tbuckley/cabot-search huggingface dataset:
Cost-effectiveness of nodal observation versus completion lymphadenectomy in patients with melanoma and sentinel lymph node metastases.
Authors: Elena Parvez, Teodora Dumitra, Dimitra Panagiotoglou, Sarkis H. Meterissian, Sinziana Dumitra
Journal: Journal of Clinical Oncology (2020)

e22076 Background: The MSLT-II trial demonstrated no survival benefit of completion lymphadenectomy (CLND) compared to nodal observation (NO) and subsequent therapeutic lymphadenectomy (TLND) in the case of macroscopic nodal relapse in patients with melanoma and SLN metastases. NO avoids the upfront cost and morbidity of CLND. However, patients followed with NO must undergo intensive surveillance and if TLND is required, it is associated with a higher complication rate than CLND. The cost-effectiveness of NO versus CLND in light of data from MSLT-II has not been previously studied. Methods: A Markov model with a 10-year time horizon was constructed to simulate two hypothetical cohorts of patients with SLN metastases undergoing NO and subsequent TLND for nodal recurrence or upfront CLND. Transition probabilities between disease states were derived from the MSLT-II trial. Remaining parameters including complication rates and health state utilities were obtained from an extensive review of the literature. Direct health care system costs were obtained from published US Medicare cost data and the literature. Primary outcomes were cost and quality-adjusted life years (QALYs) saved. Incremental cost-effectiveness ratio (ICER) was used to compare treatment strategies. Sensitivity analysis was performed in order to evaluate model uncertainty. A threshold of acceptance of $100,000/QALY was used. Results: Total projected cost over the study period for CLND was $28,609.87, while that of NO was lower at $20,865.27, resulting in $7,744.60 saved for the NO treatment strategy. Ten-year utility was 4.840 for CLND compared to 5.379 for NO, resulting in a gain of 0.539 QALYs in the NO arm. The NO strategy is dominant in the model as it results in both cost-savings and a gain in health effects, with an average ICER of -$14,368.46/QALY gained. Conclusions: From the payer perspective, the strategy of NO compared to CLND in patients with melanoma and SLN metastases is associated with an improvement in health outcomes and reduction in cost. Taking into account MSLT-II trial data, this study demonstrates NO is more cost-effective than CLND.
Effects of atorvastatin onblood pressure and left ventricular remodeling in patients with both essentialhypertension and hypercholesterolemia
Authors: 葛长江, 吕树铮, 陈韵岱, 陈欣, 张纯
Journal: BMJ (2007)

目的 比较原发性高血压合并高胆固醇血症患者治疗前后血清高敏C反应蛋白(hs-CRP)浓度和血尿酸(UA)水平的变化,探讨阿托伐他汀对其血压和左心室重塑的影响.方法将126例高血压合并高胆固醇血症患者随机分为氨氯地平(10 mg/d)组(A组,65例)、氨氯地平(10mg/d)加阿托伐他汀(20mg/d)组(B组,61例),连续治疗3个月.观察给药前后两组患者血压的变化,测定其血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)和hs-CRP浓度以及UA水平.采用心脏彩色超声测其左心室后壁厚度(LVPWT)和室间隔厚度(IVST),计算左心室重量指数(LVMI).结果治疗3个月后,B组患者血清TC、LDL-C、TG、hs-CRP浓度及UA水平均显著降低,而HDL-C明显增高(P＜0.05).两组患者收缩压和舒张压明显降低,B组血压显著低于A组(P＜O.05).与治疗前比较,两组患者LVMI均明显降低,B组患者LVMI显著低于A组(P＜0.05).结论阿托伐他汀可降低原发性高血压合并高胆固醇血症患者血hs-CRP浓度和UA水平,显著降低血压,逆转左心室肥厚.其可能通过减轻炎症、改善血管内皮功能、降低血压及抑制左心室心肌细胞肥大,从而影响高血压患者左心室重塑的过程。
The implementation status of the long-term prescription
Authors: Wen Ren, Shuai Li, Ying Liu, Yan Qiu
Journal: BMJ (2020)

In order to alleviate the difficulty and annoyance in dispensing medicine of patients with chronic diseases and promote hierarchical healthcare system, the policy of long-term prescription for chronic diseases has been implemented in the country. This article summarizes the current status and effectiveness of implementation of the long-term prescription, and explores the existing problems. The improvement of prescription formulation, review, deployment, distribution of drugs, health education and other issues to ensure the safety of treatment are discussed. Meanwhile, we suggest that the relevant supporting policies of medical insurance should be improved to further promote the long-term prescription.


Key words: 
Chronic disease; Community health service; Long-term prescription
Durvalumab following multimodality therapy for locally advanced esophageal and GEJ adenocarcinoma: Updated survival and early translational results from Big Ten Cancer Research Consortium Study.
Authors: Hirva Mamdani, Bryan J. Schneider, Pashtoon Murtaza Kasi, Laith I. Abushahin, Thomas J. Birdas, Kenneth Kesler, Heather Burney, Susan Perkins, Shadia Ibrahim Jalal
Journal: Journal of Clinical Oncology (2020)

4572 Background: Concurrent chemoradiation(CRT) followed by esophagectomy is a standard of care for locally advanced esophageal(LA-EAC) and GEJ adenocarcinoma. Approximately 50% of patients(pts) experience disease relapse within the 1 st yr after treatment(tx) completion. Immune checkpoint inhibitors have activity in metastatic PD-L1 positive EAC. Preclinical studies have shown radiation +/- chemotherapy upregulates PD-1/PD-L1 pathway. Methods: We conducted a phase II trial evaluating safety and efficacy of PD-L1 inhibitor durvalumab(durva) in pts with LA-EAC and GEJ adenocarcinoma who had residual disease in surgical specimen after neoadjuvant CRT and R0 resection. Pts received durva 1500mg IV every 4 weeks for up to 1yr. Results: Initially 24 pts were enrolled, study was expanded to enroll additional 13 pts. Median age: 61yrs (range, 43-73). 31 received carbo/paclitaxel and 6 received cis/5-FU concurrently with RT. 24(64.9%) pts had positive lymph nodes(LN) at the time of surgery following CRT: N3(n = 3,8.1%), N2(n = 10, 27%), N1(n = 11,29.7%).17 pts relapsed: 11 on tx, 6 had late relapses. 3/5 late relapses were locoregional and were re-treated with chemo-RT. Remaining relapses were systemic with lung and LN being the most common sites. 2 of 3 pts who developed grade 3 irAEs are alive and disease free at 17 and 23 mo. RFS/OS:1 yr- 79.2%/95.5%, 2yr-55.5%/67.4%. 20/37 pts have HER-2 status available: 5/6 HER2 positive pts had disease relapse, 1 is undergoing tx. Molecular profiling is available on 8 relapsed pts: all were microsatellite stable with low TMB and PD-L1 &lt; 10% CPS. Mutations in DNA repair genes ( ARID1A, ATM, ATR, CHEK2), and PIK3CA E542K were more prevalent among late relapsing pts. Circulating tumor cells (CTCs) analysis is available for 10/37 pts. 4/5 pts where CTCs increased from C1 to C4 had disease relapse. Molecular profiling of the remaining pts and correlation of PD-L1 expression, TMB, specific genes mutations, CTCs, and Immunoscore with outcomes with durva is being evaluated will be presented at the meeting. Conclusions: Adjuvant durva following trimodality therapy for LA-EAC and GEJ adenocarcinoma improved 1-yr RFS to 79.2% compared to historical rate of 50%.2-yr RFS and OS data are encouraging in this high risk pt population. HER-2 positivity may be associated with lack of benefit from durva. Mutations in DNA repair genes are prevalent in pts with delayed relapse. Rise in CTCs during durva tx may be an early marker of disease relapse. Clinical trial information: NCT02639065 .
Clinical features and risk factors of recurrent community-acquired pneumonia in elderly patients
Authors: Xiaoyun Zeng, Hui Li, Chunlin Hu, Xin Li, Yi Yu, Xiaoli Jing
Journal: BMJ (2016)

Objective
To investigate the clinical features and risk factors of recurrent community-acquired pneumonia (CAP) in elderly patients.


Methods
Clinical data of elderly CAP patients admitted to the first affiliated hospital of Sun Yat-Sen university from January 2012 to December 2014 were analyzed retrospectively, including 48 cases of recurrent CAP and 299 cases of non-recurrent CAP. The clinical features were compared between two groups, and the risk factors of recurrent CAP were assessed with logistic regression analysis. 


Results
No significant differences were observed between the two groups in age, sex, smoking, drinking, average hospital stays and total hospitalization expenses (all P>0.05). In the recurrent pneumonia group, the chronic obstructive pulmonary diseases [54.2%(26/48) vs. 35.5%(106/299), χ2=6.146, P=0.013], diabetes [41.7% (20/48) vs. 19.7%(59/299), χ2 =11.317, P=0.001], the clinical symptoms include cough [79.2%(38/48) vs. 58.5%(175/299), χ2=7.432, P=0.006], sputum [70.8%(34/48) vs. 54.5%(163/299), χ2=4.488, P=0.034], fever [64.4%(31/48) vs. 40.8%(122/299), χ2=9.488, P=0.002], poor appetite [52.1%(25/48) vs. 33.1%(99/299), χ2=6.483, P=0.011], choking cough [8.3%(4/48) vs. 2.7%(8/299), χ2=3.966, P=0.046], poor spirit [45.8%(22/48) vs. 28.4%(85/299), χ2=5.875, P=0.015], bilateral lung lesions [41.7%(20/48)vs. 28.8%(68/299), χ2=7.825, P=0.005], the complication of respiratory failure [31.3%(15/48) vs. 14.7%(44/299), χ2=8.012, P=0.005] were higher than those in non-recurrent group. Logistic regression revealed that chronic obstructive pulmonary disease (OR=2.607, 95%CI: 1.268-5.358, P=0.009), diabetes (OR=2.948, 95%CI: 1.457-5.966, P=0.003)and the history of respiratory failure (OR=2.778, 95%CI: 1.264-6.108, P=0.011) were risk factors of recurrent CAP. 


Conclusions
Elderly patients with recurrent CAP has a higher rate of cough, sputum and fever, and the scope of lung lesions is broader. Chronic obstructive pulmonary disease, diabetes and the history of respiratory failure are the independent risk factors for recurrent CAP in the elderly.


Key words: 
Community acquired pneumonia; Aged; Risk factors
The inadequacy of cardiovascular safety reporting in breast cancer clinical trials.
Authors: Arsalan Hamid, Adebamike A. Oshunbade, Rodney K. Kipchumba, Samuel Calvin Thigpen, Michael E. Hall, Javed Butler, John C. Ruckdeschel
Journal: Journal of Clinical Oncology (2020)

e24100 Background: Although some cardiovascular (CV) toxicity is detected in early phase trials of therapeutic agents, most CV toxicities are not appreciated until later phase clinical trials or general clinical practice. The high prevalence of cardiovascular disease (CVD) in the general population warrants study of how later phase oncologic pharmacotherapy clinical trials address eligibility and assess for treatment-related cardiotoxicity. We focused our study on phase 2 and 3 breast cancer trials to limit disease-specific variations. Methods: A methodical Embase search was performed for phase 2 and 3 trials administering breast cancer pharmacotherapy and including &gt; 50 participants. Firstly, we examined CVD as an exclusion criterion. Secondly, we identified what CV safety assessments were reported such as troponin, brain natriuretic peptide (BNP), lipid profile, electrocardiogram (ECG), or CV imaging. Thirdly, we examined whether trials reported adverse CV events. Fischer’s exact test was applied to compare reporting amongst trial characteristics (trial funding source and type of agent administered), and a 2 sided p-value of &lt; 0.05 was considered significant. Results: 50 published articles from 46 separate clinical trials were included. Patients with prevalent CVD were excluded in 67.4% of trials, the most frequently excluded CVD was heart failure/NYHA class &gt; 1 (65.2% of trials). At least one pre or post-treatment CV safety assessment was reported in only 58.7% of trials, most commonly an ECG (52.2% of trials). BNP or troponin assessments were not reported in any trial. Adverse CV events were reported in 82.6% of trials, the most frequently reported event was hypertension (43.5% of trials). CV Safety assessments were more frequently reported in pharmaceutically funded trials compared to non-pharmaceutically funded trials (86.4 vs 10.0%, p &lt; 0.001), and in trials administering targeted/immunotherapy agents compared to those administering only traditional chemotherapy/hormonal therapy (85.2 vs 21.1%, p &lt; 0.001). Conclusions: Later stage breast cancer clinical trials are conducted in populations under-representative of patients with prevalent CVD, a common comorbidity. Trial funding source and type of agent administered impact whether or not CV toxicity is monitored. Despite the frequent exclusion of patients with CVD and poor safety assessment reporting, adverse CV events are frequently encountered and reported. Thus, these trials may underestimate CV toxicity risks for the greater population receiving such agents in clinical practice.
四肢无力-高血压
Authors: 靳文英, 陈江天
Journal: BMJ (2010)

患者女,15岁,因四肢无力1周就诊.1周前军训时,曾腹泻3次,量少,未服药自行好转.1周来感劳累并开始出现双下肢肌肉酸痛,以双侧腓肠肌为主,后感无力,行走困难,不能抬腿,继而发展至上肢肌肉酸痛,以肩胛肌、三角肌为主,双手无力,不能握笔写字。
Therapeutic hypothermia initiated within 6 hours of birth is associated with reduced brain injury on MR biomarkers in mild hypoxic-ischaemic encephalopathy: a non-randomised cohort study
Authors: Thayyil Sudhin, 王亚如, 杜军保
Journal: BMJ (2020)

目的
探讨亚低温治疗对轻度缺氧缺血性脑病（HIE）患儿的磁共振（MR）生物标志物和神经发育结局的影响。


研究设计
非随机队列研究。


背景
在英国和美国建立了8个三级新生儿病房。


研究对象
在出生后6小时内进行NICHD神经检查的47例轻度HIE患儿。


干预措施
全身降温72小时（n=32）或常规护理（n=15，其中5例降温<12小时）。


主要结局指标
出生后2周内进行磁共振成像（MRI）和MR波谱分析（MRS），并在2岁时进行神经发育结局评估。


结果
两组的基线特征相似，但亚低温治疗的患儿10分钟Apgar评分较低（P=0.02）。然而，亚低温治疗组MRS的丘脑NAA/Cr[1.4（0.1）比1.6（0.2）；P<0.001]和NAA/Cho[0.67（0.08）比0.89（0.11）；P<0.001]比值明显更高。亚低温治疗组患儿的白质损伤评分低于未降温的患儿（P=0.02）。4名（27%）轻度HIE非亚低温治疗患儿在6小时后出现癫痫发作，而亚低温治疗患儿均无癫痫发作（P=0.008）。2岁时，40例（85%）患儿可获得神经发育结果。2例（14.3%）未行亚低温治疗的患儿出现了不良结局，而亚低温治疗的患儿均未出现不良结局（P=0.09）。


结论
亚低温疗法对患有轻度HIE的患儿可能具有神经保护作用，MRI显示MR生物标志物的改善和白质损伤的减少都证明了这一点。这可能需要在足够有力的随机对照试验中进一步予以评估。
Impact of education and management program for asthmatic patients on their use of health resources and social behavior
Authors: 母双, 何权瀛, 余兵, 崔月莉, 王悦真, 孙建国, 张刚
Journal: BMJ (2007)

目的 评估北京大学人民医院三位一体哮喘教育管理模式对患者使用医疗资源及社会行为的影响.方法 三位一体哮喘患者教育管理模式包括哮喘专业门诊、哮喘宣传教育中心和哮喘患者协会.采用面对面问卷方式,对在北京大学人民医院接受三位一体哮喘教育管理的门诊患者56例(教育组)和在北京市另一家三级甲等医院呼吸科就诊但未接受过系统教育管理的门诊哮喘患者30例(对照组),近1年内的非预约门诊就医、急诊就医和住院、医疗费用、误工情况进行调查并做对比分析.结果 教育组中非预约门诊就医、急诊就医的患者分别占9例(16%)和4例(7%),对照组分别为20例(67%)和12例(40%);教育组中人均非预约门诊就医和急诊就医次数分别为(0.5±1.7)次和(0.2±0.6)次,对照组分别为(2.1±2.8)次和(0.6±0.9)次.两组各项差异均有统计学意义(P＜0.01).教育组年医疗费用均数较对照组少1776元.教育组和对照组在职患者中因哮喘误工的比例分别为0%(0例)和33%(8例,P＜0.01).结论 三位一体哮喘教育管理模式可以有效减少患者对医疗资源的消耗并减少误工;这种医疗模式可向国内大中城市医院推广。
Metabolic profile in Mexican young women breast cancer (YWBC) to predict pathologic complete response (pCR) to neoadjuvant chemotherapy (NAC).
Authors: Marlid Cruz-Ramos, Rafel Nambo-Venegas, Jose Yair Campos-Salgado, Luz Ruíz-Godoy, Victoria Enríquez-Carcamo, Alejandro Mohar, Cynthia Villarreal-Garza
Journal: Journal of Clinical Oncology (2020)

e12652 Background: YWBC is associated with aggressive biology with a higher mortality rate and recurrence risk. Similar to older patients, pCR after NAC is a surrogate marker of disease-free survival and overall survival in YWBC. However, YWBC who did not achieve pCR did significantly worse. Metabolic profile (MP) has been used for biomarker discovery to monitor chemotherapy response. Few studies focus on using metabolomics to predict pCR in BC. The study aimed to identify MP in YWBC, before NAC to predict response to chemotherapy. Methods: A targeted metabolomics approach was employed to determine the concentration of 11 AAs, free carnitine, and 30 ACCs using electrospray tandem mass spectrometry in plasma of 30 YWBC patients, before NAC to select plasma biomarkers with the most predictive power to identify pCR in YWBC. Patients were classified in responders (R) and non-responders (NR), based on pCR or not-pCR reported by the pathologist department. The differences between R and NR groups were evaluated using an analysis of Random Forest decision trees according to the distribution of the variables. To evaluate the diagnostic power of each biomarker alone, we performed univariate receiver operating characteristics (ROC) analysis on each biomarker to obtain its ROC curve, ROC area under the curve (AUC), and standard error (SE) of the AUC. Results: We observed differences in MP between R and NR YWBC. Ten metabolites contributed most to differentiating between both groups. We developed a model that included two short-chain acyl-carnitines (AC4 and AC5:1) that allowed an AUC of 0.851 (0.767-0.921) and AUC of 0.737 (0.806-0.844) respectively, and ornithine with AUC of 0.723 (0.6-0.626). Conclusions: There are different MP among Mexican YWBC patients classified as R and NR to NAC. To our understanding, this is one of the first studies that evaluate MP in YWBC in Mexico. Further studies are needed to validate a metabolic signature to predict pCR in this patient group.
Community intervention in elderly patients with insomnia
Authors: Wang Huilan, Qi Haiping
Journal: BMJ (2019)

Community intervention was conducted for 60 elderly patients with insomnia who attended the clinic of Sanlihe NO.1 Community Health Service Station of Yuetan Community Health Service Center from October 2016 to December 2016. Community intervention strategies included appointed visit to contracted family doctors, health counseling by specialists, lifestyle interventions, drug interventions, psychological interventions, individualized interventions, regular home visits and follow-up, self-management and referral to specialist service. After 1 year of community intervention, the differences of sleep quality self-assessment score [(29.77±7.20) vs. (28.62±6.79) ; t=7.48, P<0.01] and COOP/WONCA score [(17.38±3.35] vs. (16.00±3.09); t=8.69, P<0.01] before and after the intervention were statistically significant. Community intervention is helpful to improve the quality of sleep and life of the elderly insomnia patients.


Key words: 
The elder; Insomnia; Community intervention
End-digit preference and related factors in blood pressure measurement among inpatients
Authors: Jie Gu, Qiao-wen Huang, Qing-jian Yang
Journal: BMJ (2013)

Objective
To investigate the end-digit preference and related factors in blood pressure measurement among inpatients.


Methods
A cross-sectional study was conducted on the end digits of blood pressure measurement during the admission of patients in a tertiary general hospital of shanghai in 2010, and the related factors were analyzed with the logistic regression.


Results
The average blood pressure in records of 2276 patients was (125±14) mm Hg(1 mm Hg=0.133 kPa) in systolic and (77±9) mm Hg in diastolic. End-digital zero preference accounted for 1874 records (82.3%) of systolic and 1859 records (81.7%) of diastolic readings, which were significant different to the expected frequency of 20% (P<0.001). Logistic analysis showed that admission of patients not in winter (OR=1.270, OR=1.270), patients in surgical department (OR=1.619, OR=2.045), patients with no history of hypertension (OR=1.432, OR=1.310) were the risk factors of end-digital zero preference in systolic and diastolic pressure measurement. Non-elderly patients(OR=1.288)and patients with normal heart rate(OR=1.823)were related to zero preference diastolic pressure measurement.


Conclusions
Blood pressure measurement of inpatient displays marked zero end-digit preference. Doctors tend to end in zero when taking blood pressure in some special types of patients.


Key words: 
Blood pressure; Cross-sectional studies; Regression analysis
A pooled analysis of the efficacy and safety of cabozantinib post immunotherapy in patients with advanced renal cell carcinoma.
Authors: Mototsugu Oya, Satoshi Tamada, Katsunori Tatsugami, Noboru Nakaigawa, Takahiro Osawa, Hiro-Omi Kanayama, Chihiro Kondoh, Naoto Sassa, Kazuo Nishimura, Masahiro Nozawa, Naoya Masumori, Yasuhide Miyoshi, Akiko Kimura, Shingo Kuroda, Robert J. Motzer, Toni K. Choueiri, Yoshihiko Tomita
Journal: Journal of Clinical Oncology (2020)

5089 Background: While studies have demonstrated survival benefits of first-line regimens including immuno-oncology agents (IO) in advanced renal cell carcinoma (aRCC), optimal treatment following IO is unknown. In the phase 3 METEOR trial, cabozantinib improved progression-free survival (PFS), objective response rate (ORR), and overall survival (OS) versus everolimus in patients (pts) with aRCC, after VEGFR-TKI therapy. The Japanese phase II C2001 study (NCT03339219), targeting a population similar to that of METEOR, showed similar efficacy and safety results. Here, we present a post-hoc pooled analysis of pts who had received prior IO therapy from METEOR and C2001. Methods: A pooled analysis was performed in pts who received 60mg/day of oral cabozantinib once daily enrolled in the METEOR or C2001. Patients were divided into two groups with previous IO treatment (pre-w/ IO subgroup) or without previous IO treatment (pre-w/o IO subgroup). Analyses of ORR, PFS, OS, and safety were performed as measures of clinical outcome in each subgroup. Results: 365 pts (pre-w/ IO subgroup: 33 pts, pre-w/o IO subgroup:332 pts) were included for efficacy analysis and 366 pts (pre-w/ IO subgroup: 33 pts, pre-w/o IO subgroup:333 pts) for safety analysis. Minor differences in baseline characteristics were noted between the analysis subgroups but are not expected to substantially affect efficacy outcomes. The ORR was 21.2% (95% CI: 9.0-38.9%) for pre-w/ IO subgroup, and 17.2% (95% CI: 13.3-21.7%) for pre-w/o IO subgroup. PFS rate and OS rate at 6 months pre-w/ IO was 65.5%, 90.8% and pre-w/o IO was 58.3%, 90.6%, respectively. Although there were some differences in the safety profile, almost all AEs were manageable by dose modifications. There were no differences in AEs associated with IO treatment, such as pneumonitis, endocrinolopathy or infusion related reaction. No new safety signals were noted in any subgroups. Conclusions: Safety and treatment efficacy of cabozantinib were maintained in the pooled analysis of pts from METEOR and C2001 irrespective of prior IO treatment. Funded by Takeda Pharmaceutical Company Limited, Tokyo, Japan. Clinical trial information: NCT03339219, NCT01865747 .
甘露醇在脑卒中急性期的临床应用
Authors: 李淑华
Journal: BMJ (2009)

脑卒中急性期脑水肿导致的颅内压增高是脑卒中患者死亡的主要原因.根据病理类型脑卒中分为出血性卒中(脑出血)与缺血性卒中(脑梗死).无论哪种性质的脑卒中只有在怀疑或肯定有脑水肿存在时,才考虑使用降低颅内压力的药物,如20%的甘露醇。
慢性乙型肝炎抗病毒治疗进展
Authors: 高学松, 成军
Journal: BMJ (2010)

慢性乙型肝炎(chronic hepatitis B,CHB)是我国常见的慢性传染病之一,严重危害人民健康,其治疗包括抗病毒、免疫调节和对症治疗等,其中抗病毒治疗是根本的治疗手段.抗病毒药物有干扰素α(IFN α)和核苷(酸)类似物两类.目前,IFNα分为普通IFNα和聚乙二醇IFNα(Peg-IFN α).核苷(酸)类似物分为拉米夫定、替比夫定、恩替卡韦、阿德福韦酯和替诺福韦。
牙源性黏液瘤24例临床分析
Authors: 胡砚平, 刘冰, 苏彤, 孙志军, 张文峰, 赵怡芳
Journal: BMJ (2006)

牙源性黏液瘤是一种少见的良性肿瘤,约占牙源性肿瘤的0.5%～17.7%[1].世界卫生组织(WHO)将其定义为:起源于外胚叶间充质,具有局部浸润性的良性肿瘤,肿瘤中星形细胞和梭状细胞位于黏液样基质中,可有或没有牙源性上皮条索[2].牙源性黏液瘤发病隐匿,常造成明显的颌面畸形和功能障碍.作者分析了24例牙源性黏液瘤患者的临床特征。
Corrigendum to “Readmission and reoperation rates following negative diagnostic laparoscopy for clinically suspected appendicitis: The “normal” appendix should not be removed – A retrospective cohort studyˮ [Int. J. Surg. 64 (2019) 1–4]
Authors: Amira Khattar Sørensen, Anders Bang-Nielsen, Katarina Levic-Souzani, Hans Christian Pommergaard, Anders Bech Jørgensen, Mai-Britt Tolstrup, Bo Rud, Bojan Kovacevic, Orhan Bulut
Journal: International Journal of Surgery (2020)
T reg–specific insulin receptor deletion prevents diet-induced and age-associated metabolic syndrome
Authors: Dan Wu, Chi Kin Wong, Jonathan M. Han, Paul C. Orban, Qing Huang, Jana Gillies, Majid Mojibian, William T. Gibson, Megan K. Levings
Journal: The Journal of Experimental Medicine (2020)

Adipose tissue (AT) regulatory T cells (T regs) control inflammation and metabolism. Diet-induced obesity causes hyperinsulinemia and diminishes visceral AT (VAT) T reg number and function, but whether these two phenomena were mechanistically linked was unknown. Using a T reg–specific insulin receptor (Insr) deletion model, we found that diet-induced T reg dysfunction is driven by T reg–intrinsic insulin signaling. Compared with Foxp3cre mice, after 13 wk of high-fat diet, Foxp3creInsrfl/fl mice exhibited improved glucose tolerance and insulin sensitivity, effects associated with lower AT inflammation and increased numbers of ST2+ T regs in brown AT, but not VAT. Similarly, Foxp3creInsrfl/fl mice were protected from the metabolic effects of aging, but surprisingly had reduced VAT T regs and increased VAT inflammation compared with Foxp3cre mice. Thus, in both diet- and aging-associated hyperinsulinemia, excessive Insr signaling in T regs leads to undesirable metabolic outcomes. Ablation of Insr signaling in T regs represents a novel approach to mitigate the detrimental effects of hyperinsulinemia on immunoregulation of metabolic syndrome.