tbuckley/cabot-search huggingface dataset:
Annals Graphic Medicine - COVID Blues
Authors: Carla M. Canepa
Journal: Annals of Internal Medicine (2020)

Web Exclusives7 July 2020Annals Graphic Medicine - COVID BluesFREECarla M. Canepa, MDCarla M. Canepa, MDNew York, New York (C.M.C.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/G20-0053 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Download figure Download PowerPoint Comments0 CommentsSign In to Submit A Comment Thomas Doyle MDSouthcoast Health4 June 2020 Thank You For Sharing Thank you for sharing this piece / graphics - you succinctly highlight so many of the uncertainties and troubling aspects of care of Covid patients. Francois DufresneForward5 June 2020 Thank you This was brilliant!!! Very insightful and relevant. Author, Article, and Disclosure InformationAffiliations: New York, New York (C.M.C.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=G20-0053.Author/Illustrator Information: Carla M. Canepa, MD; e-mail, [email protected]com.This article was published at Annals.org on 2 June 2020. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 7 July 2020Volume 173, Issue 1Page: W14-W21KeywordsDisclosureHealth care ePublished: 2 June 2020 Issue Published: 7 July 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Clinical characteristics of diabetes mellitus in Morindawa Daur population
Authors: Yan Wang, Nailin Chen, Zhan Yang, Xiaoxin Sun, Shiyu Wang, Wei Qiu
Journal: BMJ (2015)

Total 967 patients with diabetes mellitus treated in Morindawa People's Hospital from June 2012 to June 2014 were included in the study, among them 425 (44.0%) were of Daur nationality and 542 (56.0%) were of Han nationality. The clinical data and laboratory tests were analyzed and compared between two groups. Compared with Han nationality, Daur patients presented a younger average age[(55±11)y vs.(58±10)y, P=0.000], an earlier age of onset[(50±10)y vs.(53±11)y, P=0.000], a higher percentage of males (54.8% vs. 46.9%, P=0.008), a higher percentage of rural residents (42.1% vs.36.2%, P=0.034), a lower level of fasting blood-glucose (FBG) [(9.25±3.37) mmol/L vs. (10.28±4.33) mmol/L, P=0.000], higher levels of HbA1c [(7.61±1.71)% vs. (7.29±1.63)%, P=0.008], triglyceride (TG)[(2.91±2.06) mmol/L vs. (2.36±2.13) mmol/L, P=0.008], low density lipoprotein cholesterol (LDL-C)[(3.22±1.06) mmol/L vs. (3.01±0.92)mmol/L, P=0.020], systolic blood pressure (SBP)[(139.48±21.58)mmHg (1 mmHg=0.133 kPa) vs. (136.37±23.44)mmHg, P=0.002], diastolic blood pressure (DBP)[(87.23±12.59) mmHg vs. (85.32±12.52) mmHg, P=0.019], blood uric acid [(324.97±106.45)μmol/L vs. (285.32±98.69)μmol/L, P=0.000] and the ratio of urine microalbumin to urine creatinine [(2.29±5.57)mg/g vs. (0.12±0.98) mg/g, P=0.000]. The results show that Daur diabetic patients are younger in age, with more severe disorders in HbA1c, blood pressure, blood uric acid and lipids levels, which increase the probability of renal damage or cardiovascular diseases in these patients.


Key words: 
Diabetes; Daur
检查性宫腔镜临床应用545例分析
Authors: 李爱斌, 杨菁, 夏良斌, 李晶晶
Journal: BMJ (2005)

回顾性分析我院2004年1月至12月门诊宫腔镜检查的545例患者的临床资料,结果发现,其中宫腔粘连218例,占40.0%;子宫内膜息肉及黏膜下肌瘤109例,占20.0%;输卵管起始部阻塞81例,占14.9% ;宫腔形态正常43例,占7.9%;异物残留20例,占3.7%;子宫畸形74例,占13.5%。
Progression-free survival estimates in non-small cell lung cancer when RECIST is unavailable: Project GENIE’s integration of genomic, therapeutic and phenomic data.
Authors: Jessica A. Lavery, Katherine Panageas, Michele LeNoue-Newton, Shawn Sweeney, Seth Sheffler-Collins, Julia E Rudolph, Hira Rizvi, Nikolaus Schultz, Eva M. Lepisto, Kenneth L. Kehl, Jeremy Lyle Warner, Kristen Dang, John Phillip, Ben Ho Park, Gregory J. Riely, Deborah Schrag
Journal: Journal of Clinical Oncology (2020)

9622 Background: Molecular tumor profiling has become an integral component of oncology practice but linked genomic-phenomic data remain scarce. Recurrence, treatment response and progression are not structured consistently in medical records and this deficit has been a roadblock to discovery of biomarkers that are associated with favorable outcomes. Methods: The Genomics Evidence Neoplasia Information Exchange (GENIE) consortium is an AACR sponsored project to link and share genomic and phenomic data to promote discovery in precision medicine. 3 cancer centers that routinely perform somatic tumor profiling for advanced cancers agreed to curate anti-neoplastic treatment exposures and outcomes including recurrence, progression, response and survival using a standard method. 6 cancer types (lung, colorectal, breast, prostate, pancreas and bladder) were selected and a REDCAP database captures anti-neoplastic treatments, and specific elements from pathology, radiology and oncology reports. Curators abstract data using data fields that rely on the PRISSMM standard. “Real world” progression free survival (PFS) was identified based on curation of: 1) the text of radiologists’ reports for CT, PET/CT, PET and MRI scans (PFS I ) and 2) medical oncologists’ notes (PFS M ). PFS I and PFS M were estimated from the start of 1 st line anti-neoplastic systemic therapy until progression or death for all patients with molecularly characterized non-small cell lung cancer (NSCLC). Results: Genomic sequencing was performed between 2015 and 2017 for 748 patients with NSCLC treated at three major cancer centers. Median age at diagnosis was 66 years (interquartile range 58, 73) and 43% were male. As shown in the table, when RECIST assessments are unavailable, estimates of PFS vary based on whether they are derived from radiologists’ or oncologists’ interpretations. Conclusions: Radiologists’ reports and oncologists’ reports provide different PFS estimates. Cohort studies should specify the method used to define “real world” endpoints. Project GENIE will have 1800 NSCLC patients with curated endpoints by the ASCO meeting. [Table: see text]
Serum osteocalcin in patients with rheumatoid arthritis
Authors: 金世红, 赵丽娟
Journal: BMJ (2007)

目的 探讨类风湿关节炎(RA)患者血清骨钙素水平的变化.方法 利用放射免疫测定法,测定32例RA患者(RA组)和15例正常者(对照组)的血清骨钙素水平,同时测定红细胞沉降率和碱性磷酸酶水平.结果 RA患者的血清骨钙素水平明显低于对照组[分别为(5.1±2.3)与(8.3±1.7) μg/L,P＜0.001];两组中女性患者＜50岁者的血清骨钙素水平分别与同组中≥50岁者比较,差异均无统计学意义(P＞0.05);RA组血清骨钙素水平与红细胞沉降率、碱性磷酸酶和病程间均无直线相关关系(P＞0.05);RA组中女性患者＜50岁者的血清骨钙素水平与红细胞沉降率之间有正相关关系(P＜0.05).结论 RA患者的成骨细胞活性下降,且骨转换率降低;血清骨钙素与红细胞沉降率、磷性碱酸酶及疾病病程无关。
Roles of Trained Immunity in the Pathogenesis of Cholangiopathies: A Therapeutic Target
Authors: Chao Yan, Stephane Koda, Jing Wu, Bei‐Bei Zhang, Qian Yu, Mihai G. Netea, Ren‐Xian Tang, Kui‐Yang Zheng
Journal: Hepatology (2020)

Yan, Chao; Koda, Stephane; Wu, Jing; Zhang, Bei‐Bei; Yu, Qian; Netea, Mihai G.; Tang, Ren‐Xian; Zheng, Kui‐Yang Author Information
教给患者的饮食和运动治疗方法
Authors: 李杨, 张晓林
Journal: BMJ (2006)

我国糖尿病的患病率逐年增加,1979年成人患病率不足1%,1994年至1995年上升为2.5%,1996年升至3.21%[1].且其患病特点是:60%的患者不知道自己患有糖尿病;发病年龄有年轻化的趋势;性别间发病率相似;此外,据全国糖尿病调查资料显示,其发病率有民族差异,如汉族高于蒙古族,低于回族[2]。
Treatment of foot injury with free medial sural artery perforator muscle flap
Authors: Gong-lin Zhang, Bao-feng Ge, Xing-yan Liu, Ke-ming Chen, Meng-hai Bai, Ying Yin
Journal: BMJ (2009)

This observation was to assess the treatment effects of free medial sural artery perforator muscle flap on foot reconstruction.Seven patients(6 men,and 1 woman;age 19 to 46 years,mean 33) with soft tissue defects on the foot underwent surgical procedures by using free medial sural artery perforator muscle flap.The coverage of the muscle flaps was performed by a meshed split-thickness skin graft.The donor site Was closed.Median follow-up Was 2.5 years(range 7 monks to 5.5 years).All the muscle flaps and skin grafts survived without major complications,and no morbidity was found at the donor sites.The muscle flaps seem to have advantage in blood supply,vascular anatomy and pedicle length,and may be helpful in the mpmr of soft tissue defects on the foot.

Key words: 
Reconstructive surgical procedures;  Foot injuries
Impact of previous nephrectomy on clinical outcome of metastatic renal carcinoma treated with immune-oncology (I-O):A real-world study on behalf of Meet-URO group (MeetUro-7b).
Authors: Marco Stellato, Daniele Santini, Ugo De Giorgi, Elena Verzoni, Chiara Casadei, Giuseppe Fornarini, Marco Maruzzo, Andrea Napolitano, Andrea Sbrana, Giuseppe Di Lorenzo, Mariella Soraru', Emanuele Naglieri, Sebastiano Buti, Rocco De Vivo, Francesca Vignani, Claudia Mucciarini, Francesco Grillone, Giandomenico Roviello, Sandro Pignata, Giuseppe Procopio
Journal: Journal of Clinical Oncology (2020)

e17088 Background: Immuno-oncology (IO) treatment demonstrated to improve Overall Survival (OS) in metastatic renal cell carcinoma (mRCC). The prognostic impact of previous citoreductive nephrectomy (CN) and radical nephrectomy with curative intent in patients (pts) treated with IO is not well defined. Methods: 229 eligible pts, with a least one radiological assessment of response according to the RECIST 1:1 criteria, were retrospectively collected from 16 Italian referral centers. Baseline characteristics, outcome data including progression-free survival (PFS) and OS were collected. Kaplan-Meier method and log-rank test were performed to compare PFS and OS between groups. Results: 153(66.8%) pts received IO as second line, 61(26.6%) as third line and 15(6.6%) pts as further line. 54 pts (23.6%) were good risk, 144(62.9%) were intermediate and 31(13.5%) were poor risk according to IMDC score. 189(82.5%) pts underwent nephrectomy (of them 72(32.4%) pts had synchronous metastatic disease and underwent CN), while 40(17.4%) pts did not. Nephrectomy was performed before IO treatment. ECOG PS, at the beginning of IO, was 0 for 167 pts (72.9%), the other 62 (27.1%) had ECOG PS 1 or 2. At a median follow up time of 17.5 months (mo), 13 (5.7%) pts are still in treatment while 216 (94.3%) experienced progression. 81 (35.3%) pts were treated after IO progression with mTOR and VEGFR inhibitors. 63 (27.5%) pts continued IO beyond progression. G3-G4 iAE were reported in 46 pts (20%). Median IO-PFS was 4.5 months in pts who did not undergo nephrectomy and 2.9 mo in pts who did (HR log rank 0.713, 95%CI 0.4788 to 1.063; p= 0.0582). Median IO-OS was 18.4 mo in pts who underwent nephrectomy and 10.3 mo in pts who did not (HR log rank 1.915, 95%CI 1.118 to 3.281; p= 0.0024). The difference in OS was irrespective of the IMDC criteria and the lines of treatment. Conclusions: In our real world experience, in mRCC pts treated with IO, previous nephrectomy was associated with a better outcome in terms of OS with all the limitations of a retrospective collection.
不同镇痛模式对开胸术后镇痛效果的临床观察
Authors: 张会东, 潘红霞, 曲海芹, 周承孝
Journal: BMJ (2011)

鉴于开胸手术后疼痛剧烈，持续时间长，易演变为慢性疼痛。为取得理想的术后镇痛效果，本研究于2010年1月至201 1年3月对采用不同镇痛模式行开胸术后镇痛患者进行比较观察，现总结如下。 关键词：镇痛
Multicenter analysis of treatment outcomes for well differentiated grade 3 neuroendocrine tumors (NET G3).
Authors: Leonidas Apostolidis, Arianna Dal Buono, Elettra Merola, Henning Jann, Dirk Jaeger, Bertram Wiedenmann, Eva Caroline Winkler, Marianne Pavel
Journal: Journal of Clinical Oncology (2020)

4607 Background: Well differentiated grade 3 neuroendocrine tumors (NET G3) have been distinguished from poorly differentiated neuroendocrine carcinomas (NEC) in the most current WHO classifications from 2017 and 2019. Retrospective data suggest that commonly applied first-line chemotherapy protocols with cisplatin or carboplatin in combination with etoposide (PE) are less effective in NET G3 than NEC. Therefore, current treatment guidelines suggest alternative first-line treatment protocols like temozolomide-based (TEM), streptozotocin-based (STZ) and FOLFOX which have only been studied in second-line so far. The aim of this multicenter analysis was to evaluate treatment outcomes for NET G3 with a focus on the efficacy of different first-line regimens. Methods: We performed retrospective analysis of all patients with NET G3 in the NEN databases of 3 German cancer centers. All histopathological findings were reviewed by the investigators in order to comply with the most current WHO classification. Results: A total of 131 patients could be identified. Median Ki67 was 30 %, primary tumors were located in the pancreas in 71 % of cases, 20 patients had a history of prior NET G1/G2 diagnosis. Median overall survival (OS) was 138.1 months with a median follow-up of 20.4 months. 125 patients received palliative first-line therapy: PE n = 34, FOLFOX n = 36, TEM (mostly temozolomide+capecitabine) n = 21, STZ n = 19, other (including targeted agents, somatostatin analogues, PRRT and multimodal combination approaches) n = 15. Overall response (ORR) and disease control rate was 35.3 % and 67.6 % for PE, 52.8 % and 80.6 % for FOLFOX, 28.6 % and 66.7 % for TEM, 47.4 % and 68.4 % for STZ, 20.0 % and 73.3 % for other respectively. Median progression-free survival for PE was 5.2 months. Compared to PE, PFS in the other treatment groups was 6.0 months for FOLFOX (p = 0.164), 12.0 months for TEM (p = 0.059), 5.7 months for STZ (p = 0.519), 14.1 months for other (p = 0.003). All non-PE patients combined showed a significantly prolonged PFS vs. PE (9.0 vs. 5.2 months; p = 0.011). 89 patients received second-line systemic therapy with a median PFS of 5.3 months. Conclusions: In this first multicenter analysis of different treatment strategies for NET G3, patients receiving upfront treatment with non-PE regimens had a significantly prolonged PFS. Of the single defined protocols, FOLFOX showed the highest ORR, and TEM the longest PFS. Further prospective evaluation of the optimal therapeutic strategy for this newly defined tumor entity is needed.
Efficacy of SCRI-CAR19x22 T cell product in B-ALL and persistence of anti-CD22 activity.
Authors: Rebecca Alice Gardner, Colleen Annesley, Ashley Wilson, Corinne Summers, Prabha Narayanaswamy,, Vicky Wu, Wenjun Huang, Adam Johnson, Amanda Li, Kirk R. Schultz, Catherine Lindgren, Stephanie Mgebroff, Christopher Brown, Julie R. Park, Michael C. Jensen
Journal: Journal of Clinical Oncology (2020)

3035 Background: Loss of CD19 expression is a major cause of limited durable B-ALL remission following CD19 CAR T cells, which might be overcome by utilization of dual CD19xCD22 CAR T cell targeting. Methods: A Phase I trial (NCT03330691) of SCRI-CAR19x22 was developed using dual transduction of lentiviral vectors encoding for either a CD19- or CD22-specific CAR T cell construct, both with 4-1BB co-stimulation. Manufacturing was performed in a closed G-Rex system with IL-7, IL-15 and IL-21. After lymphodepletion, CAR T cells were infused at 1 or 3 X 10 6 CAR T cells/kg dose levels. Leukemic response and CAR T cell persistence were evaluated by flow cytometry. Results: Products were successfully manufactured in all 28 enrolled subjects with 7.92 average days in culture (range of 7-11 days) and consisted of an average CD8:CD4 ratio of 3.09 (range 0.19 to 8.9). The cellular product CAR composition was 29% CD19, 31% CD22 and 39% CD19 and CD22 targeting. 13 subjects had prior exposure to CD19 or CD22 targeting therapies with diverse expression of CD19 and CD22 on the leukemic blasts. No dose limiting toxicities occurred in the 27 infused subjects. The recommended phase 2 dose is 3 x 10 6 CAR+ cells/kg. CRS was present in 80% of subjects, with 85% of CRS being grade 2 or less, and a peak grade of 3 (n = 3). Mild neurotoxicity occurred in 38%, with a single grade 3 event. 84.6% obtained a CR, of which 95% were MRD negative. Of the 4 subjects who did not achieved a CR, 2 had a pre-existing CD19 negative population and one had previously received CAR T cells and rejected SCRI-CAR19x22. There have been 4 relapses with varying CD19 and CD22 expression as follows: 1 CD19-CD22-, 1 CD19+CD22+, and 2 CD19-CD22+. The in vivo engraftment of CAR T cells peaked most frequently between day +7 and +14 and was predominated by the CD19 CAR+ T cells. Conclusions: We demonstrate manufacturing feasibility and safety of SCRI-CAR19x22. While initial efficacy is demonstrated, CD22 activity is poor due to limited expansion of the CD22 CAR-containing components and subjects with pre-existing CD19 negative leukemia fared poorly. Development of a revised CD22 CAR that exhibits a reduction tonic signaling is underway, with plans to explore the new construct in the context of a dual-targeting CD19xCD22 CAR T cell product. Clinical trial information: NCT03330691 .
Comparison of three intubation methods in patients with restricted cervical movement
Authors: Wenqi Xin, Zeng Yan
Journal: BMJ (2015)

The clinical data of 96 intubated inpatients with restricted cervical movement from June 2012 to June 2014 were retrospectively reviewed.They were divided into fiberoptic bronchoscope, Shikani optical stylet and McCoy laryngoscope groups (n=32 each). Identical anesthesia induction was applied.Compared with McCoy laryngoscope group, the total success rate and one-time success rate of tracheal intubation was higher in Shikani optical stylet group, tracheal intubation time was shorter and postoperative complications were fewer (P 0.05). Shikani optical stylet intubation has a less impact on hemodynamics and intubation time is short so that it is ideal for surgical patients with restricted cervical spine.


Key words: 
Intubation, intratracheal; Spondylosis, cervical vertebrae
原发性骨质疏松症诊疗指南(讨论稿)
Authors: 中华医学会骨质疏松和骨矿盐疾病分会
Journal: BMJ (2006)

一、概述 骨质疏松症(osteoporosis,OP)是一种以骨量低下、骨微结构破坏、导致骨脆性增加、易发生骨折为特征的全身性骨病(WHO).2001年美国国立卫生研究院(NIH)提出骨质疏松症是以骨强度下降、骨折风险性增加为特征的骨髂系统疾病,骨强度反映了骨骼的两个主要方面,即骨矿密度和骨质量。
Preliminary study on application of clinical pathway of two-way referral in patients with type 2 diabetes
Authors: 周海虹, 杜雪平, 钱宁, 梁万年, 曹红霞
Journal: BMJ (2004)

目的 初步研究2型糖尿病患者在社区卫生服务机构与三级医院专科之间双向转诊临床路径的应用并对其进行评价.方法用同期非随机对照试验对开发研制的2型糖尿病患者双向转诊临床路径进行评价,比较就诊情况、转归情况、就诊时间、患者满意度、医疗费用等.对22名2型糖尿病患者(试验组)按照双向转诊临床路径从社区向复兴医院内分泌科病房转诊,并在出院后转回社区;对照组27例,为直接到复兴医院内分泌科就诊的2型糖尿病患者.结果出院后试验组患者再次就诊率21.4%,低于对照组的59.1%(P＜0.01);试验组糖化血红蛋白7.3±1.1,低于对照组的7.9±0.8(P＜0.05);试验组就诊时间(6±15)h,明显少于对照组(P＜0.01);患者满意度、医疗费用等试验组均明显好于对照组(P<0.05).结论在社区卫生服务机构与三级医院专科之间实施2型糖尿病患者的双向转诊有利于缩短患者的就诊时间、减少不必要的服务项目、节约医疗费用、提高治疗效果,并使服务具有连续性。
Case discussion model of general practice based on the real scene of community health institutions
Authors: Yue Jiang, Yue Sha, Fuying Zhao, Xuejun Zeng, Hui Wang, Cheng Yu
Journal: BMJ (2019)

In order to improve the professional competence of in-service general practitioners and improve the effectiveness of standardized residency training, it is necessary to carry out training with the specific problems encountered in the practice. Taking Gaobeidian Community Health Service Center as an example, the characteristics, process and precautions of the general practice case discussion model based on the real scene of the community health institutions are introduced in the article. It would provide reference for improving the teaching effectiveness and efficiency in the training base of general practice.


Key words: 
Community health service center; General Practice; Case Discussion
Depression in women breast cancer patients receiving radiation therapy: A pilot study.
Authors: Fang Chen, Hao Yu, Caining Zhao, Fan Zhang, Yaqing Nong, Zhiyuan Xu, Li Yang, Wenqi Chen, Qian Wang, Yong Zhou, Yin Han, Haiman Jing, Feng-Ming Kong
Journal: Journal of Clinical Oncology (2020)

e12546 Background: The purpose of this study is to study depression and its risk factors at baseline and explore the changes of depression status during the course of radiation therapy in breast patients. Methods: This is part of a prospective study of treatment toxicity and quality of life. Breast cancer patients, aged 18-year old and above requiring adjuvant radiation therapy were eligible. The primary endpoint depression was assessed by a self-addressed “depression” questionnaires according to NCI “PROMIS”. The Questionnaires were completed one day prior to, during and at the end of treatment. Patient, tumor and prior treatment factors were collected. Cancer specific symptoms were collected by treating physicians and graded according to NIH/NCI CTCAE v4.0. The variables of our interest included age, menopausal status, N-stage,pathology stage, immunohistochemisty, surgical approaches,margin,prior treatments and radiation models. Data are presented as mean (95% confidence interval) unless otherwise specified. Statistical significances were tested using generalized linear model, pearson correlation and t-text. Ps less than 0.05 were considered to be significant. Results: Between July 2019 and January 2020, a total of 185 patients enrolled and completed the PROMIS questionaires. Before RT commencement, 50/185 (27.0%) had some levels of depressive feeling including 40/185 (21.6%), 10/185 (5.4%), and 0/185 (0%) patients for “rarely” (score = 5-8), “sometimes” (score = 9-12), “often” (score = 13-16), and “always” (score 17-20), respectively. Interestingly, N stage and pathology staging group were significantly associated with the depression at baseline while age, menopausal status, immunohistochemistry, previous chemo cycles, chemo regimens and anti-Her2 taget therapy were not. At the end of RT, 51/149 (34.2%) patients had depression level changed, though the absolute lumped scores of depression did not change significantly (p = 0.437). Changes in depression during were significantly associated with menopausal status (p = 0.015) while grade 2 and above toxicities were not (p = 0.421). Conclusions: Depression feeling is not uncommon in breast patients receiving adjuvant radiation. Future study may identify patients with depression and associated risk factors so that proper intervention may be applied to improve long-term survival and quality of life in patients.