tbuckley/cabot-search huggingface dataset:
Prevalence of hyperuricemia in health check-up population of Beijing suburb
Authors: Lixin Zhu, Meicen Zhou, Xiangli Cui, Linbo Feng, Xuefeng Zhao, Shuli He
Journal: BMJ (2015)

Objective
To investigate the prevalence of hyperuricemia in health check-up population of Beijing suburb.


Methods
Total 1 336 rural residents in Nankou Township of Beijing received health check-up from July to Aug 2014, including 686 subjects aged 20-59 years (young/middle-aged group) and 650 subjects aged 60-96 years (elderly group). The blood pressure and body mass index (BMI) were measured; serum uric acid (SUA), fasting blood glucose (FBG) and blood lipids (TG, TC, HDL-C, LDL-C) were determined. The SUA levels >420 μmol/L for male and >360 μmol/L for female were defined as hyperuricemia.


Results
The four quartiles of SUA levels were 27.00-254.59 μmol/L (Q1), 254.60-302.35 μmol/L (Q2), 302.36-359.78 μmol/L(Q3)and 359.79-702.0 μmol/L (Q4). The prevalence of hyperuricemia was significantly higher in young/middle-aged group than that in elderly group [20.41%(140/686) vs. 13.85%(90/650), χ2=10.08, P=0.001 5], the systolic blood pressure [SBP, (126.8±15.7) vs. ( 116.7±12.0)mmHg(1 mmHg=0.133 kPa), t=2.76, P=0.008], FBG[(7.40±4.10) vs. (6.11±2.03)mmol/L, t=2.12, P=0.036], TC [(5.52±1.10) vs. (5.23±1.00)mmol/L, t=2.04, P=0.045], LDL-C [(3.5±0.7) vs. (2.4±0.9)mmol/L, t=2.21, P=0.029] in young/middle-aged group were significantly higher than those in elderly group. BMI, FBG were significantly higher in Q4 than those in other quartiles [BMI: (26.44±3.88) vs. (24.19±3.37), (25.49±3.42) and (25.61±3.49)kg/m2, t=2.78, P=0.008; FBG: (8.19±1.52) vs. (6.34±1.34), (6.09±1.51) and (6.40±1.98)mmol/L, t=2.80, P=0.007]. The triglyceride (TG) levels in group Q3 and Q4[(1.85±0.90) and (1.92±0.44)mmol/L] were higher than those in Q1 and Q2[(1.37±0.76) and (1.70±0.84) mmol/L, t=2.1, P=0.035]. Only 9.57% subjects (22/230)with hyperuricemia was not combined with metabolic disorder; subjects combined with one and two metabolic disorders accounted for 20.87%(48/230)and 69.57%(160/230), respectively.


Conclusion
Screening for hyperuricemia is important for comprehensive treatment and management of hyperuricemia in rural residents, especially in the young and middle-aged population.


Key words: 
Hyperuricemia; Obesity; Metabolic diseases; Cross-sectional studies
Correlation of apolipoprotein M with severity of coronary artery stenosis in patients with coronary heart disease
Authors: Jian-hui Sun, Jiang-tao Bai, Hai-yan Ke, Ya-ping Liu, Xiao-yu Yang, Mei-zhen Shen, Guang-hua Luo
Journal: BMJ (2008)

One hundred and thirty seven pafients diagnosed by coronary angiography were recruited in the study and divided into coronary heart disease group(CAD)and control group.Relationship between serum apolipoprotein M levels and the severity of stenosis of coronary arteries was analyzed.In covariate analysis,serum apolipoprotein M levels were significantly lower in CAD group than those in control group adjusted for sex,age,body mass index(BMI)(P＜0.05).By stepwise muhiple regression,serum levels of apolipoprotein M were correlated positively with BMI(r=0.65,P＜0.01),and correlated negatively with total cholesterol(TC)(r=-0.53,P＜0.01)and low density lipoproteins(LDL-C)(r=-0.42,P＜0.01).Serum levels of apolipoprotein M were correlated negatively with the score of coronary stenosis(r=-0.62,P＜0.01).The results suggest that apolipoprotein M might be related to the development of coronary artery disease.

Key words: 
Apolipoprotein M;  Coronary disease
Standardize and improve the management of gastroesophageal reflux disease at grassroots level
Authors: Yanbo Yu
Journal: BMJ (2019)

通过阐述胃食管反流病的诊断流程、病情评估及转诊、疾病管理等方面，旨在让基层医务人员更好地理解及应用《胃食管反流病基层诊疗指南（2019年）》，有效提高对胃食管反流病的识别、诊疗及管理水平，改善患者生命质量。
Several problems in comprehension of cervical spondylosis and neck and shoulder pain
Authors: 邓瑞雪, 陆星华
Journal: BMJ (2003)

颈椎病在中、老年人群中是一种常见病;颈肩痛也是常见与普遍存在的病症,其临床症状及其部位与颈椎病的部分表现相似,临床各科的诊治当中均会经常遇到.由于对颈椎病概念的认识存在误差,故可能做出不准确的诊断,将颈肩痛误诊为颈椎病,造成病人的恐慌,以及过度治疗。
表现为睡眠障碍的多发性胰岛素瘤一例
Authors: 柴晓利, 王琴
Journal: BMJ (2004)

患者男,21岁,因睡眠障碍4个月入我院.4个月前无明显诱因出现入睡困难,清晨难以觉醒,被强行唤醒后意识模糊,不认人,步态不稳,约半小时左右逐渐改善,若无人呼唤,上午10～12时才能自行醒来.醒来后进食、活动无异常.入院后查体正常,腹部彩超检查未见异常,两次空腹血糖检查均明显降低,餐后血糖正常.夜间视频脑电图显示:睡眠异常脑电图.为明确是否为低血糖所致,于早晨8时(当时血糖为1.4 mmol/L)给予50%葡萄糖40 ml静脉推注,推进30 ml后脑电图由全导广泛性低电压波幅逐渐恢复到正常的背景活动,同时患者神志逐渐清醒。
引起慢性疼痛的常见疾病
Authors: 李伟生
Journal: BMJ (2010)

李伟生:慢性疼痛的命名并不确切.疼痛发生的时间没有一定的概念,因此急性疼痛指短期内有可能会产生较大危险的疾病,如管腔的阻塞、缺血;而慢性疼痛则与之相反,是指持续时间比较长,引起疼痛的疾病对生命危险性并不是很急剧而是很缓慢。
PD-L1 in combination with CD8<sup>+</sup>TIL and HIF-1α are promising prognosis predictors of head and neck squamous cell carcinoma.
Authors: Jinming Yu, Zihan Zhou, Dianbin Mu, Dexian Zhang, Xianbin Zhang, Xingchen Ding, Jia Yang, Xinbin Bai, Jinming Yu
Journal: Journal of Clinical Oncology (2020)

e18545 Background: Currently, the tumor/node/metastasis (TNM) staging is the most widely used Head and neck squamous cell carcinoma (HNSCC) staging system. However, this classification only provides limit information for the prognosis of HNSCC. Recently, some studies suggest that the level of PD-L1 in tumor cells (TC-PD-L1) or in tumor microenvironment cells (TMC-PD-L1) is a promising biomarker for the prognosis of HNSCC patients. Therefore, in this study, we evaluated the prognostic value of TC-PD-L1, TMC-PD-L1, CD8+ TIL, HIF-1α. In addition, we investigated if incorporated these biomarkers into TNM stage could improve the prognostic value of TNM stage. Methods: A total of 63 patients who underwent surgical resection. The level of PD-L1, CD8 + TIL and HIF-1α was determined by immunohistochemical analysis. The survival of patients was evaluated by Kaplan-Meier analysis and Cox proportional hazards model. The prognostic power of these parameters was evaluated by C-index. Results: We observed that the survival of patients, who had high level of PD-L1 in tumor cells, was significantly shorter than those who had low level of PD-L1. However, the survival of patients who had high level of PD-L1 in tumor microenvironment was significantly longer than patients with low level of PD-L1 in tumor microenvironment. In addition, high level of CD8 + tumor-infiltrating lymphocyte or low level of HIF-1α level suggests a better prognosis. Moreover, we observed that PD-L1 in combination with CD8 + tumor-infiltrating lymphocyte and HIF-1α could significantly improve the prognostic effect of current TNM stage. Conclusions: The results of this study suggest that the level of PD-L1, CD8 + TIL and HIF-1α is useful prognostic biomarkers for patients with HNSCC. Incorporated these biomarkers into current TNM stage of HNSCC improve the discriminatory capability of TNM stage.
深静脉血栓形成的抗凝疗法和注意事项
Authors: 董国祥
Journal: BMJ (2008)

深静脉血栓形成(DVT)是血液在深静脉内不正常凝结引起的病症,多发生于下肢.目前治疗DVT的手段主要包括抗凝、溶栓、导管溶栓以及手术取栓等.但就目前的资料看,溶栓、导管溶栓和手术取栓等方法都存在争议,只有抗凝治疗是大家都认可的治疗措施.因此,有必要介绍DVT的抗凝疗法.2007年9月中华医学会外科学分会血管外科学组通过了深静脉血栓形成的诊断和治疗指南(DVT指南),肯定了抗凝疗法[1]。
Disparities in utilization of autologous stem cell transplantation as consolidative therapy for multiple myeloma: A single-institution retrospective review.
Authors: Oleksandra Lupak, Xiaoxia Han, Neha Patil, Kannan Thanikachalam, Peter Xie, Hiba Jabbour, Zaid Al Saheli, Sindhu Janarthanam Malapati, Shatha Younis-Mustafa Farhan, Josephine Emole
Journal: Journal of Clinical Oncology (2020)

e20504 Background: Multiple Myeloma (MM) accounts for about 17% of hematologic malignancies in the United States. It is a disease of older adults, with a median age at diagnosis of 66 years. The incidence in African Americans is 2 to 3 times more that in Whites, and this disparity has been found to be greater among patients less than 50 years. Most guidelines recommend induction therapy with a triplet regimen followed by autologous hematopoietic cell transplantation (HCT). Unfortunately, racial and ethnic minorities have been found to be less likely to receive ASCT. A SEER-Medicare database analysis from 2000 to 2011 noted a lower utilization of ASCT and Bortezomib among black patients. The goal of this study was to evaluate patterns of acceptance of ASCT as consolidative therapy of MM. Because the receipt of upfront ASCT is dependent on response to induction therapy, our study also investigated disparity in transplant outcomes and time to transplant, which are areas that previous studies had not looked at. Methods: In this retrospective review we used Cox PH model to investigate the association between the survival time of the patients (OS) and age of the diagnosis, race, socioeconomic status, disease cytogenetic, and initial induction regimens. 194 patients with a confirmed diagnosis of MM who were referred for autologous hematopoietic stem cell transplantation (ASCT) between January 1st 2009 and June 30st 2019 were included in this study. Patients who received ASCT for relapsed MM were excluded. Results: Using Cox PH model, we found that high risk cytogenetic were significantly associated with shorter overall survival, higher transplant related mortality and relapse related mortality (P &lt; 0.002). Use of aggressive induction choices was associated with poorer transplant outcomes (P 0.02). Time to transplant tended to be shorter in African American compared to other ethnic groups (P 0.07). Income category was not significantly associated with overall survival, time to transplant or transplant / relapse related mortality. Conclusions: Cytogenetic continues to be a significant factor in transplant outcomes affecting overall survival. Time to transplant tended to be shorter in African American comparing to others, potentially reflecting the differences in disease course. Our study provides a more real life data on ASCT outcome patterns. It is hoped that the results of this study will better guide interventions to improve utilization of ASCT as consolidative therapy for MM.
Changes in erythron peripheral component during chemotherapy in patients with malignant lymphomas and parvovirus B19 infection.
Authors: Nailya K. Guskova, Tatiana A. Zykova, Irina B. Lysenko, Ekaterina A. Guskova, Anastasia S. Nozdricheva, Svetlana V. Abakumova, Olesya N. Selyutina, Elena A. Shevyakova, Lilia A. Velikorodnaya, Svetlana V. Belgova, Irina V. Tselishcheva, Viktoria R. Zakharchenko, Oleg I. Kit
Journal: Journal of Clinical Oncology (2020)

e20086 Background: The purpose of the study was to analyze changes in the erythron peripheral component during chemotherapy for malignant lymphomas in patients infected with parvovirus B19 (B19V). Methods: The study included 34 patients with lymphomas (48.7±4.3 years). B19V infection was determined by the presence of IgM/IgG antibodies to B19V in blood serum and DNA in blood plasma and bone marrow before chemotherapy (CT). Parameters of the erythron peripheral component - RBC, HGB, MCW, MCH, MCHC, RDW, PLT, RET (#), IRF, LFR, MFR, HFR (%), and myelogram were evaluated before and after CT (Sysmex XE 2100, Japan). Results: 82.5% of patients had IgG to B19V, including IgM in 11.8%. B19V DNA was detected in 23.4% of patients: in the bone marrow and blood in 11.7%, only in the bone marrow in 11.7%. The range of viral load in the bone marrow was 1435-79573 IU/ml, in the blood 2-349 IU/ml. RBC in all patients before CT was within the reference range, with a tendency to decrease in the group with B19V: 4.01±0.06×10 12 /L with B19V and 4.57±0.08×10 12 /L without B19V. Levels of HGB before CT were respectively 112±1.26 g/L and 116±1.26 g/L, decreasing after CT by 1.5 and 1.3 times (p &lt; 0.05) depending on the viral load. MCV, MCH and MCHC varied: 78.6 – 84.8 fl, 24.9 – 28.0 pg and 314–330 g/L in the group with B19V, and 89.7–91.3 fl, 29.5–29.8 pg and 324–337 g/L, respectively, in the group without B19V, which indicates the development of hypochromic microcytic anemia. RET levels before CT in the group with B19V were 38.3±3.44×10 9 /L, after CT – 10.6±2.7×10 9 /L, being lower than in the group without B19V by 1.8 and 3.8 times (p &lt; 0.001), respectively. IRF, MFR and HFR in patients with B19V before CT were 10.6±2.23%, 9.5±1.54% and 1.1±0.022%, being lower than in non-infected patients by 1.6, 1.3 and 3.6 times, respectively. After CT, the downward trend in the proportion of young fractions continued. The noted changes in the erythron peripheral unit indicated inhibition of erythropoiesis, more pronounced in patients with B19V, and were consistent with the myelogram data. Conclusions: The development of anemia without the expected increase in RET, and in particular immature forms - IRF, MFR, HFR - in patients with lymphomas and B19V infection indicates inhibition of erythropoiesis. Early manifestation of these changes allows for timely treatment correction.
Effect of access to germline genetic testing on pancreatic cancer precision treatment across disease stage and ethnicity.
Authors: Edward D. Esplin, Rebecca Truty, Shan Yang, Sarah M. Nielsen, Margaret Klint, Stephen E Lincoln, Nhu Ngo, Kingshuk Das, Jewel Samadder, Robert Luke Nussbaum
Journal: Journal of Clinical Oncology (2020)

e16783 Background: PARP inhibitor (PARPi) treatment was recently approved for pancreatic cancer (PaCa) patients with germline mutations in 2 DNA damage repair (DDR) genes. Despite criteria recommending germline multigene panel testing for all PaCa patients, barriers to testing remain, including among underserved populations, which limit access to precision therapies. We initiated a sponsored testing program that increases access to germline genetic testing for PaCa in two ways: 1) offering a comprehensive multigene panel, and 2) removing the barrier of cost. Here we present initial results from this program, including the diagnostic yield in patients across stages of PaCa and clinical utility of the findings. Methods: We retrospectively analyzed de-identified data from 966 PaCa patients tested on an 84 gene panel as part of the program to date. The only inclusion criterion was a willingness to participate in the sponsored program by the patient and the provider who ordered the testing. Data included likely pathogenic (LP) and pathogenic (P) mutations, disease stage and ethnicity. Results: In total, 166 (17%) patients were positive for P/LP germline mutations in 30 genes. Mutation rate by ethnicity was: Caucasian 17%, African American 12%, Hispanic 16%, Ashkenazi Jewish 20%, Asian 3%. Only 25% of patients with P/LP variants reported a family history of cancer. There was no statistical difference in mutation rates by stage (p = 0.11) [Table]. In positive patients, 83 (78%) had mutations conferring potential eligibility for DDR gene-specific precision therapies or clinical treatment trials. 28 (26%) were potentially eligible for olaparib due to BRCA1/2 mutations, 8 (7%) were potentially eligible for pembrolizumab, and 47 (44%) for PARPi clinical trials. Conclusions: This study found 8.5% of all PaCa patients tested are potentially eligible for germline-based precision therapies and/or clinical treatment trials. Of mutation positive patients, 75% did not report a family history of cancer. The positive rate was not statistically different between patients with stage I and stage IV PaCa, underscoring the recommendation to test all patients with PaCa. This program had a 1.5% increased relative uptake among African American patients compared to a standard insurance reimbursement delivery model. These data suggest reducing barriers improves PaCa patient access to genetic information that enables precision therapy. [Table: see text]
Injectable Functional Biomaterials for Minimally Invasive Surgery
Authors: Maria Grazia Raucci, Ugo D'Amora, Alfredo Ronca, Luigi Ambrosio
Journal: Advanced Healthcare Materials (2020)

Abstract Injectable materials represent very attractive ready‐to‐use biomaterials for application in minimally invasive surgical procedures. It is shown that this approach to treat, for example, vertebral fracture, craniofacial defects, or tumor resection has significant clinical potential in the biomedical field. In the last four decades, calcium phosphate cements have been widely used as injectable materials for orthopedic surgery due to their excellent properties in terms of biocompatibility and osteoconductivity. However, few clinical studies have demonstrated certain weaknesses of these cements, which include high viscosity, long degradation time, and difficulties being manipulated. To overcome these limitations, the use of sol‐gel technology has been investigated, which has shown good results for synthesis of injectable calcium phosphate‐based materials. In the last few decades, injectable hydrogels have gained increasing attention owing to their structural similarities with the extracellular matrix, easy process conditions, and potential applications in minimally invasive surgery. However, the need to protect cells during injection leads to the development of double network injectable hydrogels that are capable of being cross‐linked in situ. This review will provide the current state of the art and recent advances in the field of injectable biomaterials for minimally invasive surgery.
Comparative effect of dorsal slit circumcision and disposable circumcision suture device
Authors: Bo Song, Shaozhong Xian, Peishan Wu
Journal: BMJ (2017)

Objective
To compare the safety and effectiveness of disposable circumcision suture device (DCSD) with conventional circumcision in surgical treatment of phimosis and redundant prepuce.


Methods
One hundred and sixty one patients with phimosis or redundant prepuce were randomly assigned to be treated by circumcision using disposable circumcision suture device (DCSD group, n=89) or conventional circumcision (CC group, n=72), respectively.


Results
The operation time was (3.8±0.5)min in DCSD group and (31.6±2.7)min in CC group (F=71.21, P=0.000), blood loss was 1.0(0.9, 1.2)ml in DCSD group and 6.2(5.7, 7.0)ml in CC group (Z=-10.90, P=0.000). There were no significant differences in intraoperative pain score (1.4±0.6 vs. 2.9±0.8, F=2.08, P=0.151) and wound healing time [(14.0±1.3) vs. (16.8±2.1) d, F=0.10, P=0.754] between two groups. There was no need to change the dressing for patients in DSCD group 3 days after the operation, while patients in CC group changed dressing 3 times after the operation. No significant differences in postoperative complication rate [10%(9/89) vs. 4%(3/72), χ2=2.04, P=0.153] and satisfaction rate with the penile appearance [98%(87/89) vs. 94%(68/72), χ2=0.47, P=0.494] were found between two groups.


Conclusion
DCSD exhibits superiority over CC for shorter operation time and less blood loss in circumcision.


Key words: 
Circumcision, male; Phimosis; Surgical stapling
为糖尿病患者提供个体化健康教育案例分析
Authors: 黄萍
Journal: BMJ (2010)

在治疗与生活方式密切相关的糖尿病过程中发现,临床医生对糖尿病患者进行有选择的、适时的个体化健康教育,对提高患者依从性、疾病的康复具有特别的意义.现分析3例诊治资料,探讨对糖尿病患者进行管理的实践体会及要点。
一次性手术根治肛周脓肿36例
Authors: 周世龙, 刘智伦, 刘晓君
Journal: BMJ (2005)

肛周脓肿为临床常见病、多发病,传统治疗是先一期切开引流,待形成肛瘘后再行肛瘘手术,不但增加了患者二次手术的痛苦,而且医疗费用增加,治疗时间大大延长.我科自2002年 12月至2003 年11月采用一次性根治手术治疗肛周脓肿36例,疗效满意,现报告如下。
FDG-PET metabolic tumor volume in advanced melanoma treated with ipilimumab and nivolumab (ipi/nivo).
Authors: Amir Iravani, Roslyn Wallace, Serigne Lo, Anna Galligan, Alison Weppler, George Au-Yeung, Damien Kee, Peter Kar Han Lau, Benjamin M Brady, Belinda Lee, Grant A. McArthur, Shahneen Kaur Sandhu, Rodney J. Hicks
Journal: Journal of Clinical Oncology (2020)

10041 Background: Predictors of outcomes of immune checkpoint inhibitors (ICI) are desirable. We aim to investigate the prognostic value of 18 F-fluorodeoxyglucose-PET/CT (FDG-PET) parameters at baseline and response monitoring of patients (pts) with advanced melanoma receiving ipi/nivo. Methods: From 2016-2019, melanoma pts who received ipi/nivo and had PET Response Criteria In Solid Tumors (PERCIST) measurable lesions on baseline FDG-PET were included. Baseline whole-body metabolic tumor volume (wbMTV), tumor stage, mutational status, ECOG performance score, lactate dehydrogenase (LDH) and treatment-line were correlated with overall survival (OS) in univariate and multivariate Cox-regression analysis. Response were assessed for a subset of pts with post-treatment FDG-PET based on PERCIST. Results: Of 162 pts receiving ipi/nivo, 122 pts (median age: 61; male: 73%; ECOG 0: 78%; raised LDH: 52%; M1c: 39%, M1d: 45% and BRAF V600E/K mutation: 45%) met eligibility criteria. Forty percent received ipi/nivo as first-line treatment, 48% as second-line (25% post BRAF inhibitor(i)/MEKi and 23% post single-agent ICI) and 12% as third-line. At median follow-up of 21 months (mths), median OS was 20 mths (95% CI 11-not reached[NR]). Pts with above the median wbMTV had shorter OS than those with below the median wbMTV (NR vs 10 mths, 95% CI 8-NR; HR 2.0, 95% CI 1.2-3.4, p = 0.009). In multivariate analysis, wbMTV, ECOG and treatment-line were independently associated with OS. In 106 pts with post-treatment FDG-PET, 24 mths OS rate was higher for those with objective response (OR): 91% (95% CI 82-100%) vs stable disease:55% (27-100%) vs progressive disease:17% (8-35%) as best response, p &lt; 0.001. OR was higher in first-line compared to second or third-line treatment, 75% vs 29-33% vs 23%, respectively, p = 0.0012. Conclusions: Increased baseline FDG-PET wbMTV is an independent prognostic biomarker in pts with advanced melanoma receiving ipi/nivo. FDG-PET response accurately predicts outcome. [Table: see text]
Challenges and opportunities of hepatitis C management in the direct-acting antiviral agents era in China
Authors: Xiaoxiao Wang, Bo Feng
Journal: BMJ (2016)

直接抗病毒药物在临床上的应用使得丙型肝炎的治疗获得突破性进展，2015年更新版的中国丙型肝炎防治指南对此也做了重点介绍。但事实上，我国在丙型肝炎的管理包括对丙型肝炎的认知、筛查、诊断、治疗、预防及基础研究等诸多方面，依然面临很多问题。
宫内节育器的应用和服务进展
Authors: 吴尚纯
Journal: BMJ (2010)

宫内节育器(IUD)是我国最普遍使用的避孕方法,采取避孕措施的已婚育龄妇女中有约1/2使用IUD.在农村地区,约有70%的IUD在乡级计划生育服务机构或医疗机构放置.本文将对IUD的产品种类、性能特点、服务方式和技术规范等方面的进展做简要介绍。