tbuckley/cabot-search huggingface dataset:
The role of peer support in psychosocial outcomes among adolescent and young adult (AYA) cancer survivors.
Authors: Motohiro Matsui, Kanako Taku, Rina Tsutsumi, Midori Ueno, Mayuri Seto, Atsushi Makimoto, Yuki Yuza
Journal: Journal of Clinical Oncology (2020)

e22528 Background: Adolescents and young adults (AYA) who experienced cancer treatment sometimes show posttraumatic stress symptoms (PTSS) and yet report positive psychological changes, known as posttraumatic growth (PTG). Literature suggests PTSS and PTG are not on opposite ends of a single spectrum but rather coexist. It is expected to have distinct relationships with social support, and yet, the roles of peer support remain unknown. This study examines PTG and PTSS, and their correlates with peer support among AYA cancer survivors. Methods: A cross-sectional study was conducted using a questionnaire survey with AYA cancer survivors. A total of 212 AYA survivors were recruited from 11 cancer centers and 12 cancer patients’ communities. They completed a self-report measure of the PTG Inventory and the Impact of Event Scale revised (IES-R) to assess PTSS. Diagnosis, treatment, peer support (i.e., affiliation to AYA patients’ community and friendship with other AYA cancer patients), and social status information was also collected from questionnaires. A series of multiple regression analyses was used to identify significant correlates among peer support, PTG and PTSS. Results: PTG and PTSS were not significantly correlated with each other, being consistent with the previous studies. PTG was positively associated with male gender, years since diagnosis, good communication with others, and friendship with other AYA cancer patients. Friendship with other AYA cancer patients was positively associated with not just the overall PTG but all five domains of PTG. PTSS was associated with years since diagnosis, unemployed status, and symptom of late effects. PTSS was, however, unlike PTG, not related with friendship with other AYA cancer patients or affiliation to AYA patients’ community. Conclusions: Good communication and friendship with other AYA cancer patients is suggested to play an important role in PTG but not PTSS. Psychosocial intervention to facilitate peer support among AYA cancer patients would possibly contribute to revive their lives through PTG. Future studies should further investigate what factors would contribute to alleviation of PTSS and foster PTG. Clinical trial information: UMIN000035439.
Drug reservation of community residents in Shanghai
Authors: Zhen Li, Zong-jun Fang, Ming-jian Ge, Jian Xu, Rong Yang, Mei Yang, Han-yan Shi
Journal: BMJ (2008)

Drug reservation wag investigated in 2077 community residents.We found that most drugs were obtained from the hospitals(83.78%),kept at a relatively lower place(69.23%),packed in box(75.25%),and did not meet the storage requirement(72.60%).Half of the overdue drugs(median time,12 months)were used for internal treatment.This study suggests that there might be unsafe drug storage in communities.

Key words: 
Community health services; Health care surveys
Expression and significance of interleukin-25 level in airway inflammation of asthmatics
Authors: Hong-jia Li, Fen Liu, De-gan Lu, Ying-hua Song, Chao Wang
Journal: BMJ (2013)

A total of 59 untreated asthmatics and 47 healthy control subjects were recruited from Qianfoshan Hospital of Shandong Province from May 2011 to April 2012. Compared with healthy control subjects, the levels of IL-25 in induced sputum and eosinophils, IgE, interleukin-4 (IL-4) and interleukin-25 (IL-25) in serum samples of asthmatics were significantly higher while the level of interferon-gamma (IFN-γ) were much lower. However, after inhaled glucocorticoid treatment, the levels of eosinophils, IL-4 and IL-25 decreased and IFN-γ significantly increased, while the level of IgE showed no significant changes. It was also found the expression of IL-25 was markedly positively correlated with the levels of eosinophils and IL-4 in serum and markedly negatively correlated with the levels of IFN-γ and had no relatio.


Key words: 
Asthma; Interleukin-25
EGFR gene mutation is not a significant prognostic factor in patients with EGFR mutated non-small cell lung cancer who receive best supportive care alone.
Authors: Takeshi Masuda, Yu Wakabayashi, Kiyofumi Shimoji, Kakuhiro Yamaguchi, Shinjiro Sakamoto, Yoshihumi Nishimura, Yasushi Horimasu, Taku Nakashima, Shintaro Miyamoto, Tadashi Senoo, Hiroshi Iwamoto, Hiroshi Iwamoto, Shinichiro Ohshimo, Kazunori Fujitaka, Hironobu Hamada, Noboru Hattori
Journal: Journal of Clinical Oncology (2020)

e21736 Background: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), are less toxic than conventional chemotherapy drugs, and benefit patients with EGFR-mutated non-small cell lung (NSCLC) cancer. However, there are a few patients who are not able to receive EGFR-TKI due to poor performance status, older age, or sever comorbidities. Here, we aimed to determine the prognostic significance of EGFR mutation in NSCLC patients who received best supportive care (BSC) alone, and compare the anti-tumor outcomes of only EGFR-TKI-treated patients vs. BSC patients. Methods: We retrospectively reviewed the medical records of patients diagnosed with NSCLC at Higashihiroshima Medical Center during April 1991–January 2019 and Hiroshima University Hospital during April 2008–August 2018. Results: A total of 1163 patients diagnosed with unresectable NSCLC were included in this analysis. Of these 1163 patients, 234 patients received BSC alone.Among 196 patients who underwent EGFR mutation analysis, 38 and 158 did and did not harbor an EGFR mutation, respectively, and the mean survival times (MST) did not differ significantly between these groups (121 vs. 85 days, p = 0.789). Consistent with the survival analysis, the multivariate Cox regression analyses showed EGFR mutation was not an independent prognostic factor. After propensity score matching, a comparison of only EGFR-TKI-treated (n = 35) and BSC patients (n = 35) with EGFR mutation revealed that the former had a significantly longer MST than the latter (372 vs. 121, p &lt; 0.001). Conclusions: EGFR mutation itself was not a significant prognostic factor in untreated NSCLC patients. The patients who received EGFR-TKI had a significantly longer MST than their untreated counterparts. Our results may help to explain the benefit of EGFR-TKI, particularly for patients who would be directed towards treatment with BSC.
IMvigor010: Primary analysis from a phase III randomized study of adjuvant atezolizumab (atezo) versus observation (obs) in high-risk muscle-invasive urothelial carcinoma (MIUC).
Authors: Maha H. A. Hussain, Thomas Powles, Peter Albers, Daniel Castellano, Siamak Daneshmand, Juergen Gschwend, Hiroyuki Nishiyama, Stephane Oudard, Darren Tayama, Nicole N. Davarpanah, Viraj Degaonkar, Yi Shi, Sanjeev Mariathasan, Petros Grivas, Peter H. O'Donnell, Jonathan E. Rosenberg, Daniel M. Geynisman, Jean H. Hoffman-Censits, Daniel Peter Petrylak, Joaquim Bellmunt
Journal: Journal of Clinical Oncology (2020)

5000 Background: Radical surgery ± cisplatin-based neoadjuvant chemo (NAC) is the mainstay treatment (tx) for MIUC, with no conclusive level 1 evidence for adjuvant chemo (AC). Here we present the primary analysis from IMvigor010, a global, open-label, multicenter, randomized trial of adjuvant atezo (anti–PD-L1; approved in metastatic UC [mUC] settings) in pts with MIUC at high risk of recurrence following primary resection. Methods: Pts with MIUC (bladder, upper tract [UT]), ECOG PS 0-2 and resected tissue for PD-L1 testing on immune cells (IC; VENTANA SP142 assay) were enrolled ≤ 14 wks after radical cystectomy/nephroureterectomy with lymph node (LN) dissection. Pathologic stage: 1) ypT2-4a or ypN+ if pts had NAC or 2) pT3-4a or pN+ if pts did not have NAC. No postsurgical radiation or AC was allowed; if no NAC was given, pts must have been ineligible for or declined cisplatin-based AC. Pts were randomized 1:1 to atezo 1200 mg IV q3w or obs for 16 cycles or 1 y (stratification factors: no. of LNs resected, pathologic nodal status, pathologic tumor stage, PD-L1 status, prior NAC). Disease-free survival (DFS) was the primary endpoint (EP). Final DFS, first interim overall survival (OS; secondary EP) and safety are reported. Results: The ITT population included 809 pts (median follow-up, 21.9 mo). In the atezo and obs arms, respectively, 48% and 47% had NAC; 7% and 6% had UTUC as primary disease; 48% each had LN+ disease. DFS and OS are in Table. Baseline prognostic/clinical factors did not influence DFS tx benefit; stratified HR was 0.81 (95% CI: 0.63, 1.05) in IC0/1 pts (PD-L1 &lt; 5%; n = 417) and 1.01 (0.75, 1.35) in IC2/3 pts (PD-L1 ≥ 5%; n = 392). 16% of atezo-treated pts had a tx-related G3-4 AE. Skin and gastrointestinal toxicities most commonly led to tx discontinuation. Conclusions: IMvigor010, the first phase 3 adjuvant study of a checkpoint inhibitor in MIUC, did not meet its primary EP of DFS. More tx discontinuation due to AEs was seen vs mUC studies. Safety was generally consistent with previous studies. Clinical trial information: NCT02450331 . [Table: see text]
TOOme: A novel computational framework to infer cancer tissue-of-origin by integrating both gene mutation and expression.
Authors: Wei Gao, Jianwei Yang, Changhua Zhuo, Jialiang Yang, Sha Huang, Geng Tian, Jinyuan Lin
Journal: Journal of Clinical Oncology (2020)

3591 Background: Metastatic cancers require further diagnosis to determine their primary tumor sites. However, the tissue-of-origin for around 5% tumors could not be identified by routine medical diagnosis according. With the development of machine learning techniques and the accumulation of big cancer data from TCGA and GEO, it is now feasible to predict cancer tissue-of-origin by computational tools. Methods: Developed a computational framework to infer tumor tissue-o. Results: Applied TOOme to the TCGA data containing 7,008 non-metastatic samples across 20 solid tumors including BLCA, BRCA, CESC, COAD, GBM and so on. 74 genes by gene expression profile and 6 genes by gene mutation are selected by the random forest process, which can be divided into two categories: (1) cancer type specific genes, which are highly expressed or mutated only in one specific cancer and (2) those expressed or mutated in several cancers with different levels of expression or mutation rates. Function analysis indicates that the selected genes are significantly enriched in gland development, urogenital system development, hormone metabolic process, thyroid hormone generation prostate hormone generation and so on. According to the multiple-label classification method, random forest performs the best with a 10-fold cross-validation prediction accuracy of 96%. We also use the 19 metastatic samples from TCGA and 256 cancer samples downloaded from GEO as independent testing data, for which TOOme achieves a prediction accuracy of 89%. The cross-validation validation accuracy is better than those using gene expression (i.e., 95%) and gene mutation (83%) alone. Conclusions: TOOme provides a quick yet accurate alternative to traditional medical methods in inferring cancer tissue-of-origin. In addition, the methods combining somatic mutation and gene expressions outperform those using gene expression or mutation alone.
Clinical features and prognosis of lyme diseases apropos of 21 cases
Authors: Xiao-qing Li, Xiao-qing Liu, Guo-hua Deng, Zhi-feng Qiu
Journal: BMJ (2009)

We collected the clinical information of 21 in-patients diagnosed as Lyme disease in Peking Union College Univemity Hospital from Apr. 1994 to Jan. 2008. The clinical manifestations, laboratory tests, therapy and prognosis were analyzed retrospectively. 16 of 21 (76%) patients had fever, 14 of 21 (67%) eases had skin lesion, 17 patients had nervous symptoms, 10 cases showed arthrosis and only 2 of 21 eases involved in heart. The antibiotics of penieilin,ceftriaxone and doxyeycline were used for therapy. All of the 21 patients improved clinically and discharged. 12 cases were followed up for 1 month to 12 years and 2 of them relapsed, both of whom were in Stage Ⅲ. 8 cases remained persistent symptoms. As the manifestations of Lyme disease are complicated, for clinical borderline cases the prompt detection of etiological agent may be useful for early diagnosis. The antibiotic therapy should begin as early as possible to avoid developing chronic Lyme disease.

Key words: 
Lyme disease;  Disease attributes
Characteristics of impaired glucose tolerance patients with different outcomes after one-year of lifestyle intervention in first degree relatives of type 2 diabetes
Authors: Chun-yan Shan, Ju-hong Yang, Li-ming Chen, Hui-zhu Ren, Bao-cheng Chang, Miao-yan Zheng, Ying Wang
Journal: BMJ (2013)

To evaluate the characteristics of impaired glucose tolerance (IGT) patients with different outcomes after one-year lifestyle intervention. A total of 160 IGT patients in first degree relatives of type 2 diabetes mellitus (T2DM) completed the study. Among them, 56 (35.0%) converted into normal glucose tolerance (NGT), 44(27.5%) progressed to T2DM and 60(37.5%) stood still. Baseline BMI, homeostasis model assessment of insulin resistance (HOMA-IR) and fasting serum insulin were not different among three groups. However, basal Δ'I30/ΔG30 was greater in NGT group than IGT and T2DM groups. And hemoglobin A1c was greater in T2DM group than NGT and IGT groups. T2DM patients had a largest area of insulin under curve, but a lowest level of tumor necrosis factor-α. Therefore IGT patients with different outcomes after one-year intervention have different characteristics.


Key words: 
Glucose metabolism disorders; Health behavior
泪点内毛发异物一例
Authors: 孔鲁英
Journal: BMJ (2008)

患者女,38岁,因右眼痛伴流泪2 d就诊.自述2 d前去理发店理发洗头时不慎洗发液溅入眼内,当时双眼疼痛、流泪,立即用清水冲洗后疼痛缓解,但仍有眼睛不适、流泪.理发后左眼不适、流泪症状逐渐消失,右眼加重,仍感觉有洗发液未清洗出。
Neutrophil-lymphocyte ratio as a prognostic factor for carcinoma of ampulla of Vatar
Authors: Jianjun Zhao, Xinyu Bi, Jianguo Zhou
Journal: BMJ (2014)

The clinical data of 147 patients with carcinoma of ampulla of Vatar at our hospital from January 1998 to December 2012 were retrospectively analyzed. The neutrophil-to-lymphocyte ratio (NLR) was calculated from pre-operative complete blood count. They were divided into low NLR group (NLR<5, n=121) and high NLR group (NLR≥5, n=26). The 5-year survival rates of two groups were compared and the prognostic risk factors examined by univariate analysis and Cox model. The 5-year free survival rates of low and high NLR groups were 57.9% and 27.6% respectively (P=0.005). Univariate analysis revealed that depth of invasion (P=0.006), pancreatic invasion (P=0.002), lymph nodal metastasis (P=0.008), poor differentiation (P=0.008), tumor stage (P=0.003) and per-operative NLR (P=0.005) were significant prognostic factors. Multivariate analysis showed that per-operative NLR significantly increased the risk of recurrence (P<0.05). Pre-operative NLR represents a significant independent prognostic indicator for patients with carcinoma of ampulla of Vatar.


Key words: 
Ampullary carcinoma; Prognosis
复兴医院与月坛社区卫生服务中心的双向转诊模式介绍
Authors: 严春泽, 杜雪平
Journal: BMJ (2012)

复兴社区卫生服务模式是以三级医院为依托,以社区卫生服务中心为主体,以社区卫生服务站为基础的三级管理模式.医院专门制定了双向转诊的指征、方法以及医务人员交流模式,保证了转诊渠道畅通便捷及医疗资源的合理利用。
Adoption patterns of an electronic patient-reported outcomes tool in oncology.
Authors: Fernanda CG Polubriaginof, Priti K Parekh, Naga Ravi Shankar Akella, Peter D. Stetson
Journal: Journal of Clinical Oncology (2020)

e19127 Background: Patient-reported outcomes (PROs) are critical for the delivery of patient-centric care. Previous research has shown that the use of PROs can impact clinical outcomes in Oncology. Despite these benefits, PROs have not been widely implemented as part of standard of care. Significant barriers exist for its adoption including lack of integration between PRO tools and electronic health record systems (EHRs). We developed MSK Engage, a home-grown PRO tool integrated with the EHR and embedded within MSK's patient portal (MyMSK). It was launched in late 2015 and it is currently used enterprise-wide for both standard of care and research purposes. The purpose of this study was to describe the usage patterns of PROs in a real-world setting. Methods: We conducted a retrospective analysis of patients that have been assigned at least one MSK Engage survey instrument between 2015 and 2019. Patient demographic information was extracted from the EHR system. Usage patterns including the number of survey instruments assigned and completed were extracted from MSK Engage. Survey completion rates were stratified by patient demographic information and number of assigned surveys. We performed univariate and multivariate analyses to identify factors associated with survey completion rates. Results: During the study period, 57 survey instruments were implemented, with the majority being used for standard of care (41 for standard of care only, 9 for research protocols, 6 for standard of care and research, and one for a quality improvement initiative). In total, 246,638 patients were assigned 557,559 surveys. Of those, 146,505 patients completed a total of 265,174 surveys, with a median completion time of 3 minutes. Among the patients that were assigned a survey, 73.7% were women. Women in our sample were older than men, with median age 52 and 47 years old, respectively. Men were more likely to complete the assigned surveys with 61.2% completion rate among men and 43.3% among women (p &lt; 0.001). On multivariate analysis, men were less likely to miss surveys than women (odds ratio [OR], 0.49; 95% CI, 0.48-0.49). We also identified a significant correlation between the survey completion rate and number of assigned surveys, demonstrating that assigning a large number of surveys for each patient can lead to a reduced survey response. Conclusions: Providers have quickly adopted MSK Engage demonstrating that it is feasible to incorporate PROs as part of standard of care. Patients are willing to answer PROs; however, it is important to mindful when assigning surveys to avoid negative effects of survey burden.
Disparities in cancer premature mortality in Brazil: Predictions up to 2030 and sustainable development goals.
Authors: Marianna De Camargo Cancela, Leonardo Borges Lopes de Souza, Luis Felipe Leite Martins, Arthur Correa Schilithz, Dyego Souza, Paul Hanly, Anton Barchuk, Isabelle Soerjomataram, Linda Sharp, Alison Pearce
Journal: Journal of Clinical Oncology (2020)

e13614 Background: Premature mortality affects the economy directly due to the loss of productivity of individuals who decease, thus ceasing to contribute economically to the country. The 1/3 reduction in premature mortality (30-69 years) from chronic noncommunicable diseases is goal 3.4 of the UN Sustainable Development Goals (SDG). Although cancer is a chronic disease, it comprises more than 100 different conditions, with different risk factors and prognosis. This study aimed to calculate current and predicted premature mortality by 2030 for Brazil and regions, compare with SDG 3.4 target and identify regional progress and future needs. Methods: Mortality data were extracted from the National Mortality Information System of Brazil (SIM) and subsequently corrected for ill-defined causes. Crude and age-standardized mortality rates per 100,000 inhabitants were calculated. NordPred package by software R was used to calculate predictions up to 2030 and compared with the goal of 1/3 reduction of premature deaths. Results: Comparison of observed (2011-2015) and predicted (2016-2030) mortality rates show a 12.0% reduction in the likelihood of death among men and 4.6% among women nationally. Although predicted rates for 2026-2030 are lower than those observed in 2011-2015 predicted number of deaths increases by 75,341 for men and 90,513 for women. Lung cancer mortality rates are predicted to decrease more among men than women, while colorectal cancer mortality will increase for both sexes. Conclusions: The profile of cancer premature mortality is diverse in Brazil. Nationally, only male lung cancer will be close to reaching SDG 3.4 target, endorsing government’s long term efforts to reduce tobacco consumption. Colorectal cancer mortality increases in most regions, reflecting the epidemiological transition. Despite progress in cervical cancer control, it will continue to be a major challenge, especially in the North and Northeast. Our results provide a baseline for public policies for both prevention and access to treatment to reduce premature mortality in Brazil. Differences in cancer patterns show the need to plan and to adapt regionally for each reality.
原发性高血压的合理用药
Authors: 顼志敏, 张叶萍
Journal: BMJ (2009)

原发性高血压以血压升高为主要临床表现,是多种心、脑血管和肾脏疾病的重要病因和危险因素,并最终可导致这些器官的功能衰竭.值得强调的是,目前高血压防治指南更新很快,不断完善.然而指南与临床之间存在较大缺口,合理用药是补缺的关键。
以周期性呕吐表现的延髓病变一例
Authors: 张向农, 钟平, 张雷
Journal: BMJ (2010)

患者男,46岁,因反复呕吐2年于2008年6月11日入我院干部神经科.2年前无明显诱因出现上腹不适、恶心、呕吐胃内容物,无呕血、反酸、烧心、呃逆、腹泻.呕吐呈非喷射性,周期性发作,每10天发作1次,症状持续3～4 d缓解,发作期无头痛、发热.间歇期无任何不适.多次在消化内科住院治疗,B超、胃肠钡餐、电子胃镜检查无异常发现,对症治疗无效.既往无高血压、糖尿病及消化道手术史。
Evaluation of transvaginal color Doppler sonography and magnetic resonance imaging in diagnosis for myometirial invasion of endometrial cancer
Authors: Jing Geng, Jing Feng, Jun Tang, Jian-liu Wang, Li-hui Wei
Journal: BMJ (2008)

Objective To investigate the value of transvaginal color Doppler sonography (TVCDS) and magnetic resonance imaging (MRI) in diagnosis for myometrial invasion of eudometrial cancer before surgical operation, in comparison with pathological examinations. Methods TVCDS and MRI were undergone before surgical operation in 34 patients with endometrial cancer confirmed by biopsy to evaluate depth of its myometrial invasion, as compared to those with postoperative pathological examinations. Results Predictive accuracy for myometrial invasion by TVCDS was 85%, with sensitivity, specificity, positive predictive value and negative predictive value of 80%, 9/9, 100% and 9/14, respectively, and predictive accuracy by MRI was 68%, with sensitivity, specificity, positive predictive value and negative predictive value of 60%, 8/9, 15/16 and 8/18, respectively. Resistance index (RI) averaged 0.51 for flow signal to detect superfical myometrial invasion by color Doppler flow imaging (CDFI) and 0.43 for deep myometrial invasion. Conclusions TVCDS and MRI can be used before surgical operation to judge the depth of myometrial invasion for patients with endometrial cancer, particularly more suitable for its screening, which will be helpful to judge the depth of myometrial invasion incorporated with resistance index by color Doppler flow signal.

Key words: 
Endometrial neoplasms;  Ultrasonography, Doppler, color;  Magnetic resonance imaging;  Pathology,clinical