tbuckley/cabot-search huggingface dataset:
Research progress of anticoagulant management service for atrial fibrillation
Authors: Junxia Wang, Jialin Chen, Lin Wu, Shu Cai
Journal: BMJ (2020)

The morbidity and mortality caused by ischemic stroke resulted from atrial fibrillation are increasing year by year. Anticoagulation is the core strategy for the prevention and treatment of atrial fibrillation-related stroke. At present, the prominent problems in anticoagulation of atrial fibrillation in China include low rate of anticoagulation therapy, low rate of INR compliance, non-standard drug treatment, poor compliance with medication and follow-up, and so on. It has been reported that anticoagulation management service can significantly improve the effect and compliance of anticoagulation therapy, and reduce the hospitalization rate and emergency consultation rate of adverse events related to anticoagulation therapy. In this paper, the research progress of anticoagulant management service of atrial fibrillation at home and abroad is reviewed, providing reference for the establishment of anticoagulant management system under the hierarchical medical system in China.

Key words: 
Atrial fibrillation; Anticoagulation management service; Patient education
Real-world data in limited-disease small-cell lung cancer: Results from a retrospective nationwide population-based cohort study in Korean HIRA database.
Authors: Seoree KIM, In-Ho Kim, Ji Hyung Hong, Soo-Yoon Sung, Yeo Hyung KIM, Hyun Woo Lee, Jung Soo Lee, Yoon Ho Ko
Journal: Journal of Clinical Oncology (2020)

e21096 Background: Small cell lung cancer (SCLC) is a highly proliferative and rapidly growing tumor with poor prognosis, even in limited disease (LD), and a timely and accurately high intensity therapy is necessary. During the concurrent chemoradiotherapy (CCRT), etoposide with platinum (EP) regimen is recommended, however, irinotecan with cisplatin (IP) regimen is also effective. Therefore, we performed a large-scale, retrospective and nationwide cohort study to analyze the efficacy of CCRT in patients with LD-SCLC Methods: The population data were extracted from the Health Insurance Review and Assessment Service of Korea database from January 1, 2008, to November 30, 2016. Among 14,490 patients with SCLC patients who received chemotherapy, a total of 4,496 patients with LD-SCLC were analyzed. The primary objectives were to evaluate the survival outcomes of CCRT for LD-SCLC. Results: Patients who received EP-CCRT (n = 4,187) had better PFS of 11.233 months (95% confidence interval (CI) 10.900 – 11.667, P = 0.0477) and prolonged OS of 22.233 months (95% CI 21.233 – 23.333, P &lt; 0.0001) than those who received IP-CCRT (n = 259; PFS = 9.567 months, 95% CI = 8.500 – 10.667; OS = 16.433 months, 95% CI = 14.467 – 18.333; P = 0.0477). After the failure of CCRT, we observed that dual chemotherapy (n = 925; OS = 9.133 months, 95% CI = 8.400 - 10.100) has better survival benefit (P &lt; 0.0001) than single agent chemotherapy (n = 815; OS = 7.500 months, 95% CI, 6.933 – 8.133). IP chemotherapy demonstrated a better OS (9.567 months, 95% CI, 8.667 – 10.333 vs. 7.100 months, 95% CI, 5.100 – 10.400, P = 0.0170, respectively) than EP regimen in the platinum-resistant group; patients with PFS within 6 months after CCRT. However, in platinum sensitive group; patients who recurred after 6 months, the clinical benefit of EP regimen was superior to IP regimen (OS = 17.183 months, 95% CI, 13.033 – 25.633 vs. 6.617 months, 95% CI, 5.433 – 7.767; P &lt; 0.0001). Cox proportional hazards regression analysis demonstrated that age, EP-CCRT, and dyslipidemia retained significant associations with OS after adjusting for all variables. Conclusions: In Korean population, concurrent thoracic radiotherapy with EP regimen had significantly favorable effects on OS and PFS. In addition, after the failure of CCRT, combination chemotherapy had clinical benefits over single agents. Among combination chemotherapy, IP combination regimen showed significantly favorable effects on OS and PFS, especially in the platinum-resistant group.
Effects of seretide on lower airway bacterial colonization in stable phase of chronic obstructive pulmonary disease
Authors: Shun-ping He, Zhi-feng Liu, Dong-mei Li, Jiang Huang
Journal: BMJ (2012)

Objective To explore the effects of seretide (salmeterol 50 μg and fluticasone propionate 500 μg) on lower airway bacterial colonization (LABC) in the patients with stable moderate-tosevere chronic obstructive pulmonary disease (COPD).Methods A total of 84 patients with moderate-tosevere COPD were divided into 2 groups,i.e.test (n =43) and control (n =41).The control group received basic treatment while the test group seretide 50/500 μg per inhalation twice daily for 2 years plus basic treatment.Induced sputum specimens were analyzed for quantitative bacteriology and bacterial culture.The pulmonary function key parameters and exacerbation frequency were compared between two groups at pre- and post-therapy.Results The test group has significantly a lower positive rate of bacterial culture in the lower respiratory tract than before(16.3％ vs.34.9％,x2 =3.9091,P =0.0480).While in the control group,the positive rate of bacterial culture stayed almost the same as compared with that at pre-therapy (x2 =0.2253,P =0.6350).The test group had significantly decreased exacerbation frequency than the control group (1.9±2.1 vs.2.9 ±2.3,t =2.0364,P =0.0449);FEV1 of the control group decreased by (0.0885 ± 0.0186)L in 2 years and decreased by (0.0807 ± 0.0165)L in the test group.Significant differences existed in two groups (t =2.0355,P =0.0450).Conclusion The treatment of seretide can decrease LABC,slow decreasing trend of lung function and improve clinical symptoms in the patients with stable moderate-to-severe COPD.

Key words: 
Pulmonary disease,chronic obstructive; Seretide; Bacterial colonization
5-year efficacy and safety of secukinumab in patients with ankylosing spondylitis: end-of-study results from the phase 3 MEASURE 2 trial
Authors: Helena Marzo-Ortega, Joachim Sieper, Alan J Kivitz, Ricardo Blanco, Martin Cohen, Karel Pavelka, Eumorphia M Delicha, Anna Stefanska, Hanno B Richards, Susanne Rohrer
Journal: The Lancet Rheumatology (2020)
Disease perception and awareness in patients with chronic obstructive pulmonary disease in rural Xuzhou
Authors: Pei-an Lou, Jia-xi Yu, Xiao-hong An, Ning Zhang, Pei-pei Chen, Li Zhang, Ling-cai Han, Gang Li
Journal: BMJ (2009)

Objective To evaluate perception and awareness of disease knowledge in patients with chronic obstructive pulmonary disease (COPD) in rural area of Xuzhou City. Methods Perception and awareness of COPD, including its nature, control, medication use, impact on their quality of life, experience of its acute exacerbation, and so on, in 392 patients with COPD were evaluated with self-designed ad hoc questionnaire. Proportion and percentage were used in statistical analysis. Results According to the GLOD standards, 58 of 392 patients with COPD could be classified as stage Ⅰ (14. 8%), 164 as stage Ⅱ (41.8%), 103 as stage Ⅲ (26.3%) and 67 as stage Ⅳ (17.1%), respectively. Only 14 patients (3.6%) had heard COPD, but all of them did not know the definition of COPD and its acute exacerbation. Lung function tests and health education had never been performed for all these patients. One hundred and twenty-six patients (32. 1%) did not understand that smoking is a risk factor for COPD, 343 patients (87. 5%) had never heard that COPD could be prevented and controlled. Only 95 patients (24. 2%) did regular physical exercises. Seventy-six patients (19. 4%) in stable stage did not take theophylline regularly, and none of them took inhalers or nebulizer drugs regularly or temporally, or oxygen therapy and pulmonary rehabilitation at home. During acute exacerbation, 261 patients (66.6%) could take theophyUine or analogous drugs and antibiotics. One hundred and five patients (26. 8%) were admitted to hospital during the past year due to respiratory symptoms. Physical activities were restrained in 224 patients (57.1%), 91 patients (23. 2%) had a little bit feeling of depression sometimes and social communication was impacted in 232 patients (59. 2%). Conclusions Patients with COPD in rural Xuzhan, Jiangsu province were poor in knowledge of COPD, and their treatment during stable stage and acute exacerbation did not meet the standards. COPD had significant impact on their daily life, and education and management for the patients should be strengthened.

Key words: 
Pulmonary diseases, chronic obstructive;  Cognition;  Questionaires
我的从医之路由这里开始
Authors: 冯翠娟
Journal: BMJ (2009)

我,一个普通的医学本科毕业生,2008年应北京市卫生局招聘进京,成为一名社区医生.这期间,我曾激动过,盼望过;也曾迷茫过,失落过. 短短的半年时间,我好似经历了人生的四季.毕竟青春年少,我们有昂扬的斗志,有关好的梦想。
Contraception with no abortion
Authors: 程利南
Journal: BMJ (2010)

1994年开罗国际人口与发展大会行动纲领明确指出:从任何角度来看,都不应该把人工流产当作计划生育方法.所有国家政府的相关机构和非政府机构应该积极加强他们对妇女健康的承诺,通过扩展和改善计划生育服务,把降低人工流产作为公共卫生的主要问题之一。
CD3 and CD20 immune cell densities in primary tumors, lymph node metastasis, and recurrent disease samples of head and neck squamous cell carcinoma.
Authors: Simon Laban, Romain Remark, Christian Idel, Julika Ribbat-Idel, Andreas Schröck, Jasmin Ezić, Johannes Döscher, Marie-Nicole Theodoraki, Rosemarie Krupar, Andrew G. Sikora, Glen Kristiansen, Friedrich Bootz, Guray Akturk, Thomas Jens Ettrich, Hazem Edmond El-Osta, Patrick J Schuler, Cornelia Brunner, Thomas K Hoffmann, Sven Perner, Sacha Gnjatic
Journal: Journal of Clinical Oncology (2020)

6551 Background: Immune cell (IC) infiltrates in primary tumors (PT) have been identified as prognostic markers in head and neck squamous cell carcinoma (HNSCC). IC densities may differ among PT, lymph node metastasis (LNM) and recurrent disease (RD) and by primary disease site (oral cavity- OC, oropharynx- OP, hypopharynx- HP, larynx- L). Here, we compare CD3 and CD20 IC densities in PT, LNM and RD in paired samples from different disease sites and determine the prognostic impact of IC infiltrates. Methods: Tissue microarrays with 425 PT, 198 LNM and 46 RD samples--each in triplicate--were stained immunohistochemically for CD3 and CD20 in the same slide. Immune cell densities per mm 2 were determined using a digital image analysis software (QuPath). Individual means were calculated from triplicates of each sample. IC infiltrates from different sample types (PT, LNM, RD) and primary tumor sites were compared using Kruskal-Wallis and Mann-Whitney-U tests. Paired samples were compared using Wilcoxon signed rank test. IC densities were classified as CD3 high/low and CD20 high/low for each primary tumor site using the individual median as a cut-off. Overall survival (OS) was calculated using the Kaplan-Meier method. P-values for each hypothesis were corrected using a false discovery rate of 5%. Results: CD3 and CD20 IC densities differed significantly by sample type (both p&lt;0.0001) and primary site (CD3: p=0.012, CD20: p=0.0017). CD3 and CD20 densities were significantly lower in PT compared to LNM or in RD compared to PT and LNM. Paired samples (n=172) revealed a significantly higher CD3 and CD20 density (both p&lt;0.0005) in LNM compared to PT, but no significant differences between PT and RD (n=28, p&gt;0.05). CD3 densities were significantly higher than CD20 densities in all sample types. CD3 high patients had the best prognosis in all sites except for OC (q&lt;0.05) independent of CD20 status. In OC, CD3 density was not prognostic, but CD3 low /CD20 high patients had the worst OS compared to CD3 low /CD20 low and CD3 high /CD20 high or even CD3 high /CD20 low patients (p=0.018) who had the best prognosis. Conclusions: IC densities of CD3 and CD20 vary by sample type and primary site. Except for OC, in all sites the prognostic impact is determined by CD3 high , whereas in OSCC only the combination of CD3 and CD20 IC densities achieves a good prognostic value. Interestingly, CD3 low /CD20 high patients have the worst overall survival in OC patients. Further work is needed to understand the interaction of B- and T cell infiltrates in the tumor, especially in OC.
Changes of thyroid function in patients with chronic obstructive pulmonary disease and its clinical significance
Authors: 刘波, 钟杉
Journal: BMJ (2006)

目的 探讨慢性阻塞性肺疾病(COPD)急性发作期患者血清甲状腺激素水平及其临床意义.方法 COPD急性发作期患者56例,根据动脉血氧分压分为轻度缺氧组(A组)25例,中度缺氧组(B组)19例,重度缺氧组(C组)12例.治疗后进入缓解期49例,死亡7例.对照组20例.应用电发光免疫法测定各组血清甲状腺激素水平.分析动脉血氧分压与甲状腺激素水平的关系.结果 A组三碘甲状腺原氨酸(TT3)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平低于对照组(P＜0.01,P＜0.05);B、C组TT3、总甲状腺素(TT4)、FT3、FT4均低于对照组(P＜0.01);各组治疗后血清TT3、TT4、FT3、FT4除A组TT4外均较治疗前有所升高,差异有统计学意义(P＜0.05,P＜0.01),促甲状腺素无显著变化.死亡的7例入院时动脉血氧分压、TT3、TT4、FT3、TT4水平明显低于存活者(P＜0.01).相关分析显示血清TT3、TT4、FT3、FT4水平的变化与动脉血氧分压呈正相关.结论 COPD患者急性发作期血清甲状腺激素水平明显低于对照组,缺氧是导致甲状腺激素水平变化的重要因素之一,监测血清中甲状腺激素的浓度有助于判断COPD患者病情危重程度和预测预后。
肝豆状核变性30例听觉事件相关电位分析
Authors: 刁红梅, 张梅, 马莉
Journal: BMJ (2006)

对30例肝豆状核变性患者和30例健康对照者行听觉事件相关电位分析,并使用韦氏成人、儿童智力量表中国修订版(WAIS-CR)对肝豆状核变性患者进行认知功能测定.结果显示肝豆状核变性组听觉事件相关电位异常率70%,P300潜伏期比正常对照组延长(t=2.57,P＜0.01),韦氏智力量表认知功能评分低于90分者占68%.提示P300测定比临床认知能力测定更灵敏、更客观,且检测简便,可作为肝豆状核变性患者的一项有临床价值的检测手段。
Roles of general practitioners in diabetes control
Authors: 高鑫
Journal: BMJ (2004)

随着生活水平的提高、饮食结构的改变和体力活动的减少,在世界范围内肥胖和2型糖尿病的发病率逐年增加,尤其是处在经济转型期的发展中国家,如我国和印度,2型糖尿病患病人数增加更为迅速.据2003年世界卫生组织发布的信息表明,目前全世界糖尿病患者人数约1.75亿,预测到2030年将增加1倍,达到3.5亿人.1980年我国糖尿病患病率为0.67%,1990年患病率上升到3.2%,比1980年增加了3.8倍。
TP53 R249G/S mutation as an independent prognosis indicator in hepatocellular carcinoma.
Authors: Ledu Zhou, Ying Xu, Dong Wang, Ke Ye, Liang Xiao, Guo Long, Rongrong Chen, Xuefeng Xia
Journal: Journal of Clinical Oncology (2020)

e16622 Background: Many cancers could be driven by some specially mutations exampled as EGFR in lung cancer, influenced prognosis prominently. However, there were few related studies in liver cancer, although primary liver cancer was a common malignant tumor causing high morbidity and mortality. Methods: 97 patients diagnosed with primary hepatocellular carcinoma were enrolled in this study. Operative tissue samples were collected and analyzed using hybridization capture based NGS ERSeq method from all patients. Results: 1088 somatic mutations were identified in tissue samples. Targeted-capture sequencing of 1,021 genes that are frequently mutated in solid tumors revealed that the most frequently mutated genes were TP53 (59%), TERT (32%) and AXIN1 (19%). By using the least absolute shrinkage and selection operator (LASSO), the recurrence risks were constructed on the basis of five-gene mutations, AXIN1, CTNNB1, LRP1B, PDGFRA and TP53. The ROC curve was 0.813 and 0.882 in training and validation cohorts, respectively. TP53 R249G/S point mutation was predicted prognostic independently. Up to 60% TP53 R249S mutated patients occurred recurrence, while less than 30% TP53 R249 wildtype patients occurred recurrence ( P = 0.0002). Patients with R249G/S point mutation showed a worse prognosis. The median disease-free survival time was 8.0 VS 45.0 months in R249G/S mutated group (n = 79) and R249- wildtype (n = 18) group, respectively (Log-rank test, P = 0.0364). Conclusions: In various cancer types, TP53 has a broad-spectrum mutation, but only in hepatocellular carcinoma, TP53 mutations are highly concentrated at the R249 point, which was considered to be related to aflatoxin infection, and mutations at this site can significantly affect the prognosis of patients. The discovery of this target also provide clue for subsequent targeted treatment of liver cancer.
Genital Powder Use and Ovarian Cancer
Authors: Daniel W. Cramer
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Dandy-Walker Syndrome:5 cases report and literature review
Authors: Ke-qiang Chi, Ding-an Mao, Jie-min Li, li-qun Liu
Journal: BMJ (2010)

5 cases diagnosed with Dandy-Walker Syndrome from May 2006 to November 2009 were investigated and relevant literature reviewed. Dandy-Walker Syndrome was characterized by retarded motordevelopment and cerebellar signs. The latter was observed in 3 cases in our series. The disorder, mostly influencing childhood, typically causes the fourth ventricle enlarged, and the cauda cerebelli atrophic or even absent. MRI is the most optimal radiological method to diagnose it.

Key words: 
Dandy-Walker Syndrome;  Diagnosis
Efficacy of integrated traditional Chinese medicine with Western medicine in patients with diarrhea-predominant irritable bowel syndrome and its relation to serum inflammatory cytokines
Authors: Shiwei Tang, Ming Cheng, Zhongping Wu, Yanyan Hu, Yurui Pan
Journal: BMJ (2017)

Objective
To investigate the efficacy of integrated traditional Chinese medicine (TCM) with Western medicine in treatment of diarrhea type irritable bowel syndrome (IBS-D) and its effect on serum inflammatory cytokine levels.


Methods
One hundred and sixty four IBS-D patients treated in Guangfu Hospital from July 2013 to August 2015 were randomly divided into study group and control group with 82 cases in each group. All patients received oral Saccharomyces boulardii 1.0 b. i.d, while patients in study group received additional Shuganjianpi decoction b. i.d for 4 weeks. The clinical efficacy was observed, serum IL-10, IFN-γ and TNF-α levels were measured in 2 groups.


Results
After treatment, the total score of clinical symptoms in study group was lower than that of control group [(5.71±1.41) vs. (11.70±2.88) points, t=16.707, P<0.01]. Serum levels of IFN-γ, TNF-α in study group decreased significantly after treatment [IFN-γ (2.88±1.38) ng/L vs. (1.00±0.44 ) ng/L, t=11.609, P<0.01; TNF-α (41.26±5.29) ng/L vs. (24.13±3.27) ng/L, t=24.636, P<0.01], IL-10 significantly increased [(142.23±21.58) ng/L vs.(170.23±33.45) ng/L, t=6.291, P<0.01]. The overall effective rate of study group was higher than that of control group, [87.50% (70/80) vs. 68.75% (55/80), χ2=8.228, P<0.01]. After treatment, the quality of life scores in both groups were improved; but the improvement of diet, spirit, mood and sleep scores in study group were better than those in control group [(240±69) vs. (193±60), t=4.579, (316±74) vs. (230 ± 69), t=7.603, (297±62) vs. (228±59), t=7.211; (284±62) vs. (230±54), t=5.874, all P<0.01].


Conclusion
The efficacy of integrated traditional Chinese medicine with Western medicine in treatment of IBS-D is significantly better than that of Western medicine alone, which may be associated with its regulatory effect on the serum inflammatory cytokine levels.


Key words: 
Integrated traditional Chinese medicine and western medicine; Irritable bowel syndrome; Cytokines
Types and risk factors of recurrent ischemic stroke after initial brainstem infarction
Authors: Yukui Yan, Xiaoyan Sun, Quankun Liu
Journal: BMJ (2015)

To retrospectively analyze the clinical data of 176 patients of recurrent cerebral infarction at our hospital. Based upon the treatment of acute stroke trial (TOAST) classification, the types of recurrent ischemic stroke with initial brainstem infarction were classified. And univariate and multivariate logistic analyses of risk factors were performed. The major types in a decreasing order were atherosclerotic cerebral infarction (AT, n=24, 70.6%), small arterial occlusive stroke (SA, n=8, 23.5%) and cardiogenic cerebral embolism (CE, n=2, 5.9%). Brainstem infarction was more likely to be affected by poor life habits and a history of diabetes mellitus (DM). And atrial fibrillation was a major independent risk factor for non-brainstem infarction. Multivariate logistic analysis showed that poor living habits (P=0.03), a history of DM (P=0.004), vulnerable plaque (P=0.01) and poor compliance of secondary prevention medication (P=0.02) were independent risk factors for recurrent ischemic stroke with initial brainstem infarction. Health education should be strengthened for preventing recurrent ischemic stroke with brainstem infarction.


Key words: 
Brain infaction, relapsing; Risk factors
Estimating glomerular filtration rate in acute kidney injury patients in intensive care unit by using creatinine and cystatin C: a dynamic comparison study
Authors: Qingdong Li, Xianyao Wan, Queque Li, Junfeng Zhou, Suwei Li
Journal: BMJ (2014)

To dynamically compare cystatin C estimated glomerular filtration rate (eGFRcys-c) and creatinine estimated glomerular filtration rate (eGFRScr) in acute kidney injury (AKI) patients in intensive care unit (ICU) to provide enlightenment for GFR estimation. Significant positive correlations existed between 538 paired value of cystatin C and creatinine. eGFRcys-c was significantly lower than eGFRScr. The values of eGFRcys-c and eGFRScr at 3 different timepoints were recorded for repeated measures analysis of variance. The results indicated that, with the progress of AKI, eGFRcys-c significantly decreased. eGFRScr had no significant decreases after a diagnosis of AKI. The time interval of eGFRcys-c up to the standard of RIFLE of AKI was significant shorter than eGFRScr. In conclusion, eGFRcys-c may reflect the change of GFR more sensitive and earlier than eGFRScr in ICU AIK patients. More in-depth studies are warranted.


Key words: 
Acute kidney injury; Glomerular filtration rate