tbuckley/cabot-search huggingface dataset:
超声联合乳管镜定位切除乳腺导管内占位性病变的临床观察
Authors: 夏爱君, 郝经光, 巩立国, 张忠英, 韩超
Journal: BMJ (2011)

2003年1月至2006年12月，应用超声技术联合纤维乳管镜(FDS)定位，超声引导下麦默通（Mammotome）旋切系统切除乳腺导管内乳头状瘤(IP)43例，并与常规手术的40例对照，现将结果报告如下。 关键词：乳管镜
肾虚就用六味地黄丸吗
Authors: 尹德海
Journal: BMJ (2009)

六味地黄丸出自宋代钱乙所著 ,至今已有近千年历史,是补益肾阴的代表方剂,是临床中经常使用的中成药.肾虚分为肾阴虚、肾阳虚和肾气虚,六味地黄丸专为肾阴虚而设,并不是只要有中医肾虚表现的人就可以用六味地黄丸,更不能误将六味地黄丸作为一种强身健体、延年益寿的保健药品来服用。
Cause of death in patients with newly diagnosed chronic lymphocytic leukemia (CLL) stratified by the CLL-International Prognostic Index (CLL-IPI).
Authors: Yucai Wang, Sara J Achenbach, Kari G. Rabe, Tait D. Shanafelt, Timothy Call, Wei Ding, Saad Kenderian, Eli Muchtar, Jose Francisco Leis, Amber Koehler, Susan M. Schwager, James Robert Cerhan, Susan L. Slager, Neil E. Kay, Sameer Ashok Parikh
Journal: Journal of Clinical Oncology (2020)

8026 Background: CLL progression and CLL-related complications (infections and second malignancies) were the leading cause of death (COD) in a prospective cohort of CLL patients (Strati, BJH 2017). The CLL-IPI integrates major clinical and molecular prognostic factors and stratifies patients into 4 risk groups with distinct prognosis. It is unknown if COD differs according to CLL-IPI risk group in patients with newly diagnosed CLL. Methods: Patients diagnosed with CLL between 1/2000-12/2019 and seen within 1 year of diagnosis were identified from the Mayo Clinic CLL database. Cumulative incidences of cause-specific death were analyzed using Gray’s test, with deaths from different causes treated as competing events and deaths from unknown causes excluded. Results: 1276 patients were included in this study. The median age at diagnosis was 63 years (range 24-92), and 880 (69%) were male. Based on CLL-IPI score, 449 (35%) had low risk disease, 443 (35%) had intermediate risk disease, and 384 (30%) had high/very high risk disease. Median follow-up time for the study was 6 years; 286 deaths occurred. The COD was CLL progression in 99 (35%), infection in 16 (6%), second malignancy in 47 (16%), CLL-unrelated in 59 (21%), and unknown in 65 (23%) patients. The rates of death due to CLL progression were higher (17.3% at 5 years; 30.3% at 10 years) than the rates due to CLL-related complications (5.7% at 5 years; 12.9% at 10 years) or due to CLL-unrelated causes (8.6% at 5 years; 16.9% at 10 years) in the CLL-IPI high/very high risk group, but not the CLL-IPI low or intermediate risk group (Table). A higher CLL-IPI risk group was associated with a higher rate of death due to CLL progression ( P &lt; 0.001), as well as a higher rate of death due to CLL-related complications ( P = 0.013), and CLL-unrelated causes ( P &lt; 0.001). Conclusions: Causes of death in newly diagnosed CLL patients differ according to their CLL-IPI risk group. In patients with high/very high risk CLL, improving CLL disease control with novel agents seems justified. In patients with low/intermediate risk CLL, there should be increased efforts to reverse immune dysfunction to reduce infections and second malignancies. [Table: see text]
Covid-19: Millions of women and children at risk as visits to essential services plummet
Authors: Jacqui Thornton
Journal: BMJ (2020)

Sputum specimens from 480 patients were examined for the presence of pneumococci by Gram film and culture and for pneumococcal antigen by counterimmunoelectrophoresis, coagglutination, and latex agglutination. Ninety six positive specimens were detected. Gram film and culture provided the most reliable techniques in well taken specimens collected early in the illness before antibiotic treatment had started. More than 70% of the specimens examined were submitted after starting antibiotics, however, and in these specimens, methods of antigen detection proved of greater value than either Gram film or culture. Counterimmunoelectrophoresis, coagglutination, and latex agglutination were similar in sensitivity and specificity, but coagglutination and latex agglutination were much easier to perform and to read.
In vivo base editing restores sensory transduction and transiently improves auditory function in a mouse model of recessive deafness
Authors: Wei-Hsi Yeh, Olga Shubina-Oleinik, Jonathan M. Levy, Bifeng Pan, Gregory A. Newby, Michael Wornow, Rachel Burt, Jonathan C. Chen, Jeffrey R. Holt, David R. Liu
Journal: Science Translational Medicine (2020)

Most genetic diseases arise from recessive point mutations that require correction, rather than disruption, of the pathogenic allele to benefit patients. Base editing has the potential to directly repair point mutations and provide therapeutic restoration of gene function. Mutations of transmembrane channel-like 1 gene (TMC1) can cause dominant or recessive deafness. We developed a base editing strategy to treat Baringo mice, which carry a recessive, loss-of-function point mutation (c.A545G; resulting in the substitution p.Y182C) in Tmc1 that causes deafness. Tmc1 encodes a protein that forms mechanosensitive ion channels in sensory hair cells of the inner ear and is required for normal auditory function. We found that sensory hair cells of Baringo mice have a complete loss of auditory sensory transduction. To repair the mutation, we tested several optimized cytosine base editors (CBEmax variants) and guide RNAs in Baringo mouse embryonic fibroblasts. We packaged the most promising CBE, derived from an activation-induced cytidine deaminase (AID), into dual adeno-associated viruses (AAVs) using a split-intein delivery system. The dual AID-CBEmax AAVs were injected into the inner ears of Baringo mice at postnatal day 1. Injected mice showed up to 51% reversion of the Tmc1 c.A545G point mutation to wild-type sequence (c.A545A) in Tmc1 transcripts. Repair of Tmc1 in vivo restored inner hair cell sensory transduction and hair cell morphology and transiently rescued low-frequency hearing 4 weeks after injection. These findings provide a foundation for a potential one-time treatment for recessive hearing loss and support further development of base editing to correct pathogenic point mutations.
小儿川崎病冠状动脉病变的超声心动图分型
Authors: 徐贵华
Journal: BMJ (2008)

川崎病(kawasaki disease)又称黏膜皮肤淋巴结综合征,是目前病因仍未明确的小儿急性发热性疾病,共主要病理改变为全身非特异性血管炎,以中、小动脉炎性病变为主,多侵犯冠状动脉,造成冠状动脉扩张,内膜增厚,部分形成冠状动脉瘤,少部分患儿冠状动脉可发生狭窄和血栓,甚至导致儿童急性心肌梗死.探讨该病冠状动脉的超声心动图表现特征,对早期诊断、治疗及筛选病例具有重要意义。
Efficacy of enzalutamide (ENZA) + androgen deprivation therapy (ADT) in metastatic hormone-sensitive prostate cancer (mHSPC) by pattern of metastatic spread: ARCHES <i>post hoc</i> analyses.
Authors: Neal D. Shore, Andrew J. Armstrong, Russell Zelig Szmulewitz, Daniel Peter Petrylak, Jeffrey Holzbeierlein, Arnauld Villers, Arun Azad, Antonio Alcaraz, Boris Alekseev, Taro Iguchi, Francisco Gomez-Veiga, Brad Rosbrook, Ho-Jin Lee, Gabriel P. Haas, Arnulf Stenzl
Journal: Journal of Clinical Oncology (2020)

5547 Background: ENZA + ADT significantly reduced the risk of radiographic progression or death in men with mHSPC (NCT02677896). Here, we assess how pattern of metastatic spread impacts the efficacy of ENZA + ADT in patients enrolled in ARCHES. Methods: Patients with mHSPC were randomized 1:1 to ENZA (160 mg/day) + ADT or placebo (PBO) + ADT, stratified by disease volume and prior docetaxel treatment. The primary endpoint was radiographic progression-free survival (rPFS). Secondary endpoints included time to prostate-specific antigen (PSA) progression, time to first symptomatic skeletal event (SSE), time to castration resistance, and time to initiation of new antineoplastic therapy. Post hoc analyses were performed by pattern of metastatic spread at study entry. Results: Of the overall population with known metastases at screening (n=1146), the largest patient subgroups were those with bone metastases only (n=513) and those with bone and soft-tissue metastases only (n=351); there were fewer M0 patients or patients with soft-tissue metastases only (n=154) and patients with visceral ± bone metastases (n=128). ENZA + ADT reduced the risk of rPFS and other secondary endpoint measures versus PBO + ADT across all subgroups, with greater relative efficacy observed in patients without visceral metastases (Table). Conclusions: ENZA + ADT provides improvements in rPFS and other secondary endpoints versus PBO + ADT in patients with mHSPC regardless of pattern of metastatic spread, particularly in patients without visceral metastases. These results highlight the importance of patient/physician discussion regarding the use of ENZA in the treatment of mHSPC. Clinical trial information: NCT02677896 . [Table: see text]
Determination of serum troponin levels in patients with acute ischemic stroke
Authors: Zhu Shu, Yu Kai, Niu Xiaoyuan
Journal: BMJ (2019)

From October 2017 to March 2018, 398 patients with acute ischemic stroke admitted in Department of Neurology, First Hospital of Shanxi Medical University were enrolled in the study, including 59 cases with elevated troponin (cTn) and 339 cases with normal cTn level. Patients were assessed with National institute of Health Stroke Scale (NIHSS), Chinese Ischemic Stroke Subclassification (CISS), Island cortical lesions and related non-neurological diseases. The short-term prognosis was assessed by NIHSS score during 10-15 days in hospital and compared between the two groups. Multivariate regression analysis showed that elevated serum cTn was independently associated with insular cortex damage (OR=2.87, 95%CI:1.26-6.53), NIHSS score at admission (OR=1.08, 95% CI:1.01-1.14), hemorrhagic transformation (OR=6.71, 95% CI:2.21-20.38), cancer (OR=5.04, 95% CI:1.43-17.77), and the level of serum creatinine (OR=1.02, 95%CI:1.01-1.03). Increased serum cTn in acute ischemic stroke is associated with severe neurological deficits, insular cortex damage and non-neurological diseases. Aacute ischemic stroke patients with increased serum troponin have a more severe prognosis.


Key words: 
Troponin; Brain infarction, acute; Hypoxia-ischemia, brain
Clinical potential of ctDNA-based TMB in small cell lung cancer recieving chemoradiotherapy.
Authors: Ying Jin, Yamei Chen, Huarong Tang, Qian Li, Pansong Li, Xiao Hu, Yan-Fang Guan, Xuefeng Xia, Xin Yi, Jianjun Zhang, Ming Chen
Journal: Journal of Clinical Oncology (2020)

3536 Background: Small cell lung cancer (SCLC) is an aggressive tumor with poor prognosis. Chemotherapy and / or radiotherapy is the main choice of SCLC treatment. Circulating tumor DNA (ctDNA) has received substantial attention in recent years owing to the potential of patient stratification and monitoring. Here, we assessed the value of prediction and prognosis using ctDNA in SCLC. Methods: SCLC patients (pts) with limited-stage disease (LD) receiving chemoradiotherapy and extensive-stage disease (ED) receiving chemotherapy were enrolled. Baseline plasma samples were collected for NGS using a 1021-gene-panel. Mutational features and blood-based tumor mutation burden (bTMB) were analyzed using ctDNA. pyClone software was used to cluster the mutations. The mutations in the cluster with the highest cancer cell fraction (CCF) were defined as clonal mutations. Progression-free survival (PFS) was followed. Results: 58 SCLC pts (35 LD and 23 ED) and 58 plasma samples were enrolled. Smoking pts accounted for 84% (49/58). In all samples, recurrent genes were TP53 (86%), RB1 (57%), LRP1B (34%), CREBBP (26%), and MLL3 (22%). The median of bTMB and clone count were 7.9 [0-26] and 7 [0-25]. Significant higher bTMB and clone count were observed in ED pts compared with LD (Mann Whitney test, p = 0.019 and p = 0.041, respectively). Mutated CREBBP (10/23 ED versus 5/35 LD) was enriched in ED (Fisher exact test, p = 0.017 and OR = 0.223). Mutations in NOTCH signaling pathway were enriched in ED (l6/23 ED versus 13/35 LD, p = 0.031, OR = 0.265). In LD group, there were trend toward prolonged PFS in pts with higher bTMB(p = 0.065), and pts with higher clonal bTMB (cbTMB) exhibited significant longer PFS (p = 0.016, HR 0.37, 95% CI [0.12-1.11]). Patients with alteration in PIK3CA showed shorter PFS than wild type (p &lt; 0.001, HR 0.11, 95% CI [0-2.86]). There were no significant difference in median PFS in LD stage pts with any detectable pathway alterations. Whereas, LD pts whose ctDNA contained RTK-RAS signaling pathway alterations exhibited shorter PFS than pts without those alterations (p = 0.135). In ED pts, NOTCH1 gene wild type displayed longer PFS than mutant type (p = 0.036, HR 0.38, 95% CI [0.1-1.53]). There were no difference in PFS between pts with higher and lower bTMB and cbTMB. Conclusions: ctDNA can characterize the mutational feature of SCLC. There are differences in the molecular characteristics between ED and LD pts. Clonal bTMB is a potential prognostic biomarker for LD SCLC chemoradiotherapy. The prognostic marker of ED chemotherapy is different from LD.
Sporadic late-onset nemaline myopathy with monoclonal paraprotein as a malignancy rather than disimmunity and treatment with chemotherapy-based approach.
Authors: Rouslan Kotchetkov, David Susman, Francis Buadi, Angela Dispenzieri
Journal: Journal of Clinical Oncology (2020)

8545 Background: A subset of sporadic late-onset nemaline myopathy (SLONM) associated with monoclonal gammopathy of undetermined significance (MGUS) has more aggressive course, often fatal. Whether SLONM+MGUS is a malignancy or dysimmunity is unclear. Two approaches are used to treat SLONM+MGUS: 1) immunosuppression (IS) ± plasmapheresis/exchange; 2) chemotherapy (ChT) ± autologous stem cell transplantation (ASCT). Due to the rare occurrence of the disease the best treatment modality is not known. Methods: We conducted a literature search to identify previous treatment for patients with SLONM+MGUS using PubMed, Elsevier, Medline, and CINAHL databases from 1975 to 2019. All publications were carefully reviewed to remove “duplicate” patients. Overall, 28 reports were included for the final analysis. Results: 38 unique patients with SLONM+MGUS received either IS (n = 19) or ChT ± ASCT (n = 19). The median age was 48 years [24-75]. In the IT group 74% (n = 14) were males vs 53% (n = 10) in the ChT group. All patients had IgG monoclonal protein (MP): kappa in 57% (n = 11) in the IT, 42% (n = 8) in the ChT group. In the IT group MP values were 0.42 &amp; 0.2 g/L (n = 2); in the ChT group median MP was 2.7 g/L [0.1-14, n = 14]. In the IT group 84% (n = 16) received steroids, 26% (n = 5) plasmapheresis, 53% (n = 10) non-steroid immunosuppressants, 11% (n = 2) rituximab, and 53% (n = 10) IVIG. Six patients (32%) had one IT modality; 13 (68%) had 2 or 3. In the ChT group 10 patients (53%) had ASCT; 6 patients (31%) had CyBorD or Lenalidomide+Dexamethasone + ASCT; 3 patients (16%) had chemotherapy without ASCT. 10 patients in IT group had neurological improvement (NI): 53% overall response (OR) with 16% (n = 3) complete remission (CR), and 37% (n = 7) partial response (PR). No improvement/progression had 9 patients (47%). In 2 patients (10%), neurological CR was associated with resolution of MP. Mean time to best response was 19 months. In ChT group 18 patients achieved NI: 94.7% OR with CR in 73.7% (n = 14) and PR in 21.0% (n = 4). Only one patient had no response to therapy. The best NI correlated with resolution of MP. Mean time to best response was 10 months. Conclusions: Our study with the most extensive cohort of patients with SLOMN+MGUS supports ChT ± consolidative ASCT aimed at complete elimination of the malignant plasma cell clone as the preferred treatment. Superior clinical benefits of ChT suggest that the presence of MP has clinical rather than undetermined significance, and SLOAN + MP should be considered as a malignancy rather than dysimmunity.
Impact of lymphopenia on survival for elderly patients with glioblastoma: A secondary analysis of the CCTG CE.6 (EORTC 26062-22061, TROG03.01) randomized clinical trial.
Authors: Andrew Jehyun Song, Keyue Ding, Normand Laperriere, James R. Perry, Warren P. Mason, Chad Winch, Christopher J. O'Callaghan, Johan Menten, Alba Ariela Brandes, Claire Phillips, Michael F. Fay, Ryo Nishikawa, David Osoba, Gregory Cairncross, Wilson Roa, Wolfgang Wick, Wenyin Shi
Journal: Journal of Clinical Oncology (2020)

2547 Background: Lymphopenia (LMP) may lead to worse outcomes for patients with glioblastoma (GBM). This study is a secondary analysis of the CCTG CE.6 trial evaluating the impact of chemotherapy and radiation on LMP, as well as the association of LMP with overall survival. Methods: CCTG clinical trial CE.6 randomized elderly GBM patients (≥ 65 yrs) to short course radiation alone (RT) or short course radiation with temozolomide (RT + TMZ). In this study LMP (mild-mod: grade 1-2; severe: grade 3-4) was defined per CTCAE v3.0 criteria, and measured at baseline, 1 wk and 4 wks post-RT. Pre-selected key factors for the analysis included age, sex, ECOG, extent of resection, MGMT methylation, MMSE, and steroid use. Multinomial logistic regression models were used to identify factors associated with LMP and multivariable Cox regression models were used to study effect of LMP on survival. Results: A total of 562 patients were included for analysis (281 RT vs 281 RT+TMZ). At baseline, both arms (RT vs RT+TMZ) had similar rates of mild-mod (21.4% vs 21.4%) and severe (3.2% vs 2.9%) LMP. The 1 wk post-RT LMP rates were also similar (p = 0.25). However, RT+TMZ pts were more likely to develop both mild-mod LMP (18.2% vs 27.9%) and severe LMP (1.8% vs 9.3%) [p &lt; 0.001] at 4 wks post-RT. Developing mild-mod and severe LMP post-RT were both associated with baseline LMP (p &lt; 0.001) and RT+TMZ (p &lt; 0.001). Severe LMP at 4 wks post-RT was also associated with biopsy only (p &lt; 0.02). After adjusting for confounding factors, 4 wks post-RT LMP was not significantly associated with PFS or OS regardless of severity. However, baseline LMP (HR 1.3) was significantly associated with worse OS (HR: 1.30, 95% C.I.: 1.05-1.62, p = 0.02), regardless of MGMT status. Other factors significantly associated with worse outcome included: males (HR 1.41), biopsy only (HR 1.59), and lower MMSE (HR 1.03). Conclusions: Short course RT alone does not lead to LMP after treatment. Development of LMP post-RT is associated with addition of TMZ and baseline LMP. However, only baseline LMP is associated with worse OS regardless of MGMT status. This may be considered as a prognostic biomarker for elderly GBM patients and warrants further validation. Clinical trial information: NCT00482677 .
The association between race and intrinsic subtype on hormone receptor-positive breast cancer among young black women.
Authors: Sonya Reid, Jaleesa Moore, Ann Tezak, Anne Weidner, Ingrid A. Mayer, Tuya Pal
Journal: Journal of Clinical Oncology (2020)

e12591 Background: Hormone receptor-positive, HER2-negative breast cancer (HR+/HER2- BC) has the highest incidence and mortality rate across all racial/ethnic groups. HR+/HER2- BC is clinically and biologically heterogenous. Gene expression profiling assays can provide prognostic information and predict risk of late recurrence among women with HR+/HER2- BC. Prior studies have shown worse clinical outcomes among black women with HR+/HER2- BC. We sought to compare the distribution of intrinsic subtypes among young black women with HR+/HER2- BC, compared to published data from a young white cohort in the Carolina Breast Cancer Study (CBCS). Methods: Two population-based cohorts of black women diagnosed with BC between 2002 to 2012 at or below age 50 years were analyzed. Participants were recruited from twelve Southeastern states. All participants were asked to complete release of medical records and tissue/tumor forms to verify clinical information and to obtain primary tumor samples for future analyses. We compared the distribution of intrinsic subtypes and associations to clinical characteristics as compared to white female counterparts using Pearson chi-squared test. Results: Of 569 black participants, 124 women had HR+/HER2- BC and tumor samples available for analysis. There were 66 Luminal A (53%), 35 Luminal B (28%), 19 Basal (15%), and 4 HER2-enriched (3%) tumors. Black women with non-Luminal A tumors were younger ( &lt; 40) with larger tumors ( &gt; 2cm) and had higher risk of recurrence (ROR-T) scores as compared to black women with Luminal A tumors (p = 0.065, 0.006, and &lt; 0.001, respectively). Compared to young white women in the CBCS, black women in our study had a significantly higher percentage of non-Luminal HR+/HER2- BC (p = 0.037). Conclusions: Our results suggest that among young women with HR+/HER2- BC, black women have a higher proportion of non-Luminal tumors compared to their white counterparts. Non-Luminal HR+/HER2- tumors (i.e., basal and HER2-enriched) are more aggressive and may be less sensitive to endocrine therapy. These results suggest that overrepresentation of aggressive HR+/HER2- BC subtypes may contribute to the racial survival disparity observed among black women.
胃底巨大癌肉瘤一例
Authors: 郑志伟, 惠希增, 王刚平, 付金栋
Journal: BMJ (2011)

患者男,60岁,因全身乏力1个月入院.患者1个月前出现全身乏力,食欲减退,进食后上腹部饱胀不适,有时稍感恶心,上腹部隐痛,无呕吐,无腹泻,曾有2次黑便.体检:中度贫血貌,营养一般,精神差,全身皮肤黏膜苍白,无黄染,腹部平坦,腹壁柔软,右上腹压痛,无反跳痛,肝脾肋下未触及,肝肾区无叩痛,移动性浊音阴性.腹部CT检查:考虑胃底贲门占位(图1).行胃镜检查示:贲门区及胃底区见大小约5 cm ×4 cm溃疡性改变,黏膜结节不平,周围黏膜环堤隆起,覆污苔,有陈旧出血,诊断考虑胃癌(图2).手术行全胃切除.术中所见:肠系膜、胃周围有大量肿大淋巴结,肿瘤位于胃底,约5 cm×6 cm大小,质硬,已侵出浆膜层,与周围尚无固定浸润生长,脾门处有一肿大融合淋巴结团,约5 cm×4 cm大小,尚能活动.术后病理学检查:胃癌肉瘤(图3)。
Clinical outcome of local treatment in synchronous oligometastatic non-small cell lung cancer (NSCLC): A preliminary analysis of prospective data.
Authors: Shangbiao Li, Xiaoxia Zhu, Zhihao Zheng
Journal: Journal of Clinical Oncology (2020)

e21698 Background: Advanced NSCLC is a heterogeneous disease, a large number of retrospective studies suggested that patients with oligometastases may achieve long-term survival from aggressive local treatment. However, relevant prospective studies were limited. Therefore, we prospectively evaluated the role of local treatment in synchronous oligometastatic NSCLC. Methods: We prospectively identified 50 NSCLC patients newly diagnosed with synchronous oligometastases (≤5)in two centers between 11/2017 and 12/2019, among whom there were 24 patients from a randomized clinical trial NCT03119519. Patients were given first-line systemic therapy according to the latest NCCN guidelines with either local radiotherapy or surgery to thoracic primary tumor and/or radiotherapy to metastases. They were divided into combined therapies (Tx), systemic Tx and untreated groups. Kaplan Meier Survival analysis was used to compare progression free survival (PFS) and overall survival (OS) among the groups. Results: Median age of all patients was 61 years old (range: 27-80 years) and median follow up was 5.7 months (range: 0.5-23.3 months). A total of 10 deaths were observed. In the combined Tx group, 23 patients received radiotherapy, and 2 patients received primary surgical resection. The median OS of the combined Tx group (n = 25), the systemic Tx group (n = 19) and the untreated group (n = 6) was 18.47 months, not reached, 3.27 months, respectively. Compared with the untreated group, the combined group and the systemic Tx group had better OS (hazard ratio [HR] = 0.1047, p = 0.0001; HR = 0.1125, p= 0.0006). However, the patients in the combined group did not show significant OS advantage compared with those in the systemic Tx group (HR = 1.376, p= 0.667). In addition, we conducted an ITT analysis in clinical trial NCT03119519, in which 8 progression events were observed. There was no significant difference in PFS between the combined group (n = 13) and the systemic Tx group (n = 11) (13.2 months vs. not reached, HR = 1.317, p= 0.7015; 1-year PFS: 74% vs. 54%, p = 0.7015, respectively). Conclusions: Current analysis shows that the addition of local treatment to first-line systemic Tx does not improve PFS and OS. More samples, further updated data and selection of potential beneficer are necessary. Funding: 81972853, 81572279, 2016J004, LC2019ZD009, 2018CR033. Clinical trial information: NCT03119519.
The relationship between the fat-derived hormone and the insulin resistance
Authors: 彭久君, 石芳鑫
Journal: BMJ (2008)

胰岛素抵抗(IR)指胰岛素靶组织(如骨骼肌、脂肪组织、肝脏等)对胰岛素的敏感性下降,对葡萄糖的利用降低及抑制肝葡萄糖输出的作用减弱.IR具有明显的组织特异性、选择性和异质性,其所致的糖代谢紊乱构成了糖尿病等慢性疾病的病理生理基础.近年来大量研究表明,IR与脂肪分泌的多种细胞因子有密切关系.脂肪组织是一种疏松结缔组织,主要由富含甘油三酯的脂肪细胞构成。