tbuckley/cabot-search huggingface dataset:
Camrelizumab combined with FOLFOX as neoadjuvant therapy for resectable locally advanced gastric and gastroesophageal junction adenocarcinoma.
Authors: Ying Liu, Guangsen Han, Hongle Li, Yuzhou Zhao, Jing Zhuang, Gangcheng Wang, Baodong Li, Jinbang Wang, Zhimeng Li, Qingxin Xia, Jie Ma, Chengjuan Zhang, Juan Yu, Ke Li, Shuning Xu, Lei Qiao, Gaizhen Kuang, Danyang Li
Journal: Journal of Clinical Oncology (2020)

4536 Background: Neoadjuvant chemotherapy has been demonstrated to improve the pathological complete response(pCR) and 5-year survival rate of patients with locally advanced gastric and gastroesophageal junction adenocarcinoma (GC/GEJC). Immunotherapy has become a new promising treatment for advanced GC/GEJC. Therefore, we intended to evaluate the safety and efficacy of Camrelizumab (anti-PD-1 antibody) combined with FOLFOX as the neoadjuvant therapy for patients with locally advanced GC/GEJC. Methods: Eligiblepatients were locally advanced GC/GEJC with clinical stage≥T2 and/or positive lymphoglandula confirmed by endoscopic ultrasonography (EUS) and imaging. They received 4 cycles neoadjuvant therapy which including Camrelizumab(200mg ivgtt D1), FOLFOX(Oxaliplatin 85mg/m 2 ivgtt D1, 5-Fu 400mg/m 2 iv D1, LV 200mg/m 2 ivgtt D1, 5-Fu 2.4mg/m 2 CIV 46 hours) every 14 days. Imaging evaluation was performed in 2-4 weeks after neoadjuvant therapy. Patients without progression disease (PD) received D2 radical gastrectomy. The primary endpoint was pCR, the secondary endpoints were R0 resection rate and safety. Results: From July 24 2019 to January 31 2020, 16 patients were eligible. The median age was 57 years (29-72 years). A total of 11(69%) males and 5(31%) females, ECOG PS 0 (n=9, 56%), ECOG PS 1 (n=7, 44%). All the patients completed 4 cycles treatment and none of them was confirmed PD by image. One of the patients refused gastrectomy and withdraw from the study. The other 15 patients underwent operation. Unfortunately, intraperitoneal metastases were confirmed in 2 patients during operation. 13 patients received D2 radical gastrectomy and all of them experienced R0 resection. Among the 13 evaluable patients, 1 patient (8%) was observed pCR, 3 patients (23%) experienced TRG1, 10 patients (77%) achieved stage reduction. Notably, 8 patients (62%) had lymphonodus pCR. The grade 3-4 treatment-related AEs were neutropenia (n=3, 19%), leukopenia (n=2, 13%) and anorexia (n=1, 6%). No serious AEs resulted in termination of treatment. Either severe immune-related AEs or treatment-related death was not observed. Conclusions: Camrelizumab combined with FOLFOX as neoadjuvant regimen in patients with locally advanced GC/GEJC showed promising pCR with good tolerance. Clinical trial information: NCT03939962 . [Table: see text]
Effects on glucose control of abnormal glucose metabolism during pregnancy by continuous glucose monitoring system
Authors: Chenchen Zhou
Journal: BMJ (2014)

For the case study group, 52 pregnant women diagnosed as abnormal glucose metabolism and requiring in-hospital glucose control were selected for continuous glucose monitoring. And another 49 pregnant women with known glucose levels through serial glucose monitoring at the same period were taken as case control group. We divided the case study group into A1, A2 and B based on White's typing. In case study group, the glucose levels peaked at 8 to 10 am and dropped to the lowest levels at 10 pm to 6 am on the next day. The glucose of A2 group was markedly higher than that of A1 group. The highest postprandial glucose of case study group happens at (1.6±0.5)h after breakfast, (1.6±1.2)h after lunch and (1.6±0.8) h after dinner. The blood glucose wavy coefficient of patients of A1 and A2 groups had significant statistical difference. The newborn weight of case study group was lower than that of case control group.


Key words: 
Glucose metabolism, gestational; Blood glucose; Monitoring
National, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study
Authors: Rosa Parisi, Ireny Y K Iskandar, Evangelos Kontopantelis, Matthias Augustin, Christopher E M Griffiths, Darren M Ashcroft
Journal: BMJ (2020)

Abstract Objective To systematically review and provide information on the incidence of psoriasis and quantify global, regional, and country specific estimates of its prevalence. Design Systematic review and meta-analysis. Data sources Medline, Embase, Web of Science, SciELO, Korean Journal Databases, Russian Science Citation Index, WPRIM, SaudiMedLit, Informit, IndMed, and HERDIN were searched systematically from their inception dates to October 2019. Methods Studies were included if they reported on the incidence or prevalence of psoriasis in the general population. Incidence data were summarised descriptively, whereas bayesian hierarchical models were fitted to estimate the global, regional, and country specific prevalence of psoriasis. Results 41 164 records were identified and 168 studies met the inclusion criteria. In adults, the incidence of psoriasis varied from 30.3 per 100 000 person years (95% confidence interval 26.6 to 34.1) in Taiwan to 321.0 per 100 000 person years in Italy. The prevalence of psoriasis varied from 0.14% (95% uncertainty interval 0.05% to 0.40%) in east Asia to 1.99% (0.64% to 6.60%) in Australasia. The prevalence of psoriasis was also high in western Europe (1.92%, 1.07% to 3.46%), central Europe (1.83%, 0.62% to 5.32%), North America (1.50%, 0.63% to 3.60%), and high income southern Latin America (1.10%, 0.36% to 2.96%). Conclusions Eighty one per cent of the countries of the world lack information on the epidemiology of psoriasis. The disease occurs more frequently in adults than in children. Psoriasis is unequally distributed across geographical regions; it is more frequent in high income countries and in regions with older populations. The estimates provided can help guide countries and the international community when making public health decisions on the appropriate management of psoriasis and assessing its natural history over time. Systematic review registration PROSPERO CRD42019160817.
Obstructive sleep apnea syndrome and metabolic consequences
Authors: Jiayong Xie
Journal: BMJ (2016)

阻塞性睡眠呼吸暂停综合征(OSAS)与代谢综合征是两种全身系统性的疾病，二者具有一定的共存性。本文通过介绍OSAS合并代谢紊乱的临床状况、发病机制及干预治疗方面的研究，提示临床医生重视两种疾病合并存在的危害性，早期筛查，兼顾性治疗，以改善预后。
Risk-adapted therapy for advanced-stage natural killer/T-cell lymphoma: An analysis from the China Lymphoma Collaborative Group Study.
Authors: Weiping Liu, Yong Yang, Shunan Qi, Ying Wang, Xia He, Gang Wu, Baolin Qu, Liting Qian, Fuquan Zhang, Xueying Qiao, Wang Hua, Gaofeng Li, Yu-Jing Zhang, Yuan Zhu, Jianzhong Cao, Junxin Wu, Tao Wu, Jun Zhu, Ye-Xiong Li, Yuqin Song
Journal: Journal of Clinical Oncology (2020)

e20041 Background: Few studies focused on the risk-adapted therapy for advanced-stage natural killer/T-cell lymphoma (NKTCL) due to poor prognosis. Methods: Data of 406 patients with advanced-stage NKTCL from 20 Chinese institutions between 2000 and 2015 were retrospectively analyzed. To develop a prognosis index model for advanced-stage NKTCL, all patients were divided into the primary cohort from South China (n = 198) and the validation cohort from North China (n = 208). Clinical factors related to survival in the primary cohort were identified to construct a new prognosis index model. An external validation for the prognosis index model was performed in the validation cohort. Stratified by the prognosis index model, survival benefit for treatment models was assessed. Results: The median age was 42 years with the ratio of male/female of 2.5:1. Extra-nodal involvement was observed in 72.4% of patients. More than one third of patients received asparaginase (Asp)–containing chemotherapy. In addition, radiotherapy was administrated in 135 (33.3%) patients. The overall response rate (ORR) and complete remission (CR) rate were 59.3% and 38.3% in 337 available patients. The expected 3-year progression-free survival (PFS) and overall survival (OS) rates were 26.9% and 37.3%, respectively. Based on 3 clinical variables including ECOG-PS &gt; 1, elevated LDH and solid organs involvement, a new prognosis index model (ASPRIN) was developed and showed superior discrimination than current models including IPI, KPI and PINK in this particular population. The expected 3-year OS rates in the primary and validation cohort were 54.8% and 52.9% in the low risk group (with 0-1 risk factor), 34.4% and 38.0% in the intermediate risk group (with 2 risk factors), 13.8% and 10.6% in the high risk group (with 3-4 risk factors), respectively. Stratified by ASPRIN model, combined radio-chemotherapy provided better survival benefit than chemotherapy alone regardless of chemotherapy regimens in the low risk group (3-year PFS 52.6% vs. 22.6%, P &lt; 0.001; 3-year OS 72.8% vs. 35.8%, P &lt; 0.001), while Asp–containing chemotherapy improved survival with an increase of about 10%-15% in PFS and OS compared with non–Asp–containing chemotherapy in the intermediate and high risk groups. Conclusions: The outcome of advanced-stage NKTCL is still poor and heterogeneous even in the era of Asp–containing chemotherapy, which highlighted the need of establishing more effective risk-adapted therapeutic strategies.
Using standardized patients in training of assistant general practitioners
Authors: Liang Chen, Xiuping Xia
Journal: BMJ (2015)

Thirty assistant general practitioners (GPs) of Jiading District Shanghai were trained for clinical skills and communication skills by using standardized patients (SP) in outpatient department from January to April 2014. The scores of clinical skills and communication skills were evaluated and compared before and two months after training.The results showed that the score of clinical skills [(72±5) vs (56±7), t=7.871, P 0.05). After training, the scores and the proportions of the trainees qualified for building physician-patient relationship [(20±3) vs (15±4), t=4.056], collecting information and providing feedback [(22±4) vs (13±3), t=4.682], understanding complaints from patients' perspective [(5±2) vs (3±2), t=3.107], sharing information and obtaining informed consent [(19±4) vs (11±5), t=4.322] and closing consultation [(6±2) vs (3±1), t=2.987] were higher than before training (all P<0.05). The results indicate that training by using SP can effectively improve the clinical skills and communication skills of assistant GPs.


Key words: 
Standardized patients; Clinical medical capacity; General practitioners
Observations of comprehensive interventions and alprazolam therapy for insomnia
Authors: Yong Chen, Murong Ye, Lijuan Zu
Journal: BMJ (2015)

A total of 100 insomniacs were randomly divided into intervention and contrast groups (n=50 each). The contrast group took only alprazolam while the intervention group received both alprazolam and other comprehensive regimens, including acupuncture, psychotherapy and traditional Chinese medicine. One course of treatment lasted 10 days for both groups and 6 courses were offered. After comprehensive interventions, as compared with contrast group, the scores of Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) decreased obviously in intervention group (P<0.05). And the curative rate (46%) and the total efficacious rate (96%) of intervention group were higher than those of contrast group (P<0.05).


Key words: 
Sleep initiation and maintenance disorders; Intervention studies
Importance of whole-course antidepressant treatment for depressive patients
Authors: Zhang Ling, Wang Gang
Journal: BMJ (2016)

全病程治疗和管理是防止抑郁障碍复燃或复发、改善预后的基本原则。在全病程治疗中，抗抑郁药物是最重要的治疗手段。随着医改步伐的逐步推进，未来将有更多的抑郁障碍患者在社区接受长期治疗和随访，因此全科医生有必要了解和掌握抗抑郁药物的全病程治疗原则。
Prediction of early progression (EP) to CDKIs first line treatment in ER+/HER2- metastatic breast cancer (MBC) using machine learning.
Authors: Jose Manuel Jerez, Nuria Ribelles, Pablo Rodriguez-Brazzarola, Tamara Diaz Redondo, Begoña Jimenez Rodriguez, Alfonso Sanchez-Muñoz, Antonia Marquez, Francisco Carabantes, Bella Pajares, Ester Villar, Maria-Jose Bermejo-Perez, Enrique Saez Lara, Maria Emilia Dominguez-Recio, Ana Godoy, Hector Mesa, Laura Galvez Carvajal, Leo Franco, Sofía Ruíz, Irene López, Emilio Alba
Journal: Journal of Clinical Oncology (2020)

e13040 Background: The treatment of luminal MBC has undergone a substantial change with the use of cyclin dependent kinase 4/6 inhibitors (CDKIs). Nevertheless, there is not a clearly defined subgroup of patients who do not initially respond to CDKIs and show EP. Methods: MBC ER+/HER2- patients who have received at least one line of treatment were eligible. The event of interest was disease progression within 6 months of first line treatment according to the type of therapy administered. The first line treatments were categorized in chemotherapy (CT), hormonal therapy (HT), CT plus maintenance HT and HT plus CDKIs. Free text data from clinical visits registered in our Electronic Health Record were obtained until the date of first treatment in order to generate a feature vector composed of the word frequencies for each visit of every patient. Six different machine learning algorithms were evaluated to predict the event of interest and to obtain the risk of EP for every type of therapy. Area under the ROC curve (AUC), True Positive Rate (TPR) and True Negative Rate (TNR) were assessed using 10-fold cross validation. Results: 610 RE+/HER2- MBC treated between November 1991 and August 2019 were included. Median follow up for metastatic disease was 28 months. 17426 clinical visits were analyzed (per patient: range 1-173; median 30). 119 patients received CT as first line treatment, 311 HT, 117 CT plus maintenance HT and 63 HT plus CDKIs. There were 379 patients with disease progression, from which 126 were within 6 months from first line treatment (54 events with CT, 57 with HT, 4 with CT plus maintenance HT and 11 with HT plus CDKIs). The model that yields the best results was the GLMBoost algorithm: AUC 0.72 (95%CI 0.67-0.77), TPR 70.85% (95%CI 70.63%-71.06%), TNR 66.27% (95% 66.08%-66.46%). Conclusions: Our model based on unstructured data from real-world patients predicts EP and establishes the risk for each of the different types of treatment for MBC ER+/HER2-. Obviously an additional validation is needed, but a tool with these characteristics could help to select the best available treatment when that decision has to be made, avoiding those therapies that are probably not to be effective.
Application of percutaneous transluminal angioplasty in hemodialytic patients with arteriovenous fistula stenosis
Authors: Bin Chen
Journal: BMJ (2017)

Arteriovenous fistula stenosis developed in 32 patients who received hemodialysis from April 2014 to April 2016, including 24 cases of autologous arteriovenous fistula(AVF) and 8 cases of artificial vessel arteriovenous fistula(AVG). In AVF patients, there were 20 cases with blood flow decreasing and 4 cases of venous hypertension, while in AVG patients there were no cases with blood flow decreasing and 8 cases with venous pressure increasing (χ2=17.77, P 0.05]. The blood pressure was decreased after PTA treatment[(71.2±7.9) vs. (170.4±15.7) mmHg, t=34.62, P 0.05].


Key words: 
Angioplasty, balloon; Arteriovenous fistula
Gender variation in clinical activity and Medicare payments among medical oncologists and hematologists.
Authors: Manojna Konda, Arya Roy, Richa Parikh, Tyler Fugere, Manoja Gullapalli, Yadav Pandey, Rashmi Verma
Journal: Journal of Clinical Oncology (2020)

11014 Background: While physician sex has been shown to impact salary even after adjusting for productivity, gender-based differences in clinical activity and reimbursement for oncologists and hematologists are not completely understood. We evaluated the differences in Medicare reimbursement for male and female physicians in medical oncology and hematology. Methods: A retrospective analysis using Centers for Medicare &amp; Medicaid Services Physician and Other Supplier Public Use File (POSPUF) for the year 2017 was performed to identify charges and total payment information for individual oncologists and hematologists. Mean values were compared using two-sample t-test, and the medians were compared by Wilcoxon rank-sum test. Results: A total of 8553 oncologists and hematologists (2710 women and 5843 men) were included in the POSPUF in 2017. Female physicians submitted a mean of 16,754 fewer charges (95% CI, −19,696 to −13,812; P &lt; .0001), collected a mean of $173,632 less in revenue (95% CI, −201,184 to −146,080; P &lt; .0001), and submitted a mean of 5.65 fewer unique billing codes (95% CI, - 6.69 to - 4.61; P &lt;.0001) compared to their male counterparts. Women represented 219 of the 1069 most highly productive oncologists and hematologists (20.4%) and collected a mean of $281,263 (95% CI, −417,517 to −145,008; P &lt; .0001) less than similarly productive men. Conclusions: This study suggests that female oncologists and hematologists submit fewer Medicare charges and receive lower Medicare payments compared to male providers. Even among similarly productive hematologists and oncologists, women collected less revenue than men. Further research is required to explore causes for this difference. [Table: see text]
Long-term survival from pembrolizumab (pembro) completion and pembro retreatment: Phase III KEYNOTE-006 in advanced melanoma.
Authors: Georgina V. Long, Jacob Schachter, Ana Arance, Jean-Jacques Grob, Laurent Mortier, Adil Daud, Matteo S. Carlino, Antoni Ribas, Catriona M. McNeil, Michal Lotem, James M. G. Larkin, Paul Lorigan, Bart Neyns, Christian U. Blank, Teresa M. Petrella, Omid Hamid, Erin Jensen, Clemens Krepler, Scott J. Diede, Caroline Robert
Journal: Journal of Clinical Oncology (2020)

10013 Background: 5-year follow-up of the phase 3 KEYNOTE-006 study (NCT01866319) showed pembro improved OS vs ipilimumab (ipi) in patients (pts) with advanced melanoma. 3-y OS rate from pembro completion for pts who completed 2 y of pembro was 93.8%. Results with 8 mo of additional follow-up are presented to inform clinical care. Methods: Eligible pts with ipi-naive advanced melanoma, ≤1 prior therapy for BRAF-mutant disease, and ECOG PS 0 or 1 were randomized to pembro 10 mg/kg Q2W or Q3W for ≤2 y or ipi 3 mg/kg Q3W for 4 doses. Pts discontinuing pembro with CR, PR, or SD after ≥94 weeks were considered pts with 2-y pembro. Pts who stopped pembro with SD, PR or CR could receive ≤12 mo of additional pembro (2nd course) upon disease progression if still eligible. ORR was assessed per immune-related response criteria by investigator review. OS was estimated using the Kaplan-Meier method. Pembro arm data were pooled. Post hoc ITT efficacy analyses are shown. Results: Median follow-up from randomization to data cutoff (Jul 31, 2019) was 66.7 mo in the pembro and 66.9 mo in the ipi arms. OS outcomes are shown in Table. For the 103 pts with 2-y pembro (30 CR, 63 PR, 10 SD), median follow-up from completion was 42.9 mo (95% CI, 39.9-46.3).Median DOR was not reached. 36-mo OS from pembro completion was 100% (95% CI, 100.0-100.0) for pts with CR, 94.8% (95% CI, 84.7-98.3) for pts with PR, and 66.7% (95% CI, 28.2-87.8) for pts with SD. 15 pts received 2nd-course pembro; BOR in 1st course was 6 CR, 6 PR, and 3 SD. Median time from end of 1st course to start of 2 nd course was 24.5 mo (range, 4.9-41.4). Median follow-up in pts who received 2nd-course pembro was 25.3 mo (range, 3.5-39.4). Median duration of 2nd-course pembro was 8.3 mo (range, 1.4-12.6). BOR on 2 nd course was 3 CR, 5 PR (ongoing responses, 7 pts), 3 SD (ongoing, 2 pts), and 2 PD (1 death); 2 pts pending. Conclusions: Pembro improves the long-term survival vs ipi in pts with advanced melanoma, with all pts who completed therapy in CR still alive at 5 years. Retreatment with pembro at progression in pts who stopped at SD or better can provide additional clinical benefit in a majority of pts. Clinical trial information: NCT01866319. [Table: see text]
联合用药治疗耐多药肺结核临床疗效观察
Authors: 孙小军, 金法祥, 黄明清, 赵宝珊
Journal: BMJ (2007)

评价左氧氟沙星、帕司烟肼、丁胺卡那、丙硫异烟胺、吡嗪酰胺联合应用于耐多药肺结核时的疗效.将118例耐多药肺结核患者随机分为治疗组(60例)和对照组(58例).治疗组采用左氧氟沙星、帕司烟肼、丁胺卡那、丙硫异烟胺、吡嗪酰胺联合方案;对照组采用氧氟沙星、帕司烟肼、乙胺丁醇、吡嗪酰胺联合方案,疗程均为15个月.有117例患者完成全部疗程.治疗组痰菌阴转率83%,对照组痰菌阴转率55%,痰菌阴转率治疗组明显高于对照组。
Covid-19: “Huge rise” in deaths at home is not fully explained by virus, say experts
Authors: Shaun Griffin
Journal: BMJ (2020)

Covid-19: "Huge rise" in deaths at home is not fully explained by virus, say experts Shaun GriffinLondon Deaths resulting from covid-19 infection account for only half of the number of excess deaths taking place in private homes, expert analysis of latest data suggests.
Publications of general practice education in China mainland 1993–2012: a bibliographic review
Authors: Lifen Chen, Chao Chen, Shuang Shao, Wenji Wang, Guanghui Jin, Yanli Liu
Journal: BMJ (2015)

Objective
To review the publication of general practice education in China mainland in 20 years from 1993 to 2012.


Methods
The research articles of general practice education published between January 1, 1993 and December 31, 2012 were searched from CNKI and Wanfang databases, and analyzed with bibliometric and literature management software NoteExpress 2, Epidata 3.1 and SPSS 13.0.


Results
Total 4 281 articles were retrieved and 241 education relevant articles were selected. 29.9% (72/241) of the 241 articles were on on-campus education, 67.6% (163/241) were on continuing medical education and 4.5% (11/241) were on post-graduation education. As to the published institutions, 58.5% (141/241) were from the medical colleges and research institutions, 25.7% (62/241) were from the tertiary hospitals, 3.7% (9/241) were from primary care institutions, 1.7% (4/241) were from the secondary hospitals and 5.8% (14/241) were from the government departments. The general practice education grants increased from 1 in 2001 to 46 in 2012; 20 of which were supported by provincial and ministerial level funds.


Conclusion
The contents of general medical education literature in China is mainly on on-campus education and continuing medical education; most of which were from the tertiary hospitals and the medical colleges and research institutions. The amount of research grants of general practice education were increasing year by year during 1993–2012, indicating that more attention had been paid to general practice education in mainland China in the last two decades.


Key words: 
Education; Bibliometric; General practice
口服降糖药的种类及其在控制高血糖中的作用
Authors: 傅汉菁
Journal: BMJ (2007)

近年来,口服降糖药物的种类增多,一些新型口服降糖药已在临床应用并积累了一些经验.以前选择口服降糖药物主要考虑药物的降糖效力,安全性、副作用、耐受性、依从性,费用,是否能够医疗保险报销等因素.随着近年来多种口服降糖药临床研究结果和临床荟萃分析结果的面世,在选择降糖治疗方案时更要遵循有大量循证医学数据支持的临床药物治疗规范。
Current situation and issues about community prevention and treatment of coronary heart disease
Authors: 丁静, 杜雪平
Journal: BMJ (2007)

冠心病自20世纪50年代以来,已经成为危害人类健康的一个主要非传染性疾病.1996年美国心脏协会(AHA)曾有统计,每33秒就有1例患者死于冠心病.有报道2000年欧洲每8名男子或17名女子中就有1人在65岁以前死于冠心病.冠心病占全欧洲失能调整寿命年(DALY)损失的22%[1]。