Unclassified SCST and 1 patient had Mixed SCST. Median patient age for LCT was 43 years, SCT was 29 years, unclassified SCST was 46 years and for mixed SCST was 49 years (age range of TSCST was 18 - 82 years). Median size of LCT was 11mm (range 4 – 28 mm) in 43 patients and of SCT was 16mm (range 7 – 60mm) in 10 patients. 79 patients (3.6% ) presented with stage 1 disease. One patient with LCT and 4 high risk histological features on initial diagnosis had local retroperitoneal recurrence 4 years later and underwent surgical resection with 1year distant disease-free survival. On distant relapse, he was treated with mitotane. One patient presented with metastatic SCT with 4 histological high risk features. He was treated with carboplatin and etoposide. Median survival in the metastatic disease was 10.5 months. Conclusions: TSCST have an excellent prognosis with over 98% of patients are free of disease post-surgery. Our relapse rate is 1.2% which is lower than previously reported and is confined to patients with high risk features. Metastatic LCT and SCT are resistant to chemotherapy with poor survival.
抗癫痫药高敏综合征诊治文献综述
Authors: 杨勇, 沙悦, 黄程锦, 黄晓明
Journal: BMJ (2009)

抗癫痫药高敏综合征(anficonvulsant hypersensitivity syndrome,AHS)是一种由抗癫痫药物所致的与药物剂量无关的严重不良反应.早在1930年乙内酰脲刚被应用于临床时,就有几例皮疹、发热、嗜酸细胞增多等关于药物不良反应的报道。
Synthesis and characterization of nanoemulsion-mediated core crosslinked nanoparticles, and in vivo pharmacokinetics depending on the structural characteristics
Authors: Jun Matsuno, Takuma Kanamaru, Koichi Arai, Rena Tanaka, Ji Ha Lee, Rintaro Takahashi, Kazuo Sakurai, Shota Fujii
Journal: Journal of Controlled Release (2020)
The Emerging Role of Convalescent Plasma in the Treatment of COVID‐19
Authors: Theodora Psaltopoulou, Theodoros N. Sergentanis, Vasiliki Pappa, Marianna Politou, Evangelos Terpos, Sotirios Tsiodras, George N. Pavlakis, Meletios A. Dimopoulos
Journal: HemaSphere (2020)

Various agents are currently under evaluation as potential treatments in the fight against coronavirus disease 2019 (COVID-19). Plasma from patients that have overcome COVID-19 infection, referred to as convalescent plasma, is a treatment option with considerable background in viral diseases such as Spanish influenza, H1N1, Ebola, Severe Acute Respiratory Syndrome (SARS), and Middle East Respiratory Syndrome (MERS). Although convalescent plasma has historically proven beneficial in the treatment of some viral diseases, its use is still explorative in the context of COVID-19. To date, preliminary evidence from case series is favorable as significant clinical, biochemical improvement and hospital discharge have been reported. A detailed overview of randomized as well non-randomized trials of treatment with convalescent plasma, which have been registered worldwide, is provided in this review. Based on these studies, data from thousands of patients is anticipated in the near future. Convalescent plasma seems to be a safe option, but potential risks such as transfusion-related acute lung injury and antibody-dependent enhancement are discussed. Authorities including the Food and Drug Administration (FDA), and scientific associations such as the International Society of Blood Transfusion (ISBT) and the European Blood Alliance (EBA), have provided guidance into the selection criteria for donors and recipients. A debatable, pivotal issue pertains to the optimal timing of convalescent plasma transfusion. This treatment should be administered as early as possible to maximize efficacy, but at the same time be reserved for severe cases. Emerging risk stratification algorithms integrating clinical and biochemical markers to trace the cases at risk of significant deterioration can prove valuable in this direction.