tbuckley/cabot-search huggingface dataset:
Predictors of successful smoking cessation among hospitalized smokers
Authors: Wei-hua Zhu, Xiao-jun Yue, Fen Lan, Lie Yang, Qiong Yan, Li-zhen Lü, Yi-qin Wu, Bin Zuo, Ying Zhong
Journal: BMJ (2013)

Objective
To explore the characteristics of hospitalized smokers and determine the predictors of successful quitters.


Methods
During December 2010 to November 2012, a total of 240 hospitalized smokers at department of pulmonology and cardiology, including 228 males and 12 females, completed the standard questionnaires derived from Hong Kong Smoking Cessation Health Center. Being used 5A (ask, advice, assess, assist, and arrange follow-up) skills and 5R (relevance, risk, reward, roadblock and repetition) as quitting smoking counseling interventions, they received smoking cessation counseling from healthcare professionals. A 6-month telephone follow-up post-discharge was performed. According to the self-reported status, the 6-month continuous quitters and non-quitters were determined. Moreover, successful quitting predictors were analyzed.


Results
Among them, 65 cases successfully quitted, 175 cases were non-quitters and the successful cessation rate was 27%. Quitters and non-quitters showed no significant differences in gender, age, marital status, educational level, age at initiation of smoking, average cigarettes smoked daily, exhaled carbon monoxide values or nicotine dependence (P>0.05); while perceived confidence of quitting, 5 days pre-admission to quitting, perceived importance of quitting, cigarette smoking years had significant differences (P<0.05). Logistic regression analysis showed that 5 days pre-admission to quitting was a strongest successful quitting predictor [OR=2.78 (95%CI:1.52-5.15)]; the longer cigarette smoking year, the higher quitting rate [OR=2.10 (95%CI:1.15-3.85)]; the more perceived confidence of quitting, the higher quitting rate [OR=1.95(95%CI:1.06-3.59)].


Conclusion
Five days pre-admission to quitting, longer cigarette smoking years and more perceived confidence of quitting are independent successful quitting predictors for hospitalized smokers.


Key words: 
Inpatient; Smoking cessation; Factor analysis, statistical
高敏C反应蛋白对慢性充血性心力衰竭患者的预后判断价值
Authors: 薛春才, 李毅刚, Ying Feng, 沃金善
Journal: BMJ (2006)

慢性充血性心力衰竭(CHF)患者存在血清C反应蛋白(CRP)浓度轻度升高.我们应用高敏CRP(hsCRP)检测方法,探讨其对CHF患者是否有预后判断价值. 一、对象与方法 自2001年2月至2004年12月入选128例因CHF住我院的患者,CHF的诊断以欧洲心脏病学会制定的标准为依据.[1].128例患者的临床特征见表1.所有患者的左室射血分数((LVEF) 55 mm.非缺血性CHF包括原发性扩张性心肌病26例、瓣膜性心脏病15例、原发性高血压12例。
Research advance in kldney-protection effects of statins
Authors: 闫晗, 刘淑华
Journal: BMJ (2009)

他汀类药物为3-羟基-3-甲基戊二酞辅酶A还原酶抑制剂,能竞争性抑制细胞内胆固醇合成早期过程中限速酶的活性,并抑制极低密度脂蛋白(OX-LDL)的合成,发挥降脂作用.研究认为,他汀类药物不仅可明显改善血脂水平,还具有抗炎、免疫调节、神经保护、改善血管内皮功能等作用.葛长江等[1]报道阿托伐他汀可能通过减轻炎症、改善血管内皮功能、降低血压及抑制左心室心肌细胞肥大等影响高血压患者左心室重塑的过程。
CYCLONE 2: A phase II, randomized, placebo-controlled study of abiraterone acetate plus prednisone with or without abemaciclib in patients with metastatic castration-resistant prostate cancer.
Authors: Matthew Raymond Smith, Neeraj Agarwal, Tilman Todenhöfer, Redas Trepiakas, Jae-Lyun Lee, Andrew Lithio, Sonya Chapman, Karim Nacerddine, Christopher Sweeney
Journal: Journal of Clinical Oncology (2020)

TPS5591 Background: Despite recent advances, nearly all patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) experience disease progression and cancer-specific mortality. Persistent or reactivated androgen receptor (AR) signaling and/or activation of pathways in cross-talk with AR signaling are key drivers of mCRPC progression. Evidence suggests that AR signaling promotes translation of D-type cyclins resulting in cyclin-dependent kinase 4 and 6 (CDK4&amp;6) activation and cell cycle progression. Abemaciclib is an oral selective inhibitor of CDK4&amp;6 dosed on a continuous schedule, that is FDA-approved in combination with endocrine therapy or as monotherapy to treat HR+, HER2- metastatic breast cancer pts. Preclinical studies with prostate cancer cell lines and xenograft models showed that abemaciclib induces cell cycle arrest and tumor growth inhibition. The hypothesis is that addition of abemaciclib to AR targeted therapy may be an effective treatment for mCRPC pts. Methods: CYCLONE 2 (NCT03706365) is a phase II, randomized, double-blind, multicenter, placebo-controlled study to assess the safety and efficacy of abemaciclib in combination with abiraterone acetate plus prednisone (AA+P) as first-line treatment of pts with mCRPC. The study is designed in two parts. Part 1 is a 30-patient safety lead-in to determine the recommended phase II dose (RP2D; 150 mg or 200 mg, twice daily) of abemaciclib in combination with AA (1000 mg, once daily) + P (5 mg, twice daily). In part 2, 150 pts are randomized 1:1 to abemaciclib at the RP2D with AA+P or placebo with AA+P. Pts who received prior AA+P, enzalutamide, apalutamide, darolutamide, radiopharmaceuticals, or sipuleucel-T are excluded. Prior docetaxel for metastatic hormone-sensitive prostate cancer, but not for mCRPC, is allowed. Pts must have progressive mCRPC (by PSA and/or imaging) and an accessible metastatic lesion for tumor biopsy. The co-primary objectives are radiographic PFS (per RECIST1.1 for soft tissue and PCWG3 for bone) and time to PSA progression. Secondary objectives include safety, objective response rate, duration of response, OS, time to symptomatic progression, and pharmacokinetics. Assuming hazard ratios of 0.64 (rPFS) and 0.6 (PSA progression), the study is powered to 80% and 85%, respectively, to test the superiority of abemaciclib plus AA+P vs. placebo plus AA+P at one-sided α=0.1 using stratified log-rank tests. Part 1 is completed and part 2 is enrolling in 70 sites worldwide. Clinical trial information: NCT03706365 .
Transitioning adriamycin ifosfamide mesna (AIM) chemotherapy in sarcoma patients to the outpatient setting: Evaluation of outpatient chemotherapy in an oncology care model setting.
Authors: Cindy Banh, Kendall Valsvik, Alejandra Arredondo, Kassie Notbohm, Abhijeet Kumar, Lee D. Cranmer, Andrew S. Kraft, Ivo Abraham, Ali McBride
Journal: Journal of Clinical Oncology (2020)

e19149 Background: The combination of doxorubicin, ifosfamide and mesna (AIM) significantly improves outcomes among patients with advanced soft tissue sarcomas. The rising cost of inpatient care, alternative payment model changes and patient preferences has prompted institutions to consider shifting therapy to the outpatient setting. However, the safety and feasibility of outpatient AIM chemotherapy is not well established. The University of Arizona Cancer Center developed an Outpatient Program (OP) to facilitate administration of traditional inpatient chemotherapy regimens in the outpatient setting. We transitioned AIM based chemotherapy to the outpatient setting based on selective criteria and caregiver support. The transition to outpatient treatment could lead to large cost-savings implications under the oncology care model. Methods: The current retrospective analysis evaluated the safety and efficacy of outpatient AIM chemotherapy for sarcoma administered in the outpatient setting. An economic study evaluated AIM in the outpatient setting, address, cost of labs, chemotherapy and bed days saved from transitioning chemotherapy from the inpatient setting. Results: Twenty-one patients with soft-tissue sarcoma were treated with outpatient AIM, for a total of 83 cycles. The median age was 60 (27-73) with 6 females and 15 males being evaluated. The median number of cycles per patient was 3.9 (range, 1-6), an average of 4.68 days of infusion days per cycle. Notable side effects included three patients ifosfamide-induced neurologic syndrome and 2 with hematuria. Acute grade 3 and 4 hematological toxicities were observed in 16 and 15 of patients, respectively with 11 occurrences of febrile neutropenia in 9 patients. Of the 21 patients, 15 patients (71%) were hospitalized at least once and 9 patients (43%) were hospitalized due to neutropenic fever. Total bed days saved by transitioning AIM outpatient was 390, for a total hospital cost savings of $1,043,250. Current costs savings for laboratory, chemotherapy and patient assistance access is still being tabulated. Conclusions: The combination of ifosfamide and mesna as a continuous outpatient infusion is feasible and well-tolerated using proper selection of patient and caregiver evaluation. This new model of administration provides an opportunity to decrease cost of care, improve patient satisfaction and reduce utilization of healthcare resource for community and academic cancer center sites.
Effects of prexasertib, a CHK1 inhibitor, in the immune microenvironment of head and neck squamous cell carcinoma (HNSCC).
Authors: Ritu Chaudhary, Robbert Slebos, Feifei Song, Keegan McCleary-Sharpe, Jude Masannat, Aik Choon Tan, Xuefeng Wang, Nelusha Amaladas, Wenjuan Wu, Gerald Hall, Christine H. Chung
Journal: Journal of Clinical Oncology (2020)

e18541 Background: Despite considerable advancements in the standard therapies including surgery, chemotherapy and radiotherapy, the clinical outcome for head and neck squamous cell carcinoma (HNSCC) remains poor due to tumor recurrence and metastasis. Molecular-targeted therapies have evolved as novel and promising treatment for HNSCC patients. Herein, we identified a CHK1 inhibitor, prexasertib, as a therapeutic target that enhanced the infiltration of innate and adaptive immune markers in the mice tumor immune microenvironment (TIME) and subsequently sensitizes the tumors. Methods: For this study we used syngeneic mouse model of HNSCC developed using mouse tonsil epithelial cells transformed with HRAS expression and PTPN13 knockdown to represent tobacco-induced HNSCC (MTE-Ras). In vitro drug activity of prexasertib was determined using immunoblotting, flow cytometry, cell proliferation and colony formation assays. The effect of prexasertib on TIME was quantified by Quantigene Plex panel and multiplex immunohistochemistry (mIHC). Results: We found that in vitro treatment with prexasertib increased the amount of DNA damage in the cancer cells and eventually lead to their death. Similarly, our in vivo data showed that treatment with prexasertib resulted in significant tumor regression and increased mice survival. At the molecular level, prexasertib treatment resulted in an upregulation of transcripts associated with T-cell activation, cytokines, chemokines and macrophages indicating an upregulation of inflammatory gene signature. This was further supported by our findings from mIHC staining of mice tumors showing increased infiltration of natural killer cells, natural killer T cells and dendritic cells, following prexasertib treatment. Interestingly, we also saw an increase in the Tregs after prexasertib treatment, which is indicative of an immunosuppressive environment, and we speculate this could be as a result of negative feedback following immune activation by prexasertib treatment. Conclusions: Our results uncover a previously unidentified role of prexasertib in regulating the innate and adaptive immune response in HNSCC, and therefore further corroborate CHK1 as a promising therapeutic target in HNSCC.
Knowledge of chronic stable coronary artery disease management among general practitioners in Shanghai Pudong New Area
Authors: Lan Ni, Jinhua Xue
Journal: BMJ (2016)

Objective
To survey the knowledge of chronic stable coronary artery disease management among general practitioners (GPs) in Shanghai Pudong New Area.


Methods
The survey was conducted among 363 GPs with at least 2-year work experiences from community health service centers in Shanghai Pudong New Area from July to September in 2014. A self-designed questionnaire based on the guidelines/consensus of chronic stable coronary artery disease management were used in the survey. The questionnaire consisted of 4 parts: diagnosis, drug therapy, revascularization and treatment of special types.


Results
Among 363 participants 362 questionnaires were completed. History taking, physical examination and electrocardiogram were applied for diagnosis in all participants, 49.2%(178/362)also used coronary computed tomography angiography, 26.5%(96/362)used exercise testing for assistant examination. More than 95.0% of participants recognized that smoking, obesity, hyperlipidemia, hypertension, diabetes were risk factors. 75.7% (274/362) of participants used aspirin, 91.4% (331/362) knew the dose of aspirin as 75-150 mg; for aspirin intolerance 14.6%(53/362)would use clopidogrel alternatively. 50.6%(183/362)of participants sometimes used statins; and 39.2%(142/362)did not use stain because of not knowing the contraindication. Facing increases of alanine aminotransferase or aspartate aminotransferase levels 95.3%(345/362)of participants would immediately discontinue stain; 80.4%(291/362)discontinued statins as creatine kinase increased. 32.0%(116/362)of participants gave enough drug-free period avoiding nitrates resistance. 79.6% (288/362) seldom used β-blockers and 42.5% (154/362) failed to use β-blockers because not knowing the contraindication.78.7%(285/362)knew percutaneous coronary intervention but did not know its indications; 83.1%(301/362)knew coronary artery bypass but did not know its indications. 27.6%(100/362)knew calcium antagonists were first-line drugs for variant angina and 93.6%(339/362)never heard of microvascular angina.


Conclusion
The survey shows that GPs from community health service centers in Shanghai Pudong are not well familiar with examination of coronary heart disease and lack of sufficient knowledge of drugs recommended by the guideline, not well understand the indications for revascularization and the diagnosis and treatment of special types of coronary heart disease.


Key words: 
Coronary artery disease; Questiongnaires; General practitioner
Chemotherapy and Tumor Evolution Shape Pancreatic Cancer Recurrence after Resection
Authors: Filip Bednar, Marina Pasca di Magliano
Journal: Cancer Discovery (2020)

Abstract Summary: Most patients with pancreatic cancer who undergo curative resection and systemic chemotherapy still relapse with local or systemic recurrence. In this issue, Sakamoto and colleagues use advanced genomic tools to investigate the evolutionary origins of pancreatic cancer recurrence and discover an increased mutational burden that might be promoted by therapeutic intervention and might provide an opportunity for therapeutic intervention. See related article by Sakamoto et al., p. 792.
Genomic alterations and clinical correlations of Chinese patients with hepatoid adenocarcinoma of the stomach/alpha-fetoprotein gastric cancer.
Authors: Tianshu Liu, Erbao Chen, Chen Xu, Wei Li, Qian Li, Yuehong Cui, Yiyi Yu, Weiwei Shi, Baofeng Lian, Yue-Ting Qu
Journal: Journal of Clinical Oncology (2020)

e13514 Background: Hepatoid adenocarcinoma of stomach (HAS) is a rare subtype of gastric cancer (GC) with poor prognosis due to frequent liver metastasis. HAS, recognized as an extrahepatic cancer that resembles hepatocellular carcinoma (HCC), is characterized by solid sheet-like growth structures with hepatoid differentiation and excessive production of alpha-fetoprotein (AFP). This HAS subtype of GC (AFPGC) is genetically distinct compared to other common GC but requires more evidences for better characterization. Methods: Formalin-fixed, paraffin-embedded (FFPE) tumor tissues were collected from 25 HAS and 9 AFPGC patients at Zhongshan Hospital from July 2013 to August 2017 for whole exome sequencing (WES) test. The testing was carried out by a College of American Pathologists (CAP) accredited and Clinical Laboratory Improvement Amendments (CLIA) certified laboratory. Results: Our cohort included 25 males and 9 females who had undergone surgical treatment. The 25 HAS patients had a median age of 66.5 years (range 48-82) and the 9 AFPGC patients had a median age of 64 years (range 52-76). Patients with AFP&gt;20 had a significantly better overall survival (OS) compared with patients with AFP≤20. The most frequently mutated genes were TP53 (44%), TTN (44%), and MUC19 (30%) in HAS tumor samples and CDC27 (44%), NKX2-3 (44%), and TTN (44%) in AFPGC samples. Patients with URI1 or POP4 alterations had a significantly poorer OS than patients without those genes mutations (7.6 months vs. 19.8 months, p = 0.016, and 10.9 months vs. 19.7 months, p = 0.038, respectively). However, patients with SPTA1 alterations had a significantly better OS compared to patients without SPTA1 alterations (27.6 months vs. 15.8 months, p = 0.042). Patients with higher tumor mutational burden (TMB) (≥3.9 muts/Mb) had a significantly better OS compared with patients with lower TMB (&lt;3.9 muts/Mb), which indicated TMB may be an independent prognostic factor (HR: 0.032, 95%CI: 0.003-0.33, p = 0.004). Conclusions: Our study revealed the genomic profile of HAS/AFPGC patients. The most frequently mutated genes in HAS and AFPGC were different, which helps to better characterize these tumors. AFP and TMB may be potential biomarkers for predicting patients’ prognosis.
Gender disparities in hormone positive lung cancer.
Authors: Bing Xia, Rebecca Feldman, Wendy Cozen, Irene Kang, Luis E. Raez, Hossein Borghaei, Chul Kim, Misako Nagasaka, Hirva Mamdani, Ari M. Vanderwalde, Sachin Gopalkrishna Pai, Gilberto Lopes, Mark A. Socinski, Antoinette J. Wozniak, Edward S. Kim, Alexander I. Spira, Stephen V. Liu, Jorge J. Nieva
Journal: Journal of Clinical Oncology (2020)

e21552 Background: Lung cancer has not declined in U.S. women as much as it has in men over the past 20 years despite similar rates of smoking cessation among the genders. We explored whether differences in hormone receptor status could contribute to the reason for the observation. Methods: A total of 3,256 non-small lung cancer (NSCLC) tumor samples submitted for molecular profiling between 2013-2018 were retrospectively identified for having hormone receptor (HR) expression results. HR-positive (HR+) status was defined as ≥ 1+ and 1% nuclear staining of Estrogen Receptor alpha (SP1, Ventana) and/or Progesterone Receptor (IE2, Ventana) by immunohistochemistry. DNA sequencing by NGS included cases sequenced by the Illumina MiSeq hot spot 47 gene panel (n = 2753) and Illumina NextSeq 592 gene panel (n = 503). Tumor mutation burden (TMB) was measured by counting somatic non- synonymous missense mutations on the 592 gene panel and ≥ 10 mutations/Megabase (mut/Mb) was considered high. Fisher’s Exact, Chi- square and likelihood ratio (LR) tests were utilized for statistical analyses. Results: Hormone receptor positivity (HR+) was identified in 318 women and 186 men, 504/3256 or 15% of NSCLC. EGFR mutation subtypes observed were Exon19del (46%), L858R (28%), uncommon non-classical (17%), G719X|S768I|L861Q (5%). HR+ occurred more commonly in women compared to men (20% vs 11%, p &lt; 0.001). HR+ NSCLC had the same age distribution as HR-negative (HR-) cancers (range: 16-94 and 18-93, respectively). Compared to patients (pts) who were HR-, pts with HR+ NSCLC were more likely to harbor activating EGFR mutations in men and women (LR 1.39, p = 0.0017), and less likely to have mutations in TP53 (LR 0.83, p = 0.0076), K-RAS (LR 0.66, p &lt; 0.0001), or translocations in ALK (LR 0.46 p = 0.0190). No differences in the incidence of ERBB2 or BRAF mutations were identified. The median tumor mutational burden was equivalent in HR+ vs. HR- pts, both 9 mut/MB. Conclusions: The disparity in the prevalence of hormone receptors in lung cancers affecting men and women deserves further exploration. The presence of hormone receptors in NSCLC is increased in women and in tumors bearing EGFR mutations. Further elucidation of the mechanism and dual targeting of EGFR and ER in patients with HR+ NSCLC deserves exploration.
Significance of plasma brain natriuretic peptide in differentiating chronic cor pnlmonale from hypertensive heart failure
Authors: Bei-jie Huang
Journal: BMJ (2008)

Objective To study the significance of plasma brain natriuretic peptide(BNP)in differentiating patients with chronic cor pulmonale from those with hypertensive heart failure.Methods Thirty cases of cor pulmonale and 30 of hypertensive heart disease were recruited for the study.Heart rate and arterial partial oxygen pressure(PaO2)were measured for them,as well as plasma level of BNP Was measured by rapid immunofluorescence quantitative analysis.with 30 normal healthy persons as controls.Results As compared with the control group.plasma level of BNP increased significantly in patients with chronic cor pulmonale and hypertensive heart failure(P＜0.05),and that in those with hypertensive heart failure[(597±68)ng/L]Was significantly higher than that in those with cot pulmonale[(179±34)ng/L,P＜0.05]. Conclusion Plasma level of BNP can be used as an indicator to differentiate cor pulmonale from hypertensive heart failure both with dyspnea.

Key words: 
Natriuretic peptide,brain; Heart disease; Heart failure
Eosinophilic granulomatous polyangiitis with lung involvement: clinical analysis of 8 cases
Authors: Xiguang Yang
Journal: BMJ (2018)

Clinical data, imaging finding, laboratory and pathology results of 8 patients with eosinophilic granulomatous polyangiitis (EGPA) admitted in our hospital from April 2014 to September 2016 were retrospectively analyzed. There were 7 cases with sinus involvement; 8 cases with increased eosinophil counts in peripheral blood, bronchoalveolar lavage fluid (BALF) and induced sputum, and with negative antineutrophil cytoplasmic antibodies (ANCA). Lung function tests showed mild obstructive ventilation dysfunction in 7 cases, positive relaxation test or excitation test in 4 cases, and mild dispersion function decline in 4 cases. Chest CT revealed multiple ground glass shadows and peripheral pulmonary nodules in both lungs in 4 cases, and bronchial wall thickening in 1 case. Transbrochial lung biopsy (TBLB) indicated extravascular infiltration of acidophilic granulocytes. Four cases were treated by glucocorticoid monotherapy, the other 4 cases were treated by glucocorticoids combined with cyclophosphamide. All patients achieved clinical relief after treatment, but 3 cases recurred. For suspicious EGPA patients in addition to paranasal sinus CT, ANCA vasculitis index, urine routine and renal function tests, it is necessary to perform nasal mucosa, bronchial mucosa, transbrochial lung biopsy and BLAF, induced sputum cytology to obtain timely diagnosis and treatment.


Key words: 
Churg-Strauss syndrome; Bronchial alveolar lavage fluid