tbuckley/cabot-search huggingface dataset:
Observation on the clinical effect and survival period of patients with esophageal cancer treated with UMIPIC combined with low dose radiotherapy.
Authors: Jian Liu, Peng Jing, Feng Gao, Wei Shang, Peicheng Zhang, Xiaomin Zhang, Jianbin Feng, Guangyong He, Gequn Zhang, Wenli Li, Yanfei Wu, Baofa Yu
Journal: Journal of Clinical Oncology (2020)

e16517 Background: To observe the clinical effect and survival period of UMIPIC (ultra-minimum incision personalized intratuoral chemoimmunotherapy) combined with radiotherapy in the treatment of esophageal cancer. Methods: 712 patients with esophageal cancer who received UMIPIC treatment in our hospital from January 2011 to December 2015 were selected for the study subjects, 540 cases were treated by UMIPIC combination with radiotherapy in group A and 172 cases were treated by UMIPIC without radiotherapy in group B. All patients were diagnosed with esophageal cancer, and signed the consent for treatment. The patients were treated according to the UMIPIC treatment guidelines. This study was to observe the adverse reactions, clinical efficacy, survival and survival rate of esophageal cancer patients treated with UMIPIC combined with low-dose radiotherapy. Results: The common adverse reactions in group A were fever (18.06%), pain (8.89%), hemoglobin reduction (5.59%), leucopenia (5.40%), nausea (1.48%) and thrombocytopenia (1.12%);The common adverse reactions in group B were fever (26.16%), hemoglobin reduction (17.16%), pain (16.86%), leucopenia (3.55%), thrombocytopenia (2.35%), nausea (1.74%), liver function damage (2.42%), renal function damage (1.21%) and vomiting (1.16%). The other adverse reactions were all lower than 1.00%; The fever, pain and hemoglobin decrease in group A were significantly lower than those in group B (P &lt; 0.05). There were 522 patients whose clinical efficacy could be evaluated in 712 patients. The benefit rate of group A was 95.28%, higher than that of group B 91.84%.The mean and median survival time of group A was 28.412 and 15.670 months, significantly higher than that of group B at 22.103 and 7.070 months. The 1-year survival rate of group A was significantly higher than that of group B (P &lt; 0.05). The 1-year, 2-year and 5-year survival rates of group A were 60.05%, 35.61% and 28.26% while the 1-year, 2-year and 5-year survival rates of group B were 36.94%, 26.44% and 25.00%. Conclusions: The main adverse reactions of UMIPIC in the treatment of esophageal cancer are fever and pain, and other adverse reactions are relatively low. Combined radiotherapy can improve the clinical benefit rate, prolong the survival time and the clinical treatment effect is good, it is encouraged to treat esophageal cancer using local therapy of UMPIC with radiotherapy at low dose.
The study on treatment for occult hyperprolactinemia with early recurrent abortion by traditional Chinese herbal medicine
Authors: 田冬珍, 疗鸿飞, 黄卉, 但阳, 高碧兰
Journal: BMJ (2006)

目的 探讨中药滋肾育胎丸治疗隐匿型高催乳素血症伴早期复发性流产的疗效.方法用促甲状腺释放激素负荷试验从151例不明原因复发性流产患者中检测出56例为隐匿型高催乳素血症,将其随机分为口服中药滋肾育胎丸(31例)及西药溴隐亭(25例)两组.检测其治疗前后围着床期血清雌二醇、孕酮的水平;并在同日行阴道超声检测子宫内膜的厚度;检测受孕8周内血清孕酮、催乳素和绒毛膜促性腺激素水平.结果治疗前后两组血清雌二醇变化差异无统计学意义,而孕酮和子宫内膜厚度的变化差异有统计学意义(分别为P＜0.01和P＜0.05).中药组受孕29例,受孕后检测孕酮,提示黄体功能不全1例(3.4%);流产2例,流产治愈率为87.1%(27/31)例.西药组受孕20例,黄体功能不全4例(20.0%);流产1例,流产治愈率为76.0%(19/25).两组黄体功能不全发生率差异有统计学意义(P＜0.05),流产治愈率差异无统计学意义(P＞0.05).结论复发性流产与隐匿型高催乳素血症密切相关.可通过促甲状腺释放激素负荷试验检测出不明原因复发性流产中的隐匿型高催乳血症.中药滋肾育胎丸对改善黄体功能及子宫内膜的容受性优于溴隐亭。
Health-related quality of life (HRQoL) in the phase III QUAZAR-AML-001 trial of CC-486 as maintenance therapy for patients with acute myeloid leukemia (AML) in first remission following induction chemotherapy (IC).
Authors: Gail J. Roboz, Hartmut Dohner, Christopher Pocock, Hervé Dombret, Farhad Ravandi, Jun Ho Jang, Dominik Selleslag, Jiri Mayer, Uwe Marc Martens, Jane Liesveld, Teresa Bernal del Castillo, Ming-Chung Wang, Ignazia La Torre, Barry Skikne, Keshava Kumar, Qian Dong, Julia Braverman, Salem Abi Nehme, C. L. Beach, Andrew Wei
Journal: Journal of Clinical Oncology (2020)

7533 Background: Effective AML maintenance treatment (Tx) should decrease the risk of relapse and prolong survival without compromising HRQoL. In the placebo (PBO)-controlled phase III QUAZAR AML-001 trial (NCT01757535), CC-486, an oral hypomethylating agent, provided significant improvements in overall (OS) and relapse-free survival (RFS) in patients (pts) with AML in first remission following IC. Here we present pt-reported HRQoL outcomes from that study. Methods: Eligible pts were ≥ 55 yrs of age with intermediate- or poor-risk cytogenetics and ECOG PS ≤ 3, and in CR/CRi after IC ± consolidation. Pts were randomized 1:1 to CC-486 300 mg or PBO QD on days (d) 1–14 of 28d Tx cycles. HRQoL was assessed by FACIT-Fatigue scale and EQ-5D-3L health utility index, completed on d1 of each cycle and at end of Tx (EOT). Endpoints include Tx differences in mean changes from baseline (BL), and proportions of pts with clinically meaningful change from BL (improvement, no change, deterioration). Evaluable pts had an HRQoL assessment at BL and ≥ 1 post-BL visit. Stratified ANCOVA models included Tx and BL scores as covariates. Results: In all, 225/238 pts (95%) in the CC-486 arm were evaluable for FACIT-Fatigue and EQ-5D-3L, and 219/234 pts (94%) in the PBO arm were evaluable for FACIT-Fatigue and 217 (93%) for EQ-5D-3L. Pt characteristics were comparable between Tx arms. Most pts (61%) were 65-74 yrs of age. Median number of CC-486 Tx cycles was 12 and PBO cycles was 7. Compliance rates were &gt; 95% at BL and remained high ( &gt; 85%) at all post-BL visits except for EOT. At BL, pts in both Tx arms had comparable low levels of fatigue and generally good HRQoL relative to an age-matched general population. There were no meaningful differences between CC-486 and PBO in mean changes from BL in FACIT-Fatigue or EQ-5D-3L scores at any post-BL visit. There was no statistically significant difference between Tx arms in proportion of pts with a clinically meaningful deterioration in FACIT-Fatigue score at any post-BL visit except at cycle 29 (likely due to chance; no adjustment made for multiple testing), or in EQ-5D-3L at any visit. Median time to deterioration was not significantly different between CC-486 and PBO on the FACIT-Fatigue scale (41 vs 44 weeks, respectively; P = 0.70) or the EQ-5D-3L (200 vs 164 weeks; P = 0.63). Conclusions: HRQoL and low levels of fatigue were preserved with CC-486 maintenance Tx. CC-486 significantly improved OS and RFS while maintaining HRQoL comparable to PBO. Clinical trial information: NCT01757535 .
ProCAID: A randomized double-blind phase II clinical trial of capivasertib (C) in combination with docetaxel and prednisolone chemotherapy (DP) in metastatic castration-resistant prostate cancer (mCRPC).
Authors: Simon J. Crabb, Gareth Owen Griffiths, Ellice Marwood, Denise Dunkley, Nichola Downs, Karen Martin, Michelle Light, Josh Northey, Amy Whitehead, Emily C Shaw, Alison Jane Birtle, Amit Bahl, Tony Elliott, Charlotte Westbury, Santhanam Sundar, Angus Robinson, Satinder Jagdev, Satish Kumar, Vincent Khoo, Robert J. Jones
Journal: Journal of Clinical Oncology (2020)

5520 Background: DP extends survival in mCRPC, but clinical benefit is modest. PI3K/AKT/PTEN pathway activation is common in mCRPC contributing to disease progression and DP resistance. C is a pan-AKT inhibitor. Pre-clinical data indicate activity in prostate cancer and synergism with DP. This phase II trial combined C with DP in mCRPC. Methods: Key eligibility criteria: histologically or cytologically proven measurable or evaluable mCRPC, suitable for treatment with DP for PSA and/or radiographic disease progression, ECOG performance status 0-1, no prior chemotherapy for mCRPC, not requiring insulin or &gt; 2 oral hypoglycaemic drugs for diabetes mellitus. Treatment: up to 10 cycles of DP (D: 75 mg/m 2 IV, day 1; P: 5 mg bd oral, day 1 – 21) and random assignment (1:1, double blind) to oral C (320 mg twice daily, 4 days on/3 days off, from cycle 1, day 2) or matched placebo to disease progression. Primary endpoint: progression free survival (PFS; comprising PSA, radiographic or clinical progression, new cancer therapy or death; PCWG2 criteria) in the intent to treat (ITT) population. Secondary endpoints included overall survival (OS) and safety. PFS and OS were also assessed by composite biomarker (B) subgroup for PI3K/AKT/PTEN pathway activation status (NGS/IHC on archival tumour, contemporaneous ctDNA). Statistics: designed to detect a 50% increase in median PFS (6 to 9 months (mo)) between the placebo and C arms (90% power, 20% 1-sided alpha) by Cox proportional hazards model. Registration: ISRCTN 69139368. Results: 150 patients were randomised to 01/2019. Median follow up 16.77 months (IQR 12.0-26.5). PFS and OS by ITT and B status, are shown in the table (NR, not reached; CI confidence interval). Grade 3–4 adverse events (AE) were equally common between arms (62.2%). The most common AEs were diarrhoea, fatigue and nausea. Conclusions: Adding C to DP did not extend PFS. The OS secondary endpoint was significantly increased. PFS and OS results were consistent irrespective of PI3K/AKT/PTEN pathway activation status. Clinical trial information: 69139368 . [Table: see text]
他的心力衰竭为何总迅速缓解
Authors: 曾昭耆
Journal: BMJ (2004)

患者男,62岁,饭店高级厨师,住院前2年曾发生过急性心肌梗死,近1年来多次发作急性肺水肿,常于晚间急诊住院抢救.最初几次入院时,我作为副主任医师值三线班,常主持通夜抢救.患者每次入院时均情况紧急,血压下降,重度紫绀,端坐呼吸,满肺湿啰音,但一般经吸氧、呋塞米(速尿)利尿后可迅速好转,个别严重时需用呼吸机.往往于抢救后第2天早上,好像什么事也没有啦,完全像个正常人.患者性格乐观、开朗,病情缓解后谈笑风生.他做菜技术高,而且曾随驻外使团在不少国家使馆工作过.常说:我没有什么遗憾的,好吃的东西都吃过了,好玩的地方也去过了,该死就死吧。
Phase II study of adjuvant endocrine therapy with CDK 4/6 inhibitor, ribociclib, for localized ER+/HER2- breast cancer (LEADER).
Authors: Laura Spring, Colleen Griffin, Steven J. Isakoff, Beverly Moy, Seth Andrew Wander, Jennifer Shin, Elizabeth Abraham, Karleen Habin, Jaymin M. Patel, Amy H. Comander, Therese Marie Mulvey, Aditya Bardia
Journal: Journal of Clinical Oncology (2020)

531 Background: Given the success of CDK 4/6 inhibitors for ER+/HER2- metastatic breast cancer, there is much interest in exploring these agents in early breast cancer to potentially reduce recurrence risk. However, tolerability and adherence are important considerations in the adjuvant setting. We evaluated the tolerability and adherence of adjuvant endocrine therapy with the CDK 4/6 inhibitor, ribociclib, in two different schedules, in a prospective phase II clinical trial. Methods: Eligible patients were those with localized stage I-III ER+ (≥ 10%), HER2- breast cancer who had completed surgery and were on adjuvant endocrine therapy with at least one year or more of treatment remaining. Patients were randomized to receive continuous ribociclib (400 mg daily of 28-day cycle; arm 1) or intermittent ribociclib (600 mg daily on days 1-21 of 28-day cycle; arm 2) for one year, in addition to an aromatase inhibitor (plus GnRH agonist if premenopausal). Toxicities were evaluated using CTCAE version 4.03. Adherence was monitored by review of patient diaries and pill count. Results: Of the 81 patients enrolled, 24 discontinued early. The table shows the current status of the patients based on treatment arm (data cut-off as of 1/31/20; updated results will be presented at meeting). A total of 8 serious adverse events (AEs) have occurred thus far: grade 3 transaminitis (1), grade 4 transaminitis (3), grade 3 colitis (1), grade 3 infection (2), and grade 4 lymphopenia (1). The most common grade 3 or greater AEs leading to study discontinuation thus far were transaminitis (8.6%), neutropenia (2.5%), and fatigue (2.5%). No patients discontinued early due to prolonged QTc. Adherence results will be reported at the meeting. Conclusions: Interim results demonstrate that while serious AEs with one year of adjuvant ribociclib are low, a number of patients discontinued adjuvant CDK 4/6 inhibitor. Tolerability and adherence patterns will need to be carefully considered with CDK 4/6 inhibitors in the adjuvant setting. Clinical trial information: NCT03285412 . [Table: see text]
Detection of somatic mutations in saliva of patients with oral cavity squamous cell carcinoma.
Authors: Evgeny Izumchenko, Rifat Hasina, Arun K Hariharan, Ashwini Shanmugam, Sivaraj Irusappan, Shiuli Maji, Urvashi Bahadur, Vamsi Veeramachaneni, Radhakrishna Bettadapura, Aarthi Ravichandran, Ramesh Hariharan, Vaijayanti Gupta, Vishal Uchila Shishir Rao, Ritvi K Bagadia, Manjunath N.M.L, Mark W. Lingen, Nishant Agrawal
Journal: Journal of Clinical Oncology (2020)

6562 Background: Oral cavity squamous cell carcinoma (OCSCC) frequently presents as clinically advanced disease with poor prognosis. When diagnosed at early stages, survival rates approach 80%, underscoring the need for validated, cost-effective detection methods. OCSCC is driven by the serial acquisition of genetic alterations. Tumor-defining somatic mutations are attractive biomarkers and hence their presence in saliva may be associated with malignancy as shown in a few proof-of-concept studies, including our previous work. Based on this premise, we present a low-cost, accurate, next generation sequencing (NGS) test with high clinical utility aimed at detecting mutations in the saliva for early diagnosis and potential screening of OCSCC. Methods: We have designed a custom NGS panel that covers exons of 7 most frequently mutated genes in OSCC. This minimal gene set derived from the analysis from 3 public datasets, predicted incidence of at least one somatic aberration in 89% of patients. We recruited 91 treatment-naïve OCSCC patients and profiled DNA from tissue and matched pre-operative saliva using this test. We also tested DNA from 12 subjects with premalignant lesions with high-grade oral dysplasia and matched saliva. Results: Using stringent variant calling criteria, at least one somatic variant was detected in 88 (96%) of the 91 primary tumors. 90.9% of the matched saliva were concordant, with only a minor decrease in early stage disease. Tumor-specific mutations (≥5% AF) in driver genes were detected in 10 (83.3%) dysplastic lesions, suggesting that driving clonal events may occur early in disease development. Interestingly, in 3 matched saliva of the dysplastic samples, the same mutations were detected. To ensure a variant is not a false positive call, we performed a vigorous multistep analytical validation of this saliva-based test: (i) independent re-sequencing of 24 saliva confirmed 94% reproducibility; (ii) no functionally relevant variants were detected in saliva from 12 of 13 healthy subjects without history of tobacco and alcohol usage; (iii) reproducibility, sensitivity, and specificity were confirmed using a positive control with 7 loci at 0.25% AF across 8 independent saliva sequencing runs and a certified negative control and was found to be on par with droplet digital PCR. Conclusions: These data highlight the feasibility of saliva-based testing for early diagnosis of OCSCC and premalignant lesions.
胰岛素抵抗与急性脑梗死发病的相关性研究
Authors: 杨光, 高政
Journal: BMJ (2010)

高血压、糖尿病和动脉粥样硬化等是急性脑梗死明确的危险因素,胰岛素抵抗(insulin resistance,IR)是高血压、动脉粥样硬化和冠状动脉粥样硬化性心脏病(冠心病)的独立危险因素,IR与急性脑梗死关系的研究国内也见报道[1-2].本研究通过分析75例脑梗死患者的临床资料,以探讨IR与急性脑梗死之间的关系。
Abstract 11480: Comparison of Outcome Adjudication by Investigators and by a Central Endpoint Committee (CEC) in Heart Failure Trials: Experience of the Shift Heart Failure Study
Authors: Benoit Tyl, José López Sendón, Jeffrey S Borer, Esteban López De Sá, Guy Lerebours, Claire Varin, Aurélie de Montigny, Michel Komajda
Journal: Circulation (2019)

Aims: The usefulness of adjudication by CECs vs. investigators is poorly assessed in heart failure (HF) outcome trials. We aimed to assess its impact on the outcome adjudication of the Systolic Hea...
A case report of partial right lung atelectasis with PET-CT concentration and elevated multiple tumor markers increased and literature review
Authors: Mei-lian Chen, Guo-xiang Lai, De-ling Liu
Journal: BMJ (2013)

To analyze the clinical characteristics, imaging and pathological features of 1 case with partial right lung atelectasis and summarize the relevant domestic reports on the false positive of positron emission tomography-computed tomography (PET-CT) and tumor markers. The patient was diagnosed by PET-CT as partial atelectasis and there were progressive increases of CEA, CA199 and CA242. But site of lesion biopsy showed no malignancy. After treatments of anti-inflammatory and eliminating phlegm, the tumor markers returned to normal and the lesion site had excellent re-expansion. The detection of PET-CT plus tumor markers may have false positive probability. The reason is probably related with inflammation and glandular secretion of lesion site.


Key words: 
Atelectasis; Positron-emission tomography
Association of prior interferon-alpha treatment with the efficacy of adjuvant pembrolizumab in resected melanoma.
Authors: Gu Jin, Tao Li, Yanling Niu, Tonghui Ma
Journal: Journal of Clinical Oncology (2020)

e22100 Background: Adjuvant pembrolizumab or interferon-alpha has been found to prolong recurrence-free survival as adjuvant therapy for resected melanoma. Several studies have shown that interferon-alpha could modulate immune responses to melanoma. In this study, we provided clear evidence that prior treatment with interferon-alpha significantly enhanced the efficacy of adjuvant pembrolizumab for resected melanoma. Methods: 57 patients with acral or cutaneous melanoma (stage IB or II) were enrolled. After resection of the primary tumors, 25 patients received high-dose interferon-alpha as adjuvant therapy and 32 patients received observation. The patients eventually progressed to stage III or IV, with nodal, in-transit, or resectable distant recurrence. Then the patients underwent complete resection for the recurrent tumors. Next, all the patients were given 100 mg of pembrolizumab every 3 weeks. We compared progression-free survival (the time between the date of starting anti-PD-1 and the date of recurrence after anti-PD-1) between the subgroup receiving prior adjuvant interferon-alpha treatment (IFN-pembrolizumab) and the subgroup receiving observation (pembrolizumab). Results: In the pembrolizumab group, 9.4% (3 of 32) had a recurrence within two months and 38% (12 of 32) had disease progression within four months. Whereas, no patients had a recurrence within two months and the proportion of patients with less than four months PFS was 16% (4 of 25) in the IFN-pembrolizumab group. Furthermore, 44% (11 of 25) had a relapse until the date of last follow-up in the IFN-pembrolizumab group. But 56% (18 of 32) had a recurrence in the pembrolizumab group. The Kaplan-Meier curve showed that PFS was significantly improved in the IFN-pembrolizumab group as compared with the pembrolizumab group (mPFS 34.6 weeks vs. 18 weeks, HR = 0.47, 95% CI 0.23-0.99; p value = 0.0392). For stage III melanoma, mPFS was not reached in the IFN-pembrolizumab group, demonstrating increased benefit for patients with early stage. Altogether, these data suggested that prior interferon-alpha treatment could prolong PFS for adjuvant pembrolizumab. Conclusions: In this study, we for the first time demonstrated that prior treatment with adjuvant IFN-alpha exhibited significant improvement for adjuvant pembrolizumab. Meanwhile, further investigation is required to dissect how IFN-alpha enhanced the efficacy of PD-1 blockade.
Clinical application of multi-slice spiral computed tomography imaging with post-processing technology in lamina papyracea fracture
Authors: Nuan-lin Wang
Journal: BMJ (2011)

This paper aimed at evaluating clinical value of multi-slice spiral computed tomography (MSCT) with post-processing technology in diagnosis for lamina papyracea fracture (LPF). Volume scanning with MSCT was performed for 97 cases with LPF followed by post-processing with axial highresolution reconstruction, coronal multi-planar reformation ( CMPR), coronal maximum intensity projection (CMIP) and volume rendering (VR). Obtained images in the patients with fracture were compared with their primary axial scanning, including 42 with line-type fracture without obvious dislocation, 48 cases with depression fracture with dislocation, and seven cases with non-depression fracture showing dislocation.Twelve of them displayed two margins sign, seven diagnosed by CMPR and CMIP images and five by VR combined with CMPR. Thirty-nine cases complicated with swelling of the intraocular muscle, 25 with intraorbital fat hernia into the ethmoid sinus, 66 cases with intraorbital air and liquid deposited at the ethmoid sinus, and 15 with retro-bulbar hemorrhage. MSCT with post-processing technology can accurately display direct and indirect signs of LPF which can be further divided into varied types, and is the most effective method in clinical diagnosis.

Key words: 
Orbital fractures;  Tomography spiral computed
Clinical analysis on surgical treatment of breast abscess during lactation
Authors: Juan Liu, Qingguo Li, Jinxing Wang, Yali Wang, Aitao Tao, Xiaoming Ma
Journal: BMJ (2019)

Clinical data of 85 patients with breast abscess during lactation treated in our hospital from January 2014 to October 2017 were retrospectively analyzed. Among 85 cases, 30 patients received traditional abscess incision drainage, 35 received needle aspiration, and 20 received negative pressure drainage with small incision. The pus culture findings, average hospitalization expenses, average treatment time, pain score, postoperative breast appearance were evaluated. The pus culture found 24 cases of staphylococcus aureus infection in 85 cases (28%), including 40 cases of Methicillin resistant Staphylococcus aureus (47%). The proportion of central abscess (14/20) in patients with small incision drainage was significantly higher than that of patients with needle aspiration treatment (4/35) (P<0.05). The average hospitalization expense of the puncture group was significantly lower than that of other two groups (P<0.01). The average treatment time of abscess incision drainage group was significantly higher than that of other two groups (P<0.01), and the recovery time was all longer 1 month. The score of pain in the abscess incision drainage group was significantly higher than that in other two groups (P<0.01), and all patients had moderate to severe pain. The breast shape satisfaction of abscess incision drainage group was significantly lower than that of other two groups (P<0.01). The analysis indicates that treatment of breast abscess during lactation with needle aspiration and negative pressure drainage has short treatment time, no scars and less pain; and it is suggested that central abscess may be treated early with negative pressure drainage.


Key words: 
Abscess; Mastitis; Drainage; Suction