tbuckley/cabot-search huggingface dataset:
Esophageal cancer, five years of experience in a regional oncologic reference center in Mexico.
Authors: Adelina Alcorta-Garza, José Carlos Cessa-Zanatta, Fernando Alcorta-Nuñez, Juan Manuel Muñoz-Ayala, David Hernández-Barajas, Juan Francisco Gonzalez Guerrero, Oscar Vidal-Gutiérrez
Journal: Journal of Clinical Oncology (2020)

e16515 Background: Esophageal cancer is a highly lethal entity. Within this group of tumors, squamous cell carcinoma (SCC) and esophageal adenocarcinoma (ACE) represent 95% of the total. For most of the twentieth century, the SCC predominated throughout the world, however, this trend has changed dramatically in Western countries, including ours. Mexican patients with esophageal cancer are diagnosed at later stages of the disease and have worse therapeutic outcomes than reported in the world literature. Methods: Retrospective, observational and descriptive study. The research subjects were obtained from the population of patients who attended the service of the Centro Universitario Contra el Cancer of the University Hospital "Dr. José Eleuterio González” between 2012 and 2017 (sample size calculated n = 120).The clinical and demographic characteristics of patients with esophageal cancer in our population were described. The results from international guides (AIMS65, New International Score, Glasgow-Blatchford scale and Rockall pre-endoscopic) were used to compare cut-off points with our population and their correlation with mortality. Results: A total of 179 research subjects were included in the study. The average age was 55 years, 62% male and 38% female. Various demographic characteristics such as in-hospital mortality (n = 42, 23.5%), 30-day mortality (n = 36, 20.1%), re-bleeding (n = 49, 27.4%) and transfusions (n = 99, 55.3%) were studied as incidence of positive cases to the event. We also studied the mean days of hospital stay (4.6 days), systolic blood pressure (108 mmHg) and diastolic blood pressure (66mmHg), hemoglobin (8.9 g / dL), among others. The type of bleeding was variceal in 122 subjects, and non-variceal in 57. In total, 117 subjects were treated with endoscopic treatment and 53, without endoscopic treatment. The Glasgow Blatchford scale obtained a higher discriminative score (AUROC 0.73) to predict in-hospital mortality in our subjects, compared to ASA (0.72 p &lt; 0.001), New International score (0.76 p &lt; 0.001) and AIMS65 (0.66 p &lt; 0.001). Conclusions: The used scales had no positive predictive value for bleeding risk. The Glasgow Blatchford scale was the only score that showed an AUROC of 0.65 p &lt; 0.001 to predict the efficiency of transfusion in patients compared to the other scores that showed no significant value. ASA was the predictive discriminative score (AUROC 0.73) for a 30-day in-hospital mortality (p &lt; 0.001), followed by the Glasgow Blatchford scale (0.61 p &lt; 0.04).
雪卡毒素中毒的神经系统损害
Authors: 刘志新, 韦海潮, 林振, 宋志彬, 章小兵, 伍业星, 孟景晔, 谭向红
Journal: BMJ (2006)

分析63例因食用老虎斑鱼引起的雪卡毒素中毒患者的临床特征,并测定其和60例正常人的正中神经及胫神经的神经传导速度.结果显示63例患者感觉异常均持续2周以上:四肢肌肉感觉异常占65.1%,皮肤瘙痒、蚁爬感占61.9%,其中温度感觉倒错占54.0%,唇周舌咽喉麻木占33.3%,视觉异常占14.3%.神经电生理检测显示,正中神经在早期(2周内)的感觉神经传导速度(SCV)异常检出率为36.5%,运动神经传导速度(MCV)异常检出率为11.1%;胫神经在早期的SCV异常检出率为60.3%,MCV异常检出率为14.3%,而三叉神经SCV未见明显异常.提示雪卡毒素中毒临床表现在消化、神经、心血管三大系统,可造成持续长时间的神经感觉异常,并以温度感觉倒错最具特征性,其周围神经损害主要在肢体远端,且下肢重于上肢,而无颅神经损害体征。
Etiology and treatment strategies for pediatric cholecystolithiasis
Authors: Hao Dong, Xiang-ming Ma, Qing-jiang Fu, Li-ying Cao
Journal: BMJ (2013)

A total of 55 children aged under 14 years with cholecystolithiasis were treated at our hospital between January 2005 to December 2011. Their clinical data were collected and analyzed. The etiologies included pseudolithiasis (n=36), chronic hemolytic disease (n=2), obesity (n=9) and unknown (n=8). Among 50 cases on conservative treatment, 42 cases were cured. Four cases underwent laparoscopic cholecystectomy. During a follow-up period of 2-4 years, there was no occurrence of significant complications. The removal of gallbladder stone was performed via laparoscopy plus choledochoscope in 1 case. There was no recurrence during a follow-up period of 2 years. Ceftriaxone sodium and obesity were the major cause of pediatric cholecystolithiasis. A proper selection of treatment regimens should be based upon the considerations of etiologies and symptoms.


Key words: 
Cholecystolithiasis; Children
Efficacy and safety of apatinib in patients with recurrent or refractory melanoma.
Authors: Zibing Wang, Shumin Yuan, Xiaojie Zhang, Hao Huang, Quanli Gao
Journal: Journal of Clinical Oncology (2020)

e22026 Background: The prognosis of patients with metastatic malignant melanoma is very poor, a fact that is partly due to its high resistance to conventional chemotherapies. The objectives of this phase II trial were to assess the activity and tolerability of apatinib, an oral small molecule anti-angiogenesis inhibitor, in patients with recurrent advanced melanoma. Methods: This was a single arm, single center phase II trial. The primary endpoint was progression free survival (PFS), and the second endpoints was objective response rate (ORR), disease control rate (DCR) and overall survival (OS). Eligible patients received at least one prior line of therapy for advanced melanoma and experienced recurrence. Apatinib was given daily at a dose of 500 mg orally. This study was registered at ClinicalTrials.gov , number NCT03383237 . Results: A total of 17 patients were included in the final analysis. The median PFS was 4.5 months. There were two major objective responses, for a response rate of 11.8%. Thirteen patients had a stable disease, for a DCR of 88.2%. The median OS was 11.5 months. The most common clinically significant grade 3 or 4 toxicities included hypertension (n = 1) and canker sore (n = 1). No treatment-related death occurred. Conclusions: Apatinib showed antitumor activity as a second or above line therapy in patients with malignant melanoma. The toxicity was manageable. Clinical trial information: NCT03383237.
Application of magnetic resonance imaging in differential diagnosis for tuberculous pyonephrosis and hydronephrosis
Authors: 武志峰, 朱捷, 刘荣波, 魏强
Journal: BMJ (2005)

目的 探讨几种磁共振成像技术在结核性脓肾与肾积水鉴别诊断中的价值.方法回顾性分析7例经手术病理证实的结核性脓肾及10例肾积水的磁共振图像特点,包括T1加权、T2加权、增强扫描、磁共振尿路成像及磁共振弥散加权成像.结果常规T1、T2加权可以了解肾脏的整体形态,提示肾实质破坏、积脓;增强扫描可以显示脓腔壁、肾盂、肾盏壁及输尿管壁的异常强化;磁共振尿路成像可以较清晰地显示两组病变的尿路整体形态;上述技术可使诊断正确率达84.7%.磁共振弥散加权成像既可以分析弥散图与ADC图了解水分子的弥散特点,也可以通过测量ADC值量化鉴别上述2种病变,与上述其他手段结合可使诊断正确率达91.2%.结论综合应用磁共振各项检查技术对结核性脓肾与肾积水的鉴别诊断有一定价值,可提高诊断正确率。
超声诊断脾破裂致门静脉积气一例
Authors: 李莉, 王秀平
Journal: BMJ (2005)

患者男,11岁,9 h前不慎被椅背撞伤腹部,出现渐进性腹痛难忍、伴呕吐来我院就诊.体格检查:腹胀,腹部压痛明显,尤以左上腹为甚,肌紧张(+),反跳痛(+),腹水征(+).超声检查:肝脏区扫描显示肝脏实质回声不均匀,内部可见条索状(干树枝状)强光带,不伴声影,遍及全肝脏.肝静脉欠清晰,门脉系统显示不清晰.脾包膜下可见低回声带,脾实质内靠近脾门处可探及一约55 mm×52 mm不均匀低回声区,双肾结构规整,实质回声均匀.腹腔内膈下及肝肾、脾肾间隙均可探及不规则液性暗区.诊断:脾破裂,腹水,肝脏所见系门静脉积气可能.CT检查示:脾破裂,腹盆腔积液,肝实质内门静脉分支旁小片状低密度影考虑门静脉积气可能.患儿保守治疗2周后复查:肝脏形态基本正常,实质回声均匀,脾脏回声仍不均匀,腹盆腔未探及液性暗区。
Response to: ‘Patients with lupus with COVID-19: University of Michigan experience’ by Wallace<i>et al</i>
Authors: Alexis Mathian, Zahir Amoura
Journal: Annals of the Rheumatic Diseases (2020)

Although the fundamentals of extracorporeal membrane oxygenation (ECMO) have not changed in 3 decades, the technical elements continue to improve and have evolved from an assemblage of individual components to more integrated systems with added features, enhanced safety, and improved maneuverability. The introduction of polymethylpentene (PMP) fiber technology has expanded the development of artificial membranes that have low resistance, are more biocompatible, and can be used for extended durations. Extracorporeal carbon dioxide removal techniques continue to be enhanced as stand alone technology and modified renal dialysis systems are introduced. Research continues in the development of compact and wearable artificial lungs that are intended to support patients for prolonged periods (eg, patients awaiting lung transplantation). The use of high-fidelity simulation training has become a standard and important method for reinforcing technical skills, refining troubleshooting sequences, and enhancing team interactions. Modifications to mannequins and ECMO systems coupled with clinical and physiologic scenarios will help achieve greater realism and enhance learning. ECMO technology continues to improve, with adaptability and versatility being essential attributes.
澳大利亚老年科康复小组简介
Authors: 雷慧
Journal: BMJ (2004)

在澳大利亚住在老年科病房的患者,除了接受医生和护士的常规治疗护理外,还接受着一个系统而专业的康复小组的精心诊治,这个康复小组包括物理治疗师、职业治疗师、语言治疗师、营养师、眼科治疗师以及社会工作者,他们均为医学院校毕业,获学士学位.这种系统的康复治疗体现了以病人为中心的思想,加速了老年患者的康复。
Delivery of all-trans-retinoic-acid (ATRA) in liposomes modulated MDSCs and T-cell activities in the tumor microenvironment.
Authors: Yuhong Xu, Anjie Zheng, Shanshan Jin, Xiaolong Chen
Journal: Journal of Clinical Oncology (2020)

e15644 Background: All-Trans-Retinoid-Acid (ATRA) is a naturally occurring vitamin A metabolite that participates in many biological processes. Beside its highly potent effect of promoting terminal differentiation of acute promyelocytic leukemia blasts into mature granulocytes, there have been many other studies suggesting its activity on the myeloid derived suppressor cells (MDSCs) and tumor specific CD8+ T cells in animal models as well as using clinical samples. But the use of ATRA as an immune-oncological agent in solid tumor therapy has been limited by the very poor solubility of the compound, its fast metabolism, and very limited exposure achieved after oral administration. Methods: We prepared a new dosage form by encapsulating ATRA inside PEGylated liposomes. The liposomes were shown to accumulate inside solid tumor tissues and deliver more ATRA with longer duration. Results: The effect and dose response of the liposomal ATRA on CT26 murine tumor growth were examined, as well as specific molecular signatures concerning tumor infiltrating myeloid cells. Notably, there was significant higher expression of CD86 and lower expression of PD-L1. These myeloid cells had very low inhibitory effect on ex vivo activated T cells, while on the other hand could promote specific antigen presentation to amplify CD8+ T cells. Furthermore, the liposomal ATRA was also shown to synergize with anti-PD-1 treatment to result in more CD8 T cell distribution in the tumor tissues. Conclusions: These data may suggest an exciting opportunity for targeting MDSCs using liposomal ATRA for combination with T cell based therapeutics in cancer immunotherapy.
Clinical effectiveness of incision-thread-drawing procedure for perianal abscess
Authors: 李春雨, 聂敏, 梁健
Journal: BMJ (2006)

目的 对比观察切开挂线术与切开引流术治疗肛周脓肿的临床效果.方法 回顾性总结110例肛周脓肿住院患者的临床资料,110例中行切开挂线术治疗(挂线组)46例,行切开引流术治疗(引流组)64例,比较两组术后疗效.结果 与引流组相比,挂线组患者术后脓肿复发率[4%(2/46)与19%(12/64)]、肛瘘形成率[4%(2/46)与23%(15/64)]、创面愈合时间[(20.4±0.9)d与(28.4±0.9)d]、住院时间[(15.4±0.9)d与(25.1±0.9)d]明显为低(P＜0.05).两组术后无一例发生肛门失禁、肛门狭窄及肛门畸形等.随诊2～3年,无复发,肛门功能均正常.结论 切开挂线术治疗肛周脓肿手术一次成功,脓肿复发率和肛瘘发生率低,疗程短,患者痛苦少。
The comparative effectiveness of glasdegib in combination with low-dose cytarabine versus azacitidine by bone marrow blasts counts among patients with newly-diagnosed acute myeloid leukemia who are ineligible for intensive chemotherapy.
Authors: Sophie van Beekhuizen, Yannan Hu, Ana Gezin, Bart Heeg, Timothy Bell, Majed Charaan, Andrew Brown, Geoffrey Chan, Joseph C Cappelleri
Journal: Journal of Clinical Oncology (2020)

e19512 Background: Acute myeloid leukemia (AML) is an orphan disease with one of the lowest five-year survival rates among myeloid malignancies. Recently, a randomized, open label study among previously untreated, chemotherapy-ineligible AML patients demonstrated improved overall survival (OS) among patients treated with glasdegib (GLAS) + LDAC compared with LDAC alone. Two trials of AZA vs. conventional care regimens report data by bone marrow blast (BMB) counts: one with 20-30% and the other with &gt;30%. In the absence of head-to-head comparisons, this study aims to perform the indirect treatment comparison between GLAS+LDAC and AZA by BMB counts. Methods: As there were potential imbalances between the GLAS and AZA trials and within the AZA trial arms in the baseline characteristics (e.g. poor cytogenetics% and de novo%), simulated treatment comparisons (STCs) for GLAS+LDAC vs. LDAC were performed to derive robust estimation by adjusting for the imbalances in the baseline effect modifiers. Afterwards, the classical network meta-analysis (NMA) was conducted. To derive the hazard ratio (HR) of GLAS+LDAC vs. AZA, three NMAs were conducted in each BMB group. Each NMA used a different HR of GLAS+LDAC vs. LDAC: 1) an unadjusted HR (classical NMA), 2) an STC adjusted HR adjusting for potential imbalances between the trials, and 3) an STC adjusted HR additionally accounting for potential imbalances between arms within the AZA trial. Results: In the 20-30% BMB group (N = 30), the OS HRs of GLAS+LDAC vs. AZA resulting from the three respective NMAs were as follows: 1) 0.46 [95% confidence interval: 0.10-2.14], 2) 0.31 [0.06-1.69], and 3) 0.36 [0.06-2.15]. In the &gt; 30% BMB group (N = 80), the HRs were 1) 0.69 [0.39-1.20], 2) 0.48 [0.23-0.97], and 3) 0.48 [0.24-1.00]. All the HRs suggest that patients with GLAS+LDAC have a survival advantage over patients with AZA. Conclusions: Both the classical NMAs and the NMAs based on the STC adjusted HRs correcting for the potential imbalances at baseline suggest that GLAS+LDAC may be preferred over AZA as a treatment option for previously untreated chemotherapy-ineligible AML patients regardless of BMB counts. [Table: see text]
Prognostic relevance of CD4+ T-cells in the microenvironment of newly diagnosed follicular lymphoma (FL) patients is independent of the tumor gene expression profile.
Authors: Patrizia Mondello, Angelo Fama, Melissa C. Larson, Andew L. Feldman, Zhi-Zhang J Yang, Jose Caetano Villasboas, Sarah Huet, Bruno Tesson, Susan L. Slager, Brian K. Link, Sergei Syrbu, Anne Novak, Thomas Matthew Habermann, Thomas E. Witzig, Grzegorz S. Nowakowski, Gilles A. Salles, James Robert Cerhan, Stephen M. Ansell
Journal: Journal of Clinical Oncology (2020)

8052 Background: A significant proportion of patients with FL experience an early relapse and a subsequent poor outcome. While several prognostic indices have been developed, none were designed to predict early failure. Recently, we established that lack of intrafollicular CD4+ T-cell expression predicted risk of early failure, and integrating this microenvironment biomarker with the Follicular Lymphoma International Prognostic Index, termed BioFLIPI, further improved identification of FL patients at risk of early failure ( Blood 2019;134(suppl1):121). However, the microenvironment may be influenced by the genetic composition of tumor. We investigated whether the CD4 biomarker and BioFLIPI were impacted by genetic features of the tumor as assessed by a 23-gene expression prognostic score ( Lancet Oncol 2018;19:549-61). Methods: Of the 186 cases with FL grade 1-3A treated with immunochemotherapy (IC) in our prior study, 152 had digital expression quantification of 23 selected genes (23-GEP score), which used RNA from formalin-fixed, paraffin-embedded samples. Event-free survival (EFS) was defined as time from diagnosis to progression, relapse, retreatment, or death. Early failure was defined as failing to achieve EFS at 24 months. Risk of early failure was estimated using odds ratios (ORs) and 95% confidence intervals from logistic regression models. We also used Cox regression to assess associations with continuous EFS and overall survival (OS). Results: 28% of patients failed to achieve EFS24. Lack of CD4+ intrafollicular expression (38% of patients, OR = 2.33, p = 0.024) and high risk 23-GEP score (26% of patients, OR = 3.52, p = 0.001) each predicted early failure, and in a multivariable model that included FLIPI, both CD4+ (OR = 2.26, p = 0.046) and 23-GEP score (OR = 2.26, p = 0.0.057) remained predictors. Similarly, BioFLIPI modeled as a continuous score (1-4, OR per one point increase = 2.31, p &lt; 0.001) predicted early failure, and the association remained (OR = 2.14, p &lt; 0.001) when the high risk 23-GEP score (OR = 2.79, p = 0.013) was included in the model. When stratified on 23-GEP score, BioFLIPI was a stronger predictor of early failure in low risk (74%, OR = 2.51, p = 0.002) relative to high risk (26%, OR = 1.55, p = 0.27) patients. Similar patterns were observed for EFS and OS. Conclusions: CD4+ T-cell infiltrate and tumor gene expression appear to be independently predictive of early failure in newly diagnosed FL patients treated with IC. Future studies should integrate and validate these measures.
Preliminary population pharmacokinetics supports phase II dose selection for masked anti-PD-L1 antibody CX-072.
Authors: Mark Stroh, Michelle Green, Bjorn L. Millard, William Garner, Hong Lu, Jennifer Hope Richardson, Alison L. Hannah
Journal: Journal of Clinical Oncology (2020)

3602 Background: PROBODY therapeutics (Pb-Tx) are antibody prodrugs designed to reduce off-tumor, on-target toxicities. The mask inhibits Pb-Tx binding in the periphery yet can be removed by tumor-associated proteases, restricting target engagement to the tumor. This is the first report of preliminary clinical pharmacokinetic (PK) analysis supporting selection of the phase II dose for CX-072, an anti–PD-L1 Pb-Tx, from the ongoing phase I/II PROCLAIM-CX-072 study (NCT03013491). Methods: A quantitative systems pharmacology (QSP) model 1 was used to project the CX-072 plasma trough level (C min ) corresponding to 95% intratumoral receptor occupancy (RO). Human PK and anti-drug antibody (ADA) data were obtained at selected times postdose following IV administration of 0.03–30 mpk CX-072 in PROCLAIM-CX-072. Population PK (POPPK) modeling was performed with NONMEM v7.3.0. Exploratory analysis and simulations were done with R v3.3.1 or later. Covariates were selected for POPPK using forward addition ( P&lt;0.05) followed by backward deletion ( P&lt;0.01). Results: The preliminary POPPK analyses were informed using available PK data as of August, 2019 from 135 subjects receiving CX-072 Q2W as monotherapy in the dose-escalation and expansion cohorts of PROCLAIM-CX-072. A mixture model was used to capture time- and dose-dependent apparent ADA effect on clearance (CL). The preliminary POPPK model estimates for CX-072 CL and volume of distribution (Vd) were 0.306 L/day and 4.84 L, respectively. Statistically significant covariate effects included body weight on the central Vd and CL, and albumin on CL. The QSP model predicted a CX-072 C min of 13–99 nM would be required for 95% intratumoral RO. POPPK simulations suggested that &gt;95% of patients receiving CX-072 10 mg/kg Q2W would meet or exceed this targeted C min regardless of ADA. Additional observed data indicated that the majority of patients receiving 10 mpk CX-072 Q3W × 4 with 3 mpk ipilimumab (IPI) Q3W × 4 in the CX-072-IPI combination part of PROCLAIM-CX-072 maintained the targeted C min . Simulations did not suggest there would be a clinically meaningful change in exposure following a fixed dose of CX-072 800 mg relative to the 10 mpk weight-based dose. Conclusions: Preliminary PK analysis supports selection of 800 mg CX-072 Q2W as the recommended monotherapy dose and 800 mg Q3W when combined with IPI. The combination of 800 mg CX-072 + 3 mpk IPI Q3W × 4 doses, followed by monotherapy administration of 800 mg CX-072 Q2W is being further explored in phase II. Reference: 1) Stroh M et al. CPT. 2019(9):676-84. Clinical trial information: NCT03013491 .
Reliability of mRECIST criteria for HCC in the relationship between response and progression.
Authors: Manish Sharma, Oliver Bohnsack, Anitha Singareddy, Jayant Narang, Michael O'Connor, Surabhi Bajpai, Rudresh Jarecha, Rajesh Kaja
Journal: Journal of Clinical Oncology (2020)

e16645 Background: Response Evaluation Criteria in Solid Tumors (RECIST) guidelines consider the measurement of treatment response based on tumor shrinkage due to the antitumor activity of cytotoxic drugs. However, tumor response can be misleading when molecular-targeted therapies or locoregional therapies are used in Hepatocellular carcinoma (HCC). RECIST 1.1 does not specify for changes in tumor vascularity or necrosis. The modified RECIST (mRECIST) adapts the concept of viable (Enhancing) tumor and tumoral necrosis in the assessment of response. According to mRECIST, if a tumor that is solid at baseline becomes entirely necrotic, all the tumors are evaluated as complete response (CR). Edeline et al. evaluated the response of sorafenib in HCC and reported that 26.2% of the patients who were classified as having stable disease (SD) according to RECIST were reclassified as responding to treatment, according to the mRECIST. Takada et al. analyzed tumor responses with sorafenib in HCC according to RECIST 1.1 and mRECIST where 13.1 % of patients were assessed as responders by mRECIST and 7.8 % by RECIST 1.1. There was a significant difference in overall survival (OS) between responders and non-responders according to mRECIST ( p = 0.0117), but no significant difference in OS between responders and non-responders according to RECIST 1.1 ( p = 0.0722). Methods: A retrospective review of time points associated with HCC was performed for 3 clinical trials with a total of 1060 patients with 3998 time points and evaluated using RECIST and mRECIST guidelines. The responses: overall response rate (ORR), CR and partial response (PR) were compared using both guidelines and correlated with disease progression. Results: At a subject level, there are 128 responders by RECIST, of which 73 progressed (57%), 274 responders by mRECIST, of which 156 progressed (57%); while of 148 responders by mRECIST, which were non-responders by RECIST only 80 progressed (54%) within the stipulated study duration. At the visit level, there are 520 timepoints of response by both RECIST &amp; mRECIST, while there are 509 timepoints of response by mRECIST, which are SD by RECIST due to necrosis related difference in criteria implementation. Conclusions: It can be concluded that subjects with response by mRECIST with response or no response by RECIST tend to have an excellent correlation with progression as well. The use of mRECIST improves the outcome of the response in HCC treatment. [Table: see text]
Chronic obstructive pulmonary disease associated with biomass fuel use in women: a systematic review and meta-analysis
Authors: Sana Adama, Somda Serge M A, Meda Nicolas, Bouland Catherine, 王臻, 施焕中
Journal: BMJ (2018)

目的
慢性阻塞性肺疾病（COPD）是世界范围内患病率和死亡率不断增长的主要疾病。女性的COPD患病率较男性增长更快，因为女性更常暴露在生物燃料燃烧产生的室内污染物中。


方法
我们进行meta分析以明确女性COPD和生物烟暴露之间的关系。根据报告系统和meta分析指导方针，我们于2016年12月31日检索MEDLINE和Scopus数据库，使用关键词woodcharcoalbiomasssolid fuelsorganic fuelbiofuelfemalewomenCOPDchronic bronchitisemphysemachronic obstructive pulmonary disease。与室内生物质燃料暴露相关的病例-对照研究或横向研究均可入组，不限时间与地域。使用固定效应模型或随机效应模型合并比值比（OR）。


结果
最终24篇文献入组：5篇病例-对照研究和19篇横向研究。有生物燃料暴露的个体诊断COPD的机会是无生物燃料暴露个体的1.38倍[OR 1.38，95%可信区间(CI）1.28~1.57]。肺活量诊断COPD的研究未显示出明显相关性（OR 1.20，95%CI 0.99~1.40）。无论如何，对慢性支气管的OR值进行整体评价是有意义的（OR 2.11，95%CI 1.70~2.52）。横向研究和病例-对照研究的合并OR值分别为1.82（95% CI 1.54~2.10）、1.05 (95%CI 0.81~1.30）。在农村或城市生活的女性均发现COPD和生物烟暴露有明显相关性。


结论
本研究显示无论农村或城市，女性罹患COPD与生物烟暴露是相关的。在许多发展中国家，越来越多使用现代化燃料，而不是传统燃料，特别是在城市地区。目前仍需要大量数据来进一步探索使用混合燃料烹饪对呼吸系统健康，尤其是降低COPD发病率的益处。
Compression therapy in preventing deep vein thrombosis of lower extremities
Authors: Yi Sun, Biao Yuan
Journal: BMJ (2020)

Drug prophylaxis is commonly used for prevention of deep vein thrombosis (DVT), but it has deficiencies such as causing thrombocytopenia and weakening coagulation function. Compression therapy is a safe and economical physiotherapy method, which can effectively prevent the occurrence of DVT with less adverse reactions. This article reviews the clinical application and efficacy of four pressure treatment methods: graduated compression stockings, intermittent pneumatic compression, venous foot pumps and continuous enhanced circulation therapy.


Key words: 
Venous thrombosis; Physical therapy modalities; Compression therapy; Stockings, compression