tbuckley/cabot-search huggingface dataset:
Survey on the awareness of diabetic foot screening among community medical personnel
Authors: Xiuwen Fei, Aimei Dong, Xiaohui Guo, Bing Wen, Xin Qi, Jingjing Wang, Chen Zhang, Yuxia Kong, Jiatang Zheng
Journal: BMJ (2020)

From July to August 2018, a survey on the awareness of diabetic foot screening was conducted using the online questionnaires posted on the WeChat group. From 107 trainees in General Practitioner Teacher Training Program of Beijing Xicheng District and 50 general practitioners working in Chinese Academy of Sciences, 145 valid questionnaires were received. All 145 participants worked in community health care settings, including 105 general practitioners, 76 had 10 to 20 years of service, and 98 had undergraduate degree. The survey showed that 75.9% (110/145) heard the diabetic foot screening and knew that screening should be done for all diabetic patients; 98.6% (142/145) knew that the screening should include medical history, foot skin, neuropathy, vascular status, and 73.1% (106/145) also knew that screening should include the foot bone, joint deformities and footwear selection; 21.4% (31/145) had participated in training related to diabetic foot screening. It is suggested that the awareness and knowledge of diabetic foot screening among Beijing community medical personnelare not sufficient, and more training opportunity is necessary for them.


Key words: 
Diabetic foot; Questionnaires; Medical staff; Community health services; Cognition
激光治疗尖锐湿疣合并包皮过长62例
Authors: 史晓红, 刘雪梅, 程琳
Journal: BMJ (2006)

由人乳头状瘤病毒(HPV)感染引起的尖锐湿疣发病增长较快,该病在发展过程中一般不痛不痒,合并包皮过长者往往不予注意和重视.生殖器多发性尖锐湿疣合并包皮过长者,局部潮湿封闭,利于病毒生长聚集,容易复发[1].我科近几年采用二氧化碳激光治疗尖锐湿疣合并包皮过长患者62例,取得较满意的效果,现报告如下。
Abstract 11104: Deterioration Risk Detection for Acute Heart Failure Patients in the General and Cardiac Wards to Support Proactive Decision Making and Transitions of Care
Authors: Kristen Tgavalekos, Shreyas Ravindranath, Minnan Xu-Wilson, Joel Fernandez, Claire Y Zhao
Journal: Circulation (2019)

Introduction: Acute heart failure (AHF) is a complex disease with heterogenous manifestations. Large amounts of data are collected from multiple modalities; however, there is no readily available q...
Phase I results from a phase 1/2 multi-center study of <i>nab</i>-sirolimus combined with mFOLFOX6+bevacizumab (FB) as first-line (1L) therapy in patients (pts) with metastatic colorectal cancer (mCRC) with or without PTEN loss.
Authors: Sunil Sharma, E. Gabriela Chiorean, Angela Tatiana Alistar, Fadi S. Braiteh, Marc Ryan Matrana, Carlos Roberto Becerra, Berta Grigorian, Shihe Hou, Anita N. Schmid, Neil Desai
Journal: Journal of Clinical Oncology (2020)

e16050 Background: The PI3K/mTOR pathway overactivation and loss of PTEN occur in 20-40% of mCRC pts. A recent phase 1/2 study in mCRC pts showed evidence that everolimus added to 1L SOC treatment improved outcomes, in particular in pts with PTEN loss (Gilcrease, 2019). This prospective, single-arm phase 1/2 study aims to identify the optimal dose and schedule of nab-sirolimus (ABI-009), an mTOR inhibitor, plus FB and evaluate the safety and preliminary efficacy of this regimen. Methods: Eligible pts have no prior therapy, ≥18 years old, ECOG performance status of 0-2. PTEN loss (by IHC) is evaluated for all pts. nab-Sirolimus IV starting dose and schedule was 30mg/m 2 weekly for 3 weeks followed by a week of rest (on D1, 8, and 15 in a 28-day cycle, qw3/4) plus standard doses of FB on D1 and D15. Dose escalation to 45 and 60mg/m 2 or de-escalation to 20 and 10mg/m 2 followed the 3+3 design. Dose limiting toxicity (DLT) was assessed in cycle 1. Results: As of Jan 31, 2020, 24 pts were treated in the phase 1 study and 18 were evaluable for response. No DLTs were observed in the first 3 pts treated with nab-sirolimus at 30mg/m 2 qw3/4; however, all 3 pts missed D8 doses (due to G2 thrombocytopenia and G3 neutropenia) and the cohort expanded to additional 3 pts for further observation. 5/6 pts missed D8 doses and a new dose cohort enrolled pts at 20mg/m 2 qw3/4. No DLTs were observed and the cohort was expanded to 10 pts. A safety review of the first 18 pts observed that 9/18 pts missed doses on D8 and a new cohort was added to enroll pts at 20 mg/m 2 q2w (D1 and D15, as for FB). This cohort enrolled 8 pts with no DLTs and represents the recommended-phase-2-dose (RP2D) and continues enrollment in phase 2. For all pts, 15/24 (63%) pts had G3-4 treatment-related adverse events (TRAEs); most common were neutropenia (6/24, 25%) and thrombocytopenia (4/24, 17%). At the RP2D 3/8 (38%) pts had G3-4 TRAEs (thrombocytopenia, weight loss, and hypertension, 1 pt each). Among 18 evaluable pts, best response was: 7/18 (39%) partial response, 10/18 (56%) stable disease, and 16/18 (89%) had tumor shrinkage. PTEN was assessed in 14 pts: 4/14 (29%) had PTEN loss, 2/4 (50%) PTEN loss pts responded, while 3/10 (30%) pts that were PTEN+ (WT) had a response. Conclusions: The RP2D of nab-sirolimus is 20mg/m 2 q2w in combination with standard mFOLFOX+bevacizumab. The phase 2 portion of the study is ongoing. Clinical trial information: NCT03439462 .
Tumor, immune, and stromal characteristics associated with clinical outcomes with atezolizumab (atezo) + platinum-based chemotherapy (PBC) or atezo monotherapy (mono) versus PBC in metastatic urothelial cancer (mUC) from the phase III IMvigor130 study.
Authors: Matt D. Galsky, Romain Banchereau, Habib Rahman Hamidi, Ning Leng, Will Harris, Peter H. O'Donnell, Edward Ernest Kadel, Kobe Chi Yung Yuen, Dexter Jin, Hartmut Koeppen, Darren Tayama, Enrique Grande, Jose Arranz, Maria De Santis, Ian D. Davis, Eiji Kikuchi, Xiaodong Shen, Aristotelis Bamias, Sanjeev Mariathasan
Journal: Journal of Clinical Oncology (2020)

5011 Background: Tumor mutational burden (TMB), PD-L1 expression, T-effector gene expression (GE) and a fibroblast TGF-β–response signature (F-TBRS) are associated with clinical outcomes with atezo mono in mUC (Mariathasan, Nature, 2018). Here we explore the potential predictive role of these biomarkers and APOBEC mutagenesis in IMvigor130. Methods: Pts receiving first-line (1L) mUC treatment (tx) were randomized 1:1:1 to atezo + PBC, atezo mono, or placebo + PBC. Coprimary efficacy endpoints were PFS and OS. Planned exploratory biomarker analyses included PD-L1 expression, TMB (FoundationOne), and T-effector GE (RNA-seq). Results: The 851 biomarker-evaluable pts (BEP) were representative of the 1200 ITT pts. Biomarker results are shown in Table. PD-L1 IC2/3 was associated with significantly longer OS for atezo mono vs placebo + PBC and a combination of PD-L1 IC2/3, and high TMB (&gt; 10 muts/Mb) identified a pt subset (≈ 14% of BEP) with particularly favorable outcomes with atezo mono vs placebo + PBC; similar results for PD-L1 and TMB were not seen with atezo + PBC vs placebo + PBC. APOBEC mutagenesis was associated with improved OS with atezo-containing regimens whereas high F-TBRS was associated with inferior OS with atezo mono. Conclusions: These results reinforce the potential predictive nature of biomarkers associated with response/resistance to atezo and highlight potentially distinct biology driving benefit with atezo and atezo + PBC. These findings suggest a possible biomarker-directed approach to 1L mUC tx that warrants mechanistic interrogation and prospective validation. Clinical trial information: NCT02807636 . [Table: see text]
Abstract 12086: A Novel Approach to Managing Heart Failure Populations Using Actionable Machine Learning Models
Authors: Linyuan Jing, Alvaro Ulloa Cerna, Christopher Good, Nathan M Sauers, Dustin N Hartzel, Joseph B Leader, H Lester Kirchner, Yirui Hu, David M Riviello, Joshua V Stough, Seth Gazes, Allyson Haggerty, Sushravya Raghunath, Brendan J Carry, Christopher M Haggerty, Brandon K Fornwalt
Journal: Circulation (2019)

Introduction: Heart failure is a prevalent, costly disease for which new value-based payment models demand optimized population management strategies. We aimed to generate a novel strategy for mana...
"Informed choice" in a time of too much medicine
Authors: Johansson Minna, Jørgensen Karsten Juhl, Getz Linn, Moynihan Ray, 刘倩丽, 关健
Journal: BMJ (2016)

随着医学科学的不断发展，临床诊疗方法日益增多，许多疾病的检查和治疗没有单一的最佳选择。目前备受推崇的是非家长式的医患合作选择模式，即医生告知患者，使他们在知情的基础上基于个体化做出合理的决策。The BMJ最近发表的分析文章，提出了现代医药快速发展下实行知情选择的潜在问题和困惑，即在太多医药和诊疗方法的情况下，知情选择是否对患者真正有益？以及可能带来的伤害和伦理问题。——编者

Minna Johansson和他的同事认为，预防医学和拓展疾病含义已经改变了知情选择的伦理前提以及我们良好的愿望，可能会不经意地推进过度治疗。
Large-diameter plastic biliary stents for unresectable distal malignant biliary strictures: Rehashing the same or rekindling more interest?
Authors: Mihir S. Wagh
Journal: Endoscopy (2020)

Biliary stenting via endoscopic retrograde cholangiopancreatography (ERCP) is well established as the preferred method of biliary drainage for unresectable distal malignant biliary strictures [1]. However, cholangitis, stent occlusion, and recurrent biliary obstruction after stent placement has plagued the practice of ERCP for decades. Many different stent types are available, with broad categorization into two main groups: (a) plastic stents, and (b) self-expanding metal stents (SEMS) which can be fully covered (FCSEMS), partially covered (PCSEMS), or uncovered (UCSEMS). Multiple studies have assessed the various types and properties of stents for maximizing stent patency and improving patient outcomes for biliary drainage. For distal malignant biliary strictures in patients with a life expectancy greater than 4 – 6 months, SEMS have become the standard of care because of similar technical success, longer patency, and lower risk of recurrent obstruction compared to plastic stents, translating to a more cost-effective approach for this patient population [2] [3] [4]. However, plastic stents, being cheaper than SEMS, continue to be used in many parts of the world where cost of the stent is a major factor, especially when the patient’s life expectancy is less than 3 – 4 months. So, the question of whether a larger-caliber plastic stent (diameter more than standard 10-Fr plastic stents) would be better becomes very relevant. Kadakia & Starnes retrospectively assessed 10-Fr and 11.5-Fr plastic stents and concluded that 10-Fr stents have the same success and adverse event rate as 11.5-French stents in the management of biliary tract obstruction and offered no significant advantage [5]. Similar results were reported by Pereira-Lima and co-investigators in their retrospective study [6]. Our group (Wagh et al.) also published a multicenter randomized study where 234 patients with malignant biliary obstruction were randomly allocated to receive an 11.5-Fr plastic stent (n = 119) or a 10-Fr plastic stent (n = 115) [7]. Technical success was similar for the 10-Fr and 11.5-Fr stent groups (99.1 % vs. 97.4 %, respectively; P = 0.37) and there was no statistically significant difference in stent survival between 10-Fr and 11.5-Fr stents (median 149 vs. 258 days, P = 0.16). We concluded that the theoretical advantage of improved bile flow for the 11.5-Fr stent did not translate into longer patency, better clinical response, or longer patient survival than the 10-Fr stent. Overall, these larger-caliber plastic stents are not routinely used in clinical practice and have not been directly compared with SEMS.
Rehabilitation management of congenital muscular torticollis coexisted with developmental dysplasia of the hip in children
Authors: Qing Du, Xuan Zhou, Nan Chen, Shu-xin Zhang
Journal: BMJ (2010)

Objective Congenital muscular torticollis (CMT) and developmental dysplasia of the hip (DDH) are common congenital problems in infants. Association between CMT and DDH has been reported in literatures. The aim of this study was to assess coexistence of DDH in infants with CMT and curative effects of its rehabilitative therapy. Methods In total, 187 infants less than two months old with CMT were recruited in the study. DDH was diagnosed and graded by Graf's bilateral hip type B ultrasonography and pelvic X-ray films. Massage manipulation, magnetic strapping, postural orthosis at home and heat compress were instituted for CMT and frog spica device and hip-flexion abduction plaster immobilization were instituted for DDH. Their early rehabilitative effects were evaluated. Results DDH was coexisted in 24 of 187 infants with CMT, with incidence of 12. 8%. The hips of 22 infants were graded as type Ⅱ b (91.7%) and two as type Ⅲ a (8.3%), and eight at the left side and seven at the right side.Comorbid hips completely recovered normal with early frog spica device and hip-flexion abduction therapy in 24 infants. Conclusions Coexistence of CMT and DDH are relatively common in infants. Type B ultrasonography can be used as a measure for screening DDH in neonates with CMT. Early rehabilitative therapy is effective for those coexisted with DDH and CMT at the same time.

Key words: 
Plagiocephaly,nonsynostotic;  Hip;  Joint diseases;  Rehabilitation
Current status of non-surgical treatment for severe acute pancreatitis
Authors: 胡常红, 吕农华
Journal: BMJ (2005)

急性胰腺炎是一种常见病,近年发病率呈上升趋势.80%的患者病情呈自限性,经过一般治疗可痊愈,很少发生局部及全身性并发症;而另20%则呈暴发性,通常伴多器官功能衰竭(MOF),死亡率高达30%,称为重症急性胰腺炎(SAP)[1].80年代以来,随着人们对SAP发病机制和临床研究的深入,SAP的治疗观念发生了一场革命,由过去强调的早期手术治疗发展到对胰腺坏死合并感染才行手术治疗的个体化治疗方案.非手术治疗使大部分SAP患者获得了满意疗效.现就有关SAP的非手术治疗现况综述如下。
1995年至2004年安海地区儿童中毒情况分析
Authors: 林荣出, 蔡少茹, 李燕玉
Journal: BMJ (2005)

安海地区儿童中毒大部分送我院治疗,对我院1995年至2004年收治的儿童中毒病例进行回顾性分析,探讨安海地区儿童中毒的基本特点,现报告如下. 一、对象与方法 1.研究对象:安海医院1995年1月至2004年12月收治的1～14岁儿童中毒病例,分为两组:第1组,1995年1月至1999年12月收治;第2组,2000年1月至2004年12月收治.第1组142例,男82例,女60例; 0.05)。
Radix et Rhizoma Rhei plus abdominal massage to prevent constipation in patients with acute stroke
Authors: Yi-wen Fan, Hong-xia Li
Journal: BMJ (2008)

A total of 100 in-hospital patients with acute stroke were randomly assigned to receive traditional Chinese medicine Radix et Rhizoma Rhei combined with abdominal massage(once daily; study group, n=50) or observation (control group, n=50 ) to prevent from constipation. After 3 days' treatment, 3 patients (6%) in the study group and 44 patients (88%) in the control group developed constipation (χ2=67.482, P<0.01). In addition, no adverse effects occurred in the study group. Our results indicated that traditional Chinese medicine Radix et Rhizoma Rhei combined with abdominal massage might help acute stroke patients to prevent from constipation, achieve earlier health recovery, and improve quality of life.

Key words: 
Cerebrovascular accident;  Constipatoin
RNA pathway enrichment in serum-based mass spectroscopy prognostic analyses.
Authors: Benjamin D German, Jeffrey Allen Borgia, Ankur D Naqib, Philip D. Bonomi, Marta Batus, Sanjib Basu, Mary J. Fidler
Journal: Journal of Clinical Oncology (2020)

e15197 Background: Veristrat(VS) good and poor labels were found to be prognostic in the front-line NSCLC setting with or without immune checkpoint inhibitors. Little is known about RNA expression data corresponding to these good and poor prognostic labels. Methods: Raw RNA seq expression data was obtained from TEMPUS XP RNA analysis. Sequences were filtered for allowing only genes that had an overall count of at least 20 across all samples. Samples were then processed through the EdgeR analysis in the R programming environment. Along with a Z-scored heatmap, PCA plot was also generated. Differential abundance analysis was done further filter out the genes. Benjamini-Hochberg correction was done and only genes with corrected p-value of &lt; 0.05 were selected for further pathway analysis. 242 genes with corrected p-value &lt; 0.05 were used. Pathway analysis was performed using the Broad Institute GSEA (Gene Set Enrichment Analysis) and DAVID (Database for Annotation, Visualization and Integrated Discovery). The gene list was ran using KEGG database in GSEA and using KEGG, BioCarta and Reactome pathway databases. Functional analyses against the KEGG and REACTOME database were reported out to determine the enriched pathways in the VS poor and VS good groups. Kaplan-Meier and Logrank were used to compare overall survival in the poor vs. good label cohorts of patients. Results: 26 patients had VS label and RNA expression data available. Nine patients had VS poor label and 17 had veristrat good label. 6(66%) VS poor 13(76%) VS good patients received anti PD1 agents during the course of their therapy. Overall survival was not significantly different between good and poor label groups in this small series. 242 genes had significantly different abundance in the VS poor vs good patients with the majority (211) over expressed in the poor label patients. Significant pathways enriched in the VS poor group included the intrinsic pathway of fibrin clot formation, platelet degranulation (DAVID), steroid hormone biosynthesis and dilated cardiomyopathy (KEGG). Systemic lupus erythematous pathway was enriched in the VS good group (KEGG). Conclusions: In this small set of front-line patients with RNA pathway analyses and known VS poor or good labels, differential expression of acute phase reactants was found in VS poor patients. DAVID and KEGG pathways were differentially enriched and may reveal potential targets to mitigate prognosis in poor risk NSCLC.
Clinical features of primary Sjögren's syndrome with pulmonary hypertension
Authors: Xuemei Li, Qian Wang, Yunyun Fei, Mengtao Li, Zhuang Tian, Yongtai Liu
Journal: BMJ (2014)

The clinical data were collected from medical record of 749 patients admitted into Peking Union Medical College Hospital from January 2008 to March 2013. They were diagnosed with primary Sjogren's syndrome (PSS) at discharge. Clinical manifestations, laboratory results and outcomes were compared between PSS patients with pulmonary hypertension (PSS-PH) and those without (PSS-non PH). PSS-PH group had higher proportions of Renault phenomenon (36.8% vs. 20.0%, P=0.05), pericardial effusion (55.3% vs. 0.0%, P<0.01), leukocytopenia (42.1% vs. 30.0%, P=0.03), elevated IgG level [(28.8±11.2) vs. (21.5±10.0) g/L, P=0.01] and hypothyroidism(34.2% vs. 12.5%, P=0.05)with significant significance. The PSS patients had leukocytopenia low thyroid function, rising IgG and pericardial effusion with pulmonary hypertension.


Key words: 
Sjogren's syndrome; Pulmonary hypertension
女性代谢综合征的临床特征与防治
Authors: 陈庆瑜, 甘小玲, 叶枫, 袁翠萍, 石一洁, 刘小珍
Journal: BMJ (2006)

对369个健康体检的女性进行调查,结果显示其代谢综合征的检出率为23.3%(86/369),40岁以上者检出率明显升高,超重或肥胖是关键因素.提示防治代谢综合征应针对女性的特点,改变不良生活习惯。
Epidemiology and risk factors of hypertension in 35 to 70 years old adults living in Xicheng District of Beijing
Authors: Dong Li, Bing Liu, Yao-hua Zhang, Jun Zhang, Ji-wen Tian, Hui Jin, Yu-min Ma, Wei Li, Yi Sun, Yang Wang
Journal: BMJ (2009)

This investigation was to assess the prevalence and risk factors of hypertension in 35 to 70 years old adults living in Xicheng District of Beijing. Cluster sampling was conducted in 2230 adults, and only 1958 individuals agreed to enter into the study. Written informed consents were obtained before questionnaire and physical examination. A total of 1889 data were used for analysis. The prevalence rate of hypertension was 47.8% (n=902). The age-standardized prevalence rate was 40. 1%. Hypertension was seen in 368 men (53.0%) and 534 women (44.7%) (P=0.0005). The rates of disease awareness, treatment, and control were 47.5%, 38.5%, and 24.1%, respectively. The prevalence of hypertension increased with age (P<0.0001). Linear trend was found between body mass index (BMI) and systolic blood pressure (P<0.0001). In multiple logistic model analysis, the hypertension risk for men was 1.33 times that of women (95% CI, 1.08-1.64), for participants with obesity was 2.81 times that of those with normal weight (95%CI, 2.00-3.97). Hypertension has become one of the most concerned public health problems in the district. Middle-aged people should pay attention to changed blood pressure, especial for overweight men. Health promotion should be needed for hypertension prevention. More attention should be paid to substantial increase in hypertension.

Key words: 
Hypertension; Risk factors ; Cross-sectional studies
Application of "three-in-one" tutorial system in standardized residency training of general practice
Authors: Bei Li, Yue Gao, Xiaonan Wang, Ye Zhou, Xiaohong Yu
Journal: BMJ (2020)

The mentor system has been applied in the standardized residency training, currently the  to  ortwo mentors′ system are more common applied. However, the clinical training of general practitioners needs joint effort of mentors from the general practice department and specialists in hospital, as well as of mentors from primary health institutes. Thus, we proposed a three-in-one tutorial system, which consisted of one GP mentor, one specialists in the hospital and one primary physician for residency training of general practice. The implementation of the three-in-one system has motivated the enthusiasm of specialists and community instructors, and enhanced their responsibility. The mentors from different department can learn from each other and complement each other, so the overall teaching level can be raised and the quality of standardized training of general practitioners can be improved.


Key words: 
General medicine; Preceptorship; Resident standardized training; Three-division co-management
YAP1 Withdrawal in Hepatoblastoma Drives Therapeutic Differentiation of Tumor Cells to Functional Hepatocyte‐Like Cells
Authors: Jordan L. Smith, Tomás C. Rodríguez, Haiwei Mou, Suet‐Yan Kwan, Henry Pratt, Xiao‐Ou Zhang, Yueying Cao, Shunqing Liang, Deniz M. Ozata, Tianxiong Yu, Qiangzong Yin, Max Hazeltine, Zhiping Weng, Erik J. Sontheimer, Wen Xue
Journal: Hepatology (2020)

Background and Aims Despite surgical and chemotherapeutic advances, the 5‐year survival rate for stage IV hepatoblastoma (HB), the predominant pediatric liver tumor, remains at 27%. Yes‐associated protein 1 (YAP1) and β‐catenin co‐activation occurs in 80% of children’s HB; however, a lack of conditional genetic models precludes tumor maintenance exploration. Thus, the need for a targeted therapy remains unmet. Given the predominance of YAP1 and β‐catenin activation in HB, we sought to evaluate YAP1 as a therapeutic target in HB. Approach and Results We engineered the conditional HB murine model using hydrodynamic injection to deliver transposon plasmids encoding inducible YAP1 S127A , constitutive β‐catenin DelN90 , and a luciferase reporter to murine liver. Tumor regression was evaluated using bioluminescent imaging, tumor landscape characterized using RNA and ATAC sequencing, and DNA footprinting. Here we show that YAP1 S127A withdrawal mediates more than 90% tumor regression with survival for 230+ days in mice. YAP1 S127A withdrawal promotes apoptosis in a subset of tumor cells, and in remaining cells induces a cell fate switch that drives therapeutic differentiation of HB tumors into Ki‐67‐negative hepatocyte‐like HB cells (“HbHeps”) with hepatocyte‐like morphology and mature hepatocyte gene expression. YAP1 S127A withdrawal drives the formation of hbHeps by modulating liver differentiation transcription factor occupancy. Indeed, tumor‐derived hbHeps, consistent with their reprogrammed transcriptional landscape, regain partial hepatocyte function and rescue liver damage in mice. Conclusions YAP1 S127A withdrawal, without silencing oncogenic β‐catenin, significantly regresses hepatoblastoma, providing in vivo data to support YAP1 as a therapeutic target for HB. YAP1 S127A withdrawal alone sufficiently drives long‐term regression in HB, as it promotes cell death in a subset of tumor cells and modulates transcription factor occupancy to reverse the fate of residual tumor cells to mimic functional hepatocytes.