tbuckley/cabot-search huggingface dataset:
Gender differences in faculty rank and subspecialty choice in academic medical oncology.
Authors: Laura Graham, Ali Raza Khaki, Alexandra Sokolova, Nancy E. Davidson
Journal: Journal of Clinical Oncology (2020)

11013 Background: The gender gap in the United States healthcare field has been closing. In 2000 women made up 45% of medical school matriculants and by 2017 outnumbered men. Based on our personal observations at academic meetings, however, we hypothesized that gender differences persist in faculty rank and subspecialty choice in academic medical oncology. Methods: We created a database of medical oncologists at the top 15 cancer centers as ranked by the U.S News and World Report in 2019. We identified all medical oncology faculty in the subspecialty fields of breast, gastrointestinal (GI), genitourinary (GU) and thoracic oncology from institution websites (12/2019-1/2020). Faculty working only at satellite clinics (i.e. non-research appointments), and the few faculty in more than one subspecialty group, were excluded. Gender (determined by pictures), subspecialty and academic rank were recorded based on data from institution websites and professional social networking sites. Proportions of men and women in each subspecialty and at each faculty rank were calculated; odds ratios (OR) and χ 2 tests were used for comparisons. Results: 346 men and 244 women were identified as subspecialty medical oncologists, comprising 59% and 41% of faculty members, respectively. Gender representation by subspecialty and academic rank are shown in the Table. Breast oncology had more women oncologists than men (OR 2.9, p &lt; 0.001); GU oncology had fewer women (OR 0.3, p &lt; 0.001). The representation of women and men was comparable at the lower academic ranks (instructor, assistant and associate professors). But at the top rank of full professor, only 31% were women (OR 0.54, p = 0.001). Notably, even in breast oncology, the one subspecialty with a greater proportion of women, women still comprised a lower proportion of full professors than men. Conclusions: Gender differences persist in academic medical oncology. At the top 15 US cancer centers, gender differences are seen in subspecialty representation, with more men in GU oncology and more women in breast oncology. Fewer women than men achieve the rank of full professor, even in breast oncology. Additional research is needed to explore the causes of, and contributors to, these differences as well as their impact. [Table: see text]
Comprehensive genomic profiling (CGP) in patients with relapsed/refractory germ cell tumors (GCT).
Authors: Reem Akel, Bilal Anouti, Sean Kern, Clint Cary, Timothy A. Masterson, Joseph M Jacob, Gennady Bratslavsky, Natalie Danziger, Dean Pavlick, Nasser H. Hanna, Lawrence H. Einhorn, Jeffrey S. Ross, Nabil Adra
Journal: Journal of Clinical Oncology (2020)

e17053 Background: Understanding the genetic alterations in patients with relapsed/refractory GCT (rrGCT) could delineate the pathogenesis of cisplatin resistance. Our study uses CGP to characterize genomic alterations (GA) in refractory GCT and correlate with clinical outcomes. Methods: 432 patients with rrGCT were seen at Indiana University between Jan 2016 to Sep 2019 of whom 52 patients underwent CGP using a hybrid-capture based commercial assay to evaluate all classes of GA. Tumor mutational burden (TMB) was determined on 1.1 Mbp of sequenced DNA and reported as mutations/Mb and microsatellite instability (MSI) was determined on 114 loci. PDL1 expression was determined by IHC (DAKO 22C3 antibody). Results: All patients relapsed after first-line cisplatin-based combination chemotherapy. Median age at diagnosis was 33 (range 15-68). Primary site of GCT was testicular in 85% and mediastinum in 8%. 6 patients had pure seminoma and 46 had non-seminoma. Platinum refractory disease, defined as serologic or radiographic progression within 4 weeks of first-line chemotherapy comprised 23% of patients. The primary tumor was used for sequencing in 6 cases (12%) and non-primary tumor metastatic site (lymph node, lung, liver, brain, omentum) in 46 cases (88%). The most common GA in the entire cohort were FGF6 (27%), FGF23 (27%), KDM5A (27%), CCND2 (27%), KRAS (18%), TP53 (14%), KIT (8%), APC (8%), ZNF217 (6%), MUTYH (6%), AURKA (6%), NRAS (6%), EGFR (6%), CTNNB1 (6%), GNAS (6%). Most common alterations for testicular primary tumors were FGF6, FGF23, KDM5A, CCND2, KRAS, TP53, KIT. For non-testicular primary GCT, most common GA were APC, TP53, EGFR. Most common GA for non-seminoma were FGF6, FGF23, KDM5A, CCND2, KRAS, TP53, APC. Most common GA for pure seminoma was KIT. Potentially targetable genomic alterations were found in 17 patients (33%). 10 of 17 patients (59%) tested had PDL1 score ≥1% and 3 patients had PDL1 ≥50%. Median TMB was 3.5 mutations/MB. There were 4 patients (8%) with TMB ≥ 10 mutations/Mb and 2 patients (4%) with TMB ≥ 20 mutations/Mb. 1 of 48 patients (2%) evaluated for MSI had MSI-High status. Isochromosome 12p was detected in the majority of samples where it was tested. Outcomes with GA-directed therapy will be presented at the conference. Conclusions: CGP can reveal potential therapeutic targets in patients with rrGCT including EGFR, ERBB3, KIT, and MET. Consistent with reported clinical trials in rrGCT, biomarkers predicting response to immune checkpoint blockade are uncommon with most patients having low TMB, absence of MSI-H status, and low expression of PDL1.
青霉素迟发过敏性休克一例
Authors: 高连礼, 王可崇
Journal: BMJ (2005)

患者男,40岁,入院诊断为右下肺炎.予生理盐水+青霉素800万U静脉滴注,每日1次.青霉素皮试阴性后,第1日输液过程无不良反应.第2日输液20 min后,患者烦躁不安,觉胸闷气短、呼吸困难、四肢发凉,立即停止输液,测血压60/30 mm Hg(1 mm Hg=0.133 kPa),双肺可闻及哮鸣音,心音低钝.立即予吸氧,0.1%肾上腺素1 ml皮下注射,非那根12.5 mg肌内注射,5%葡萄糖液250 ml+地塞米松10 mg快速静脉滴注.30 min后患者恢复正常,复查血压125/75 mm Hg。
Recognition and prevention of peripheral arterial diseases
Authors: Qihong Ni, Lan Zhang
Journal: BMJ (2019)

外周动脉疾病是中老年人常见的血管外科疾病之一，主要由于动脉粥样硬化造成血管狭窄或闭塞，表现为间歇性跛行、静息痛、下肢溃疡甚至坏疽，严重者导致患者截肢甚至死亡。随着人口老龄化与饮食结构改变，近年来发病率逐年增高。通过患者症状、体征以及辅助检查早期识别该疾病并积极预防治疗，尤为重要。
Analysis of influencing factors leading to major birth defects in six counties of Shanxi province
Authors: Hong Zhang, Huan-xiao An
Journal: BMJ (2012)

To explore the influencing factors of major birth defects.The children of 0 -3 years and their mother from six different districts were surveyed from November 2009 to December 2009.The incidence rate was 134.27/10 000 (493/36 716)in 6 counties. And the first five birth defects were as follows:congenital heart disease,neural tube defects,cheilopalatognathus,polydactylia and hypophrenia.The risks and protective factors of the first 5 birth defects were different.Anamnesis of birth defects and defective children from relatives,multiple pregnancy & birth and intake of antipyretic analgesics during pregnancy were the common risk factor for the first 5 birth defects.The key points for the prevention of birth defects are to reinforce the pre-pregnancy guidance,the screening and evaluation of risk factors and disease prevention during pregnancy.

Key words: 
Birth defects;  Effecting factors
Real-world evidence: A retrospective-cohort study of castration-resistant advanced prostate cancer (CRAPC) patients treated with abiraterone 1000 mg or 250 mg.
Authors: Leonel Smolje, Dario Niewiadomski, Claudia Lorena Acuna, Cesar Gonzalez, Liliana D Gonzalez, Sandra L. Ares, Marcelo Muino, Carlos Garcia Gerardi, Ernesto Gil Deza, Eduardo L. Morgenfeld, Edgardo G. J. Rivarola, Felipe G. Gercovich
Journal: Journal of Clinical Oncology (2020)

e19315 Background: The efficacy of Abiraterone 250 mg with food was established ten years ago (Ryan JCO 2010). Recent publications (Szmulewitz JCO 2018) have concluded that 1000 mg on an empty stomach or 250 mg with food have similar results. This paper focuses on our experience with patients treated with either scheme at Instituto Oncológico Henry Moore (IOHM). Methods: Between July 2013 and December 2019, CRAPC patients were treated with Abiraterone 1000 mg on an empty stomach (Group A) or 250 mg with breakfast (Group B), according to the decision of the attending physician. Both groups received 5 mg of Prednisone twice a day. All cases from Group B were included and they were matched in a 1:2 ratio with Group A by two criteria: age at diagnosis and interval between diagnosis and Abiraterone. We studied: A) response rate of PSA at 12 weeks, B) time to progression, C) post-Abiraterone survival and D) overall survival. Results: We included 99 patients in the study: 66 in Group A and 33 in Group B. The table below shows population characteristics and results. Conclusions: 1) Abiraterone 1000 mg on an empty stomach or 250 mg with food both have similar outcomes. 2) In Argentina, the monthly cost of Abiraterone 1000 mg per patient is equivalent to USD 5,300. This cost can be reduced by 75% with Abiraterone 250 mg with food without losing efficacy. [Table: see text]
逆行交锁髓内钉治疗股骨远端骨折14例
Authors: 刘元朗, 祝少博
Journal: BMJ (2005)

自2000年2月至2003年10月,武汉市第十二医院采用逆行交锁髓内钉(GSHN)结合术后持续被动关节活动(continuous passive motion,CPM)功能锻炼治疗股骨远端骨折14例,疗效满意,现报告如下。
Circular RNA circSATB2 promotes progression of non-small cell lung cancer cells
Authors: Nan Zhang, Aruo Nan, Lijian Chen, Xin Li, Yangyang Jia, Miaoyun Qiu, Xin Dai, Hanyu Zhou, Jialu Zhu, Han Zhang, Yiguo Jiang
Journal: Molecular Cancer (2020)

Lung cancer has high morbidity and mortality worldwide with non-small cell lung cancer (NSCLC) accounting for 85% of the cases. Therapies for lung cancer have relatively poor outcomes and further improvements are required. Circular RNAs have been reported to participate in the occurrence and progression of cancer. Information on the functions and mechanism of circRNAs in lung cancer is limited and needs more exploration. We detected expression of genes and proteins by qPCR and western blot. Function of circSATB2 was investigated using RNA interference and overexpression assays. Location of circSATB2 was assessed by fluorescence in situ hybridization (FISH). Interaction of circSATB2, miR-326 and FSCN1 was confirmed by dual-luciferase reporter assay. Data from the investigation showed that circSATB2 was highly expressed in NSCLC cells and tissues. circSATB2 positively regulated fascin homolog 1, actin-bundling protein 1 (FSCN1) expression via miR-326 in lung cancer cells. Furthermore, circSATB2 can be transferred by exosomes and promote the proliferation, migration and invasion of NSCLC cells, as well as induce abnormal proliferation in normal human bronchial epithelial cells. Also, circSATB2 was highly expressed in serumal exosomes from lung cancer patients with high sensitivity and specificity for clinical detection and was related to lung cancer metastasis. circSATB2 participated in the progression of NSCLC and was differentially expressed in lung cancer tissue and serumal exosomes. circSATB2 may be potential biomarker for the diagnosis of NSCLC.
Inclusion of economic outcomes in NCI grants: A portfolio analysis.
Authors: Michael T. Halpern, Sharon McCarthy, Priyanga Tuovinen
Journal: Journal of Clinical Oncology (2020)

7047 Background: While new interventions have improved cancer screening, treatment, and survivorship, the costs and other economic impacts of interventions may affect their uptake and availability. It is unknown what proportion of recently-funded National Cancer Institute (NCI) grants include economic outcomes. Methods: We used the NIH Query/View/Report (QVR) System to determine the number of competitive grants funded by NCI 2015-2020 that included economic outcomes. Grants were identified using the NIH Research, Condition, and Disease Categorization (RCDC) category “Cost Effectiveness Research”; 19 RCDC terms/concepts related to economic analyses; and 18 economic phrases searched for in grant titles, abstracts, and specific aims. The specific aims and abstracts of all grants meeting any of these search criteria were reviewed by an NCI scientist to ensure the presence of economic study outcomes. Results: Among over 13,700 competitive grants awarded by NCI 2015-2020, the search identified 149 grants; following abstract/specific aims review, 102 of these grants (0.74% of all grants) included an economic outcome. Most (69 of 102, 67.6%) included cost-effectiveness analysis; 24 included other cost analyses, 7 assessed financial hardship or similar outcomes, and 2 focused on developing economic methods. Among RCDC terms, more than half (53) listed modeling (9 listing Cancer Intervention and Surveillance Modeling Network), 24 randomized controlled trials, 15 QALYs, 11 implementation science, 3 willingness to pay. The most common cancer sites listed were breast (28), lung (23), cervical (19), and colorectal (17) cancer. Almost half (48) mentioned screening and 24 cancer prevention. Risk factors listed included 28 for smoking, 18 HPV, 8 HIV, 8 physical activity, 6 obesity, 4 nutrition. Ten listed treatment efficacy, 6 chemotherapy, 4 radiation therapy, 3 hormone therapy, and 1 chemoradiation. “Treatment as usual” was listed by 16, symptom management 4, and telehealth 4. Survivors were listed for 15, caregivers 3, health disparity 18, rural 15, young adult 4. The majority of grant mechanisms were R01 (76, 74.5%); 3 were R21/R03, 4 other R mechanisms, 7 K awards, 6 U grants, 6 P, F, or L grants. Conclusions: While this search may not have identified all funded NCI grants over the past 5 years involving economic analyses, we found that less than 1% included economic outcomes. Recommendations to assist NCI in supporting health economics research focused on cancer across the entire care spectrum should be considered.
颈动脉内膜切除术治疗症状性颈动脉狭窄82例
Authors: 王志强, 刘建林
Journal: BMJ (2005)

颈动脉内膜切除术(Carotid endarterectomy,CEA)是当今欧美治疗症状性颈动脉狭窄的主要方法之一,但在我国开展较晚,远未普及.我们郑州、西安协作小组自2002年4月至2003年10月共进行CEA 82例,早期疗效满意,现报告如下。
血小板异常的临床解读
Authors: 李振华
Journal: BMJ (2008)

血小板是人体血液系统中的一种重要成分,它在人体的出凝血、血栓形成、反映全身状况中有着极其重要的意义.血小板同其他血液细胞一样也是来源于骨髓,由骨髓中的全能干细胞→骨髓干细胞→巨核系祖细胞→幼巨核细胞→颗粒型巨核细胞→产血小板型巨核细胞,最后生成为血小板(即为有巨核细胞的胞浆分离之膜片段所形成)。
Efficacy of donepezil hydrochloride for patients with mild Alzheimer's disease
Authors: Xinhua Wang, Hengfang Liu
Journal: BMJ (2016)

Objective
To investigate the effect of donepezil hydrochloride tablets in the treatment of mild Alzheimer's disease(AD) patients with clinical effect.


Methods
Ninety two patients with mild Alzheimer's disease (AD) were enrolled from March 2013 to March 2015. Patients were randomly assigned in two groups with 46 cases in each: patients in study group were treated with donepezil hydrochloride tablets (4 mg, q. n) and patients in control group were treated with piracetam tablets (1.2 mg t. i.d). The Mini Mental State Scale (MMSE) and Montreal Cognitive Assessment Scale (MoCA), the Alzheimer's disease assessment component table Perception Scale (ADAS COG), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were applied for evaluation of cognitive, activity ability and mental state before and after treatment.


Results
Before treatment, there were no significant differences in MMSE, MoCA, ADAS-cog, HAMA and HAMD scores between study and control groups (all P>0.05). The MMSE, MoCA scores after treatment in study group were higher than those in control group [24.80±1.15 vs. 23.75±1.20(t=4.285, P=0.000) and 23.30±0.55 vs. 22.41±0.64(t=7.153, P=0.000)]; the ADAS-cog score in study group was lower than that in control group (26.0±1.7 vs. 27.6±1.5, t=2.884, P=0.035). There were no significant differences in HAMA, HAMD scores between two groups (7.1±1.9 vs. 7.4±1.7 and 6.6±2.0 vs. 7.1±2.2, all P>0.05]. After treatment, the visual-spatial ability to execute in study group was 3.81±0.65, pay attention to the ability was (4.30±0.66) points and delayed recall score was 3.20±0.35, which were significantly higher than those in control group (3.42±0.66, 3.78±0.69 and 2.85±0.34; t=2.864, P=0.036; t=3.900, P=0.000; t=2.991, P=0.032). Mild adverse reactions were observed in 4 cases of study group and 2 cases of control group, all patients had spontaneous remission.


Conclusions
Donepezil hydrochloride tablets is effective in treatment of patients with mild AD with low incidence of adverse reactions.


Key words: 
Alzheimer disease; Donepezil hydrochloride tablets; Drug therapy
Relationship of body mass index and non-alcoholic fatty fiver disease in patients with type 2 diabetes mellitus
Authors: Mu-xu Zhai, Ai-hong Wang, Shu-kai Sun
Journal: BMJ (2011)

To investigate the relationship of body mass index and non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus. Three hundred and eleven patients with type 2 diabetes mellitus diagnosed according WHO 1999 consensus criteria and 366 healthy subjects were enrolled in the study. Medical history was acquired and physical examination was conducted, and blood sugar, liver and kidney functions, lipid profile and abdominal ultrasonography color were examined. Sixty seven out of 366 healthy subjects were confirmed to have non-alcoholic fatty liver disease (NAFLD) ,including 51 mild case ( 13.9％ ) ,15 moderate cases(4. 1％ ) and 1 severe case(0. 3％ ) ; while in 311 diabetic patients NAFLD was detected in 144 cases, including 85 mild cases (27.3％) ,53 moderate cases( 17.3％ )and 19 severe cases( 1.9％ ). The prevalence rate of NAFLD was higher in diabetic patients than control group in BMI ＜ 23.0 kg/m2 group, 23.0 -24. 9 kg/m2 group and 25.0 -29. 9 kg/m2 group(P ＜0. 01 ) ; however, there was no difference between two groups when BMi ≥30 kg/m2 (P ＞0. 05 ). The prevalence of NAFLD increased with BMI whether in control group or in diabetic group, especially when BMI ＞ 25 kg/m2. In addition to the prevalence of NAFLD, metabolic syndrome increased with BMI in diabetic patients. These findings indicate that type 2 diabetic patients have a high prevalence of NAFLD, especially in obese patients.

Key words: 
Body mass index;  Nonalcoholic fatty liver disease
Salmeterol/fluticasone combined with N-acetylcysteine in treatment of airway inflammation of stable chronic obstructive pulmonary disease
Authors: Shi-lun Yu, Guang-jun Jiang, Hong Guo, Jing Li, Tong-jun Liu, Xue-li Cha, Qing-dong Ou
Journal: BMJ (2008)

Objective To evaluate salmeterol/fluficasone combined with N-acetylcysteine in treatment of stable chronic obstructive pulmonary disease (COPD). Methods Sixty patients with stable COPD were randomized into treatment group(n = 30) and control group(n = 30). Patients in control group were given salmeterol/fluticasone twice per day ; while patients in treatment group in addition to salmeterol/ fluticasone, also took N-acetylcysteine 0.6 g three times per day. The course of treatment lasted for four weeks. Pulmonary function was measured in all patients; interleukin-8 (IL-8), tumor necrosis factor α (TNF-α), superoxide dismntase (SOD) and malondialdehyde (MDA) in blood serum and induced sputum were determined. The white cell count and classification in sputum smear was examined and the quality of life (QOL) of patients was evaluated. Results FEV1, FEV1 %, QOL evaluation, IL-8, TNF-α, white cell count and the percentage of neutrophil granulocytes in induced sputum after treatment were significantly improved compared with those before treatment in control group (P <0.05 or P <0.01). FEV1, FEV1%, QOL evaluation, SOD and MDA in blood serum, IL-8, TNF-α, SOD and MDA, total white cell count, the percentage of neutrophil granulocytes and macrophage in induced sputum after treatment were significantly improved in treatment group (P <0. 05 or P <0.01). The differences in SOD and MDA in blood serum and the percentage of neutrophil granulocytes in induced sputum smear between treatment group and control group were staffsticaUy significant (93 ± 8) × 10-6 U/L, (4. 0 ± 1.0) × 10-3 mmol/L and 0. 5 ± 0. 3 vs (85 ± 10) ×10-6U/L,(4.2±1.1) ×10-3mmol/Land0.6±0.2; allP<0.05. Conclusion Combination of salmeterol/fluticasone and N-acetylcysteine has better therapeutic results in treatment of airway inflammation of stable COPD.

Key words: 
Adrenergic beta-agonists;  Glucocorticoids;  acetylcysteine;  Pulmonary disease,chronic obstructive
Prospective evaluation of spatial heterogeneity at single cell resolution in multiple myeloma.
Authors: Maximilian Merz, Almuth Maria Anni Merz, Jie Wang, Lei Wei, Qiang Hu, Ahmed Belal, Ronald Alberico, Anne Marie W. Block, Megan Herr, Theresa Hahn, Paul K Wallace, Joseph Tario, Jesse Luce, Sean Glenn, Prashant Singh, Song Liu, Philip L. McCarthy, Jens Hillengass
Journal: Journal of Clinical Oncology (2020)

8524 Background: Osteolytic lesions (OL) characterize symptomatic multiple myeloma (MM). It is still unclear why plasma cells (PC) cause OL in certain regions of the body while other areas show no signs of bone destruction despite significant bone marrow infiltration. We conducted the first study of single cell RNA sequencing (scRNA-seq) and whole-exome sequencing (WES) of PC obtained from random bone marrow samples (RS) and paired OL. Methods: As part of a prospective clinical trial, patients consented to an imaging-guided biopsy of new OL identified by PET/CT in addition to the RS from the iliac crest. Both samples were acquired in the same session. On the same day PC were isolated using a CD138 positive selection kit and single cell gene expression libraries were generated for scRNA-seq. Frozen PC were subjected to DNA extraction and WES. Results: We sequenced 93569 purified, viable PC from paired samples from 15 different locations in the first 7 consecutive patients (median PC from location: 7203; range 1121-10279). Quality assessment of scRNA-seq data revealed no differences between PC in OL and RS. Based on scRNA-seq, 9-24 different subpopulations of PC in individual patients were identified. Over 90% of clusters found in the RS were also present in corresponding OL suggesting a common ancestor. This was true for patients with overlapping as well as divergent mutational profiles in RS and OL as shown by WES. In each patient we found PC clusters that were predominantly present in OL. Respective clusters were characterized by expression of Wnt-signaling inhibitors like DKK-1, Frzb and sFRP-2 and other genes linked to MM bone disease (HGF, CXCL-12, CCL3). Lysosome-associated membrane protein-like molecule 5 (LAMP5) and J-chain were overexpressed in OL clusters. Analysis of genes (IKZF1 and IKZF3) associated with response to treatment and outcome revealed vast heterogeneity and differences in risk scores (UAMS70 and IFM15) on a single cell level from different locations in individual patients. Conclusions: Our study provides the first evidence that PC from OL have distinct transcriptomic profiles that link site-specific gene expression to development of bone disease and adverse outcome.