tbuckley/cabot-search huggingface dataset:
甲状腺肿瘤侵及气管致呼吸困难一例
Authors: 张庆泉, 王强, 王丽, 张杰, 宋西成
Journal: BMJ (2012)

患者女,98岁.因为哮喘样呼吸困难3个月,加重10d,于2010年6月12日入当地医院治疗,CT检查发现总气管有孤立性占位性病变(图1),同时伴有甲状腺的异常,遂转入本院.心肺体检无异常,甲状腺功能正常,甲状腺B超显示右侧甲状腺体积增大,密度欠均匀,血流丰富,考虑为甲状腺肿瘤,突向气管内.因患者高龄,支气管镜检查有加重呼吸困难可能,故未行支气管镜.考虑患者不能耐受开胸手术,但支气管镜下又很难处理体积较大的气管肿瘤. 关键词：甲状腺肿瘤
A post-hoc study of relative dose intensity in elderly patients with advanced ovarian cancer (JGOG3016-A3).
Authors: Yoshio Itani, Hitomi Sakai, Mikiko Asai-Sato, Shinya Sato, Masayuki Futagami, Nao Suzuki, Masaki Fujimura, Yoichi Aoki, Tetsutaro Hamano, Yoshio Yoshida
Journal: Journal of Clinical Oncology (2020)

e18053 Background: The number of elderly (aged ≥70 years) ovarian cancer patients (OCP) has doubled in the last 40 years. The clinical question is whether equivalent-strength chemotherapy could be administered to both young and fit-elderly OCP with advanced disease who are eligible in a randomized controlled trial setting. Methods: We retrospectively analyzed the cases of 605 OCP who received a dose dense T(PTX)C(CBDCA) (dTC) (n = 301) or conventional TC (cTC) (n = 304) regimen after the initial surgery in the Japanese Gynecologic Oncology Group 3016 trial. The relative dose intensity (RDI)(a treatment strength indicator), overall survival time (OS), and adverse events(NCI-CTC ver.2.0) of the elderly (≥70 years old) (E) and young ( &lt; 70 years old) patients (Y) were compared, and prognostic factors were analyzed. Results: 1) Mean RDI of the Y and E: dTC group: CBDCA: 80.1% and 79.0%, respectively (p = 0.648); PTX: 81.5% and 79.8%, respectively (p = 0.384); cTC group: CBDCA: 89.6% and 88.1%, respectively (p = 0.429); PTX: 90.4% and 88.5%, respectively (p = 0.262). 2) Three-year survival rates of the Y and E: dTC: 75.5% (95% confidence interval (CI): 70.3–81.0) and 57.6% (95%CI: 44.5–74.6) ( p = 0.004, Log-rank), respectively; cTC: 67.7% (95%CI: 62.2–73.6) and 49.7% (95%CI: 36.5–67.5) ( p = 0.002, Log-rank), respectively. 3) Univariate analyses demonstrated that the RDI-related hazard ratio for OS was 0.95 (95%CI: 0.83–1.08; p = 0.425) and 0.94 (95%CI: 0.81–1.08; p = 0.396) in the dTC and cTC groups, respectively. 4) Age (≥70 vs. &lt; 70 years old; p = 0.049) in the cTC group was an independent prognostic factor. The serum albumin level (p = 0.005) in the dTC group and the WBC (p &lt; 0.001) in the cTC group within 2 weeks from the chemotherapy introduction were identified as independent prognostic factors. The ECOG-PS (≥2 vs. 1), clinical stage (III&amp;IV vs. II), and residual tumor size (≤1 cm vs. &gt; 1 cm) also acted as independent prognostic factors in both groups. 5)Toxicities of G3 or G4 occurred higher in the E: arthralgia (p = 0.003) in the dTC group; creatinine (p = 0.02), febrile neutropenia (p = 0.011), and infection (p = 0.028) in the cTC group. Conclusions: There was no difference in RDI by age among the subjects, but the prognosis of fit-elderly OCP was worse than that of young OCP. It is suggested that the worse prognosis of fit-elderly OCP with advanced disease is caused not by chemotherapy strength, but by the smaller physiological reserves possessed by such patients after debulking surgery. Both hematologic and non-hematologic toxicities occurred higher in fit-elderly than young OCP.
A brief introduction of TeamSTEPPS
Authors: Zhijie Yu, Hua Yang, Xiuying Mao, Yuezhong Tang, Donghao Xu, Shanzhu Zhu
Journal: BMJ (2017)

TeamSTEPPS (team strategies and tools to enhance performance and patient safety) defines four core capabilities in teamwork which can be trained: leadership, situation monitoring, mutual support and communication. TeamSTEPPS is a successful medical team training project and its effectiveness has been proved. The application of TeamSTEPPS can provide a new teaching model for general practice training.


Key words: 
Quality assurance, health care; General practice; Training
中药与针灸治疗阴道前壁膨出一例
Authors: 张志萍, 张红英
Journal: BMJ (2011)

患者女，33岁，维吾尔族。2010年5月14日在职工医院经会阴侧切生子，初产，新生儿体重2.68 kg。患者产后使用开塞露才可排便，小便淋漓不尽，且发觉阴道有异物突出，小便后异物可自行进入阴道内，被诊断为中度阴道前壁膨出。按医院建议做提肛缩阴锻炼3个月后、自觉无好转。因恐惧阴道子宫前壁修补术，于2010年9月到我中医科求诊，患者纳少、失眠、面色少华、小腹下坠、舌质淡、苔薄白、脉细弱，考虑到产妇年龄，检查后中医辨证为中气下陷、肾气不固，给予中药补中益气汤口服和针刺治疗；取穴百会、关元、足三里、三阴交、维道、气冲。2个疗程（10 d为一疗程）后，患者大小便正常，身体的不适感均消失，只有行走久后、咳嗽或打喷嚏时阴道偶有异物突出。又经过2个疗程的治疗，不再有阴道异物突出。 关键词：阴道疾病
MR1 in combination with tumor mutational burden and PD-1/PD-L1 expression as a potentially novel clinical predictor for T cell exhaustion and immune checkpoint inhibitor response.
Authors: Mark Farha, Neil Jairath, Issam El Naqa, Daniel Eidelberg Spratt, Theodore Lawrence
Journal: Journal of Clinical Oncology (2020)

3109 Background: Immune checkpoint inhibitors (ICIs) restore T cell function by reversing T cell exhaustion. Variable response to ICIs warrants the development of precise predictive biomarkers, which is challenging due to difficulty in capturing the interplay of factors involved with tumor cell immune recognition. High intratumoral expression of MR1, the MHC-I related protein basally expressed on cancer cells, may drive T cell exhaustion through presentation of cancer-specific antigens. Here, we construct a database to study the relationship between MR1, tumor mutational burden (TMB), the PD-1/PD-L1 axis and T cell exhaustion across 8,975 sequenced tumors and 27 cancer types. Methods: RNA Seq by expectation maximization (RSEM) values from the TCGA were collected and normalized along with expression data for markers of interest (Table). TMB was defined as the number of non-synonymous somatic mutations per sample. For each cancer, 5 cohorts were created based on ascending mean expression levels of MR1, PD-1, PD-L1, and increasing TMB. For each cancer, an “immunogenicity score” for these factors was computed, and its relationship with T cell exhaustion signatures was assessed via linear regression. Data is presented as adjusted R 2 and p-value. Results: While PD-1 and T cell exhaustion marker expression were correlated across cancers, the “immunogenicity score” (IS) correlated with exhaustion markers specifically in cancers with FDA-approved ICIs. Excluding MR1 from the score weakened the correlation with EOMES and TBET expression (Table). Each component of the score analyzed independently failed to show a statistically significant correlation for both EOMES and TBET expression. Conclusions: In this cross-cancer analysis, we support the hypothesis that presentation of metabolic intermediates in cancer cells via MR1 may drive T cell exhaustion. Also, the novel “immunogenicity score”, which incorporates MR1 into standard biomarkers for response to ICIs may convey the global picture of cancer cell recognition by the immune system and warrants further investigation as a tool for predicting clinical response. [Table: see text]
Differential association of proton pump inhibitors with efficacy of capecitabine and 5-fluorouracil in metastatic colorectal cancer: A post-hoc analysis from AXEPT phase III trial.
Authors: Sun Young Kim, Ji Sung Lee, Junho Kang, Satoshi Morita, Young Suk Park, Junichi Sakamoto, Kei Muro, Rui-hua Xu, Tae Won Kim
Journal: Journal of Clinical Oncology (2020)

4023 Background: Proton pump inhibitors (PPIs) reportedly can impair the absorption of oral anticancer agents by potent acid suppression. Concomitant use of a PPI with capecitabine (Cap) was suggested to be associated with poor outcome in gastrointestinal cancers, however, the potential interaction has not been studied yet in a prospective randomized clinical trial comparing Cap with 5-fluorouracil (FU). We analyzed the differential impact of PPI use on Cap and FU using dataset from AXEPT trial, a phase III randomized trial that demonstrated non-inferiority of a modified XELIRI (mXELIRI; Cap plus irinotecan) with FOLFIRI (FU, leucovorin and irinotecan), both either with or without bevacizumab in patients (pts) with metastatic colorectal cancer (mCRC). Methods: From the per-protocol set (n = 620), pts with available information on concomitant medications (n = 482) were eligible for this sub-study. PPI use was defined as concomitant exposure of Cap and any PPI for 20% or more of the study period. The treatment-by-PPI-use interaction was examined adjusting to stratification factors including age, sex, country, performance status, number of metastatic sites, previous use of oxaliplatin, and concurrent bevacizumab treatment. Results: 49 (10.1%) pts were PPI users. Clinical characteristics were well balanced between the two groups differing in PPI use. In PPI users, the mXELIRI group tended to have poorer OS (hazard ratio [HR], 1.83; 95% confidence interval [CI], 0.96–3.48; p = 0.0644) compared with the FOLFIRI group. In contrast, within PPI non-users, OS of mXELIRI was better than that of FOLFIRI (HR, 0.76; 95% CI, 0.61- 0.95; p = 0.0162). Similarly, a trend of worse PFS with mXELIRI than with FOLFIRI was observed in PPI users (HR, 1.73; 95% CI, 0.94-3.21; p = 0.0798), but not in PPI non-users (HR, 0.90; 95%CI, 0.73 – 1.10; p = 0.2871). Treatment-by-PPI-use interaction was significant for OS (p = 0.0116) and PFS (p = 0.0415). No significant interactions were found between treatment and PPI use in terms of treatment failure, overall response, disease control, and grade 3–4 toxicities. Conclusions: There was a significant interaction between PPI use and treatment (Cap vs FU) in terms of OS and PFS in AXEPT dataset. This suggests that PPI use could impair the efficacy of Cap, but not that of FU. PPIs should be used with caution in pts with mCRC taking Cap. Clinical trial information: NCT01996306 .
Survival among colorectal cancer patients with a history of previous cancer.
Authors: Sandi Pruitt, David E. Gerber, Hong Zhu, Daniel Heitjan, Bhumika Maddineni, Amit G Singal, Danyi Xiong, Anna Tavakkoli, Ethan Halm, Caitlin C. Murphy
Journal: Journal of Clinical Oncology (2020)

e16146 Background: A growing number of patients with colorectal cancer (CRC) have survived a previous cancer. Although little is known about their prognosis, this population is frequently excluded from clinical trials. We examined the impact of previous cancer on overall and cancer-specific survival in a population-based cohort of patients diagnosed with incident CRC. Methods: We identified patients aged ≥66 years and diagnosed with CRC between 2005-2015 in linked SEER-Medicare data. For patients with and without previous cancer, we estimated overall survival using Cox regression and cause-specific survival using competing risk regression, separately by CRC stage, while adjusting for numerous covariates and competing risk of death from previous cancer, other causes, or the incident CRC. Results: Of 112,769 CRC patients diagnosed with incident CRC, 15,935 (14.1%) had a previous cancer – most commonly prostate (32.9%) or breast (19.4%) cancer, with many 7505 (47.1%) diagnosed ≤5 years of CRC. For all CRC stages except IV in which there was no significant difference in survival, patients with previous cancer had modestly worse overall survival (hazard ratios from fully adjusted models range from 1.11-1.28 across stages; see Table). This survival disadvantage was driven by deaths due to previous cancer and other causes. Notably, most patients with previous cancer had improved CRC-specific survival. Conclusions: CRC patients who have survived a previous cancer have generally worse overall survival but superior CRC-specific survival. This evidence should be considered concurrently with concerns about trial generalizability, low accrual, and heterogeneity of participants when determining exclusion criteria. [Table: see text]
Symptomatic myocardial bridge induced acute myocardial ischemia in children: a case report and literature review
Authors: Xiao-dong Liu, Chun-lei Sun, Lu-hua Zhao, Xiao-mei Qiu, Hai-ying Yu, Tian-hua Li
Journal: BMJ (2013)

A child case of acute myocardial ischemia induced by symptomatic myocardial bridge (SMB) was reported and relevant literatures were reviewed in this article. The case and literatures indicate that myocardial bridge is a rare congenital coronary artery anomaly in children. The pathogenesis may be related to stenosis, spasm, arteriosclerosis of coronary artery because of myocardial bridge compression during systole. Clinical manifestations include chest pain, malignant arrhythmia, syncope, cardiac arrest and myocardial infarction. The diagnosis of myocardial bridge is based on cardiac imaging. SMB patients should be first treated with β-adrenergic; if ineffective, surgical treatment or implantable automated cardiac defibrillator should be chosen. The patients complicated with hypertrophic cardiomyopathy have worse conditions with high mortality.


Key words: 
Myocardial bridge; Myocardial ischemia
Paediatric cohort studies on lower respiratory diseases and their reporting quality: systematic review of the year 2018
Authors: Cristina Ardura-Garcia, Rebeca Mozun, Eva S.L. Pedersen, Maria Otth, Maria Christina Mallet, Myrofora Goutaki, Claudia E. Kuehni
Journal: European Respiratory Journal (2020)

The paediatric respiratory research community uses cohort studies extensively. However, the landscape of these studies and their quality of reporting has not been assessed. We performed a systematic review of publications on cohort studies reporting on paediatric lower respiratory problems published in 2018. We searched MEDLINE and Embase and extracted data on study and journal characteristics. We assessed the number of items of the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist that a random sample (100 papers) reported. We analysed factors associated with the STROBE score and with the most poorly reported items, using Poisson and logistic regression. Of the 21 319 records identified, 369 full-text articles met our inclusion criteria. Most papers studied asthma aetiology through birth cohorts and were based in Europe or North America. The reporting quality was insufficient: 15% reported the 22 STROBE items; median (interquartile range) score 18 (16–21). The most poorly reported items were sources of bias, sample size, statistical methods, descriptive results and generalisability. None of the study or journal factors were associated with the STROBE score. We need a joint effort of editors, reviewers and authors to improve the reporting quality of paediatric cohort studies on respiratory problems.
An investigation andanalysis on current status of general practice service teams in urban Sbanghai
Authors: Hua Yang, Sun-fang Jiang, Shan-zhu Zhu
Journal: BMJ (2010)

：Objective To investigatecurrent status of general practice service teams in urban Shanghai to provide practicalevidence and lay theoretical basis for sustainable development of general practice serviceteams in the future. Methods A cross-sectional study was carried out for 40 staff membersof eight general practice service teams in eight urban districts of Shanghai, as well as110 local residents, by observation, interview and questionnaire methods during March toApril 2008. Results Among 21 general practitioners, 86 percent of them ( 18/21 ) weregraduated from medical colleges or universities with three-year curriculum or at levelsabove it and 52 percent ( 11/21 ) had intermediate professional titles or above.Among theeight general practice service teams, five had full coverage of supervision and managementfor tuberculosis therapy, six had full coverage of management for tumor patients, four hadfull coverage of management for cardiovascular and cerebrovascular diseases and four hadfull coverage of management for patients with mental disorders. In all staff members ofeight general practice service teams, 38 percent of them (15/40) were satisfactory withtheir working environment, 40 percent (16/40) with their work activities, five percent(2/40) with their incomes, and 28 percent (11/40) with their professional future.In 110local residents, 77 percent (85/110) were satisfactory with service environment, 85percent (93/110) with quality of health-care service and 89 percent (98/110) with theattitude of service teams.Conclusions Implementation of management for chronic diseasesand two-way referral, as well as satisfaction of staff members in general practice serviceteams should be improved further.
某油田企业60岁以上人群门诊疾病谱分析
Authors: 杨泽福, 陈虎, 马学清
Journal: BMJ (2012)

对2009年1月至12月内科门诊60岁以上初诊患者5788例的疾病谱进行分析.结果 显示,心血管系统疾病最高(25.57％)；单病种构成比依次为高血压、冠心病、2型糖尿病、高脂血症、脑卒中、慢性阻塞性肺气疾病和恶性肿瘤；患有两种以上疾病者高达74.15％。
Research advances on bifidobacterium and inflammatory bowel disease
Authors: Zhengru Liu
Journal: BMJ (2018)

Inflammatory bowel disease (IBD) is achronic and relapsing inflammation of the intestinal tract. The pathogenesis of IBD is still unknown. In recent years, the research on the relationship between intestinal flora and IBD has become a hot topic. The change of intestinal flora may be one of the important pathogenic factors of IBD. Bifidobacterium is known as one of the probiotics in the intestine, the change of the bifidobacterium flora is closely related to the pathogenesis of IBD. It can effectively reduce the intestinal inflammatory response of IBD patients by enhancing the mucosal barrier function, regulating intestinal immunity and intestinal flora. The regulation of bifidobacterium in the intestine may have a positive effect on the treatment of IBD.


Key words: 
Colitis; Probiotics
Characteristic manifestations of disseminated peritoneal adenomucinosis on multislice spiral CT
Authors: Li-ying Xu, Yun-feng Zhou, Guang-yao Wu, Mei-yan Liao, Zhi-xiong Tian, Zai-peng Zhang, Xiong Huang
Journal: BMJ (2012)

Clinical data and manifestations on muhi-slice spiral CT (MSCT) of 11 patients with disseminated peritoneal adenomucinosis (DPAM) were retrospectively reviewed.The CT manifestations were also compared with surgical and histopathological findings.MSCT findings showed a large amount of gel-like ascites in 9 cases and local cystic masses in 2 cases.Among 9 cases with a large amount ascites,abdominal multiple cystic masses were shown in 5 case,and infiltration of the greater omentum and mesentery in 5 cases.Hepatic scalloping was found in 6 cases ; parenchymal invasion of the liver or spleen were showed in 5 cases; calcification of the cystic masses in 5 cases.Ovary mueinous cystadenoma was presented in 3 female patients.Enlarged lymph nodes and omental cake were not found in all cases.The results indicate that the characteristic MSCT manifestations of DPAM include diffuse gel-like ascites,multiple cystic masses with or without calcification,hepatic scalloping and parenchyma invasion.

Key words: 
Pseudomyxoma peritonei ;  Tomography, X-ray computed
Recovery of Left Ventricular Systolic Function and Clinical Outcomes in Young Adults With Myocardial Infarction
Authors: Wanda Y. Wu, David W. Biery, Avinainder Singh, Sanjay Divakaran, Adam N. Berman, Gloria Ayuba, Ersilia M. DeFilippis, Khurram Nasir, James L. Januzzi, Marcelo F. Di Carli, Deepak L. Bhatt, Ron Blankstein
Journal: Journal of the American College of Cardiology (2020)
Second primary melanoma in advanced melanoma patients treated with anti-PD-1 monoclonal antibodies.
Authors: Elisa Funck-Brentano, Estelle Charvet, Louise Chaplain, Amelie Gantzer, Oula Kassem, Christine Longvert, Astrid Blom, Nicolas Dupin, Sélim Aractingi, Maxime Hamon, Ute Zimmermann, Jean-François Emile, Pierre Sohier, Nora Kramkimel, Philippe Saiag
Journal: Journal of Clinical Oncology (2020)

e22025 Background: Development of a second primary melanoma (SCPM) has not been reported in melanoma patients treated with anti-PD-1 monoclonal antibodies (mAb), in contrast with those reported in BRAF-inhibitor-treated patients. Our aim was to report arising SCPM in patients with advanced melanoma treated with anti-PD-1 therapy. Methods: Retrospective study, conducted in 2 referral centres, including advanced melanoma patients who developed a SCPM after anti-PD-1 mAb initiation, between September 2010 and May 2019. BRAF or NRAS mutational status was assessed by targeted NGS panels, real-time PCR, and immunohistochemistry. Results: Among a total of 509 patients treated with anti-PD-1 mAb, 4 had a SCPM (incidence: 0.8%; 95%CI: 0.02-1.57%). All patients were treated with nivolumab, in first (N = 3) or second line after progression with BRAF + MEK inhibitors (N = 1). No immune-related adverse event greater than grade 2 according to Common Terminology Criteria for Adverse Events version 5.0. was observed in these 4 cases; a vitiligo-like depigmentation (grade 1) was observed in two patients. The median time from the first nivolumab infusion to the SCPM diagnosis was 17.5 months (range: 5-21). All patients developed the SCPM after achieving a complete response. Nivolumab administration had been discontinued (4 months prior) in one patient. Histology revealed 4 superficial spreading melanomas (SSM): one invasive (without BRAF V600 mutation) and 3 intraepidermal melanomas (2 with a BRAF V600E mutation and one with a NRAS Q61H mutation). 3 patients had risk factors for developing multiple melanomas: a dysplastic nevus syndrome, a high number of nevi (≥100 nevi), and a family history of melanoma in first-degree relatives and constitutional heterozygous mutation of exon 2 of the CDKN2A gene. Occurrence of SPCM did not alter advanced melanoma treatment. With a median follow-up of 29 months [range: 18-41] from the first anti-PD-1 mAb infusion, all patients had prolonged CR, and treatment was discontinued in all patients, without relapse after a median 11.5 months [0-18] off therapy. The median duration of nivolumab treatment was 15.5 months [10-24]. Conclusions: Although anti-PD-1 mAb could theoretically decrease the risk of developing another melanoma in metastatic melanoma patients, we found 4 such cases, highlighting the importance of regular clinical screenings for new primary melanoma in patients with metastatic melanoma even when responsive to anti-PD-1 therapy. Immune checkpoint inhibitors do not totally prevent the risk of occurrence a SCPM.