tbuckley/cabot-search huggingface dataset:
Computational discovery of non-mutational tumor-restricted antigens reveals evidence of immunoediting in head and neck squamous cell carcinoma.
Authors: Jan Ole Kemnade, Thomas M. Wheeler, Maria Cardenas, Andrew G. Sikora, Mitchell Frederick
Journal: Journal of Clinical Oncology (2020)

6564 Background: We previously identified 107 expression-based tumor antigens (EbTAgs) defined as genes with negligible expression in healthy tissue and overexpression in cancer. EbTAgs present novel targets for the adaptive anti-tumor immune response and exhibit evidence of immunoediting in highly immune infiltrated oral cavity tumors. To detail the landscape of EbTAgs in head and neck squamous cell carcinoma (HNSC) and further elucidate EbTAg immunoediting, we compared the expression EbTAgs in the context of tumor immune infiltration among four HNSCC subtypes: oral cavity (OC), HPV+ oropharyngeal (HPV+OP), HPV- oropharyngeal (HPV-OP), and laryngeal/hypopharyngeal (LH). Methods: Upper quartile FPKM gene expression values of all protein coding genes were calculated for all HNSC samples using RNAseq data from The Cancer Genome Atlas (TCGA). TCGA HNSC tumors were divided into subtypes and analyzed for EbTAg expression. Individual tumor sample immune infiltrate was determined using unsupervised clustering of 14 immune cell signature ssGSEA scores for the HNSC dataset as a whole and for each subtype. Results: LH tumors expressed significantly more EbTAgs than other subtypes (p=0.0014), specifically HPV+OP (p=0.0008, Tukey’s test). Immune clustering analysis showed that LH tumors were significantly more likely to be in the low than the high immune cluster whereas the reverse was true for HPV+OP tumors (p&lt;0.0001). Hypothesizing that EbTAg expression was a function of tumor immune infiltration rather than HNSC subtype, we compared EbTAg expression between tumors in low and high immune clusters of the entire HNSC dataset as well as of each HNSC subtype. Significantly more EbTAgs were expressed in low immune tumors compared to high immune tumors of the HNSC dataset (p&lt;0.0001). Similarly, significantly more EbTAgs were expressed in low immune tumors compared to high immune tumors of the OC, OP-all tumors, and HPV+OP datasets (p=0.0003, p&lt;0.0001, p=0.0006) with a trend of more EbTAgs in the immune low versus high tumors in the HPV-OP and LH datasets (p=0.12, p=0.095). Conclusions: EbTAg expression in TCGA HNSC samples correlates with tumor immune infiltration resulting in lower expression under greater immunological pressure. These results reinforce the hypothesis that EbTAgs undergo immunoediting and are immunologically relevant. Exploration of EbTAgs as antigenic targets of modular vaccines or adoptive T-cell therapy as well as biomarkers of immune checkpoint inhibition therapy response is warranted.
Integrated TCM and western medicine fast-track surgery in perioperative management of laparoscopic cholecystectomy
Authors: Yechun Gu, Renwu Zhu, Qile Ye, Yan Xu, Zhiye Chen, Yi Jiang, Xiaochao Han
Journal: BMJ (2016)

Objective
To investigate the effect of integrated traditional Chinese (TCM) and western medicine fast-track surgery (FTS) in the perioperative management of laparoscopic cholecystectomy (LC).


Methods
One hundred and fifty patients with acute cholecysititis undergoing LC from June 2012 to January 2015, were recruited and divided randomly into 3 groups. Patients in group A (n=30) were treated with routine method in perioperative period, patients in group B (n=60) were treated with western medicine FTS, and patients in group C (n=60) were treated with integrated TCM and western medicine FTS. The first exhaust time after operation, length of stay, times of clinic visit, symptoms, levels of IL-6, CRP and ALB, postoperative complications, readmission rate, reoperation rate, and patient satisfaction were evaluated in three groups.


Results
The first exhaust time after operation of group B and group C was earlier than that of group A [(25.16±8.36)h and (21.61±6.52)h vs. (36.06±10.88)h, P 0.05).


Conclusion
Integrated traditional Chinese and western medicine FTS in the perioperative period of LC can promote recovery, reduce symptoms and operation stress and maintain albumin level.


Key words: 
Integrated traditional Chinese medicine and western medicine; Cholecystectomy, laparoscopic; Rehabilitation nursing
围绝经期妇女情绪障碍
Authors: 郁琦, 李颖
Journal: BMJ (2008)

女性进入围绝经期,除了潮热、出汗等血管运动症状,往往也会伴随一些情绪问题,如忧郁、焦虑、多疑等.可有两种类型:①兴奋型:表现为情绪烦躁、易激动、失眠、注意力不集中、多言多语、大声号啕等神经质样症状。
Panel-based methodology for assessing the impact of public policies on cancer patients and survivors.
Authors: Amy Farner, Tenbroeck Smith, Mark Fleury
Journal: Journal of Clinical Oncology (2020)

12059 Background: Cancer interventions are subject to a range of regulations, but data from large, nationally representative surveys are not always available in time to inform the policy process and do not always address issues specific to cancer patients and survivors. Understanding their experiences is critical to achieving policy solutions to issues such as access to effective pain relief, reducing unexpected medical bills, and reducing the impact of high prescription drug costs on treatment for lower income cancer patients. This research intended to better understand patient experiences and opinions in a statistically valid manner specifically targeted to the policy process. Methods: 3057 panelists were identified from ACS contacts, health systems, and social media advertising through ACS/ACS CAN pages and paid Facebook ads, to participate in a series of surveys across a year. The panel included diverse survivors across age, gender, race, ethnicity, economic status, and cancer type. Online surveys deployed semi-monthly on cancer survivorship topics impacted by current policy, including access to/affordability of care, pain treatment, and prescription drug costs. Responses were analyzed for the entire population and across subgroups of cancer survivors. Results: Each survey achieved a response rate between 35% and 50% of all panel members, resulting in a margin of error +/- 3% and 95% confidence level. Insights from cancer patient and survivor experiences helped support public policies through findings such as (but not limited to): 41% of those prescribed opioids had trouble getting their medicine, creating difficulty participating in work, family, or social events; extra trips to the doctor or pharmacy; negative impact on treatment, and trips to the Emergency Room due to uncontrolled pain; 24% received a surprise medical bill, increasing their anxiety, reducing likelihood to see a specialist, and reducing likelihood to seek emergency care during a serious health issue; and 31% of those with household income less than $30,000 report trouble affording prescription drugs and 17% have delayed or not filled a prescription due to cost. Findings supported the policy process by helping craft policy positions aligned with cancer patient preferences, raising public awareness, and communicating to policymakers the impact of policies on cancer. Conclusions: The panel methodology illustrates the impact of policy decisions on cancer patients and survivors. Findings provide an unprecedented level of input to the policy process for cancer patients and survivors.
Exposure to Pyrethroids and Health Risk
Authors: David A. Larsen
Journal: JAMA Internal Medicine (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
The impact of 2nd-line treatment (tx) after 1st-line Gemcitabine plus Nab-paclitaxel (GemNab) in advanced pancreatic cancer (APC) patients (pts).
Authors: Brunella Di Stefano, Maria Bensi, Cinzia Bagalà, Alexia Spring, Marta Chiaravalli, Marta Ribelli, Maria Grazia Maratta, Floriana Camarda, Giampaolo Tortora, Lisa Salvatore
Journal: Journal of Clinical Oncology (2020)

e16759 Background: Three main phase III randomized studies investigated the role of 2nd-line tx in APC pts. The PANCREOX study failed to demonstrate a survival advantage of mFOLFOX vs 5FU/LV. Conversely, the CONKO-003 and NAPOLI-1 trials, demonstrated a significant survival improvement from the combination regimen OFF and 5FU+Nal-IRI, respectively, in comparison to 5FU/LV alone. Recently, final OS analysis from NAPOLI-1 demonstrated an association of specific characteristics (ECOG PS, age, Ca 19.9 baseline level, neutrophil-to-lymphocyte ratio and no liver metastases (m)) with OS &gt; 1 year. The main limit of all these studies was due to the period they were carried out: no pts received 1st-line GemNab. Hence, we retrospectively analysed an homogeneous population of APC treated with 1st-line GemNab at our Institution, investigating the impact of 2nd-line tx. Methods: APC pts receiving a 2nd-line tx after 1st-line GemNab were included in the analysis. The following variables were collected: gender; age ( &gt; vs ≤ 55 years and ≥ vs &lt; 70 years ); baseline ECOG PS (0-1 vs 2-3); Ca 19.9 baseline level (≥ vs &lt; 200); anamnesis of diabetes; site of primary tumor (head/uncinate process vs body/tail); number of m sites (1 vs &gt; 1); m sites (liver, peritoneum, lung, nodes); RECIST response and ETS during 1-line GemNab. Univariate and multivariate analyses for PFS and OS were performed. Results: Out of 167 APC pts progressed to 1st-line GemNab, 93 (56%) pts received a 2nd-line tx, specifically 58 pts received an oxa-based regimen, 11 FOLFIRINOX, 8 FOLFIRI and 16 pts received other tx. Median 2nd-line PFS and OS were 3.3 and 5.6 months, respectively. Out of 87 pts evaluable for response, 7 pts achieved a partial response and 27 a stable disease, with a RR and a disease control rate (DCR) of 8% and 39%, respectively. Pts with baseline ECOG PS 0-1 had a significant better outcome in comparison to pts with PS 3-4 (PFS 4.2 vs 1.2 months, p &lt; 0.0001; OS 7.2 vs 2.6 months, p = 0.0001). This significant association with survival parameters and ECOG PS was confirmed at the multivariate analysis. Conclusions: Despite the limited number of pts evaluated and the restrospective nature of our analysis, our results are in line with previous evidences, confirming the importance of a 2nd-line combination tx, when feasible, as well in an homogeneous population of APC pts treated with 1st-line GemNab. On the basis of our results, ECOG PS may be considered a prognostic factor and the choice of 2nd-line tx should be guided in primis by the baseline general conditions of APC pts.
Novel CoupledCAR technology for treating colorectal cancer.
Authors: Lei Xiao, Song Li, Chengfei Pu, Zhiyuan Cao, Cheng Lu, Yang Hang, Xi Huang, Xiaogang Shen, Xiuwen Wang, Zhao Wu
Journal: Journal of Clinical Oncology (2020)

e15035 Background: Conventional CAR-T cell therapy has thus far shown weak cell expansion in solid tumor patients and achieved little or no therapeutic responses. Methods: We developed CAR T cells based on a novel CoupledCAR technology to treat solid tumors. We engineered CoupledCAR-T cells with lentiviral vectors encoding an anti- colorectal cancer specific protein CAR molecule, and anti- colorectal cancer specific protein (CRCSP) CAR-T cells showed anti-tumor activities in vitro and in vivo experiments. Further, we conducted several clinical trials for various solid tumors, including two patients with colorectal cancer. After the infusion of CoupledCAR T cells, these two patients showed rapid expansion of CoupledCAR T cells and the killing of tumor cells. Specifically, we observed that CoupledCAR T cells expanded significantly in the patients and infiltrated tumor tissue sites. Results: Both patients achieved PR (Partial Response). Patient Profile: Patient 1: Male, 55Y, Colon Adenocarcinoma. In May 2016, 8 cycles of XELOX chemotherapy and 1 dose of radiotherapy were performed. In Step 2016, “radical rectal resection and terminal ileum double ileostomy” was performed. After surgery, gemcitabine chemotherapy was performed for 2 cycles. In January 2018, relapse and metastasis of prostate and left lung were observed. In April 2019, relapse and metastasis were observed. Patient 2: Female, 57Y, Colon Adenocarcinoma. In December 2014, DT46Gy/2Gy/23 radiotherapy was performed. In December 2014 and January 2015, the single drug chemotherapy of Xeloda was taken orally. In February 2015, laparoscopic radical resection of rectal cancer was performed. In April, May, June, and July 2015, mFOLFOX6 chemotherapy was performed. In June 2019, CT showed tumor metastasis. Observations and Results: Patient 1: One month after infusion (M1), the patient was evaluated as PR; most of the target lesions were significantly reduced by more than 50%, and the primary tumor volume was reduced by ~45%. Patient 2: M1, the patient was also evaluated as PR; the tumor in the left upper lobe tip posterior segment was reduced by approximately 75%. Conclusions: The clinical data demonstrated that CoupledCAR-T cells effectively expanded, infiltrated tumor tissue sites, and kill tumor cells in patients with colorectal cancer. We are recruiting more colorectal cancer patients to further test the safety and efficacy of anti-CRCSP CoupledCAR T cells. Further, since our CoupledCAR technology is a platform technology, we are developing it to treat other solid tumors using different target markers.
A multi-institution analysis of molecular biomarkers in patients with metastatic colorectal cancer in ethnically diverse populations.
Authors: Zunaira H Choudhary, Shailesh M Advani, Nadia Ashai, Sara Tariq, Axel Grothey, Scott Kopetz, Lakshmi Rajdev
Journal: Journal of Clinical Oncology (2020)

e16074 Background: Differences in clinical outcomes for metastatic CRC (mCRC) have been reported across racial-ethnic groups, particularly between Hispanics (HA), non-Hispanic Blacks (NHB), and non-Hispanic Whites (NHW), with limited information available among Asian Americans (AA). We examined if there were differences in clinical outcomes by molecular drivers between these groups in a pooled analysis of two institutions serving ethnically diverse patient populations. Methods: We retrospectively examined 1927 mCRC patients from Montefiore Medical Center and the University of Texas MD Anderson Cancer Center. Mutations in KRAS, NRAS, and BRAF were determined by polymerase chain reaction or next generation sequencing. Mutations were then correlated with overall survival (OS). Results: Our patient population consisted of 1153 (61%) NHW, 314 (17%) HA, 320 (17%) NHB and 59 (3.1%) AA. Across subgroups, borderline significant difference in prevalence of BRAF mutation was observed (p = 0.04), with higher prevalence observed among NHW as compared to other groups. No differences were observed for KRAS and NRAS mutation prevalence. In univariate analysis, the median survival for BRAF MT tumors was 18.5 months vs 32 months for BRAF WT tumors (p &lt; 0.0001). Similarly, median OS for KRAS WT, KRAS MT, NRAS WT and NRAS MT was 29.3, 27.4, 31 and 31.5 months respectively, with no differences between groups. In subgroup analysis by race/ethnicity, median OS in BRAF MT NHW was 19.98 months vs 33.48 in BRAF WT NHW (p &lt; 0.0001). Similar trends were observed in HA and NHB. No differences in median OS were observed by KRAS or NRAS mutation status across racial-ethnic groups. Conclusions: This multi-institution study found no meaningful difference in the prevalence of molecular drivers across racial-ethnic groups. Additionally, in our subgroup analyses, OS based on the presence of a specific molecular driver mutation did not seem to vary by race. For example, RAS mutated and BRAF mutated patients showed similar OS across racial-ethnic groups. Our study demonstrates that reported differences in clinical outcomes by race and ethnicity in the literature are unlikely to be dependent on the difference in the presence of certain molecular drivers.
如何进行科学有效的健身锻炼
Authors: 韩澈
Journal: BMJ (2008)

现在有不少人参与到健身锻炼的队伍中,但是,其效果往往不十分的理想,而且由于缺乏基本的健身锻炼知识,不但没有达到锻炼效果,反而还给身体带来伤害.在很多年轻人的心目中,运动就是打球、跑步,然后满身大汗,气喘吁吁;在老年人的心目中,运动就是从家中走出来在外面遛弯.然而,这样的运动方法到底有没有效果,而且适合自己呢?
Comparison of clinical characters of pulmonary embolism in elderly and non-elderly patients
Authors: Jinbao Ma
Journal: BMJ (2014)

The clinical materials of pulmonary embolism in 130 elderly patients (>65 years) and 66 non-elderly patients (≤65 years) were retrospectively analyzed. The most common risk factors for pulmonary embolism in elderly patients were cardiovascular disease, chronic obstructive pulmonary disease and deep venous disease. And the most common risk factors for pulmonary embolism in non-elderly patients were deep venous disease and surgery. Correct first diagnosis rate in elderly group was less than that in non-elderly group(102/130 vs. 62/66) while misdiagnosis rate in elderly group was more than that in non-elderly group(28/130 vs. 4/66). Consistency of revised Geneva score and ventilation and perfusion V/Q scanning was excellent in elderly group while poor in non-elderly group.


Key words: 
Pulmonary embolism; Age factors
How to evaluate compound antihypertensive drug
Authors: 曾昭耆
Journal: BMJ (2010)

20世纪50年代以前,还没有真正有效的降压药,对高血压患者只能给一些具有镇静安眠作用的药物,如小剂量巴比妥类、溴化物和缬草提取物等,有时还加用一些具有安神作用的中药,形成一种事实上的复方.但是,由于实际疗效不佳,血压控制不满意,患者中发生高血压性心脏病、脑卒中或肾损害等并发症者不少见。
理顺社区卫生服务业务管理的必要性
Authors: 张长利
Journal: BMJ (2008)

为了加快社区卫生服务的发展,提高和规范社区卫生服务的业务,近年来不少地区的卫生行政部门在疾病控制中心(疾控中心)、妇幼保健中心等专业性业务管理机构之后,成立了专门的社区卫生服务管理中心,以进一步加强对社区卫生服务机构的管理.在北京市,2006年市委、市政府提出要求:市和区县分别成立社区卫生服务管理中心(社管中心),主要负责质量管理、绩效考核、人员培训、运行管理、药品及医用耗材的配送结算管理、信息统计等工作[1]。
BARCODE 1: A pilot study investigating the use of genetic profiling to identify men in the general population with the highest risk of prostate cancer to invite for targeted screening.
Authors: Ros A. Eeles, Holly ni Raghallaigh
Journal: Journal of Clinical Oncology (2020)

1505 Background: Genetic profiling could be used to target population screening for prostate cancer (PrCa). Approximately 170 single nucleotide polymorphisms (SNPs) have been identified that associate with PrCa development. Although these confer a low to moderate risk of PrCa, the risk is cumulative with increasing number of risk alleles. BARCODE1 is the first study to prospectively investigate the use of a genetic profile in PrCa screening in the UK general population. Methods: A custom Eurek Genomics (EG) SNP assay was developed. Healthy males aged 55-69 were invited to participate via their General Practitioners (GPs). Saliva samples were collected via mailed collection kits. After DNA extraction, genotyping was conducted using the EG assay and a polygenic risk score (PRS) was calculated for each participant. The PRS was calculated using the sum of the weighted alleles for 130 risk loci. Men in the top 10% of the genetic risk profile were invited for prostate MRI and biopsy at the Royal Marsden Hospital (RMH) in London. Results: Invitation letters were sent to 1434 men; overall uptake was 26% (range 13%-47%). 87% of responders were eligible for study entry. DNA was extracted from 303 samples and genotyped. Data were available for 285 men following QC. Mean PRS was 10.33 with a standard deviation of 0.64; twenty-five participants with a PRS above the 90 th centile were identified for screening with MRI and prostate biopsy. Of these men (after exclusions due to medical comorbidity/invitations declined) 9 out of 20 had an abnormal MRI (45%) and 18 men underwent biopsy with 7 diagnoses of PrCa (38.8%). All cancers were low-risk with a mean PSA of 1.8 and were managed with Active Surveillance (AS). There were two adverse events following biopsy, both simple lower urinary tract infections managed with oral antibiotics. Average duration of follow-up is 4.5 months (range 1-11). Conclusions: Successful completion of recruitment has shown this community study to be feasible, with an average uptake of 26%. Approximately 70 GP sites have been identified to allow a transition to the full BARCODE-1 study which will recruit 5000 men. The use of genetic profiles to guide PrCa screening is attractive; it requires a one-off test utilising germline DNA which can be assessed for risk loci which are constant, unlike PSA which fluctuates. The results of the BARCODE1 study will be important in defining the role of genetic profiling in targeted PrCa population screening.