tbuckley/cabot-search huggingface dataset:
Rosuvastatin combined with silibinin capsule in treatment for hyperlipidemic patients with nonalcoholic fatty liver disease: a randomized double-blind controlled study
Authors: Binghua Liu, Fuqiang Dong, Yong Jiang, Lijuan Zhang
Journal: BMJ (2019)

Objective
To investigate the efficacy of rosuvastatin combined with silibinin capsule in treatment of hyperlipidemic patients with nonalcoholic fatty liver disease.


Methods
One hundred and nineteen hyperlipidemic patients with non-alcoholic fatty liver disease admitted in hospital from January 2016 to March 2017 were randomly assigned into two groups: 60 patients received rosuvastatin(10 mg, q.d) and silibinin capsules(70 mg, t.i.d., study group) and 59 patients received starch tablets(10 mg, q.d) and silibinin capsules(70 mg, t.i.d.,control group). The blood lipid, liver function, inflammatory factors, liver CT value, the specific CT value of liver and spleen were compared at baseline and 6 months after intervention.


Results
Compared to baseline values, the levels of total cholesterol (TC), triglyceride (TG), alanine aminotransferase (ALT),γ-glutamyltranspeptidase (GGT),TNF-α,IL-6,and CRP were decreased (t=2.44, 2.04, 2.48, 6.95, 2.38, 2.78, 3.97, all P<0.05); and the levels of HDL-C, liver CT value, liver/spleen CT value ratio were increased (t=5.44, 2.26, 2.08, all P<0.05) after treatment in study group.The improvement of TG,LDL-C, ALT,GGT,TNF-α,CRP,liver CT value,liver/spleen CT value ratio were more marked than those of the control group (P<0.05) (t=1.92, 2.65, 2.02, 5.62, 2.11, 2.20, 2.22, 2.08, all P<0.05). The effective rate of study group was higher than that of the control group[98.2%(55/56) vs. 85.7%(48/56), χ2=2.05, P=0.04]; the adverse reactions were similar in two groups.


Conclusion
Compared with silibinin alone, rosuvastatin combined with silibinin capsules is more effective in treatment of hyperlipidemic patients with nonalcoholic fatty liver disease,which can significantly improve the blood lipids,liver function, inflammatory response and aliphatic degree without increase of adverse reaction.


Key words: 
Hyperlipidemia; Nonalcoholic fatty liver disease; Treatment outcome
Notice of Retraction: Effectiveness of Surgical and Cotton Masks in Blocking SARS-CoV-2
Authors: Seongman Bae, Min-Chul Kim, Ji Yeun Kim, Hye-Hee Cha, Joon Seo Lim, Jiwon Jung, Min-Jae Kim, Dong Kyu Oh, Mi-Kyung Lee, Seong-Ho Choi, Minki Sung, Sang-Bum Hong, Jin-Won Chung, Sung-Han Kim
Journal: Annals of Internal Medicine (2020)

According to recommendations by the editors of Annals of Internal Medicine, we are retracting our article, "Effectiveness of Surgical and Cotton Masks in Blocking SARS-CoV-2.A Controlled Comparison in 4 Patients," which was published on Annals.org on 6 April 2020 (1).We had not fully recognized the concept of limit of detection (LOD) of the in-house reverse transcriptase polymerase chain reaction used in the study (2.63 log copies/mL), and we regret our failure to express the values below LOD as "<LOD (value)."The LOD is a statistical measure of the lowest quantity of the analyte that can be distinguished from the absence of that analyte.Therefore, values below the LOD are unreliable and our findings are uninterpretable.Reader comments raised this issue after publication.We proposed correcting the reported data with new experimental data from additional patients, but the editors requested retraction.
糖尿病前期的临床干预
Authors: 傅汉菁
Journal: BMJ (2009)

我国多次糖尿病流行病学调查数据表明,在2型糖尿病患病率逐年升高的同时,糖尿病前期的患病率也迅速上升,甚至已经超过2型糖尿病的患病率.面对如此庞大的轻度高血糖人群,应该如何进行临床处置?下面就糖尿病前期的定义、危害、临床干预意义、生活方式干预和药物干预方法做一简要介绍。
Predicting tumor mutational burden in head and neck squamous cell carcinoma based on CT imaging features: A TCGA/TCIA study.
Authors: Yangkun Luo, Lu Li, Gang Yin, Jin Yi Lang
Journal: Journal of Clinical Oncology (2020)

e15254 Background: Immunotherapy has substantially changed the therapeutic strategies for cancers. Unfortunately, only 20–50% of patients with advanced solid tumours respond to treatment. There is therefore a need for the development of methods to identify patients who are most likely to respond to immunotherapy. Tumor mutation burden (TMB) have been served as the most prevalent biomarkers to predict immunotherapy response. This study was designed to investigate the ability of radiomics to predict TMB status in patients with head and neck squamous cell carcinoma (HNSCC). Methods: TMB values were calculated using genomic data obtained from the HNSCC dataset in The Cancer Genome Atlas (TCGA).We identified matching patients (n = 100) who underwent contrast-enhanced CT scan prior to treatment from The Cancer Imaging Archive (TCIA),and patients were grouped based on the cutoff value; high group(&gt;4.2 mutations/Mb) and low group(≤4.2 mutations/Mb). A total of 249 radiomics features(9 non-texture features and 240 scan-texture-parameter features) were extracted from CT images of the tumor. The incorporation of features into multivariable models was performed using logistic regression. The multivariable modeling strategy involved imbalance-adjusted bootstrap resampling in the following four steps leading to final prediction model construction: (1) feature set reduction; (2) feature selection; (3) prediction performance estimation; and (4) computation of model coefficients. The performance was evaluated in terms of area under the curve (AUC), sensitivity, and specificity. Results: Among all the features, twenty features were found to have the most impact on the predictive value; the two top texture parameters were GLCM-Variance and GLCM-Sum Average. In multivariable analysis, the best performance was obtained using a combination of seven texture features that can discriminate between high mutation burden versus low mutation burden. The AUC, sensitivity, and specificity of this model were 0.97 ± 0.01, 0.92 ± 0.04, and 0.92 ±0.01, respectively. Conclusions: The proposed CT-derived predictive model can accurately predict TMB status in patients with HNSCC. It may be helpful in guiding immunotherapy in clinical practice and deserves further analysis.
Taking Gaming Disorder Treatment to the Next Level
Authors: Daniel L. King, Klaus Wölfling, Marc N. Potenza
Journal: JAMA Psychiatry (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Psychiatry HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Psychiatry journal
A prospective analysis of chemotherapy-induced nausea and vomiting in gastrointestinal cancers: Results from a tertiary cancer center.
Authors: Akhil Kapoor, Vikas S. Ostwal, Anant Ramaswamy, Prabhat Ghanshyam Bhargava, Sudeep Gupta, Kumar Prabhash
Journal: Journal of Clinical Oncology (2020)

12111 Background: Chemotherapy-induced nausea and vomiting (CINV) is a bothersome side-effect associated with cancer chemotherapy which adversely impacts both quality of life and the ability to carry out the activities of daily living. This study was conducted to assess the proportion of patients developing CINV after receiving chemotherapy for gastrointestinal (GI) cancers, in spite of receiving antiemetic prophylaxis as per the standard guidelines. Methods: Consecutive patients with GI malignancy who had not received previous chemotherapy were eligible for enrollment in the study if they were scheduled to receive at least one cycle of chemotherapy. SPSS version 20 was used for all statistical calculations. Results: 701 patients fulfilling the eligibility criteria were included in this study, out of which 55.4% were males, median age was 51 years (range 22-77). Biliary tract cancer (34%) was the most common diagnosis followed by colorectal (30.2%) and gastric cancer (19.6%). As per MASCC guidelines, 22.1% patients received highly emetogenic chemotherapy, 56.0% moderately emetogenic chemotherapy (MEC) while 19.9% received regimen with low emetogenicity. Failure to achieve complete response (CR, absence of acute and delayed CINV) was found in 27.4% patients. On separately analysing MEC group, overall CR was not achieved in 33.8% with failure in acute settings in 17.8% and delayed in 16.0% patients. Only significant factor for not achieving CR was use of oxaliplatin based chemotherapy (p = 0.018 for acute and p = 0.014 for delayed CINV). Conclusions: More than one fourth patients failed to achieve complete response for CINV in gastrointestinal cancers despite using prophylaxis as per standard guidelines. Use of oxaliplatin based therapy is an important factor for MEC causing CINV. There is urgent need to update the guidelines for prophylaxis in this setting. [Table: see text]
First-in-human dose-escalation study of anti-EGFR ADC MRG003 in patients with relapsed/refractory solid tumors.
Authors: Rui-hua Xu, Miao-Zhen Qiu, Yang Zhang, Xiao-Li Wei, Chaohong Hu
Journal: Journal of Clinical Oncology (2020)

3550 Background: MRG003 is a novel antibody drug conjugate (ADC) composed of a fully human anti-EGFR IgG1 monoclonal antibody conjugated to a microtubule disrupting agent monomethyl auristatin E (MMAE). MRG003 is presently being tested in an ongoing phase I study for safety, pharmacokinetics, and preliminary antitumor activity in patients (pts) with solid tumors (CTR20180310). Methods: In the phase I dose escalation study of a traditional (3+3) design, pts with relapsed or refractory cancers received single agent MRG003 once every 3 weeks (Q3W) for a maximum of 8 treatment cycles. The starting dose of MRG003 is 0.1 mg/kg, followed by 0.3, 0.6, 1.0, 1.5, 2.0, 2.5, and 3.0 mg/kg. Observations included adverse events (AEs), dose-limiting toxicity (DLT), and antitumor activity which is assessed every two cycles. Results: A total of twenty-two pts with colorectal (CRC, n = 15), nasopharyngeal (NPC, n = 3), head and neck (H&amp;N, n = 2), esophageal (EC, n = 1), and duodenal (DC, n = 1) cancer were enrolled in the dose escalation. The median age of pts was 56.5 years. The MTD identified was 2.5 mg/kg. Commonly observed adverse events were anemia (50%), AST increase (41%), decreased appetite (41%), rash (36%), pruritus (36%), asthenia (36%), and proteinuria (32%). Majority of AEs were mild to moderate in severity. EGFR expression in patients’ tumor samples was determined retrospectively by a validated IHC method in a central laboratory. Nine out of 22 pts tested were EGFR positive. Among these 9 EGFR positive pts, one with NPC in the 2.5 mg/kg cohort had partial response, four had stable disease (one with H&amp;N in the 1.5 mg/kg, one each with NPC and H&amp;N in the 2.0 mg/kg, and one with EC in the 2.5 mg/kg cohorts). The disease control rate (DCR) at doses ≥1.5 mg/kg was 100% for the EGFR positive pts. Conclusions: The dose escalation study of MRG003 showed manageable safety profiles and encouraging preliminary antitumor activity in pts with EGFR-positive solid tumors. MRG003 is currently being evaluated as a single agent in phase I dose expansion cohorts to further assess safety, PK, and antitumor activity. Clinical trial information: CTR20180310 .
Baseline and early change of systemic inflammation index (bSII and ΔSII) as prognostic factors in metastatic renal cell carcinoma (mRCC) patients treated with Nivolumab: Final results of the Meet-URO 15 (I-BIO-REC) study.
Authors: Sara Elena Rebuzzi, Francesco Atzori, Marilena Di Napoli, Marco Stellato, Marco Messina, Silvia Chiellino, Francesca Vignani, Alessia Cavo, Hector J. Soto Parra, Giandomenico Roviello, Veronica Prati, Davide Bimbatti, Ugo De Giorgi, Melissa Bersanelli, Federico Paolieri, Paolo Andrea Zucali, Emanuela Fantinel, Giuseppe Procopio, Alessio Signori, Giuseppe Fornarini
Journal: Journal of Clinical Oncology (2020)

5072 Background: Biomarkers to select mRCC patients most likely to benefit to immunotherapy are still needed. The retrospective multicentre Meet-URO-15 study evaluated the prognostic role of peripheral blood cells in mRCC patients treated with Nivolumab. Methods: Complete blood count was collected at the first four cycles of Nivolumab. The primary endpoint was median overall survival (mOS) according to baseline neutrophil-to-lymphocyte ratio. Secondary analyses included bSII defined as platelet x NLR (cutoff = 1375) and ΔSII defined as the difference between SII at 2 nd cycle and bSII (median used as cutoff = 383). Results: From October 2015 to October 2019, 470 patients started Nivolumab as 2 nd (67%), 3 rd (22%) and &gt; 3 rd (11%) line. Median age was 66 years, 71% were male and 83% had clear cell histology. Baseline IMDC group was favorable in 25%, intermediate in 63% and poor in 12%. Lymph-nodes, visceral and bone metastases were present in 54%, 91% and 36%. mOS and progression-free survival (PFS) were 34.8 and 7.5 months. Overall response rate (ORR) and disease control rate (DCR) were 30% and 61%. SII was available in 404 patients: SII &lt; 1375 (82%) correlated with statistically significant improvement of PFS [10.2 vs 4.1 months, HR 2.06 (1.54-2.76), p&lt; 0.001], OS [46.2 vs 9.5 months, HR 3.16 (2.23-4.49), p&lt; 0.001], ORR (35% vs 21%, p= 0.035) and DCR (67% vs 40%, p&lt; 0.001). ΔSII was available in 360 patients: ΔSII &lt; 383 (75%) correlated with statistically significant improvement of PFS [11.3 vs 4.7 months; HR 1.64 (1.23-2.18), p= 0.001] and OS [NR vs 21.1 months; HR 1.76 (1.21-2.56), p= 0.003], ORR (37% vs 24%, p= 0.023) and DCR (68% vs 53%, p= 0.01). Multivariate analyses adjusted for IMDC group, line of therapy and metastatic sites, confirmed the statistically significant correlation of bSII and ΔSII with OS, PFS and DCR. Conclusions: Our study showed the statistically significant correlation of lower bSII and early ΔSII with longer OS, PFS and higher DCR in mRCC patients treated with Nivolumab.
Progresses in diagnosis and local treatment of diabetic foot infection
Authors: Hu Yanhong, Shen Shiqin, Xiang Qin, Li Xia
Journal: BMJ (2016)

Diabetic foot infection may hamper wound healing and lead to non-traumatic amputation in diabetes patients and early diagnosis and proper treatment can improve prognosis. In this review, the progress in classification, influencing factors, diagnostic methods and local treatment of diabetic foot infection is introduced.


Key words: 
Diabetic foot; Infection
Druggable fusion gene landscape in solid tumors.
Authors: Gareth Haydn Williams, Robert Paul Thatcher, Borja Nevado Polo, Tiffany Eira Haddow, Keeda-Marie Hardisty, Marco Loddo
Journal: Journal of Clinical Oncology (2020)

e13517 Background: Kinases activated by gene fusions represent an important class of oncogenes in solid tumors highlighted by the unique site agnostic FDA approval of larotrectinib for NTRK gene rearrangements. However, the frequency and types of druggable fusions in solid tumors are not well characterized from the clinical perspective. Methods: Oncofocus is a clinically validated precision oncology platform that includes analysis of 399 druggable driver-partner oncogenic fusion genes linked to 140 unique targeted therapy protocols. A retrospective analysis of Oncofocus trending data in a real-life cohort of 1111 patients has been used to determine the actionable fusion gene landscape in solid tumors. Results: Eighty nine actionable fusion genes were identified in 1111 samples of solid tumors linked to 73 targeted therapy protocols. Seven of the samples harbored multiple fusion genes. Eighty two of the 1111 samples tested had at least one actionable fusion gene representing a frequency of 7.38%. The highest frequency of actionable fusions were observed in glioblastoma (23%), head and neck (12%), kidney (11%) and prostate (10%) cancers. Four of the seven samples with multiple actionable fusions were found in glioblastoma. Pancreatic, lung and endometrial cancers and cancer of unknown primary (CUPs) had an actionable fusion gene frequency ranging from 7-9%. TBL1XR1-PIK3CA, MET-MET, WHSC1L1-FGFR1 and EGFR VIII fusions were identified as the most common druggable fusions. All actionable fusion genes were found to interact with one or more of the following pathways RAS/RAF/MEK/ERK, PI3K/AKT/MTOR, PLCy/PKC and JAK/STAT. Although a targeted agent for TRK fusions now has FDA approval, this rearrangement appears to be a rare event. In contrast, inhibitors targeting the TBL1XR1-PIK3CA, MET-MET, WHSC1L1-FGFR1 fusions and linked downstream signalling pathways appear to offer much broader clinical utility. Conclusions: Druggable fusions were identified at an unexpectedly high frequency and should therefore be included as part of routine comprehensive precision oncology testing. Notably, many of the actionable fusions are not tumor type specific reinforcing the “site agnostic” approach to profiling and supporting the concept of “molecular basket” clinical trials. Precision oncology trending data also provides actionable mutational landscapes which can be used to refine precision oncology testing, patient selection for targeted therapy protocols and enhancement of clinical trial design.
Clinical efficacy of magnesium isoglycyrrhizinate injection in protecting liver function for patients on chemotherapy with 5-fluorouracil
Authors: Chun-shan Han, Lu Gao
Journal: BMJ (2013)

A total of 116 hospitalized patients between May 2006 and March 2012 were divided into observation (n=39), treatment control (n=41) and blank control group (n=36). All groups received standard doses of chemotherapy with 5-fluorouracil. Patients in observation group received a daily intravenous infusion of 100 mg magnesium isoglycyrrhizinate plus chemotherapy while those in the treatment control group a daily 1.2 g reduced glutathione intravenous infusion plus chemotherapy. And the blank control group accepted chemotherapy alone. The parameters of liver function, including aspartate aminotransferase, alkaline phosphatase, gamma glutamyl transferase, lactate dehydrogenase, total bilirubin and albumin, were recorded and compared at Week 1. No significantly difference in the above parameters was found in observation group (P>0.05). However, in treatment control and blank control groups, significant statistical differences existed in some of the parameters (P<0.05). Magnesium Isoglycyrrhizinate is an efficient protector of liver function for patients on chemotherapy with 5-fluorouracil.


Key words: 
Glycyrrhizic acid; Antineoplastic combined chemotherapy protocols
Survival of subjects with recurrent glioblastoma receiving intratumoral administration of controlled IL-12 with limited exposure to dexamethasone.
Authors: Rimas Vincas Lukas, Sylvia Christine Kurz, John Yu, Joseph C. Landolfi, Ganesh Rao, Christina Amidei, Jill Yannetti Buck, Nira Hadar, Taylor Estupinan, John Miao, John W. Loewy, Yunxia Wang, Nathan A. Demars, Arnold Bruce Gelb, Laurence JN Cooper
Journal: Journal of Clinical Oncology (2020)

2564 Background: Interleukin-12 (IL-12) results in anti-tumor responses in preclinical models but requires tightly controlled production to achieve safety and elicit immune system activation to realize efficacy. A phase 1 “main study” (NCT02026271) enrolled subjects with Grade III or IV gliomas who at the time of resection received intratumoral administration of a replication-deficient adenovirus expressing IL-12 under control of a transcriptional switch (Ad-RTS-hIL-12, Ad) regulated by veledimex (V), referred to as “Controlled IL-12”. It was anticipated that dexamethasone (dex), a lymphocytotoxic corticosteroid used to control edema, might diminish response to immunotherapies. We report updated findings from a substudy of subjects who were dex-free during the 4 weeks prior to Ad administration. Methods: Multicenter, phase 1 substudy (NCT03679754) that assesses safety and tolerability of Controlled IL-12 by local injection (Day 0, time of resection) of Ad (2 x 10 11 viral particles) + V (20 mg PO QD x15 doses, Days 0-14) in subjects that were bevacizumab naïve and not receiving dex 4 weeks prior to Ad. Results: 36 subjects were treated. Of the 36, a majority received low-dose corticosteroids (≤ 20 mg dex total during V) as compared with the main study (75% vs 40%). More subjects in the substudy as compared with the main study had multifocal vs. unifocal disease (39% vs 7%). The safety profile was similar for both. Adverse reactions were mild to moderate and were manageable and reversable upon withholding V. Activation of the switch in both the main study and substudy (V 20 mg; n = 51) resulted in increased mean peak values (Day 0-28) of serum IL-12 (25.8 vs. 20.4 pg/mL) and IFN-g (57.0 vs. 39.5 pg/mL). Initial median overall survival (mOS) (unifocal, ≤ 20 mg dex cumulative, n = 20) was 16.2 (8.9, 18.5) mons (mean follow-up 12.3 mons) (Neuro Oncol 2019; 21 [suppl_6]:vi5). mOS including the impact of dex and key subject characteristics from the two studies (n = 51) will be updated and tumor response data will be provided. Conclusions: Monotherapy with Controlled IL-12 resulted in sustained increase in serum recombinant IL-12 and downstream endogenous IFN-g. There is evidence of immune-mediated anti-tumor effects which is associated with increased mOS as compared with historical controls. Follow up will investigate the adverse impact of dex, as well as the effect of additional subject characteristics ( e.g., unifocal vs. multifocal disease) on mOS. Clinical trial information: NCT03679754 .
系统性红斑狼疮伴发新型隐球菌性脑膜炎一例
Authors: 施若非, 李霞, 郑捷
Journal: BMJ (2005)

患者女,25岁.2001年3月起关节酸痛、口腔溃疡、日晒后面部红斑.11月出现高热(40℃), 红细胞沉降率(ESR)130 mm/1h;抗核抗体 1∶ 640;Sm抗体、核糖核蛋白抗体阳性;红细胞2.93×1012 /L;尿蛋白(+),于外院诊断为系统性红斑狼疮(SLE).依次予甲强龙120 mg/d×15 d、100 mg/d ×10 d、80 mg/d×10 d静脉滴注.此时患者又出现高热(39～40℃)、头晕、头痛,诊断为狼疮性脑病,予环磷酰胺0.4 g静脉滴注1次,高热仍不退.12月底转入我院,入院时高热头晕、头痛伴呕吐(非喷射性).无喂养鸽子、食烂水果史.入院检查:体温39℃,心率100次/min,血压135/100 mm Hg(1 mm Hg=0.133 kPa),心、肺无异常,肝、脾无肿大,双下肢无浮肿,神经系统阴性.面颊淡红斑,甲周见淡红斑.实验室检查:白细胞13.2×109 /L,中性粒细胞92%,红细胞3.4×1012 /L, ESR 93 mm/1h;C-反应蛋白1.2 mg/L,血糖、肝肾功能、电解质正常;尿蛋白定量正常;抗核抗体1∶ 40、核糖核蛋白抗体阳性;抗双链DNA抗体7.4 IU/L;免疫球蛋白正常,补体C3 0.712 mg/ml、C4 0.112 mg/ml.胸片示纵隔多枚淋巴结肿大。