tbuckley/cabot-search huggingface dataset:
Prevalence and genetic features of TMPRSS2-ERG fusion in Chinese patients with prostate cancer.
Authors: Wei He, Fukang Sun, Juping Zhao, Dai Jun, Le Xu, Chenghe Wang, Chen Fang, Xin Huang, Shiqing Chen, Xiaochen Zhao, Yuezong Bai
Journal: Journal of Clinical Oncology (2020)

e17529 Background: Prostate cancer (PCa) is one of the most common malignancies, with rising incidence rate in China. The Cancer Genome Atlas (TCGA) revealed 53% of patients with PCa had ETS family gene fusions. The most frequent fusion type of ETS fusions is TMPRSS2-ERG, which may predicts resistance to taxane and androgen-deprivation therapies. The prevalence of TMPRSS2-ERG fusion in Chinese PCa patients evaluated by fluorescence in situ hybridization (FISH) or immunohistochemistry (IHC) varied from 7.5% to 78.0%. However, the sample sizes were small. In the present study, we investigated the prevalence and genetic features of TMPRSS2-ERG fusion by next generation sequencing (NGS) in a larger Chinese PCa cohort. Methods: Genomic profiling was performed through NGS from Chinese patients with PCa between January, 2017 and November, 2019. Formalin fixed paraffin-embedded (FFPE) tumor specimens or blood samples from participants were collected for NGS. IHC staining for PD-L1 expression was performed using PD-L1 IHC 22C3 pharmDx assay or Ventana PD-L1 SP263 assay. Data analyses were performed using SPSS and R 3.6.1. Results: A total of 526 Chinese PCa patients were included in this study. The median age was 70 (range, 29-90) years old. We observed 13.1% patients with a positive PD-L1 expression, 3.0% patients with MSI-H, and a median TMB of 4.0 muts/Mb (range: 0-72.9). TMPRSS2 fusions were detected in 47 (8.9%) PCa patients, and 6.8% of patients had TMPRSS2-ERG fusion, which is significantly lower than that of Caucasian patients. The PD-L1 expression pattern and TMB distribution of the TMPRSS2-ERG fusion-positive patients were similar with TMPRSS2-ERG fusion-negative patients, however no fusion-positive patients were identified as MSI-H. Among these 36 TMPRSS2-ERG fusion-positive patients, the most frequently somatic mutations were detected in TP53 (38.9%), AR (11.1%), ATM (11.1%), and PTEN (11.1%). 9 (22.2%) patients harbored somatic mutations in PI3K/ AKT/mTOR pathway that has been previously demonstrated to collaborate with ERG to promote prostate cancer progression. Conclusions: This study revealed the prevalence and genetic features of TMPRSS2-ERG fusion in Chinese PCa patients by NGS in the first time. Our results provide a better understanding of molecular features in Chinese TMPRSS2-ERG fusion-positive PCa patients.
全科医师培训情况的调查分析
Authors: 方建新, 黄敏, 赵齐, 赵中, 唐奇峰, 朱惠英
Journal: BMJ (2011)

我院于2006年11月3日通过卫生部全科医学专科医师规范化培训基地的评审,同年开始招收学员到目前已培训4届、共106名学员,其中第一届(2006级)26名学员完成卫生部 规定的3年培训并通过江苏省全科医学培训中心组织的结业考试,返回所属单位开展基层医疗卫生服务工作。
Persistent fever-liver dysfunction-repeated bleeding-abnormal activation of natural killer cells
Authors: Yadong Wang, Lingling Wu, Lixia Sun, Wei Wang, Fang Liu, Jinqiao Zhang, Caiyan Zhao
Journal: BMJ (2019)

回顾分析1例以发热合并肝损伤起病慢性活动性EB病毒感染，后逐渐演变为EB病毒相关NK细胞淋巴瘤，并继发噬血细胞性淋巴组织细胞增生症患者的临床资料，以提升临床医师对本病认知和诊治能力。
超重和肥胖大学生健康生活方式干预途径探讨
Authors: 朱慧楠, 王桂云, 侯立君, 崔继烨, 张怡玲, 业乾玥, 王光
Journal: BMJ (2012)

近年来,肥胖现象在我国大学生中迅速蔓延[1].莫晓冬和星一[2]调查显示,大学生中体质量超重及肥胖(BMI≥23 kg/m2)的检出率为32.4％.青少年肥胖是成年期代谢综合征的独立危险因素,易引起早发心脑血管事件的发生.探讨如何从学生时代着手慢病防控,防患于未然,是实现慢病防控的有效途径之一.积极倡导健康生活方式,引导大学生重视慢病防控,对超重和肥胖大学生进行干预,探讨如何实现超重和肥胖大学生的自我健康管理,应该成为高校教育需要思考和实践的问题.中国人民大学医院重视大学生超重和肥胖的干预,积极探索超重和肥胖大学生健康生活方式干预途径,开展了以下工作。
Stroop color-word test in screening of minimal hepatic encephalopathy
Authors: Wenqin Yu, Liyuan Gong
Journal: BMJ (2017)

Objective
To assess the application of Stroop color-word test (SCWT) for screening of minimal hepatic encephalopathy (MHE) in patients with liver cirrhosis.


Methods
Sixty patients aged 18-65 years with liver cirrhosis and 60 age, education level- matched healthy subjects were examined with SCWT. The SCWT indexes were compared between two groups. MHE was identified when patients had abnormal number connection test-A (NCT-A) and/or digit symbol test (DST).


Results
Time consuming and errors of card 2, 3, 4 and Stroop interference effects (SIE) reflecting word-interference and color-interference in SCWT were increased significantly in liver cirrhotic patients [(17.28±0.69)sec, (12.96±1.10)sec, (30.30±1.40)sec, (5.00±0.90)sec, (13.74±1.22)sec, (0.36±0.10) times, (0.50±0.11) times, (0.50±0.11) times, (5.00±0.90) times, (1.98±0.23) times, respectively] compared to those in healthy subjects [(10.18±0.57) sec, (7.68±0.39)sec, (15.68±0.33)sec, (1.94±0.37) sec, (6.56±0.70)sec, (0.02±0.02) times, (0.10±0.04)times, (0.10±0.04)times, (0.04±0.02) times, (0.20±0.08)times, respectively; t=12.95, 6.98, 8.19, 7.02, 11.91, 10.09, 8.97, 8.15, 17.94, 11.37, all P=0.00]; while there were no significant differences in time consuming and errors of card 1 between liver cirrhotic patients [(7.10±0.40)sec and (0.04±0.03) times] and healthy subjects [(6.72±0.36)sec and (0.02±0.02) times; t=1.89, 1.91, both P=0.06]. The sensitivity of word SIE, color SIE and word SIE + color SIE of SCWT for primary screening of MHE was 0.83(50/60), 0.88(53/60) and 0.98(59/60) respectively, whereas the specificity was 0.87(52/60), 0.80(48/60) and 0.83(50/60) respectively.


Conclusion
The SCWT may serve as a convenient, effective and reliable tool for primary screening MHE.


Key words: 
Hepatic encephalopathy; Neuropsyehology; Psychological tests; Stoop color-word test
肠梗阻手术的时机及预后临床分析
Authors: 王长辉, 支庆江, 高恒岭
Journal: BMJ (2010)

肠梗阻是外科常见的急腹症之一,绞窄性肠梗阻是肠梗阻发展的严重阶段,如未及时明确诊断或处理,将导致肠坏死、穿孔及继发性腹膜炎,乃至感染性休克、多器官功能衰竭(multiple organ dysfunction syndrome,MODS)而死亡。
Possibilities for improving the diagnosis of clinically significant prostate cancer based on 3D modeling.
Authors: Sergey N. Dimitriadi, Elena M. Frantsiyants, Nikolay S. Demchenko, Dmitry Ya. Iozefi, Mikhail A. Vinidchenko, Oleg I. Kit
Journal: Journal of Clinical Oncology (2020)

e17617 Background: The purpose of the study was improving the accuracy of diagnosis of clinically significant prostate cancer, using 3D models based on multiparametric MRI. Methods: We examined a total of 126 patients using a 12-point transrectal biopsy supplemented with an MRI targeted biopsy. The study included patients with a PSA in plasma of 1-20 ng / ml and symptoms of the lower urinary tract. We used a GE Signa HD 1.5T tomograph and an Advantage workstation. The scanning protocol included DWI, T2-FS, T2, 3D-Cube and a multiphase series with contrast. We evalueted focal changes in the structure of the prostate during MRI, using the PiRads v2.0 system, the results were processed at the GEAW 4.7 workstation, the prostate gland, urethra, seminal vesicles and sections were separated in layers. In the final 3D model, the prostate was labeled transparent, the urethra and seminal vesicles were labeled white. This model was saved and used as a visual three-dimensional image of the volume, size and localization of the foci of the prostate gland. When conducting a standard 12-point biopsy of the prostate under ultrasound control, based on a visual analysis of the 3D model, 2 additional injections were made into each part of the prostate, graded according to the PiRads≥ 3 scale. Results: We compared MRI with the histological results of a 12-point biopsy on the main 3D models of the prostate gland Among 126 patients, changes in MRI using the PiRads v2.0 system had 3 points in 48, PiRads 4 points - 32, PiRads 5 in 46 Among patients with PiRads 3 who underwent a standard 12-point biopsy, supplemented by targeted biopsy based on analysis of 3D models after MRI in 4 (8.3%) revealed clinically significant prostate cancer. Among patients with PiRads 4, clinically significant cancer was found in 11 (34.4%). In patients with PiRads 5, clinically significant cancer was found in 33 (71.7%). Conclusions: A transrectal biopsy of the prostate (using 3D modeling based on MRI with focal marking according to PI-RADS v2.0) allows to effectively identify clinically significant prostate cancer. Performing a transrectal biopsy of the prostate based on 3D modeling is the result of the effective application of an interdisciplinary approach to solving the problem of diagnosing clinically significant prostate cancer.
Association between BRCA2 status and histologic variants (intraductal [IDC] and cribriform [CRIB] histology) in prostate cancer (PC).
Authors: Elena Castro, Daniela Correia Salles, Rebeca Lozano, Heather Thorne, Isabel Aragon, Fernando Lopez Campos, Jose Rubio, Ana Gutierrez Pecharroman, Daniel Prieto, Isabel García, Maria I Pacheco, Casilda Llacer Perez, Laneisha Maldonado, Nuria Romero-Laorden, Francisco Zambrana, Pedro P. López-Casas, Shahneen Kaur Sandhu, Emmanuel S. Antonarakis, David Olmos, Tamara L. Lotan
Journal: Journal of Clinical Oncology (2020)

5579 Background: IDC histology in PC has been suggested to associate with germline BRCA2 mutations (gBRCA2) in small series, leading to the potential recommendation of genetic testing for all PC patients with IDC in the primary tumor. Methods: We conducted a case-control study in which primary PC from 58 germline BRCA2 mutation carriers ( gBRCA2) and 116 from non-carriers (NC) were matched 1:2 by Gleason score and specimen type (core biopsy/prostatectomy). Samples were independently reviewed by two expert pathologists blinded to genetic status who established the presence of IDC and/or CRIB morphology with supportive immunohistochemical stains in a subset of cases. Next-generation sequencing, aCGH and/or FISH were used to assess for somatic mono-/bi-allelic BRCA2 alterations. PTEN protein loss was determined by IHC, and TMPRSS2-ERG was detected by FISH/qRT-PCR. Chi-square tests were used to compare the frequency of IDC and cribriform histology in gBRCA2 vs NC, as well as to assess the associations with other variables. Logistic regression models were built to identify independent factors associated with IDC and CRIB histology. Results: gBRCA2 cases were younger at diagnosis (median 61.3 vs 64, p &lt; 0.01) and had T3-4 disease more often than NC cases (31% vs 10.5%, p &lt; 0.01), but the two groups did not differ in any other clinical-pathologic characteristics. After independent histopathological review, 79 cases demonstrated IDC histology and 81 had CRIB histology. No differences in the prevalence of IDC (50% NC vs 36% gBRCA2, p = 0.09) or CRIB (43% NC vs 53% gBRCA2, p = 0.20) patterns were observed. The probability of IDC was higher in PC with bi-allelic BRCA2 alterations (OR 5.1, 95%CI 2.1-12.6), PTEN loss (OR 5.1, 95%CI 1.9-13.5) or both (OR 23.0, 95%CI 4.9-107.2) compared to those without these alterations. Bi-allelic BRCA2 alteration was also associated with higher probability of CRIB histology (OR 7.2, 95%CI 3.1-16.4). TMPRSS2-ERG fusions were not associated with IDC or CRIB histology. MVA confirmed the independent association of bi-allelic BRCA2 alteration (p &lt; 0.01) and PTEN loss (p &lt; 0.01) with IDC histology. Bi-allelic BRCA2 alteration (p &lt; 0.01) and Gleason &gt;8 (p &lt; 0.01) were independent risk factors for CRIB histology. Conclusions: Primary PC with bi-allelic BRCA2 alterations was significantly associated with IDC and CRIB histology, independent of other clinical-pathologic factors (while gBRCA2 status alone was not). PTEN loss in primary PC was also independently associated with IDC, but not CRIB, histology.
Integrating PROs with prognostic value into oncologic care: High ESAS global distress score associated with lower overall survival in advanced cancer patients.
Authors: Ishwaria Mohan Subbiah, Maira Charone, Jason Roszik, Ahsan Azhar, Maxine Grace De la Cruz, Ali Haider, Daniel E. Epner, Marvin Delgado Guay, Akhila Sunkepally Reddy, Marieberta Vidal, Angelique Wong, Shalini Dalal, Rony Dev, Joseph Anthony Arthur, Suresh Reddy, Eduardo Bruera
Journal: Journal of Clinical Oncology (2020)

12021 Background: Despite compelling data supporting their use, patient reported outcomes (PROs) are not widely integrated into routine cancer care. In our Palliative Care (PC) practice, all patients complete the Edmonton Symptom Assessment Scale (ESAS), a simple, validated 10-item PRO tool which uses a 0 to 10 rating of 10 common symptoms (pain, fatigue, nausea, drowsiness, appetite, sleep, dyspnea, well-being, anxiety &amp; depression). Our team has previously validated the Global Distress Score (GDS), a sum of 9 physical + psychosocial ESAS items. Here, we studied the implementation of the GDS as a streamlined way to capture the overall symptom burden while providing prognostic value. Methods: We queried a PC database for patients w metastatic cancer at time of 1st PC visit. GDS was calculated &amp; grouped into 3 cohorts based on previous work &amp; clinical experience: high (GDS of 35+), Moderate (16-34) or Low (0-15). Overall Survival was defined as time from 1st PC visit date to death. Regression analysis, ANOVA and t-tests were conducted. Results: 333 patients met the inclusion criteria: median age 62.4y (range 20.5-88.4y), 25 AYA (15-39y), 169 mid age (35-64y), 140 seniors (65y+); 190 female 143 male; median prior therapies 2 (range 0-11), 227 patients were in 2nd line + above therapy. Median ECOG PS 2; 124 patients w ECOG PS 3 &amp; 33 w ECOG PS 4. 262 patients had died at time of analysis. Lower OS was associated w higher GDS (r 0.21, P &lt; 0.001). OS in Low, Mod, High GDS cohorts was 13.1m, 7.9m, &amp; 3.7m, respectively (p &lt; 0.001). There were no sig OS difference between 3 age cohorts (AYA 5.2m, mid age 6m, seniors 5.4m, p0.56). Conclusions: Higher GDS score was associated with a clinically significant decrease in overall survival highlighting the potential of the ESAS as a PRO tool in prognostication and clinical decision making for patients with advanced cancers with a high symptom burden. In the realm of increasingly complex PRO instruments, the ESAS represents a simple, well-validated tool which, in our studies and 25 years of clinical experience, takes the patient less than a minute to complete, with subscores such as the GDS which carry a highly prognostic utility for patients with advanced cancers.
左卵巢嵌顿于左侧腹股沟区一例
Authors: 姚国栋
Journal: BMJ (2008)

患儿女,5岁,发现左腹股沟区可复性肿物2年,肿物不能还纳伴左下腹痛2 d,于2006年4月12日入院.发病以来无尿频,无呕吐,排气、排便如常.人院检查:神清语利,腹平坦,无肠型及蠕动波,左下腹压痛阳性,无肌紧张,无反跳痛,无移动性浊音,叩之呈鼓音,肠鸣音可,左腹股沟区可触及2.0 cm×1.5 cm×2.0 cm大小包块,质中,表面欠光滑,触痛阳性。
A survey on external genital organ diseases among 1822 young men in Beijing
Authors: Lin Chen
Journal: BMJ (2009)

The external genital organs were examined in 1822 male military recruiters from 2004 to 2008 in Beijing.The prevalence of redundant prepuce was 67.07%.that of phimosis was 2.36%and that of moderate to severe varicocele Writs 1.43%.Among all examinees 68(3.73%)recruiters failed physical examination due to phimosis or moderate to severe vailcocelel.We suggest a joint effort should be made by community health centers and urological specialists to check up genital organs of male youngsters,and health education should be provided in schools,so early cure would be possible and qualification rate of recruiters could be raised.

Key words: 
Genitals diseases,male;  Cress-sectional study
Clinical outcomes of thoracoscopic thymectomy versus open surgery for early-stage thymoma
Authors: Xunyu Xu, Qianshun Chen, Xing Lin, Chen Huang
Journal: BMJ (2015)

From June 2008 to December 2012, video-assisted thoracoscopic surgery (VATS group) was performed for 24 cases of thymoma. Their operative procedures, postoperative complications, remission of myasthenia gravis (MG), perioperative mortality and oncological outcomes were compared with 19 cases of trans-sternal open thymectomy (OT group). Compared with OT group, VATS group had significantly shorter operation duration, less blood loss, shorter postoperative hospital stay, shorter chest tube duration and less chest drainage amount (P 0.05). The effective remission rate of thymomatous MG was 7/9 in VATS group and it was similar to that in OT group (6/8, P>0.05). VATS group had a recurrent or metastatic rate of 0%(0/23) and it was better than OT group with 1/17. And there was no significant inter-group difference (P>0.05). The total survival rate of VATS group was 100% and it was similar to that of OT group (16/17, P>0.05). Thoracoscopic thymectomy is safe, feasible, efficacious and mini-invasive for thymoma. With fewer complications and a quicker recovery, it has similar short-term outcomes to conventional open thymectomy.


Key words: 
Thoracic surgery, video-assisted; Thymectomy
4D radiomic biomarker of functional tumor heterogeneity to predict breast cancer recurrence in pretreatment dynamic FDG-PET.
Authors: Rhea Chitalia, Varsha Viswanath, Austin R. Pantel, Lanell Peterson, Eric Cohen, Mark Muzi, Joel Karp, David A. Mankoff, Despina Kontos
Journal: Journal of Clinical Oncology (2020)

e12573 Background: Breast cancer heterogeneity is thought to be associated with adverse outcomes. Dynamic molecular imaging modalities, including PET, permit 4-D sampling of tumor biologic properties and can therefore capture functional heterogeneity revealed by the temporal dimension of the dynamic tracer uptake. With the goal of improved non-invasive characterization of in vivo tumor biology, we have developed and tested a novel radiomic biomarker that characterizes 4-D functional tumor heterogeneity (FTH). We hypothesize subclonal populations are spatially contiguous regions of shared physiologic behavior that drive breast cancer heterogeneity and can be quantified. We describe an initial application of this approach to FDG PET imaging of breast cancer. Methods: We retrospectively analyzed data from a study of 50 patients with locally advanced breast cancer. Patients underwent 60-minute dynamic FDG PET over the chest prior to neoadjuvant chemotherapy and breast surgery and were followed for disease recurrence (DFS). A 3-D region bounding each tumor was identified by a radiologist and a novel Markov Random Field based 4-D segmentation paradigm segmented each tumor into three spatially constrained sub-regions with distinct time activity curve dynamics. From each tumor, an FTH imaging signature was extracted characterizing cluster compactness and separation. FTH imaging signatures were z-score normalized across all patients. Time-to-event analysis was used to assess the prognostic value of the FTH imaging signatures in predicting DFS. Discriminatory capacity compared to a baseline model of established prognostic factors (age, hormone receptor status, baseline tumor size) and standard PET uptake and kinetics markers (SUV, K 1 , and Ki) shown to be predictive of DFS (Dunnwald, J Clin Oncol 26:4449, 2008) was evaluated using the c-statistic and the log-likelihood statistical test. Results: 17 of 50 women (34%) had recurrence events. Adding FTH imaging signatures to the baseline model of age, baseline tumor size, and hormone receptor status improved a cross validated c-statistic from 0.51 to 0.74 (p &lt; 0.05), and demonstrated higher discriminatory capacity over a model of age, tumor size, hormone receptor status, and standard PET measures (c-statistic = 0.59). Conclusions: Imaging biomarkers of 4-D metabolic tumor heterogeneity may add prognostic value in predicting recurrence-free survival in breast cancer and merit further study.
A pilot randomized, placebo-controlled, double-blind study of omega-3 fatty acids to prevent paclitaxel-associated acute pain syndrome.
Authors: Zoneddy R. Dayao, Ursa Abigail Brown-Glaberman, V. Shane Pankratz, Lu Chen, Jacqueline M. Lafky, Charles L. Loprinzi, Debra L. Barton
Journal: Journal of Clinical Oncology (2020)

e24115 Background: Paclitaxel, a widely used chemotherapeutic agent, is associated with an acute pain syndrome (P-APS) and chronic chemotherapy-induced peripheral neuropathy (CIPN). Currently, there is no standard of care for P-APS. Commonly used analgesics, including NSAIDs and narcotics, have considerable toxicity profiles. Omega-3 fatty acids, a common dietary supplement, have well established anti-inflammatory and neuroprotective properties. The primary aim of the study was to assess if omega 3 fatty acids could prevent P-APS. Methods: Patients scheduled to receive weekly paclitaxel (70-90mg/m2) were randomized to receive 4 g of omega-3 acid ethyl esters (Lovaza) or placebo, beginning 1 week prior to starting paclitaxel and continued until paclitaxel was discontinued. Patients completed acute pain questionnaires at baseline, Days 2-7, prior to each subsequent treatment and one month after completion of therapy. The EORTC- QLQ CIPN 20 questionnaire was completed prior to each dose of paclitaxel and 1 month after completion. The primary objective was to compare the effect of omega 3 fatty acids, versus placebo, on the maximum pain score for the week following the 1 st treatment and each subsequent paclitaxel treatment, and to compare pain medication use between the 2 arms. The secondary objective was to compare the effect of the intervention on the severity of CIPN. Results: 49 patients were randomized to treatment versus placebo. Linear mixed effects models were applied with the addition of a bootstrap approach to overcome limitations in the distributional assumptions to compare outcomes between treatment groups. Placebo results were similar to the reported natural history of P-APS. There was no significant difference in trends over time between the 2 groups in the maximum pain score at week 1 (p = .14) and over 12 weeks (p = .21). There was also no difference noted in the rates of use of over the counter analgesics (p = .39) and narcotics (p = .46). CIPN results did not differ between the 2 groups (p = .08). Conclusions: The results of this pilot study do not support the use of omega-3 fatty acids for the prevention of paclitaxel-associated pain syndrome. Clinical trial information: NCT01821833 .