tbuckley/cabot-search huggingface dataset:
Percutaneous microwave ablation of stage T1b renal cell carcinoma: Assessment of technical feasibility, clinical outcomes, and safety.
Authors: Ronald Arellano, Jianhai Guo
Journal: Journal of Clinical Oncology (2020)

e17104 Background: The use of percutaneous microwave ablation (MWA) for T1b (4.1-7.0 cm) renal cell carcinoma (RCC) has not yet been widely adopted. Methods: This single-center retrospective study investigated consecutive patients who underwent CT-guided percutaneous MWA for T1b RCC from December 2015 to May 2019. Patient baseline characteristics, tumor biological features, technical parameters, clinical outcomes, and complications were recorded and evaluated. Local progression-free and overall survival (OS) rates were estimated using the Kaplan-Meier method. Results: This study included 23 patients (18 men [mean age ± standard deviation, 74.6 y ± 10.2; range, 58–89 y] and 5 women [mean age, 71.6 y ±10.1; range, 62–86 y]; overall mean age, 74.0 y ± 10.0; range, 58-89 y) with 23 T1b tumors. Technical success was achieved in all of tumors. Local progression-free survival was 94.7%, 86.1%, and 86.1% at 1-, 2-, and 3-year respectively. OS was 95.2%, 85.7%, and 71.4% at 1-, 2-, and 3-year respectively. Of the 2 (8.7%) complications, both were classified as Clavien-Dindo grade I complication. Conclusions: CT-guided percutaneous MWA was associated with high rates of technical success, excellent local progression-free survival and OS, and a low complication rate for stage T1b RCC.
食源性寄生虫病应引起临床医生的重视
Authors: 庄建林, 姜庆五
Journal: BMJ (2007)

2006年5月,北京有数十名患者因脑膜炎症状就诊,经诊断,这是由于食用了生的福寿螺而感染的广州管圆线虫病.其后陆续有新病例发生,至9月底,共诊断160例.广州管圆线虫病在我国南方比较常见,而在北京如此大规模的人群同时感染则是首次发生,因此被称为福寿螺事件。
抗菌药自我药疗的现状
Authors: 李丽剑, 汪培山
Journal: BMJ (2006)

不合理应用抗菌药除造成资源浪费和毒副作用外,由此引发的细菌耐药已成为全球重要的公共卫生问题.耐药菌的出现和蔓延一方面与临床不规范用药有关,另一个容易被人们忽视的方面是自我药疗过程中抗菌药的误用和滥用。
Prediction of watchful waiting in newly diagnosed metastatic clear cell renal cell carcinoma patients with a good or intermediate prognosis.
Authors: Sarah Verhoeff, Suzanne C van Es, Sjoerd G. Elias, Sophie Gerritse, Lindsay Angus, Sjoukje Oosting, Sandra Heskamp, Adrienne H. Brouwers, Anne I.J. Arens, Catharina Wilhelmina Menke, Otto S. Hoekstra, Gerben J.C. Zwezerijnen, Astrid Aplonia Maria Van Der Veldt, Peter Mulders, Winette T.A. Van Der Graaf, Elisabeth De Vries, Wim J.G. Oyen, Erik H.J.G. Aarntzen, Carla M.L.- Van Herpen
Journal: Journal of Clinical Oncology (2020)

5079 Background: In metastatic clear cell renal cell carcinoma (mccRCC), the number of International Metastatic Database Consortium (IMDC) risk factors plus metastatic sites may identify patients with rapid or slow disease progression in a period of watchful waiting (WW) (median WW of 8.4 vs 22.2 months; Rini et al. Lancet Oncol. 2016). We aimed to validate this and prospectively assess the added value of baseline PET with [ 18 F]FDG and [ 89 Zr]Zr-DFO-girentuximab to predict the WW-period in the multicenter IMaging PAtients for Cancer drug selecTion (IMPACT)-RCC cohort study. (NCT02228954). Methods: Between February 2015 and March 2018, 40 treatment-naïve mccRCC patients with a good (n=13) or intermediate prognosis (n=25) according to IMDC, were enrolled. Following baseline CT, [ 18 F]FDG and [ 89 Zr]Zr-DFO-girentuximab-PET, CT scans (RECIST1.1) were acquired at 2, 4, 6, 9, 12 months and thereafter every 4 months. Primary endpoint was time to radiological and/or clinical disease progression, requiring systemic treatment. Patients were assigned to a favorable (&lt;2 IMDC risk factors and &lt;3 metastatic sites) or unfavorable for WW-group (all others; Rini et al). Maximum standardized uptake values (SUV max ) were measured in PET-positive lesions measuring ≥10mm, or 15mm in lymph nodes. High and low-uptake groups were defined based on median geometric mean (gm) SUV max across patients. A one-sided test was used to validate observations by Rini et al; other tests were two-sided. Results: The median WW-period was 9.3 months in the unfavorable WW-group (n=19) vs 20.4 months in the favorable WW-group (n=21) (HR 1.89 95%CI 0.94-3.89; p=0.037), confirming observations of Rini et al. Patients with high [ 18 F]FDG uptake had a median WW-period of 8.5 months compared to 25.2 months in the low-uptake group (HR 4.08 95%CI 1.89-9.28; p=0.0002). Patients with high [ 89 Zr]Zr-DFO-girentuximab uptake had a median WW-period of 10.7 versus 16.4 months in the low-uptake group (HR 1.37; 95%CI 0.69-2.76; p=0.37). [ 18 F]FDG uptake groups improved a Cox-model for WW based on the prognostic groups of Rini et al (p=0.0015); [ 89 Zr]Zr-DFO-girentuximab did not (p=0.98). Conclusions: The IMPACT-RCC study validated the observations by Rini et al. and shows that adding baseline [ 18 F]FDG PET further improves the prediction of the duration of the WW-period in mccRCC patients. Clinical trial information: NCT02228954 .
Advance in management of refractory/relapsing thrombotic thrombocytopenic purpura
Authors: Yu Chen, Meifang Wang
Journal: BMJ (2017)

Thrombotic thrombocytopenic purpura (TTP) is a kind of thrombotic microangiopathies which has low incidence but highly mortality. The outcome of TTP has been improved significantly since last decade due to the application of plasma exchange, however, early relapse occurs in some patients, and for relapsed/refractory patients the prognosis is still poor. This article reviews the recent progress in treatment and relevant influencing factors of TTP.


Key words: 
Thrombotic thrombocytopenic purpura; Treatment
Molecular Imaging of Infective Endocarditis With 6′′-[ <sup>18</sup> F]Fluoromaltotriose Positron Emission Tomography–Computed Tomography
Authors: Mirwais Wardak, Gayatri Gowrishankar, Xin Zhao, Yonggang Liu, Edwin Chang, Mohammad Namavari, Tom Haywood, Moustafa T. Gabr, Evgenios Neofytou, Tony Chour, Xulei Qin, José G. Vilches-Moure, Jonathan Hardy, Christopher H. Contag, Michael V. McConnell, Joseph C. Wu, Sanjiv Sam Gambhir
Journal: Circulation (2020)
Current status of self-management behaviors among patients with type 2 diabetes mellitus in community
Authors: Min Shi, Ridong Zhang, Gang Chen, Qian Qian, Changdu Xu, Liping Wang, Hong Zhang
Journal: BMJ (2019)

Two hundred and thirty nine patients with type 2 diabetes mellitus (T2DM) managed in the community health service centers of Huai′an city were selected for survey by random sampling method between January and December 2017. A self-designed questionnaire was used to assess self-management prescription. Patients received community management for 3 months. The rates of patients with not receiving diabetes health education, with healthy diet, with regular exercise, without monitoring blood glucose, with repeated hypoglycemic attacks were 44.8% (107/239), 23.0% (55/239), 46.4% (111/239), 54.8% (131/239) and 21.3%(23/108), respectively; and 51.9% (124/239) of the participants did not adhere to medication. The awareness rate of diabetic complications was 27.2% (65/239). Only 25.1% (60/239) and 15.1% (36/239) of the participants apply oral hypoglycemic agents and insulin rationally. The survey results indicate that the current status of self-management in community diabetic patients is relatively poor, it is necessary to strengthen standardized management of diabetic patients in community health institutions.


Key words: 
Diabetes mellitus, type 2; Community health service; Self-management prescription; Blood glucose self-monitoring
Abstract 15265: Intra- and Inter-Individual Changes in Daily Resting Heart Rate Over Two Years for 92,457 Individuals
Authors: Giorgio Quer, Pishoy Gouda, Michael Galarnyk, Eric J Topol, Steven R Steinhubl
Journal: Circulation (2019)

Introduction: Heart rate is routinely measured but is rarely acted upon unless well out of a population-based normal range. In the era of wearable sensor technologies, heart rate can be continuousl...
Diagnosis of leptomeningeal metastasis (LM) through identification of circulating tumor cells (CTCs) in cerebrospinal fluid (CSF).
Authors: Kathleen Fenn, Veena M. Singh, Shing Mirn Lee, David Cieremans, Andrew B. Lassman, Dawn L. Hershman, Katherine D. Crew, Melissa Kate Accordino, Meghna S. Trivedi, Fabio Massaiti Iwamoto, Robbie Schultz, Lan Huynh, Edgar V. Sales, Deanna M Fisher, Julie A Mayer, Teri Nguyen Kreisl, Kevin Kalinsky
Journal: Journal of Clinical Oncology (2020)

3567 Background: Diagnosis of LM from solid tumors can be challenging. The TargetSelector (TS) CTC detection assay has demonstrated highly specific and sensitive CTC capture both for epithelial (CK+) and non-epithelial (CK-) subsets. The assay utilizes a ten-antibody (ab) capture cocktail followed by biotinylated secondary abs that bind to CTCs, enriched in a microfluidic device. TS targeted next-generation sequencing (NGS) assay detects somatic mutations in 12 breast cancer-related genes. The aim was to determine whether TS can improve sensitivity in the diagnosis of LM compared to CSF cytology by lumbar puncture (LP). Methods: CSF was collected prospectively from patients (pts) with a prior solid tumor diagnosis and suspicion of LM. CTCs were isolated from CSF using the TS platform. Cells were stained with cytokeratin (CK), CD45, streptavidin and DAPI. CTCs captured in a microchannel were classified as CK + or -. Peripheral blood samples obtained at time of LP underwent similar CTC analysis. Cell-free total nucleic acids (cfTNA) were extracted from plasma and CSF followed by NGS. Data analysis used the Ion Torrent Suite with annotation and report curation by Ion Reporter and Oncomine Knowledgebase Reporter software respectively. Results: There were 14 pts (13 women and 1 man), median age 56 years (range 32-75) with cancers of the breast (10), lung (1), colon (1), CNS lymphoma (1) or glioma (1). Pts had received a median of 2.5 lines of systemic metastatic therapy (range 0-8). CSF cytology was not sent for 1 pt and TS was not performed for 1 pt. TS and standard cytology had 89% agreement in pts with metastatic breast cancer (MBC, 8/9). Of the 6 pts for whom CTCs were detected in CSF by TS, 3 pts had + cytology (all MBC), 2 pts had - cytology and 1 pt with MBC was not tested by cytology. Of the 3 pts with + CSF by cytology (all MBC), all were detected by TS (Table). Among 5 MBC pts with CTCs present in CSF, ER status was concordant in 2 of 5 (40%). HER2 status was concordant in 3 of 4 (75%) evaluable pts and not determined in 1 pt. Analysis of cfDNA from CSF identified somatic mutations in 3 pts (TP53, PIK3CA, CCND1, respectively). In 1 of 3 pts, the mutation identified in the CSF (PIK3CA) in HR+/HER2- MBC was also identified in the blood. Conclusions: TargetSelector is a viable platform for the detection of breast cancer CTCs in the CSF. NGS performed on CSF samples can identify potentially actionable mutations. [Table: see text]
Pyrotinib or lapatinib plus capecitabine for HER2+ metastatic breast cancer (PHOEBE): A randomized phase III trial.
Authors: Binghe Xu, Min Yan, Fei Ma, Xi-Chun Hu, Ji Feng Feng, Quchang Ouyang, Zhongsheng Tong, Huiping Li, Qingyuan Zhang, Tao Sun, Xian Wang, Yongmei Yin, Ying Cheng, Wei Li, Xiaoyu Zhu, Chunxia Chen, Jianjun Zou
Journal: Journal of Clinical Oncology (2020)

1003 Background: Pyrotinib (an irreversible pan-ErbB inhibitor) plus capecitabine showed clinically meaningful benefits and acceptable tolerability in patients (pts) with HER2+ metastatic breast cancer (MBC) in phase 1 and 2 studies. Methods: This open-label, multicenter, randomized phase 3 study enrolled HER2+ MBC pts after trastuzumab and taxanes, and/or anthracyclines. Up to two prior lines of chemotherapy (chemo) for metastatic disease were allowed. Pts were randomly assigned (1:1) to receive pyrotinib 400 mg or lapatinib 1250 mg qd continuously plus capecitabine 1000 mg/m 2 bid on days 1–14 of 21-day cycles. The primary endpoint was progression-free survival (PFS) per blinded independent central review. Results: From Jul 2017 to Oct 2018, 267 pts were randomized to the pyrotinib (n=134) or lapatinib (n=133) arm. One pt in the lapatinib arm did not receive study treatment and was excluded from analyses. 42.5% and 34.8% of pts in the pyrotinib and lapatinib arm had no prior chemo for metastatic disease, 41.8% and 49.2% had one prior line, and 15.7% and 15.9% had two lines. At the planned interim analysis, the median PFS was 12.5 months (95% CI 9.7–not reached) with pyrotinib plus capecitabine vs 6.8 months (95% CI 5.4–8.1) with lapatinib plus capecitabine (HR 0.39 [95% CI 0.27–0.56]; P&lt;0.0001), which met the criterion for statistical significance (≤0.0066). Among trastuzumab-resistant pts, prolonged PFS with pyrotinib plus capecitabine was also observed (12.5 months [95% CI 6.9 to not reached] vs 6.9 months [95% CI 5.4 to not reached]; HR 0.60 [95% CI 0.29 to 1.21]). Benefits in objective response rate, clinical benefit rate, and duration of response with pyrotinib plus capecitabine were also indicated (Table). The most common grade ≥3 adverse events were diarrhea (30.6% vs 8.3% in the pyrotinib vs lapatinib arm) and hand-foot syndrome (16.4% vs 15.2%). Conclusions: In pts with HER2+ MBC after trastuzumab and chemo, pyrotinib plus capecitabine achieved a significant better PFS than lapatinib plus capecitabine, with manageable toxicity, verifying the phase 2 findings. Clinical trial information: NCT03080805 . [Table: see text]
Primary care utilization and barriers among pediatric cancer and bone marrow transplant survivors.
Authors: Keagan Lipak, Cynthia Gerhardt, Randal S. Olshefski, Rajinder Bajwa, Micah Skeens
Journal: Journal of Clinical Oncology (2020)

e22523 Background: The Institute of Medicine (IOM) report on childhood cancer survivorship specified the need to create and evaluate standards and alternative models of care delivery, including collaborative practices between oncologists and primary care physicians (PCP). 1 We aimed to examine the utilization of primary care physicians by childhood cancer and bone marrow transplant (BMT) survivors, as well as identify barriers to non-oncology follow-up care. Methods: Survivors and caregivers were recruited from a cancer and bone marrow transplant survivorship clinic at a large Midwestern pediatric hospital. Participants completed a demographic survey and an 8-item semi-structured interview in clinic or online. Results: A total of 472 participants (211 survivors, 259 caregivers, 2 left unanswered) completed the survey (Survivors M age = 26.11, SD= 7.32). Most participants were Caucasian (89%) and female (58%). Only 57 (12.3%) survivors received a BMT. There were no significant differences in PCP utilization between BMT survivors and those who did not receive a BMT, t(448) = -.519, p = .604. In addition, there were no significant group differences in PCP utilization between oncological and hematologic survivors, t(387) = 1.144, p = .253. Most survivors (87%) had a PCP, but 43% sought care for ill visits only. Survivors most commonly chose their PCP through referral from family or friends (45%), with only 4% obtaining a recommendation from their oncology provider. Top reasons for not having a PCP included being unsure who to see (52%), lack of insurance (20%), and not perceiving a need for a PCP (18%). In a logistic regression, greater annual family income ( β= .209, p&lt; .001) and having health insurance ( β= .161, p&lt; .01) were predictive of having a PCP. The frequency of PCP visits was also positively correlated with annual family income ( r= .13, p= .014). Conclusions: While most survivors had a PCP, higher income and insurance coverage were important predictors of having a PCP. There is a clear need for education and formal transition programs to primary care, as survivors and their family identified the need for guidance in choosing a PCP. Stronger partnerships between oncology and primary care providers may improve surveillance and outcomes for these survivors. 1. Blaauwbrock R, Zwart, N., Bouma, M., Meyboom-de Jung, B., Kamps, W., &amp; A. Postma. The willingness of general practitioners to be involved in the follow up of adult survivors of childhood cancer. Journal of Cancer Survivors. 2007;1:292-297.
中药致慢性铅中毒一例
Authors: 许蕴, 史敦云, 苏健, 吕贺蓉, 吕丽君
Journal: BMJ (2004)

患者男,27岁,无明显诱因出现剑突下阵发性灼烧样腹痛半年就诊.既往有胆囊息肉、乙型病毒性肝炎史近10年.查体贫血貌,心肺听诊无异常,腹部平软,肝脾肋下未及,肝肾区无叩痛,神经系统无异常.辅助检查:Hb 82 g/L,白细胞计数 7.72×109/L,网织红细胞 1.2%;粪尿常规(-);尿含铁血黄素试验(-);CD59-红细胞正常;丙氨酸转氨酶(ALT)50 U/L;HBsAg(+)、HBeAg(+)、HBcAb(+);乙肝病毒核酸定量:7.28×104(+);全消化道钡餐未见器质性病变;B超示胆囊息肉;腹部核磁扫描示胆囊小结石,左肾小囊肿;骨穿病理示红系增生明显活跃,呈增生性贫血骨髓象;红细胞脆性46.81%(正常:＞60%).门诊胃镜检查示慢性胃炎、胆汁反流性胃炎。
Results of a prospective phase II national study: Prophylactic radical fimbriectomy (NCT01608074), in women with a documented high risk of breast/ovarian cancer—Final pathological results and outcomes.
Authors: Eric Leblanc, Fabrice Narducci, Delphine Hudry, Audrey Mailliez, Anne-Sophie Lemaire, Emmanuelle Tresch-Bruneel, Michel Salzet, Christophe Pomel, Frederic Caquant, Gilles Houvenaeghel, Jean-Yves Charvolin, Agathe Crouzet, Frederic Guyon, Yves Fouche, Gwenael Ferron, Sebastien Gouy, Veronique Vaini-Cowen, Virginie Fourchotte, Francois Golfier, Pierre Collinet
Journal: Journal of Clinical Oncology (2020)

1594 Background: Risk-reducing salpingo-oophorectomy (RRSO) is the gold standard in surgical prophylaxis of pelvic high-grade serous carcinoma (HGSC) for women at risk of breast/ovarian cancer. Due to significant adverse effects of early oophorectomy, 20-30% of women delay or deny performing this operation. Recent data highlight the fallopian origin of most pelvic HGSC, especially its fimbrial part. Thus, we suggested a new two-step risk-reducing procedure: the radical fimbriectomy (RF) with delayed oophorectomy (DO) (Leblanc et al Gyn Oncol 2011), leading to the current RF/DO Phase 2 study. We present the definitive results on primary and secondary objectives of this trial. Methods: BRCA1/2 carriers or any women with a documented familial risk of breast/ovarian cancer were first counseled to perform a classical laparoscopic RRSO. If they denied, they were offered to enter the RF/DO study. All specimens were submitted to the SEE-FIM pathological protocol. Pathological data along with all intra- and 30-day and beyond post-operative adverse events were prospectively recorded. Follow-up consisted in an annual clinical breast and gynecological examination, with tumor markers and hormonal status assessment. Primary endpoint was the rate of pelvic serous carcinoma. Secondary endpoints were procedure morbidity, rates of tubal abnormalities, breast cancer, secondary oophorectomy. Results: From January 2012 to October 2014, 121 RF were performed: 120 by laparoscopy, 1 laparotomy (concurrent myomectomy). An occult neoplasia was found in 3 cases with 1 invasive HGSC. Intraoperative complications were two grade1 bleedings without transfusion with no grade ≥3 early post-operative or delayed complication. With a median follow-up of 5.3 years (0.2 -7.6), no patient developed any pelvic HGSC, 21 patients developed a breast cancer (3 de novo, 18 recurrences/contralateral.). 1 cancer-free BRCA1-mutated lady delivered safe twins, after an uneventful post-RF pregnancy obtained with assisted reproductive technology (ART). Overall, 29 women underwent DO (by choice: 12 or menopause: 17) resulting in grade 3b complication in 1 case, but no pathological abnormality. Conclusions: RF/DO appears as a safe, well tolerated and effective procedure in terms of occult neoplasia detection. A successful pregnancy with ART was possible after radical fimbriectomy. Longer follow-up and larger cohort are necessary to confirm its efficacy in terms of ovarian cancer prophylaxis. Clinical trial information: NCT01608074.
Cost-effectiveness of combined atezolizumab/nab-paclitaxel for advanced triple-negative breast cancer.
Authors: Mia A Salans, Daniel R Cherry, Anthony T Yip, Patrick T Courtney, Abhishek Kumar, James Don Murphy
Journal: Journal of Clinical Oncology (2020)

e19388 Background: The IMpassion 130 trial found prolonged progression-free and overall survival among PD-L1-positive, advanced triple-negative breast cancer (TNBC) patients receiving atezolizumab and nab-paclitaxel versus nab-paclitaxel alone. These results were the basis of the first FDA approval of a breast cancer immunotherapeutic agent. With the high cost of combined therapy we present a cost-effectiveness analysis of the addition of atezolizumab to nab-paclitaxel for the treatment of advanced TNBC in PD-L1-positive patients. Methods: We constructed a Markov model to simulate cancer progression, survival, and toxicity in advanced TNBC patients receiving atezolizumab and nab-paclitaxel compared to nab-paclitaxel alone. Transition probabilities were derived from the IMpassion 130 trial, while costs (in 2019 US dollars) and health utilities were estimated from the literature. Cost effectiveness was assessed with incremental cost-effectiveness ratios (ICERs), expressed as dollar per quality-adjusted life-year (QALY), with values of less than $100,000/QALY considered cost effective. We conducted one-way and probabilistic sensitivity analyses to examine model uncertainty. Results: Our base-case model found that treatment with atezolizumab and nab-paclitaxel increased overall cost by $120,800 and improved effectiveness by 0.11 QALYs compared with nab-paclitaxel alone, leading to an ICER of $1,101,000/QALY. The base-case model was not sensitive to any single variable. Women in the combined atezolizumab and nab-paclitaxel arm spent more time with stable disease before progression and with progressive disease before death compared to those treated with nab-paclitaxel alone. In our base-case analysis the addition of atezolizumab was not cost effective at any price of atezolizumab secondary to the high costs of stable and progressive disease. If we assumed lower costs of stable disease and progression, our model became sensitive to the cost of atezolizumab. A probabilistic sensitivity analysis found that adding atezolizumab would be cost ineffective 99.9% of the time at a willingness-to-pay of $100,000/QALY. Conclusions: Despite improved clinical outcomes, the addition of atezolizumab would not be considered cost effective in part due to the high costs of stable disease and disease progression among women with advanced TNBC. Novel therapeutics in this costly patient cohort will need to bend the cost curve of stable and progressive disease before becoming cost effective at thresholds acceptable by today’s standards.
Wiltse paraspinal muscle splitting approach for treatment of L5-S1 spondylolisthesis
Authors: Jinyu An, Yixiong Wu, Jiajun Lu, Huidong Hu, Libo Gao
Journal: BMJ (2016)

Forty three patients with L5-S1 spondylolisthesis undergoing surgical treatment from April 2012 to November 2014 were included for analysis, including 20 cases received transforaminal lumbar interbody fusion (TLIF group) and 23 cased received posterior lumbar interbody fusion (PLIF group). The incision length, operative time were shorter and blood loss was less in TLIF group than those in PLIF group[(9.6±0.9) vs. (16.1±1.5) cm , (125.6±13.0) vs. (156.4±11.8) min and (218.7±22.5)ml vs. (326.5±20.1) ml, respectively, all P=0.000]. There was no statistical difference in the S1 pedicle screw (S1PS) insertion point between two approaches[(29.4±1.9) vs. (28.5±1.0) mm, P=0.069], but the distance from the midline to the lateral edge of the screw (12.9±3.6) mm, S1PS angle (23.3±2.1)° and length of S1PS length with the sacral body(40.9±2.6) mm in the TLIF group were better than those in PLIF group (P=0.000). Our results demonstrate that the paraspinal muscle approach for the treatment of L5-S1 spondylolisthesis may be superior with less trauma, better functional recovery and stable screw placement.


Key words: 
Spondylolysis, lumbar vertebrae; Paraspinal approach; Pedicle screw
Establishment of evaluation indicators with Delphi method in the management of antiretroviral therapy and AIDS patients in China
Authors: 马烨, 赵德才, 臧春鹏, 于兰, 赵燕, 文毅, 张福杰
Journal: BMJ (2006)

目的 筛选合适的指标作为我国艾滋病抗病毒药物治疗管理及患者管理指标,用于指导我国艾滋病抗病毒治疗工作.方法 采用改良特尔菲专家咨询法,对卫生管理、疾病控制、临床医生以及流行病学、卫生统计学方面的专家进行两轮电子邮件咨询.结果 通过两轮咨询,历时1个月,共筛选出32个指标.其中政府及卫生行政部门关注的指标17个,治疗管理及各级疾病预防控制机构关注的指标26个,临床患者管理人员关注的指标19个.结论 建立了一套评价我国艾滋病抗病毒药物治疗管理和患者管理的指标。