tbuckley/cabot-search huggingface dataset:
The BCR repertoire comparison, lymphoma typing model and OS predicted model in 5 different pathological lymphomas: T-LBL/ALL, PTCL-NOS, B-MCL, B-FL, and DLBCL.
Authors: Wenhua Jiang, Shiyong Zhou, Jian Li, Mingyou Gao, Kuo Zhao, Limeng Zhang, Xiaojing Xie, Ning Zhao, Caijuan Tian, Zanmei Xu, Zhenzhen Zhang, Fang Yan, Yi Pan, Pengfei Liu
Journal: Journal of Clinical Oncology (2020)

8059 Background: Lymphatic system cancer is characterized by high heterogeneity in histology and clinical manifestations, B-cell antigen receptor (BCR) plays a vital role in anti-tumor immune responses. This study aimed to compare the BCR repertoire and identify some specific immune markers for different pathological lymphomas. Methods: 5 pathological types of non-Hodgkin's lymphoma (T-LBL/ALL, PTCL-NOS, B-MCL, B-FL, DLBCL) were collected, with reactive lymph node (RLN) hyperplasia as control. All patients were tested by high-throughput immunohistochemical sequencing (HTS-IR) to analyze the correlation between B-cell immunohistochemistry and clinical indicators, and constructed new strategy typing and overall survival (OS) predicted models for lymphomas. Results: The BCR repertoire had the highest diversity in RLN, followed by T-LBL/ALL, PTCL-NOS, DLBCL, B-MCL and B-FL. The diversity of BCR repertoire and similarity of B cell antigens were higher in B-MCL and B-FL patients. Similar to RLN, T-LBL/ALL and PTCL-NOS had broad and diverse V-J pairs, and rare in B-MCL, B-FL and DLBCL. RLN patients were with the highest average number of amino acids, followed by T-LBL/ALL, DLBCL, PTCL-NOS, B-MCL and B-FL. The expressed amino acid sequencing of ARDLIALDY, ARRPGSFDY, ARDIAGWGAVAGLLGRAYYGMDV, and ARDGPYGGNSVEYFQH were markedly different among 5 groups. Patients tended to recurrence expressed ASLDSSPSGFC, ARGMTTVTTAPNY, ARVPLYDDQNINDV and AGGVGGYDWGSYYFDY (P = 0.01605, 0.02869, and 0.01569), and prone to metastasis with expressions of ARVKEFYGILTGYDY, AHSIIGSSWYNWFDP and VRDGGWQSNNWLGFDV (P = 0.04259, 0.0450 and 0.0481). For all patients, 18 (7 negative, 11 positive) and 12 (10 negative, 2 positive) IGH V-J pairs were respectively associated with lymphoma recurrence and metastasis. The top 3 most significant pairs were IGHV7-4-1_IGHJ4, IGHV3-53_IGHJ5 and IGHV3-7_IGHJ5 bound up with recurrence (P = 0.0019, 0.0020 and 0.0021), and IGHV3-74_IGHJ1, IGHV1-69_IGHJ3 and IGHV1-2_IGHJ1 related to metastasis (P = 0.0022, 0.010 and 0.019). The accuracy of typing model in training and test sets was 78.125% (25/32) and 60% (6/10), respectively. The OS model can predict long (≥ 24 months) or short ( &lt; 24 months) OS. Conclusions: Our study identified new biomarkers, constructed novel lymphoma typing model and OS predicted model based on B cell repertoire. It provides a comprehensive understanding of immune response, and contributes to the diagnosis and prognosis of non-Hodgkin's lymphoma.
Clinical outcomes and prognostic factors in HER-2 positive breast cancer with brain metastasis: A single-center experience.
Authors: Serdar Karakaya, İbrahim Karadağ, Ayse Ocak Duran, Omur Berna Oksuzoglu, Umut Demirci
Journal: Journal of Clinical Oncology (2020)

e13015 Background: Brain metastasis is common in HER2 positive metastatic breast cancer patients. There is limited data on the prognosis, incidence, treatment, risk factors and complications of brain metastasized breast cancer because most clinical trials excluded these patients. we aimed to determine the characteristics and prognosis of brain metastasized HER2 positive breast cancer in our patient group, retrospectively. Methods: We scanned 3100 patients retrospectively and included 105 patients who met the criteria for inclusion in the study. Patients older 18 years old, had HER2 positive breast cancer and brain metastasis with no secondary malignity participated in the study. Results: In total, 35 (33.3%) patients had de-novo metastasis. Median overall survival (OS) was found to be 50 months in all patients. Median OS was 31 and 66 months for patients with de-novo metastasis (without brain metastasis) and patients with no metastasis at the time of the diagnosis, respectively (p &lt; 0.01). When we compared median OS between 25 patients with one brain metastasis and 80 patients with multiple brain metastasis, it was found to be 90 months in the first-mentioned group whereas it was determined to be 45 in the latter group (p &lt; 0.01). In all patients, the median elapsed time for the occurrence of brain metastasis was 22 months (for de-novo metastasis 15 months, for no metastasis 35 months; p &lt; 0.01). Median OS was determined to be 15 months for all patients with brain metastasis after the occurrence of the metastasis. Patients with ECOG PS score of 0-1 at the time of the brain metastasis had 19 months median OS, while patients with ECOG PS score of 2 at the time of the brain metastasis had 8 months median OS (p &lt; 0.01). Median OS after brain metastasis was 32 and 14 months for patients with one brain metastasis and patients with multiple brain metastasis, respectively (p &lt; 0.01). Multivariate cox regression analyses revealed that elapsed time for the occurrence of brain metastasis was shorter in patients with high-grade tumours compared to patients with low-grade tumours (p = 0.04), and in patients with de-novo metastasis compared to patients without de-novo metastasis (p &lt; 0.01). Conclusions: Our study indicated that tumour grade and de-novo metastasis are independent predictive factors that may cause the earlier occurrence of brain metastasis and affect mortality in breast cancer patients. After the occurrence of brain metastasis, lower ECOG PS score and multiple brain metastasis at the time of the diagnosis affected median overall survival as bad prognostic factors.
BET inhibitor molibresib for the treatment of advanced solid tumors: Final results from an open-label phase I/II study.
Authors: Sophie Cousin, Jean-Yves Blay, Irene Braña Garcia, Johann S. De Bono, Christophe Le Tourneau, Victor Moreno, Jose Manuel Trigo, Christine L. Hann, Arun Azad, Seock-Ah Im, Geraldine Ferron-Brady, Antara Datta, Yuehui Wu, Thierry Horner, Brandon Edward Kremer, Arindam Dhar, Peter J. O'Dwyer, Geoffrey Shapiro, Sarina Anne Piha-Paul
Journal: Journal of Clinical Oncology (2020)

3618 Background: Molibresib is an orally available, small molecule bromodomain and extra-terminal domain (BET) protein inhibitor under investigation for treatment of advanced solid tumors. Methods: This was an open-label, single- and repeat-dose, 2-part, Phase 1/2 study including patients (aged ≥16 years) with advanced solid tumors. Part 1: patients received different oral doses of molibresib (2–100mg QD; amorphous free-base formulation) to determine recommended Phase 2 dose. Part 2 (expansion cohort): patients with various tumor types received the bioequivalent besylate formulation (75mg) to explore clinical activity at recommended dose. Safety and efficacy (response rate [RR] based on RECIST 1.1 criteria, progression-free survival [PFS], and overall survival [OS]) were evaluated for the total cohort (patients from Part 1 and 2). Safety, pharmacokinetic, pharmacodynamic, and efficacy per tumor type were evaluated in Part 2. Results: Part 1 only data have previously been reported. Overall, 196 patients were included in the total cohort (1 patient in Part 1 was counted twice). In the all treated population, 195 patients (median age 58 years; 46% male) received ≥1 dose of molibresib (Part 1: n = 93; Part 2: n = 102). Adverse events (AEs) were experienced by 193/196 (98%) patients; 180/196 (92%) had a treatment-related AE (TRAE). AEs led to permanent treatment discontinuation in 38/196 (19%) patients. Of different tumor types in Part 2, NUT carcinoma (NC) had the lowest frequency of TRAEs (10/12 [83%]) and AEs leading to permanent treatment discontinuation (1/12 [8%]). In total cohort, 3/31 NC patients and 1/35 with castration-resistant prostate cancer (CRPC) achieved a confirmed partial response. A further 67/196 (34%) achieved stable disease (SD). In Part 2, RR in 12 NC patients was 8% (CI: 0.2–38.5); 50% had SD and median PFS was 4.8 months with median OS of 5.0 months. In CRPC patients, RR was 4% (CI: 0.1–21.9); 22% had SD; median PFS was 8.0 months with median OS of 9.1 months. Plasma concentrations for molibresib and active metabolites were similar between different tumor types. Gene expression analysis from pre- and post-dose biopsy samples collected from 10 mCRPC patients showed transcriptional downregulation of Myc target genes upon treatment with molibresib. Conclusions: Molibresib demonstrated a manageable safety and tolerability profile with single agent activity observed in selected patients with NC and CRPC. Clinical trial information: NCT01587703 .
阿奇霉素序贯疗法与单纯口服治疗小儿支原体肺炎的疗效分析
Authors: 冯庆国, 陈建明, 方平
Journal: BMJ (2007)

将112例支原体肺炎患儿随机分成两组.序贯治疗组54例,先静脉滴注阿奇霉素后再予阿奇霉素口服.口服治疗组58例,单纯给予阿奇霉素口服.序贯治疗组显效48例,有效4例,无效2例,有效率96%;口服治疗组显效50例,有效5例,无效3例,有效率95%.两组比较差异无统计学意义(P＞0.05).不良反应序贯治疗组7例,发生率13%;口服治疗组2例,发生率3%.差异有统计学意义(P＜0.05).说明单纯口服阿奇霉素治疗小儿支原体肺炎与阿奇霉素序贯疗法治疗具有相同的疗效,而不良反应发生率小,可以降低医疗成本。
Overall survival in high and very high PD-L1 expressing patients with advanced non-small cell lung cancer treated with immune checkpoint inhibitors in a real-world data setting.
Authors: Chenan Zhang, Connor Sweetnam, Frank Wolf, Sheetal Walters, Jonathan Hirsch, Thomas D. Brown
Journal: Journal of Clinical Oncology (2020)

e15156 Background: Clinical trials show improved survival for advanced non-small cell lung cancer (aNSCLC) patients whose tumors are positive for PD-L1 expression when treated with immune checkpoint inhibitors (ICI), including pembrolizumab (Pb) and nivolumab (Nb). It is unclear whether relatively higher PD-L1 expression by tumor proportion score (TPS) is associated with better response to treatment, and whether this can be generalized to a real-world setting. Methods: We assessed overall survival (OS) across categories of PD-L1 expression levels among aNSCLC patients who received ICI monotherapy in the advanced/metastatic setting (stages IIIB or IV, or documented metastatic disease at diagnosis). Sub-analyses were performed based on first, second, or subsequent lines of treatment, as well as for patients receiving only Pb. The patient population is a sample from community health systems based in the United States, with data derived from electronic medical records and supplemented with molecular data integration from diagnostics labs. Results: 874 aNSCLC patients received ICI in the advanced/metastatic setting in the first line (n = 246, 28%), second line (n = 456, 52%), or third or later lines (n = 172, 20%). ICI-treated patients in any line with TPS of 1-49% (n = 148), 50-89% (n = 124), and 90-100% (n = 97) had OS of 6.9, 11.5, and 11.7 months, respectively. Pb-treated patients in any line with TPS of 1-49% (n = 38), 50-89% (n = 104), and 90-100% (n = 72) had OS of 5.5, 10.1, and 11.7 months, respectively. ICI-treated patients in the 1st line with TPS of 1-49% (n = 10), 50-89% (n = 80), and 90-100% (n = 59) had OS of 3.7, 8.0, and 7.4 months, respectively. Pb-treated patients in the first line with TPS of 1-49% (n = 7), 50-89% (n = 80), and 90-100% (n = 58) had OS of 3.7, 8.0, and 9.5 months, respectively. Conclusions: Results suggest OS benefit for real-world ICI-treated aNSCLC patients with PD-L1 TPS ≥50%, consistent with observations in clinical trials. The data further suggest additional benefits in the highest TPS category of 90-100% among Pb-treated patients, while the evidence is weaker for all ICI-treated patients, although comparisons did not reach statistical significance. A similar trend was seen in analyses of both patients treated in first-line only and in any line. Further analyses, to include comparison to clinical trial results, are warranted.
Participating in a musician's stream of consciousness
Authors: Björn Vickhoff
Journal: Behavioral and Brain Sciences (2020)

Abstract Do we acquire culture through other minds, or do we get access to other minds through culture? Music culture is a practice as well as the people involved. Sounding music works as a script guiding action, as do, to varying degrees, many rituals and customs. Collective co-performance of the script enables inter-subjectivity, which arguably contributes to the formation of subcultures. Shared-emotional experiences give material to the narrative of who we are.
Epidemiology, prevalence, and prognosis of multiple malignancies of a subpopulation of a large German cancer center.
Authors: Gina Rüter, Robin Schmidt, Yassen Abdelatif, Ulrich Keilholz, Susen Burock
Journal: Journal of Clinical Oncology (2020)

e13634 Background: Cancer patients have an increased risk of developing secondary primary neoplasia (SPN) compared to the general population. These multiple primary malignancies (MMs) represent an increasing challenge for patients and physicians. So far, little is known about risk factors, patient characteristics, and survival. The study’s purpose was to obtain an overview of the occurrence and distribution of MMs and the outcome and prognosis of affected patients reporting to a large cancer center in Germany. Methods: The cancer registry data base of the Charité Comprehensive Cancer Center was queried for patients, which had their first cancer diagnosis between 01.01.2009 - 31.01.2010 and consecutively developed at least one more primary cancer within the follow-up period till 31.03.2019. For defining MM the rules from the Surveillance, Epidemiology, and End Results (SEER) Program were used. General tumor and patient characteristics as well as outcome were analyzed. Results: In total, 231 patients (155 male; 76 female) were included in the final analysis. Out of the 231 patients, 203 (87.9 %) presented with 2 primary tumors, 27 patients (11.7 %) with 3 and 1 patient (0.4%) with more than three. MMs occurred mostly in patients &gt; 65 years (59.3%) and between 50-64 years (30.3%). According to the SEER definition 75.3% of the patients had metachronous and 24.7% had synchronous MMs. Most male patients presented initially with cancer of the bladder and the urinary tract (20.6%) and developed SPN in the prostate and the testicles (53.1%). The second most common initial cancer in this cohort was cancer of the prostate and testicles (18.1%) and the subsequent developed SPN was cancer of the bladder and the urinary tract (28.6%). For female patients the most common initial diagnosis was breast cancer (32.9%) followed by breast cancer as SPN in 60%. Overall, most frequent SPN were cancer of the prostate and testicles (13.4%), cancers of the lung and trachea (12.6%), and breast cancer (10.4%). Most patients (37.7%) developed the SPN within the 1st year and 28.6% after 5 years or later. Patients with synchronous MMs had a more than 40 months shorter OS than patients with the metachronous MM (79.00 ± 14.58 months vs. 122.00 ± 9.66 months). Conclusions: We could show that most MMs develop within the first year but that there is another peak after 5 years. However, it is still unclear how often SPN are misinterpreted as progressive disease. Therefore, further analyses and close follow-up are necessary.
Resource and reimbursement barriers to comprehensive cancer care (CCC) delivery: An association of community cancer centers (ACCC) survey research analysis.
Authors: Al Bowen Benson, Leigh Boehmer, Latha Shivakumar, Julia Rachel Trosman, Christine B. Weldon, Elizabeth A. Hahn, Sheetal Mehta Kircher
Journal: Journal of Clinical Oncology (2020)

31 Background: CCC delivery is recommended in guidelines, required by accreditation bodies, and essential for high-quality cancer management. Barriers, such as insufficient reimbursement and lack of specialist staff, prevent consistent access to and delivery of CCC, particularly supportive oncology services. Challenges especially persist in community programs, where access to philanthropy and similar funding is limited. ACCC conducted a representative survey of its member programs to elucidate capacity and barriers to CCC delivery in the community/academic setting in order to inform policy and value-based payment reform. Methods: Survey development methodology included item generation with expert review, iterative piloting and cognitive interviews to achieve content and internal validity. An online survey was piloted at the ACCC 2018 Annual Meeting and sent to member programs via email link. The final survey included 22 questions on availability and funding for supportive services. Twenty-seven supportive oncology services were assessed for availability, reasons not offered, reimbursement/funding and patient payment. Analyses were conducted with SAS. Results: 172 of 704 ACCC member programs responded and completed the majority of survey as of 10/7/19. Despite a high proportion of programs offering supportive oncology services, gaps between cost and reimbursement were present for all (Table). Deficits in reimbursement are compensated by patient out-of-pocket payments, grants and donations. Most centers report needing more staffing in psychology (61%), social work (60%), navigation (59%), nutrition (57%), palliative care (56%), genetic counseling (52%), and financial counseling (53%). Gaps were observed regardless of region or practice type. Conclusions: There is a lack of sufficient reimbursement, staffing, and budget to provide CCC across the U.S., regardless of region or practice type. Oncology care models and reimbursement policies must include CCC services to optimize delivery of care.
Exploratory analysis of factors associated with hyperprogression in advanced non-small cell lung cancer (NSCLC) treated with PD1/PDL1 inhibitors.
Authors: Marios P. Decatris, Joy A Thomas, Mark Hayes, Philip Ryan, Aled Phillips, Sherouk ElBatrawy, Caitlin Bowden, Ingrid Du Rand
Journal: Journal of Clinical Oncology (2020)

e21634 Background: Hyperprogressive disease(HPD) is a recently recognized type of accelerated tumor progression with immune checkpoint inhibitor(ICI) therapy. A recent meta-analysis identified serum lactate dehydrogenase(LDH) above upper limit of normal(ULN), liver metastases and &gt; 2 metastatic sites to be associated with increased likelihood of HPD. Methods: We performed a single-center retrospective analysis of NSCLC patients treated with ICI from 2/2017-1/2020. We defined HPD using combined criteria of failure to complete &gt; 4 cycles of ICI and radiological progression with development of new lesions or marked clinical progression where restaging was not achievable because of rapid decline in performance status. Treatment discontinuation/interruption because of toxicity alone, was not designated as HPD. Results: HPD was seen in 9/41(22%) patients treated with at least 1 cycle of ICI. In 6/9 there was marked radiological progression (new lesions/significant progression of existing lesions); in the remaining 3 restaging was not possible because of rapid decline which mandated treatment cessation. Patients with HPD were more likely to have a raised LDH, liver metastases or &gt; 2 metastatic sites but these differences were not statistically significant. 9/9 versus 5/32 patients in the HPD/non-HPD cohorts respectively progressed within 10 weeks of treatment (p &lt; 0.001) and 7/9 versus 12/32 respectively did not survive beyond 6months (p = 0.057). Conclusions: This small study has shown a non-statistically significant trend for association between HPD, raised LDH, liver metastases and presence of &gt; 2 metastatic sites. A better understanding of risk/predictive factors for HPD is essential for improved patient selection for treatment with ICI. [Table: see text]
听诊的重要性
Authors: 曾昭耆
Journal: BMJ (2011)

曾昭耆：自从1816年法国医生雷奈克发明了最初的听诊器，经过近200年来的不断改进，听诊器使医生对患者体征的了解更准确，诊断能力进一步提高，成了医生工作中离不开的工具。以致有一段时期在我国，听诊器竟成了医生的“代名词”。近些年，随着大量高科技成果被引入临床，研制出许多先进诊疗仪器设备，让医生们觉得临床工作似乎比过去容易了，碰到什么患者，只要开一些化验单和特殊检查申请单，等有了报告，诊断就心中有数了。尽管医生们仍旧带着听诊器，也用它来测血压和听心、肺、腹等，但是否人人都认真检查，就不得而知了。
Clinical features of antibiotic-associated diarrhea in intensive care unit
Authors: 是若春, 张新征, 方雷, 刘龙
Journal: BMJ (2006)

目的 分析我院重症监护室患者抗生素相关性腹泻的临床特点及治疗体会,探讨其相关危险因素.方法对2003年7月至2004年12月收住重症监护室的危重患者发生抗生素相关性腹泻的病例进行回顾性分析,并与同期未发生抗生素相关性腹泻患者进行对比.结果 192例危重患者中发生抗生素相关性腹泻48例,发生率25%.单因素分析显示抗生素相关性腹泻与患者年龄偏大、APACHEⅡ评分高、住院时间长、白蛋白数值低及多合并有心、肺、肝、肾等慢性疾病史相关,与同期入住监护室未发生抗生素相关性腹泻患者相比差异有统计学意义;而抗生素使用时间与抗生素相关性腹泻的发生无相关性.但多因素分析显示,APACHEⅡ评分、白蛋白水平、慢性疾病患病率为抗生素相关性腹泻的相关危险因素,年龄、住院天数与抗生素相关性腹泻的发生没有显著相关性.结论病情危重程度、慢性疾病史和免疫功能低下是引起抗生素相关性腹泻的相关危险因素.及时的诊断和干预、给予胃肠道保护是治疗抗生素相关性腹泻的重要措施。
High Prevalence of Deep Vein Thrombosis in Mechanically Ventilated COVID-19 Patients
Authors: Sebastian Voicu, Philippe Bonnin, Alain Stépanian, Benjamin G. Chousterman, Arthur Le Gall, Isabelle Malissin, Nicolas Deye, Virgine Siguret, Alexandre Mebazaa, Bruno Mégarbane
Journal: Journal of the American College of Cardiology (2020)
Validation of tumor DNA in bronchial lavage as a diagnostic tool in lung cancer.
Authors: Sara Witting Christensen Witting Christensen Wen, Caroline Brenner Thomsen, Torben Hansen, Rikke Fredslund Andersen, Line Nederby, Henrik Hager, Kristian Rasmussen, Anders Kristian Moeller Jakobsen, Ole Hilberg
Journal: Journal of Clinical Oncology (2020)

9020 Background: Diagnosing lung cancer requires invasive procedures with risk of complications for the patient. The HOXA9 gene is highly methylated in lung cancer, and methylated tumor DNA (meth-tDNA) in bronchial lavage has previously shown potential as a diagnostic biomarker. The aim of the present study was to validate these preliminary results. Methods: Patients were referred by the general practitioner on suspicion of lung cancer. The Danish diagnostic package includes chest and abdominal CT scan, bronchoscopy, blood tests, and histopathological or cytological verification. Twelve ml lavage fluid was collected at bronchoscopy for analysis of meth-tDNA based on droplet digital PCR according to our published method. A positive test was defined as ≥ 4 droplets containing meth-tDNA and a ratio between HOXA9 and Albumin of &gt; 0.15%. The analysis was performed blinded to clinical data and meth-tDNA status was compared with the final diagnosis. Results: The study population was 204 consecutively enrolled patients. The material consisted of a discovery cohort (n = 105, presented at ASCO 2019) used for establishing the cut-points, and a validation cohort (n = 99). Six were excluded from analysis due to malignancy other than lung cancer and one due to failed analysis. In the discovery cohort, the sensitivity was 68.7% (95% CI 56.2-79.4%), specificity 88.2% (95% CI 72.6-96.7%), and positive predictive value (PPV) 92.0% (95% CI 80.8-97.8%). In the validation cohort, the same values were 76.9% (95% CI 63.2-87.5%), 77.3% (95% CI 62.2-88.5%), and 80.0% (95% CI 66.3-90.0%), respectively. Analyzing the entire patient material (n = 197) the sensitivity, specificity, and PPV were 72.3% (95% CI 63.3-80.1%), 82.1% (95% CI 71.7-89.8%), and 86.0% (95% CI 77.6-92.1%), respectively. The false positive samples were equally distributed among patients with cryptogenic organizing pneumonia, granulomatous inflammation, and acute inflammatory disease. The false negative samples were mainly from patients with peripheral tumor, no radiologically detectable tumor, and mesothelioma. Conclusions: Meth-tDNA in bronchial lavage holds potential as a supplementary tool in the diagnosis of lung cancer with a clinically relevant sensitivity and specificity. Routine clinical application awaits further validation in a clinical trial. [Table: see text]
心力衰竭引起的慢性咳嗽一例
Authors: 易春波
Journal: BMJ (2010)

慢性咳嗽是指咳嗽时间大于8周,其病因很复杂,有呼吸道本身的疾患,如肺炎、肺结核、支气管肺癌、慢性支气管炎、咳嗽变异性哮喘(CVA)[1]、上气道咳嗽综合征(UACS)、嗜酸粒细胞性支气管炎(EB)[2]等;还有很多呼吸道以外的原因,如胃食道反流性咳嗽(GERC)、血管紧张素转换酶抑制剂(ACEI)药物引起的咳嗽、习惯性咳嗽、纵隔肿瘤、左心功能不全等[3]。
不同剂量丙戊酸钠防治偏头痛的对照观察
Authors: 许燕, 柴洪昌
Journal: BMJ (2006)

偏头痛是神经科常见病.我们应用小剂量丙戊酸钠防治偏头痛获较好疗效,报告如下. 一、对象与方法 1.研究对象:选取我院神经内科1999年1月至2005年1月门诊和住院患者136例,男34例,女102例,年龄16～65岁,平均(41±8)岁.均符合国际头痛学会1988年制定的诊断标准[1],并符合预防性药物治疗指征.排除癫痫、肝病、血小板减少及妊娠.
硫化氢中毒的诊断、治疗与预防
Authors: 黄关麟
Journal: BMJ (2005)

硫化氢(hydrogen sulfide,H2S)是一种窒息性气体,广泛存在于自然界和多种生产作业环境中,中毒发生率及死亡率高,是威胁我国劳动者生命健康安全的主要化学性病因之一.周顺福等[1]报告1982至1997年上海市急性职业性化学中毒病例中,H2S中毒的发生率(10.3%)仅次于一氧化碳(CO)中毒(21.8%),居第2位;病死率则为首位(29.3%,CO为6.4%).张敏等[2]分析1990至2003年全国重大H2S中毒事故死亡率为9.3%～61.5%,平均46.0%.本文拟简要介绍H2S的理化性质、中毒机制、预防和救治方法,供临床工作参考。