tbuckley/cabot-search huggingface dataset:
Association between human leukocyte antigen DRB1 gene polymorphisms and asthma among Mongolian and Han peoples in China
Authors: Li-ying Cui, Shu-fen Zhu
Journal: BMJ (2009)

Objective To investigate the association between human leukocyte antigen DRB1gene (HLA-DRB1) polymorphisms and asthma among Mongolian and Han peoples in China. Methods Sequence-specific primer polymerase chain reaction (PCR-SSP) was used to detect frequencies of HLA DRB1 alleles in 45 Han and 45 Mongolian patients of asthma, as well as 46 healthy Han and 45 healthy Mongolian people as controls. Frequencies of each locus of HLA-DRB1 gene were calculated and odds ratio (OR) for each locus was estimated and tested by chi-square test. Results Frequency of HLA-DR9 allele was significantly higher in Han ( 13.33 %, OR of 7. 82) and Mongolian ( 16.67 %, OR of 4. 10) asthmatic patients, as compared to Han ( 2. 22 % ) and Mongolian ( 5.43 % ) controls, respectively ( P < 0. 05 ) ;frequency of HLA-DR11 allele in Mongolian asthmatic patients ( 10. 00 % ) was significantly higher than that in healthy Mongolians ( 1.11% ) ( P < 0. 05, OR of 11.00 ) ;and frequency of HLA-DR7 allele in Han asthmatic patients was significantly lower than that in healthy Han people ( P < 0. 05, OR of 0. 08 ). Frequency of HLA-DR7 allele in Han asthmatic patients (1.11% ) was significantly lower than that in Mongolian patients (10. 87 % ). Conclusions HLA-DR9 allele is a common in the people of Inner Mongolian Autonomous Region, and associated with susceptibility of asthma in Han and Mongolian peoples. HLA-DR11 allele is a unique susceptive gene for Mongolian asthmatic patients and HLA-DR7 allele is a protecting one for asthma in Han people.

Key words: 
Asthma; HLA antigen ; Mongolian nationality; Han nationality
Management of psycho-cardiac disease in primary hospital
Authors: Hui Liu
Journal: BMJ (2017)

基层医院的双心疾病患者逐渐增加，但其诊断和治疗存在许多问题。加强双心诊疗技能培训，以心内科医生为主导，充分发挥护理人员的作用，施行适时双向转诊的模式，通过心理筛查、量表评估后给予个体化心理治疗、药物治疗再结合运动康复将有助于优化基层医院双心患者的管理，促进患者身心健康。
药物流产并发症27例分析
Authors: 郑卫红, 鲁桦
Journal: BMJ (2006)

随着药物流产在计划生育领域的广泛应用,越来越多的妇女希望选择此种痛苦较小的方法终止妊娠.但由于对药物流产的过程和安全性缺乏必要的认识,私自服药或不能够遵医嘱按时复诊,造成药物流产后发生并发症,现将我院收治的27例药物流产并发症患者的资料进行临床分析。
植皮治疗颌颈部深度烧伤晚期创面16例
Authors: 高小青
Journal: BMJ (2005)

颌颈部深度烧伤创面愈合过程中常出现瘢痕增生、挛缩,对患者的生理、心理产生严重影响.从2000年4月至2003年12月,我院采用全厚或中厚皮片移植治疗颌颈部晚期深度烧伤16例,疗效满意,现报告如下。
Efficacy of ramosetron in the prevention of postdelivery nausea and vomiting during emergency cesarean delivery
Authors: Xiao-jian Li, Xia Chen
Journal: BMJ (2012)

We sought to determine the efficacy of ramosetron in the prevention of nausea and vomiting during emergency cesarean delivery under spinal anesthesia with strict controls of causative factors.A total of 206 parturients participated in a randomized,single-blind and placebo-controlled trial.They received an intravenous injection of either ramosetron 0.3 mg or normal saline immediately after cord clamping.The primary outcome was the presence of postdelivery nausea and vomiting.Secondary outcomes included the need for rescue antiemetic,hypotension,pain and adverse effects.The incidence of postdelivery nausea and vomiting was 10.7％ in the ramosetron group vs.28.2％ in the control group (P ＜ 0.01 ).The incidence of intraoperative hypotension and postdelivery was similar in both groups.The incidence of postdelivery pain and the requirement for rescue antiemetic were similar in both groups.Ramosetron 0.3 mg is effective in the prevention of postdelivery nausea and vomiting during cesarean delivery.

Key words: 
Cesarean section;  Postpartum vomiting
Importance of public awareness of the association of tobacco products to bladder cancer.
Authors: N Mullai, K. Eric Ruby, Ryan Weiss
Journal: Journal of Clinical Oncology (2020)

e13564 Background: Many cancers have well-known association with the use of tobacco products. Cancers of lung, esophagus, head and neck, urinary tract including bladder, kidney, pancreas, cervix, etc. have proven causation to tobacco use. This study highlights the close association of the use of tobacco products to bladder cancer and emphasizes the need for increased public awareness in this regard. Methods: Data were collected from the medical records of patients treated during a five-year period (2012-2017). Three hundred sixty-two (362) biopsy proven bladder cancers were analyzed retrospectively. The association of bladder cancer to tobacco use was established and presented. Results: Three hundred sixty-two pathology proven bladder cancers were studied. Eighty percent (80%) of the occurrences were in men and twenty percent (20%) were in women. Twenty-five percent (25%) of the events were multiple occurrences in same patients. The most common histology was urothelial (transitional cell) cancer. A majority, eighty-one percent (81%) had a history of using tobacco products. Only thirteen percent (13%) were non-smokers. However, several of the non-smokers had exposure to secondary smoking or to chemicals of uncertain nature. About six percent (6%) of the cases had no definitive documentation of their risk factors. Conclusions: Bladder cancer is the ninth most common malignancy in the United States. Urothelial carcinoma is the most common histology. The most important risk factors are the use of tobacco products and exposure to certain environmental factors. More than sixty known carcinogens in tobacco smoke are attributed as the casual factors. Field cancerization is one of the hypotheses that account for multiple occurrences of urothelial cancer. The risk due to tobacco use is associated in 50%-65% in men and 20%-30% in women, which triples the incidences of malignancies as compared to non-smokers. Although, the public are well aware of the association of the use of tobacco products with cancers, such as lung, esophagus, and head and neck, there is less awareness that it is also a casual factor for bladder cancer. This study stresses the importance of this conclusion and the need to create a wide spread awareness among the public on the use of tobacco products as a cause for bladder cancer in both men and women.
Research practice enhances personnel professionalism and competency in Shanghai Malu community health service center
Authors: Yuanyuan Ge, Ping Lu
Journal: BMJ (2018)

The technical development and health system reform require high professionalism and competency for medical workers. At present the cultivation of medical professionalism is mainly limited in campus education only for medical and nursing students, and little is involved in clinical practice for health personnel. This paper introduces that the personnel professionalism and competency had been enhanced through scientific research practice in Shanghai Malu Community Health Service Center, the experiences would provide reference for other community health service institutions.


Key words: 
Community health centers; Medical staff; Scientific research; Occupation literacy
Progress of immunotherapy in neuromyelitis optica spectrum disorders
Authors: Yang Chunsheng, Zhang Qiuxia, Zhang Linjie, Zhou Bingjie, Zhang Chao, Yang Li
Journal: BMJ (2019)

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune demyelinating disease in central nervous system, mainly involving the optic nerves and spinal cord. NMOSD is a relapsing disease with severe residual disability, therefore, prevention of attacks is critical for the preservation of visual and neurologic function. The conventional immunosuppressants, including prednisone, azathioprine, mycophenolate mofetil and methotrexate, can be used to prevent relapse of NMOSD. And immunotherapeutics such as rituximab, tocilizumab and eculizumab are increasingly used in recent years. This review summarizes the current status and the future strategies in treatment of NMOSD based on the progress of NMOSD pathogenesis.


Key words: 
Neuromyelitis optica; Immunotherapy; Aquaporin 4
阿尔茨海默病的诊断与治疗
Authors: 冯锋
Journal: BMJ (2006)

阿尔茨海默病(AD)是中枢神经系统一种常见的退行性疾病,临床上以记忆减退、认知障碍、人格改变为特征[1].据北京协和医院2000年对中国北京地区进行的AD流行病学调查初步结果统计,中国该病的患病率与西方国家接近,我国北方地区65岁及以上居民AD发病率为4.2%[2]。
Impact of lenalidomide-bortezomib-dexamethasone (RVd) induction on patients with newly diagnosed multiple myeloma and renal impairment: Results from the Connect MM Registry.
Authors: Sikander Ailawadhi, Hans Chulhee Lee, Jim Omel, Kathleen Toomey, James W. Hardin, Cristina Gasparetto, Sundar Jagannath, Robert M. Rifkin, Brian G. Durie, Mohit Narang, Howard R. Terebelo, Lynne I. Wagner, Mazaher Dhalla, Mia He, Shankar Srinivasan, Prashant Ramesh Joshi, Suzanne Robinson, Rafat Abonour
Journal: Journal of Clinical Oncology (2020)

8518 Background: Patients (pts) with newly diagnosed multiple myeloma (NDMM) and renal impairment (RI) are often excluded from clinical trials. Data are limited on the effects of induction treatment in these pts, who may also be ineligible for autologous stem cell transplant (SCT) due to severity of RI. This analysis investigated the impact of RVd induction on renal function in transplant eligible (TE) and noneligible (TNE) pts from the Connect MM Registry, a US, multicenter, prospective, observational study. Methods: Eligible pts were ≥ 18 y and had symptomatic MM diagnosed ≤ 2 mos prior to enrollment, as defined by the International Myeloma Working Group criteria. For this analysis, pts that received front-line RVd for ≥ 3 cycles were grouped per transplant eligibility and renal function at baseline (BL; creatinine clearance [CrCl] &lt; 30, 30-50, &gt; 50-80, and &gt; 80). Pts with progressive disease at BL were excluded. Renal function at 3 mos was measured. Median unadjusted progression-free survival (PFS) was calculated from start of regimen in TE and TNE populations, with pts grouped by CrCl (≤ 60 or &gt; 60) at BL. Results: As of 7/23/19, 421 TE and 212 TNE pts received RVd for ≥ 3 cycles. TE and TNE pts were grouped by BL CrCl of &lt; 30 (20 and 16 pts), 30-50 (36 and 50 pts), &gt; 50-80 (117 and 63 pts), and &gt; 80 (248 and 83 pts). Renal function improvement was observed in all pts receiving RVd, including those with moderate (30-50 CrCl) and severe (&lt; 30 CrCl) RI at BL (Table). In pts with &gt; 60 CrCl and ≤ 60 CrCl at BL, median PFS in TE pts was 48.6 mos and 43.2 mos, respectively. In TNE pts, median PFS was 36.4 mos and 30.6 mos, respectively. Conclusions: The results from the Connect MM Registry indicate that pts with NDMM and RI (including moderate and severe) who receive front-line RVd for ≥ 3 cycles may see improvement in renal function at 3 mos, regardless of transplant eligibility. RVd therefore can potentially be used in pts with RI. This analysis provides real-world data that support further investigation of RVd treatment in pts with moderate or severe RI. Clinical trial information: NCT01081028 . [Table: see text]
Blood clots and TAM receptor signalling in COVID-19 pathogenesis
Authors: Greg Lemke, Gregg J. Silverman
Journal: Nature reviews. Immunology (2020)

We suggest that the exuberant blood clotting and immune hyper-reaction seen in patients with COVID-19 may be exacerbated by depletion of the same regulator. This agent is protein S, which is both an anticoagulant in the blood coagulation cascade and an activating ligand for the immunosuppressive TAM family of receptor tyrosine kinases. In this Comment, Greg Lemke and Gregg Silverman propose that the excessive blood clotting and immune activation seen in severe COVID-19 may be mechanistically linked through protein S, a ligand for the immunosuppressive TAM receptor family.
Clinical significance of interventional therapy for patients with both renal and cerebral artery stenosis
Authors: 边小曦, 孙玉衡
Journal: BMJ (2005)

目的 探讨早期介入治疗对动脉粥样硬化性肾动脉狭窄合并脑动脉狭窄的疗效和临床意义.方法 40例经动脉造影确诊为脑动脉狭窄的患者同时进行肾动脉造影,对其中同时合并肾动脉狭窄和脑动脉狭窄者采取联合介入治疗,并对治疗前后的血压、血脂、尿蛋白、肾功能及用药情况进行比较和分析.结果 40例患者中12例为肾动脉狭窄合并脑动脉狭窄(30%).肾动脉病变血管18条(狭窄比例均≥50%),脑动脉病变血管21条(血管闭塞或狭窄比例≥50%者16条).对其中的13条肾动脉、14条脑动脉分别进行血管成形术或血管成形术+支架植入术.手术成功率(病变血管开通≥80%):肾动脉狭窄者92%,脑动脉狭窄者87%.6～12个月后血管开通率:肾动脉狭窄者85%,脑动脉狭窄者86%.追踪观察(25±6)个月,83%的患者血压降到140/90 mm Hg(1 mm Hg=0.133 kPa)以下,患者平均收缩压、舒张压均有不同程度下降;24 h尿蛋白定量下降,肌酐清除率上升.降压药由治疗前平均服用3.2种减少到1.3种.均P<0.01或0.05.结论 肾动脉狭窄合并脑动脉狭窄进行介入治疗对患者的预后有较大影响.大部分患者高血压可治愈,肾功能得到改善。
Acute Lymphoblastic Leukemia Cells Bypass the Blood Brain Barrier to Enter the CNS Via a Neuronal Developmental Pathway
Authors: Hisayuki Yao, Matthew Warner, Trevor Price, Lindsey Olivere, Gaia Cantelli, Sarah Ridge, Brandon Ngo, Surya Ravichandran, Stacey Tannheimer, Anjen Chenn, Dorothy A. Sipkins
Journal: Blood (2017)
Clinical features of 136 inpatients with acute kidney injury
Authors: Xiao-qing Guo, Qing-li Cheng, Chao Wang, Shu-ping Ye
Journal: BMJ (2009)

Clinical data of 136 inpatients with acute kidney injury (AKI) admitted to the hospital during September 2005 to September 2008 were analyzed. Seventy-eight of 136 cases ( 57.4% ) with AKI aged 65 years or over, and 69 (50.7%) with pre-renal injury, 49 (36.0%) with renal injury and 18 (13. 3% ) with post-renal injury, respectively. AKI occurred in 57 cases (41.9%) based on their chronic renal disease. Renal function recovered completely or improved in 111 (81.6%) cases after treatment. The elderly inpatients were tend to suffer from AKI, with the most common cause of pre-renal injury and drugs such as antibiotics and contrast medium used in X-ray imaging. Outcomes of the patients with AKI depends on severity of their kidney injury.

Key words: 
Renal failure
Abstract 18257: A Novel Portable Polyvinylidene Fluoride Based Sensor for Detection of Hemorrhage
Authors: Sardar Ansari, Daniel Slavin, Mohamad H Tiba, Harm Derksen, Kenn Oldham, Kevin Ward, Kayvan Najarian
Journal: Circulation (2015)

Introduction: Hemorrhage (Hem) is one of the leading causes of mortality from trauma, and continuous monitoring for Hem using techniques such as traditional BP, especially in field conditions, poses significant challenges. We have built a portable low-powered noninvasive sensor for continuous vascular tone monitoring to detect significant Hem as an alternative to BP monitoring. The sensor, made of polyvinylidene fluoride (PVDF) material, can sense and record changes in the mechanical properties of arteries due to peripheral vasoconstriction caused by Hem. Methods: Nine pigs underwent Hem by femoral artery bleeding. Systolic arterial pressure (SAP) was used to select 16 instances of significant hemorrhage (SAP&gt;85mmHg pre-Hem and &gt;10mmHg drop in SAP post-Hem). The PVDF signal was measured from the animal’s distal forelimb. A piecewise linear estimation of the PVDF signal was computed using a newly developed Taut String algorithm such that the error was &lt;4% of the signal amplitude. The number of pieces in each period was used as a complexity score (CS) to detect Hem. Results: Arterial BP and the CS derived from the PVDF signal for one subject (Fig), as well as snapshots from the PVDF signal demonstrating morphology changes are shown. Maximum separation between pre- and post-Hem CS was achieved by a threshold of 5.5; 14 instances (87.5%) transitioned from CS≥6 to 5 within 5 minutes of the onset of HS (t0) while the remaining 2 instances transitioned from CS=5 to 3. The average detection delay was 1.95±1.2 min. These changes corresponded to &gt;10mmHg decrease in SAP from baseline. CS improved during subsequent resuscitations. Conclusions: The proposed low-powered portable sensor captures continuous vascular tone and can be used to detect significant Hem in a continuous manner that may offer diagnostic and therapeutic guidance as an alternative to traditional intermittent BP measures. The results indicate that the derived CS can effectively separate the signals pre- and post-Hem.
循证医学在防止医疗纠纷中的作用
Authors: 余开焕, 张孝斌
Journal: BMJ (2004)

医疗纠纷是指医患双方对治疗、护理过程及其后果所产生的分歧,近年来医疗纠纷呈明显上升趋势.中华医院管理学会曾对全国326所医院进行了多项选择式的问卷调查,显示医疗纠纷发生率高达98.4%[1],并具有患者要求获得经济赔偿、扰乱医院工作秩序和打砸医院的特点.上述行为不仅对医院设施直接造成破坏,导致医务人员受伤,而且严重影响医院的声誉、生存和发展.而现代临床医学的缺陷是发生医疗纠纷的主要原因之一。
Gut microbiome to predict efficacy and immune-related toxicities in patients with advanced non-small cell lung cancer treated with anti-PD-1/PD-L1 antibody-based immunotherapy.
Authors: Taiki Hakozaki, Corentin Richard, Yusuke Okuma, Lisa Derosa, Arielle Elkrief, Laurence Zitvogel, Bertrand Routy, Yukio Hosomi
Journal: Journal of Clinical Oncology (2020)

3095 Background: The gut microbiome (GM) plays an important role in shaping systemic immune responses. Preclinical and clinical data suggest that GM influences anti-PD-1/PD-L1 or -CTLA-4 Antibody (Ab)-mediated anti-cancer responses. Furthermore, there is strong evidence that antibiotics (ATB) worsen clinical outcomes based on multiple retrospective and one prospective studies using immune checkpoint inhibitor (ICI). However, whether GM profiling, at baseline or post-ATB, could represent a biomarker of response in advanced non-small cell lung cancer (NSCLC) during ICI therapy remains unknown. Methods: We prospectively collected baseline (pre-ICI) fecal samples and clinical data Japanese patients (pts) with NSCLC treated with anti-PD-1/PD-L1 Abs in first or second-line therapy. We performed a 16S rRNA V3-V4 sequencing of gene amplicons of fecal microbes. Amplicon sequence variants were generated with dada2 R package. Diversity analysis was performed with phyloseq R. Differential abundance analysis was performed with both LEfSe and DESeq2 methods. Clinical endpoints were progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and immune-related adverse events (irAE). Results: 70 fecal samples were analyzed. Median OS and PFS in all patients were 16.1 and 5.2 months, respectively. 16 pts (23%) were exposed to ATB 1 month prior to ICI initiation. Pts on ATB had lower α-diversity at baseline and underrepresentation of Clostridiales and Ruminococcaceae UCG 13. When analyzing ATB-free pts, lower α-diversity was observed in non-responders. In addition, Ruminococcaceae UCG 13 was enriched in patients with OS &gt; 12 months, favorable ORR, and PFS &gt; 6 months. Clostridiales order was also enriched in patients with OS &gt; 12 months. Compositional GM differences were also observed between the patients who experienced clinically significant (≥grade 2) irAE; Lactobacillaceae and Raoultella were enriched in pts who had no significant irAE. Conclusions: We demonstrated the negative influence of ATB on GM composition and identified differential bacteria repertoire in pts experiencing favorable clinical outcomes or low grade irAE. Our data pave the way to the development of diagnosis tools aimed at identifying gut dysbiosis to predict resistance or irAE during ICI for NSCLC.
Prognostic impact of dose, duration, and timing of corticosteroid therapy in patients with large B-cell lymphoma treated with standard of care axicabtagene ciloleucel (Axi-cel).
Authors: Paolo Strati, fateeha furqan, Jason Westin, Luis Fayad, Sairah Ahmed, Hun Ju Lee, Swaminathan Padmanabhan Iyer, Ranjit Nair, Loretta J. Nastoupil, Simrit Parmar, Maria Alma Rodriguez, Felipe Samaniego, Raphael Steiner, Michael Wang, Chelsea Camille Pinnix, Christopher Flowers, Sandra B. Horowitz, Catherine Classen, Haleigh Mistry, Sattva Swarup Neelapu
Journal: Journal of Clinical Oncology (2020)

8011 Background: Corticosteroids are commonly used for management of severe toxicities associated with chimeric antigen receptor (CAR) T-cell therapy. However, it remains unclear whether the dose, duration, and timing of corticosteroid therapy may impact clinical efficacy of CAR T-cell therapy. Methods: This is a retrospective analysis of patients with relapsed or refractory LBCL treated with standard of care axi-cel at MD Anderson Cancer Center, Houston, Texas between 01/2018 and 05/2019 (data cut-off 12/21/2019). Progression-free survival (PFS) was defined as time from axi-cel infusion to progression/death or last follow-up, and the Breslow test was used for comparisons between subgroups. Results: One hundred patients with relapsed or refractory LBCL were included in the study, and 60 (60%) received corticosteroids for management of toxicities after axi-cel infusion. There was no significant difference in baseline tumor burden, disease stage or international prognostic index between the 2 groups. The median cumulative dexamethasone-equivalent dose was 186 mg (range, 8-1803 mg) and the median duration of corticosteroid treatment was 9 days (range 1-30); 45 (45%) patients started corticosteroid treatment between day 0 and 7, and 15 (15%) beyond day 7. After a median follow-up of 10 months (95% CI 8-10 months), median PFS was 8 months (95% CI, 3-13 months), and use of corticosteroids (any dose) showed a trend for association with shorter PFS (6 vs 9 months, p = 0.13). Use of high-dose corticosteroids (Quartiles (Q) 3-4, 195-1803 mg) significantly associated with shorter PFS (2 vs 9 months, p = 0.005). A trend for shorter PFS was observed among patients receiving corticosteroids for a prolonged time (Q3-Q4, 10-30 days) (5 vs 8 months, p = 0.12) and among patients starting corticosteroids within the first 7 days after axi-cel infusion (6 vs 11 months, p = 0.07). At most recent follow-up, 36 patients died, 28 of progression. Median overall survival has not been reached, and was significantly shorter among patients who received corticosteroids (13 vs not reached, p = 0.006). Conclusions: Early and prolonged use of high-dose corticosteroids is associated with early progression and death in patients with LBCL treated with axi-cel. Additional evaluation is needed to understand the mechanism underlying this association.
Health status and health service demand of residents in Beijing Xicheng District
Authors: Jian-gong Zhao
Journal: BMJ (2012)

A survey with self-designed questionnaire was conducted among (33 936)permanent residents aged over 15 years in Beijing Xicheng District,who were randomly selected using stratified multistage cluster sampling method.The items of survey included the prevalence of chronic diseases,behavioral risk factors and intention of visiting doctor.The results revealed that the prevalence of hypertension,diabetes,coronary heart disease,chronic arthropathy,dyslipidemia,chronic obstructive pulmonary disease (COPD) and stroke was 21.9％,8.0％,7.4％,5.8％,5.6％,3.2％ and 2.5％,respectively.Lacking physical exercise (49.3％) was the most frequent behavior risk factors of chronic diseases.The results also showed that 62.6％ residents chose large hospitals as first preference for seeking health care,only 23.7％ residents chose community health services institutions.The survey indicates that integrated intervention and management of chronic disease should be further enhanced in communitics; and the health insurance policy should be adapted to attract more residents to utilize community health service as primary care setting.

Key words: 
Community health services; Chronic disease