tbuckley/cabot-search huggingface dataset:
<i>STK11/LKB1</i> revisited: A prognostic rather than predictive biomarker for immune checkpoint inhibitor in <i>EGFR/ALK</i><sup>WT</sup> nonsquamous non-small cell lung cancer (NSCLC).
Authors: Hui Zhao, Nan Qi, Dianjun Chen, Donghui Li, Yan Fu, Yu Xu, Guoqiang Wang, Yuezong Bai, Nan Du
Journal: Journal of Clinical Oncology (2020)

e21548 Background: Previous retrospective studies identified the mutation of serine/threonine-protein kinase (STK11, also known as Liver Kinase B1 [LKB1]) as predictor to the benefit from immune checkpoint inhibitor (ICI) in KRAS-mutant lung adenocarcinoma. This conclusion was drawn from merely the patients receiving ICI, lacking the indispensable control group undergoing chemotherapy. Therefore, we hereby revisit the impact of STK11 mutation in both immunotherapeutic and chemotherapeutic cohorts, in addition to TCGA database as a control cohort representing prognosis. Methods: 6 immunotherapeutic cohorts involving 807 patient-level data (Van Allen, Rizvi-34, Rizvi-240, MSKCC-75, MSKCC-350, and POPLAR/OAK-atezolizumab), 1 chemotherapeutic cohort (POPLAR/OAK-docetaxel, n = 244), and TCGA database (n = 485) were included to comprehensively re-examine the questionably predictive effect of STK11 mutation on the benefit from immunotherapy in patients with EGFR/ALK WT non-squamous NSCLC. Results: In the 6 immunotherapeutic cohorts, STK11 mutation was associated with shorter progression-free survival (PFS, HR = 1.54, 95%CI 1.17-2.03, P = 0.002) and overall survival (OS, HR = 1.57, 95%CI 1.16-2.11, P = 0.003), but no statistically lower overall response rate (ORR, RR = 0.71, 95%CI 0.39-1.28, P = 0.251). Similarly, in the patients receiving docetaxel, worse ORR and PFS at borderline level and significantly reduced OS (HR = 1.82, 95%CI 1.18-2.80, P = 0.006) were observed. Specifically, in the POPLAR/OAK cohort retrieved from two randomized controlled trials comparing atezolizumab and docetaxel, STK11 mutation and treatment choice separately impacted on OS, but the interaction between these two variables was barely profound (HR 1.10, 95%CI 0.60-2.01, P = 0.766), indicating the prognostic, but not predictive utility of STK11 mutation. Furthermore, in TCGA database, STK11 mutation was linked with poorer prognosis, with the similar hazard ratio in immunotherapeutic cohorts. Conclusions: Genomic abberation of STK11 remarkably worsens prognosis among 6 immunotherapeutic cohorts, 1 chemotherapeutic cohort, and TCGA database, demonstrating the prognostic, but not predictive utility of STK11 mutation in patients with EGFR/ALK WT non-squamous NSCLC.
Will adding alkylating agent to bortezomib improve survival of newly diagnosed AL amyloidosis patients?
Authors: Yumeng Zhang, Lauren Duncanson, Taiga Nishihori, Doris K. Hansen, Jose L. Ochoa-Bayona, Hien D Liu, Rachid C. Baz, Brandon Jamaal Blue
Journal: Journal of Clinical Oncology (2020)

8517 Background: The combination of bortezomib (Bort) and alkylating agent (AA) is a frequently used first-line therapy for AL amyloidosis. Kastritis et al. compared melphalan and dexamethasone with or without bortezomib as primary therapy and demonstrated increased hematologic response rate with the bortezomib and melphalan combination. However, the role of AA is unclear. This study aimed to evaluate if adding AA to Bort improved patient outcomes in AL amyloidosis. Methods: We retrospectively reviewed clinical data on 209 patients with systemic AL Amyloidosis at Moffitt Cancer Center between 2008 and 2020. We excluded patients with localized amyloidosis or amyloid other than AL. Patients were divided into two groups based on upfront therapy: A) Bort and B) Bort + AA. All patients also received dexamethasone. The staging was per Mayo 2012. Organ involvement, response, and progression were defined based on the 2005 criteria. Overall survival (OS) was defined as the time from initial diagnosis until death or last contact. Time to next therapy (TTNT) was calculated in patients with the documented hematologic response from the time of initiation of therapy to time of the next therapy/last follow up/death. Results: Of 209 patients, 36% (n=76) received Bort+AA; 30% (n=62) received Bort. No significant difference in clinical characteristics was seen in both groups except for age (which was higher for arm A: median 65 and 62 years, respectively, p=0.043) (table). In addition, Bort+AA became more commonly used as a frontline therapy after 1/1/2014 (p=0.001). Group A and B had similar median OS (69.9 months [95% CI. 44.7-95.2] and 64.4 mo [95% CI 40.5-88.3] respectively, p=0.60). 86% of patients in group B achieved a hematologic response as compared to 74% of patients in group A (p=0.15). Similarly, 47% of patients in group B achieved an organ response as compared to 34% of patients in group A (p=0.22). TTNT was higher in group A than group B (16.9 mo [95% CI, 0-41.5] and 7.8 mo [95% CI, 3.5-12.0], respectively, p=0.08). Conclusions: While Bort+AA is a commonly used regimen for amyloidosis, the addition of AA to Bort did not result in superior OS, TTNT compared to Bort alone in this retrospective study. This finding should be confirmed in prospective studies. Baseline Characteristics. [Table: see text]
2011年新春团拜会纪实
Authors: 刘伟竹, 顾湲
Journal: BMJ (2011)

2011年1月7日, 和中华医学会全科医学分会首次联合组织新春团拜会,在北京市方庄社区卫生服务中心(方庄医院)的大力支持下,此次团拜会成为一次专家下社区的联谊会.来自京津地区的全科医学分会委员和编委会专家们由吴浩主任带领参观了方庄社区卫生服务中心和芳群园社区卫生服务站。
Clinical value of risk of ovarian malignancy algorithm in risk stratification of ovarian cancer
Authors: Aimin Zhang, Li Jia
Journal: BMJ (2014)

The serum specimens were collected from ovarian cancer (n=100), benign ovarian disease (n=69) and healthy women (n=95). The serum levels of HE4 and CA125 were detected. Risk of ovarian maliqnancy algorithm (ROMA) was calculated. Accuracy of prediction was evaluated by the area under receiver operating characteristic curve (ROC-AUC). And validity of prediction was evaluated by sensitivity and specificity. The results showed that the median level of ROMA algorithm was 83.0%, 8.9% and 8.7% in ovarian cancer, benign ovarian disease and healthy women groups respectively. The difference were statistically significant (all P<0.01). Compared with benign ovarian disease group, the ROC-AUC of ROMA algorithm was 0.900 in ovarian cancer group. The sensitivity and specificity were 81.0% and 92.8% in ovarian cancer group respectively. Thus ROMA algorithm is a useful parameter in risk stratification for ovarian cancer. The diagnostic accuracy of ROMA algorithm is better than that of HE4 and CA125 in ovarian cancer.


Key words: 
Ovarian neoplasms; Epididymal secretory proteins
Comparative analysis of upper ureteral stones treated with retroperitoneoscopic ureterolithotomy and percutaneous nephrolithotomy
Authors: Jiahe Zhou, Tao Fan
Journal: BMJ (2014)

To explore an appropriate treatment for patients with upper ureteral stone (>15 mm in size) by comparing the therapeutic outcomes for those undergoing retroperitoneoscopic ureterolithotomy (RPUL) and percutaneous nephrolithotomy (PCNL). A total of 62 patients with large upper ureteral stone were divided randomly into 2 groups. RPUL was performed in group A (n=30) and PCNL in group B (n=32). No significant inter-group difference existed in age, gender, stone location and size, operative duration or surgical success rate (P>0.05). Blood loss volume, rate of postoperative analgesic usage, time of hospital stay and incidence of postoperative complications in group A were significantly lower than those of group B (P<0.05). Thus RPUL offers more advantages and better efficacies.


Key words: 
Laparoscopy; Nephrostomy, percutaneous; Ureteral calculi
Prevention of orthodontic enamel demineralization with Duraphat
Authors: Sheng Lu
Journal: BMJ (2014)

The clinical data was collected from 26 orthodontics patients at our hospital. All of them received straight wire appliance. The observed teeth were randomly classified into experiment and comparison groups. After the mounting of orthodontic bracket, Duraphat was smeared on the surface of maxillary central incisor, maxillary lateral incisor, maxillary canine, maxillary first premolar and maxillary first premolar in the experiment group while no Duraphat was applied in the comparison group. After wearing orthodontic appliance for 1, 3, 6 and 9 months, enamel demineralization of each tooth was observed. And the enamel decalcification index (EDI) of different areas of each tooth at different timepoints was recorded. More demineralization areas existed in the comparison group than the experiment group (P<0.01). In addition, no Ⅲ degree enamel demineralization was observed in the experiment group after Duraphat applying for 1 month. EDI were 0.20, 0.24, 0.21 and 0.16 in the experiment group after Duraphat applying for 1, 3, 6 and 9 months versus 0.37, 0.44, 0.44 and 0.34 in the comparison group during the same time periods. Therefore EDI and demineralization areas were significantly smaller in the experiment group than those in the comparison group (P<0.01).


Key words: 
Orthodontics; Sodium fluoride
Present status of cervical immobilization skills for trauma of some hospital doctors of Hubei Province
Authors: Qi-sheng Yang, Yan Zhao, Xiang Wan, Xiao-bing Song
Journal: BMJ (2013)

Retrospective analysis was conducted for the results of first-aid competitions so as to understand the present status of how emergency doctors of Hubei Province grasp the skills and consciousnesses of cervical immobilization. From 6 out of 19 teams, 38 participating doctors from grade 3A hospitals provided patient cervical immobilization while 2 teams offered no cervical protection. It is necessary to intensify the skills and consciousnesses of cervical immobilization in clinical practice.


Key words: 
Cervical immobilization; Transportation of patients
Comparison of responsiveness of asthma-specific and general instruments for evaluation of quality of life in patients with asthma
Authors: 李凡, 蔡映云, 徐晓雯, 李海玲, 韩志青, 罗艳蓉
Journal: BMJ (2006)

目的 探讨疾病特异性量表与普适性量表对支气管哮喘患者生命质量评估的灵敏度.方法12个月非双盲定群研究,分别以5分制、7分制哮喘生命质量量表(5-AQLQ、7-AQLQ)和SF36量表对50例哮喘患者在初次、6个月和12个月时进行生命质量评估.随访期间每日监测呼气峰流速(PEF),并记录哮喘日记,根据支气管哮喘防治指南给予治疗,观察影响度和标准反应均数.结果经过12个月的治疗,50例支气管哮喘患者呼气峰流速占预计值的百分比从初次的51%,提高到6个月时的71%和12个月时的87%(P＜0.01).5-AQLQ和7-AQLQ总分分别从初次的3.35和4.3提高到6个月的4.03和5.6,12个月时的4.55和6.4(P＜0.01);SF36总分从初次的410提高到6个月的494和12个月的640(P＜0.01).影响度和标准反应均数显示,5-AQLQ和7-AQLQ总分的影响度分别从0.84和0.91提高到1.39和1.52,标准反应均数分别从1.08和1.41提高到1.80和1.95,SF36总分的影响度从0.35提高到0.78,标准反应均数从0.42提高到1.22,均低于5-AQLQ和7-AQLQ总分的影响度和标准反应均数的变化.结论支气管哮喘生命质量量表和SF36均可反映支气管哮喘患者生命质量的变化,但支气管哮喘生命质量量表对患者生命质量的评估反应灵敏度比SF36量表高。
The clinical activity and safety of anlotinib combined with anti-PD-1 antibodies in patients with advanced solid tumors.
Authors: Min Yuan, Juemin Fang, Zhongzheng Zhu, Wei Mao, Hui Wang, Weixing Liu, Hong Qian, Jianguo Wu, Xianling Guo, Qing Xu
Journal: Journal of Clinical Oncology (2020)

e15081 Background: Anlotinib (AL3818) is a novel multi-target tyrosine kinase inhibitor (TKI) for tumor angiogenesis and tumor cell proliferation. Modulation of vascular endothelial growth factor-mediated immune suppression via angiogenesis inhibition may augment the activity of immune checkpoint inhibitors. We reported results from the clinical activity and safety of anlotinib combined with anti-PD-1 antibodies in patients with advanced solid tumors. Methods: 21 patients with advanced lung, gallbladder, endometrial, gastric, pancreatic, penile cancers and melanoma were treated since January 2019. Patients received a combination of anlotinib (12mg) once daily on day 1 to day 14 (21 days as a course) plus anti-PD-1 antibodies every 3 weeks until progression or unacceptable toxicity. Radiologic imaging was performed every 6 weeks for the first year of therapy. Results: Among 21 enrolled patients, 11 tumor types were represented, with lung, gallbladder, endometrial cancers and sarcoma being the most common.Most patients had received prior systemic therapy for metastatic disease (76.2%). The objective response rate (ORR) was 19.1%, including one complete responses (CR) (4.8%) and three partial responses (PR) (14.3%) and a disease control rate (DCR = CR+PR+SD) of 81.0% (17 of 21). One CR and three PRs have lasted 4, 4, 5 and 8 months, respectively. Thirteen patients (61.9%) had stable disease (SD) that lasted 1.5 to 13 months. Treatment-related adverse events occurred in 12 patients (57.1%). Three patients (14.3%) had grade 3 treatment-related adverse events. There were no grade 4 and 5 treatment-related adverse events. Grades 3 toxicities included hand-foot syndrome (n = 1) and hypertension (n = 2). Conclusions: anlotinib can be administered combined with anti-PD-1 antibodies with acceptable toxicity and promising durable antitumor efficacy that warrant further testing in a randomized trial.
Clinical outcomes with early-elective discontinuation of PD-1 inhibitors (PDi) at one year in patients (pts) with metastatic melanoma (MM).
Authors: Rebecca Pokorny, Jordan P. McPherson, Kenneth F. Grossmann, Carolyn Luckett, Benjamin Newell Voorhies, Daniel S. Sageser, Jocelyn Wallentine, Zachary Tolman, Siwen Hu-Lieskovan, Umang Swami
Journal: Journal of Clinical Oncology (2020)

10048 Background: Randomized trials of PDi in MM permitted treatment for 2 years (pembrolizumab) or more (nivolumab). However, the optimal treatment duration is unknown, and shorter courses may be effective. We reviewed clinical outcomes of pts who electively discontinued PDi at 1 year at our institution. Methods: We performed a real-world, observational cohort study of pts with MM treated with single-agent PDi from 1/1/2015 to 12/31/2018 at Huntsman Cancer Institute. This was a continuous series of pts who made the joint decision with their provider to electively discontinue PDi at 1 year ( &gt; 6 mos and &lt; 18 mos) in the setting of ongoing treatment response or disease stability. Exclusion criteria: PDi with other systemic therapy, discontinuation due to disease progression or immune-related adverse event, and PDi in neoadjuvant, adjuvant, or clinical trial settings. Local therapies, as in real-world, were allowed. Best objective response (BOR) per RECIST 1.1 at PDi discontinuation, progression-free survival (PFS) and retreatment characteristics were analyzed. Results: Of 485 pts who received PDi, 52 met inclusion criteria. Median age was 60.5 years and 26.9% were female. Median duration of PDi from first to last dose was 11.1 mos (95% CI 10.5 - 11.4). BOR was complete response in 13 (25%), partial response in 28 (53.8%), and stable disease in 11 (21.2%) pts. After median follow-up of 20.5 mos (range 3 - 49.2) from treatment discontinuation, 39 (75%) pts remained without disease progression (median PFS not reached). Only 13 (25%) pts progressed. Median time to progression after treatment discontinuation was 3.9 mos (range 0.7-30.9). Of the 13 pts, 7 immediately underwent successful localized treatment to the solitary site of progression (3 SRS/SBRT, 4 resection; followed by PDi in 2), 5 were retreated with PDi and 1 received BRAF/MEK followed by PDi. Retreatment with PDi controlled disease in all 5 pts. All pts except 1 were alive at data cut-off. Conclusions: In the largest continuous series of pts with MM who electively discontinued PDi after 1 year of treatment, the majority remained without progression on follow-up. Risk of disease progression even in pts with residual disease on imaging was low, and retreatment was effective. Strengths of our study include real-world cohort and treatment pattern analysis. Limitations include single-institution, retrospective design. After prospective validation, elective PDi discontinuation at 1 year may reduce financial and PDi-related toxicity without sacrificing outcomes.
Efficacy and safety of sitagliptin phosphate in type 2 diabetics poorly controlled by antidiabetic drugs
Authors: Jing Wang, Yong Ruan, Qing-ying Tan, Yun Ruan
Journal: BMJ (2012)

A 24-week study was performed to compare the efficacies of before and after dipeptidyl peptidase-4 inhibitor sitagliptin phosphate 100 mg/d in 42 type 2 diabetics who were inadequately controlled with multiple oral antidiabetic drugs for at least 3 months.The treatment group sitagliptin phosphate fasting plasma glucose,2 h postprandial glucose (2 hPPG) and glycated hemoglobulin decreased significantly compared with before treatment [(9.3 ±1.2) to (6.5 ±1.9) mmol/L,(15.2 ±3.1) to (8.1 ±2.1)mmol/L,(8.2 ± 2.1) ％ to (6.7 ± 1.3) ％,all P ＜ 0.01].There was no hypoglycemia,weight gain or other adverse reactions.The short-term sitagliptin phosphate could effectively reduce the blood sugar levels of poorly controlled obese type 2 diabetics.With a low incidence of hypoglycemia and an excellent safety profilc,there was no weight gain.

Key words: 
Dipeptidyl peptidases, antagonists & inhibitors; Diabetes,type 2
Application of CT imaging in diagnosis of internal hernia
Authors: Sun Zhongqi, Li Xin, Wang Yiqiao, Jiang Huijie
Journal: BMJ (2019)

Internal hernia is the protrusions of the viscera through the peritoneum or mesentery in the abdominal cavity. It lacks specific clinical symptoms and has a poor prognosis. According to the anatomical classification, the intra-abdominal hernia can be divided into Duodenal paralysis, Winslow hernia, mesenteric hernia and mesenteric hiatal hernia. Among various imaging methods, multi-slice spiral CT has a higher value for preoperative diagnosis of internal hernia. This article will focus on the imaging features of several intra-abdominal hernias under multi-slice spiral CT, and summarize the general diagnostic strategies of internal hernia.

Key words: 
Hernia, abdominal; Tomography, spiral computed; Diagnosis
睡眠呼吸暂停与脑血管疾病
Authors: 丁宁, 张希龙
Journal: BMJ (2010)

国脑血管疾病患者约500万～600万,每年新发脑卒中患者150万以上,死亡率居各种致死性疾病的第3位~([1]).大量研究结果显示,阻塞性睡眠呼吸暂停(OSA)与脑血管疾病关系密切,二者可相互促进、共同进展,导致许多不良事件的发生。
Randomized clinical trial on the effect of a supervised exercise program on quality of life, fatigue, and fitness following esophageal cancer treatment (PERFECT study).
Authors: Anne Maria May, Jonna van Vulpen, Anouk E Hiensch, Jelle P. Ruurda, Grard Nieuwenhuijzen, Ewout Kouwenhoven, Richard PR Groenendijk, Donald Van der Peet, Eric J Hazebroek, Camiel Rosman, Bas P.L. Wijnhoven, Mark I. van Berge Henegouwen, Hanneke W.M. Van Laarhoven, Richard van Hillegersberg, Peter Siersema
Journal: Journal of Clinical Oncology (2020)

12055 Background: Patients with potentially curable esophageal cancer are often treated with chemoradiotherapy followed by surgery. This treatment might have a negative impact on physical fitness, fatigue and quality of life (QoL). In patients with other types of cancer, evidence suggests that physical exercise reduces treatment related side effects. We investigated whether a supervised exercise program also beneficially affects QoL, fatigue and cardiorespiratory fitness (CRF) in patients after treatment for esophageal cancer. Methods: The multicenter PERFECT study randomly assigned patients in the first year after esophagectomy to an exercise intervention (EX) or usual care (UC) group. EX patients participated in a 12-week moderate to high intensity aerobic and resistance exercise program supervised by a physiotherapist. UC patients were advised to maintain their physical activity levels. Attendance and compliance with the exercise intervention protocol were retrieved from exercise logs. QoL (primary outcome, EORTC-QLQ-30, range 0-100), fatigue (MFI-20, range 4-20) and CRF (cardiopulmonary exercise testing) were assessed at baseline and after 12 weeks (post-intervention). The outcomes were analyzed as between-group differences using either linear mixed effects models or ANCOVA adjusted for baseline and stratification factors (i.e. sex, time since surgery, center), according to the intention-to-treat principle. Results: A total of 120 patients (age 64±8) were included and randomized to EX (n = 61) or UC (n = 59). Patients in the EX group participated in 96% (IQR:92-100%) of the supervised exercise sessions and compliance with all parts of the exercise program was high ( &gt; 90%). Post-intervention, global QoL was not statistically different between groups, but significant (p &lt; 0.05) beneficial EX effects were found for QoL-Summary scores (between-group difference 3.5, 95% CI 0.2;6.8) and QoL-role functioning (9.4, 1.3;17.5). Physical fatigue wat non-significantly lower in the EX group (-1.2; -2.6;0.1, p = 0.08). CRF was significantly higher (VO 2peak (1.8 mL/min/kg, 0.6;3.0) following the EX intervention. Conclusions: Patients were well capable to complete an intensive supervised exercise program after esophageal cancer treatment, which led to small but significant improvements in several aspects of QoL and cardiorespiratory fitness. Our results suggest that supervised exercise is a beneficial addition to routine care of patients with esophageal cancer. Clinical trial information: NTR5045 .
A unified account of culture should accommodate animal cultures
Authors: Andrew Whiten
Journal: Behavioral and Brain Sciences (2020)

Abstract Discoveries about social learning and culture in non-human animals have burgeoned this century, yet despite aspiring to offer a unified account of culture, the target article neglects these discoveries almost totally. I offer an overview of principal findings in this field including phylogenetic reach, intraspecies pervasiveness, stability, fidelity, and attentional funnelling in social learning. Can the authors’ approach accommodate these?
Contrast-enhanced CT radiomics for predicting calcification in metastatic colorectal cancer: Based on machine learning.
Authors: Yuwen Zhou, Qiu Meng
Journal: Journal of Clinical Oncology (2020)

e16095 Background: In patients with metastatic colorectal cancer (mCRC), calcification is a predictive factor and associated with a better prognosis. This study was aimed to estimate the textural features performance derived from contrast-enhanced CT in prediction of calcification in mCRC. Methods: Four hundred fifty patients from a single center with pathologically diagnosed colorectal adenocarcinoma (training dataset, n = 159; validation dataset, n = 31) were enrolled in our retrospective study. A three-dimensional region of interest (ROI) around the margin of the lesion was manually assessed by two radiologists on the basis of CT scans, and all textural parameters were retrieved from the ROI. The least absolute shrinkage and selection operator (LASSO) method was applied to select the textural feature. The differential diagnostic capabilities of textural features, morphological features, and their combination were analyzed by receiver operating characteristic (ROC). AUC was used as the main indicator. Results: Twenty-one radiomics features extracted from contrast-enhanced CT were screened as a calcification-associated radiomics signature of mCRC. They were able to predict calcification in both the training group (slice thickness of 5 mm, sensitivity 0.84, specificity 0.71, accuracy 0.81, AUC 0.916, 95%CI 0.87-0.97) and the validation group (slice thickness of 5 mm, sensitivity 1.00, specificity 0.88, accuracy 0.77, AUC 0.964, 95%CI 0.904-1.0). Conclusions: In summary, a noninvasive radiomics signature derived from contrast-enhanced CT images was conveniently used for the prediction of calcification in mCRC before therapy, which might be a non-invasive approach in clinical practice to determine whether surgery is needed. However, multi-center studies with larger sample size are needed to confirm these results.