tbuckley/cabot-search huggingface dataset:
Hematologic neoplasms incidence categorised by WHO classification and centralization of treatment facilities in Japan: Analysing a nationwide Hospital-Based Cancer Registry data.
Authors: Ayako Okuyama, Yoichiro Tsukada, Koji Izutsu, Takahiro Higashi
Journal: Journal of Clinical Oncology (2020)

e19348 Background: More than 55,000 patients are diagnosed as hematologic neoplasms in Japan. In this study incidence of hematologic neoplasms was categorised based on the World Health Organisation (WHO) classification, and centralisation of treatment facilities was analysed, using the nationwide Hospital-Based Cancer Registries (HBCR) which covers more than 65% of new cancer patients. Methods: The HBCR data for patients diagnosed in 2017 was used. We categorized patients in line with the 2017 Revision of WHO classification of lymphoid, myeloid neoplasms, and acute leukaemia. Incidence and age distribution was analysed by subtype. Centralisation of treatment facilities for haematological malignancy patients was also analysed. Hospitals were classified into four approximately equal groups based on patient volume per year (very high: over 108 patients; high: 43-107; low: 10-42; and very low: under 10). Results: In total, 51,936 patients in 809 hospitals were identified. Overall average age was 68.4 years (SD 16.5). 43.6% were diagnosed as mature B-cell neoplasms except plasma cell neoplasms, followed by 12.6% of myelodysplastic/myeloproliferative neoplasms and myelodysplastic syndromes, 10.1% of plasma cell neoplasms, 9.4% of myeloproliferative neoplasms, and 8.8% of acute myeloid leukaemia and related precursor neoplasms. 1,438 patients (2.8%) were diagnosed as precursor lymphoid neoplasms and 54.7% of these patients were under 10 years old. Looking at the age distribution of mature B-cell neoplasms, 70s were accounted for 32.6% and 60s were accounted for 26.4%. Among hematologic patients aged 70s, 46.4% were mature B-cell neoplasms and remaining 14.3% of myelodysplastic/myeloproliferative neoplasms. Most of patients received treatment at very high (62.1%, 206 hospitals) or high patient volume hospitals (28.5%, 200 hospitals). Only 1.8% of patients received treatment at very low patient volume hospitals (221 hospitals) which have less than 10 hematologic patients per year. Most of patients received treatment at very low patient volume hospitals were mature B-cell neoplasms. Conclusions: In this study, the first detailed analysis of the number of hematologic neoplasms by subtype was performed. Treatment facilities for hematologic neoplasms patients was almost centralised.
中华医学会全科医学分会第七届学术年会纪要
Authors: 顾湲
Journal: BMJ (2009)

中华医学会全科医学分会第七届学术年会于2009年8月7-10日在天津召开.本次年会是分会第五届委员会成立后举办的第一次全国性会议,与中国社区卫生协会联合主办,会议主题是服务质量与队伍建设,是在新医改形势下促进全科医学学科与全科医师队伍大发展的盛会。
Performance status restriction in phase III cancer clinical trials.
Authors: Ramez Kouzy, Joseph Abi Jaoude, Walker Mainwaring, Timothy Lin, Austin B. Miller, Amit Jethanandani, Andres F. Espinoza, Cullen M. Taniguchi, Ethan B. Ludmir
Journal: Journal of Clinical Oncology (2020)

2059 Background: Patients with good performance status (PS) tend to be favored in randomized clinical trials (RCTs), possibly limiting the generalizability of trial findings. We sought to characterize trial-related factors associated with the use of eligibility criteria that restrict patients by PS, and analyze patient accrual breakdown by PS. Methods: We searched ClinicalTrials.gov for phase III RCTs between 2003-2018. Randomized multi-arm trials assessing a therapeutic intervention in cancer patients were included. PS data were extracted from corresponding manuscripts. Trials with PS restriction Eastern Cooperative Oncology Group (ECOG) ≤1 were identified. Factors associated with PS restriction were determined, and trial patient accrual was analyzed. Results: Six-hundred trials were included with PS data for 238,213 patients. In total, 527 studies (87.8%) specified an upper PS restriction cutoff as part of their exclusion criteria, and 237 studies (39.5%) had a strict inclusion criterion of patients with ECOG PS ≤1. Enrollment criteria restrictions based on PS (ECOG PS ≤1) were more common among industry-supported trials (P&lt; 0.001) and lung cancer trials (P &lt; 0.001). Nearly half of trials that led to subsequent FDA approval included strict PS restrictions. Binary logistic regression revealed stable use of restrictive PS eligibility criteria between 2007-2018 (P= 0.789). The vast majority of patients enrolled across all trials had an ECOG PS of 0 to 1 (96.3%). Even among trials that allowed patients with ECOG PS ≥2, only 8.1% of enrolled patients had a poor PS (ECOG 2 or higher).Trials of hematologic cancers had the largest proportion of patients with ECOG PS ≥2 (8.7%), while lung, breast, gastrointestinal and genitourinary trials all included less than 5% of patients with poor PS (P&lt; 0.001). Only 4.8% of patients enrolled in trials that led to subsequent FDA approval had a poor PS. Conclusions: The use of PS restrictions in oncologic RCTs is pervasive, and exceedingly few patients with poor PS are enrolled. The selective accrual of healthier patients has the potential to severely limit and bias trial results. Future trials should consider a wider cancer population with close toxicity monitoring, to ensure generalizability of results, while maintaining patient safety.
A pilot study to determine the feasibility of a customized low glycemic load diet in patients with stage I-III colorectal cancer.
Authors: Michelle Elizabeth Treasure, Alicia Thomas, Stephen Ganocy, Augustine Hong, Smitha S. Krishnamurthi, David Lawrence Bajor, Nathan A. Berger, Neal J. Meropol
Journal: Journal of Clinical Oncology (2020)

4643 Background: Observational evidence associates energy balance factors, particularly diet, with survival in patients with colorectal cancer (CRC). Consumption of a diet with high glycemic indices has been associated with inferior cancer-specific outcomes, but there is limited prospective evidence that alterations in dietary habits improve cancer outcomes. This was a pilot study to determine the feasibility and acceptability of following a low glycemic load (GL) diet in patients with stage I-III CRC and to assess the nutritional resources necessary to follow the diet. Methods: 18 patients with stage I-III CRC, who completed definitive cancer therapy and consumed an avg daily GL &gt; 150 participated in a 12 week, tailored, in-person dietary intervention with a target GL of ≤102. Compliance was assessed using 24 hour telephone recalls. Acceptability of the diet was assessed using a food acceptability questionnaire, and exploratory correlative laboratories were assessed monthly. Results: 67% of patients were compliant with a low GL diet ≥ 75% of the time, over a 12 week time period. Majority of participants experienced a decrease in BMI and waist circumference, 28% experienced meaningful weight loss defined as ≥ 5%. The nutritionist spent an avg of 6.97 hours (SD 2.18) in-person and 1.58 hours (SD 0.68) by phone with each participant. In the overall group, significant decreases were seen in total cholesterol (7.2% decrease; t = -2.33, p = 0.03), VLDL (26.8% decrease; t = -2.33, p = 0.03) and triglycerides (26.6% decrease; t = -2.29; p = 0.04). All participants were satisfied with the diet; 43% were extremely satisfied. 75% of participants liked the foods they were able to eat “very much” or “extremely”. All participants felt the in-person meetings were helpful. 77% did not feel an online video could replace the in-person meetings. 62% of participants did not feel a virtual meeting (e.g skype, etc.) could replace the in- person meeting while 38% felt it could. Conclusions: Patients with stage I-III CRC are able to follow a low GL diet with an in-person dietary intervention. Significant decreases in laboratory measures confirm the efficacy of the diet in altering metabolic indices. All participants who completed the study were satisfied with the diet, the majority of whom enjoyed the foods and planned to continue to follow the diet after study completion. The majority felt in-person contact with the nutritionist was essential to their success. This study was an essential step in designing a larger scale trial to evaluate the impact of low GL diet on cancer outcomes. Clinical trial information: NCT02129218 .
Peripheral blood T-cell receptor immune repertoire characterization of resectable stage IIIA non-small cell lung cancer patients receiving neo-adjuvant chemo-immunotherapy treatment from NADIM study.
Authors: Alberto Cruz Bermudez, Marta Casarrubios, Raquel Laza Briviesca, Belen Sierra-Rodero, Miguel Barquin, Atocha Romero, Fernando Franco, Virginia Calvo, Ernest Nadal, Amelia Insa, Rosario Garcia-Campelo, Joaquin Casal, Manuel Domine, Bartomeu Massuti, Margarita Majem, Delvys Rodriguez-Abreu, Alex Martinez-Marti, Javier De Castro, Mariano Provencio-Pulla
Journal: Journal of Clinical Oncology (2020)

9041 Background: Characterization of the peripheral blood T-cell receptor (TCR) repertoire has become a novel approach to predict the clinical benefit to anti-PD1/PDL1 therapy. However, there is lack of knowledge about the clinical relevance of TCR repertoire in terms of pathological response and clinical outcomes (PFS and OS) in chemo-immunotherapy. To answer this question we have analysed samples from the NADIM study (NCT03081689), in which resectable stage IIIA NSCLC patients were treated with neoadjuvant chemo-immunotherapy with Nivolumab. Methods: Using ION Torrent-based next-generation sequencing we have analysed TCR repertoire of peripheral blood from 30 patients receiving chemo-immunotherapy. Using 25ng of total RNA from PBMCs, clonal convergence, evenness and diversity were calculated at diagnosis (pre-treatment) and after 3 cycles of Nivolumab plus carboplatin (post-treatment). Regarding pathological responses, patients were classified in 3 groups: complete response (pCR) (0% viable tumour at the resection specimen), mayor response (pMR) ( &lt; 10% viable tumour) and incomplete response (pIR) ( &gt; 10% of viable tumour). At data analysis, PFS and OS median follow-up times were longer than 20 months. Results: No statistically significant differences in TCR repertoire in terms of evenness (p = 0,373), diversity (p = 0,691) or convergence (p = 0,054) between pre- and post-neoadjuvant treatment were observed. Similarly, no significant differences were observed in these metrics between pathological response groups. However, a detailed analysis of the clones showed that the percentage of frequent clones (greater than 0.1%) that increase after neoadjuvant therapy does show differences between the different pathological response groups (pIR vs pMR), being elevated in patients who presented responses greater than 90% (p = 0.0385). Regarding the clinical benefit, having this parameter higher than the median (43,90% in this cohort) is associated with a higher PFS (p = 0.0490) and OS (p = 0.078) using KM Log-rank test. Conclusions: Evenness, Diversity and Convergence derived from immune repertoire analysis do not appear to be clinically useful in the context of neoadjuvant chemo-immunotherapy in lung cancer. However, the detailed analysis of the clones seems promising. The increase of the most frequent clones after treatment seems to be associated to different clinical variables such as pathological response and PFS in these patients. Clinical trial information: NCT03081689.
Three dimensional hysterosalpingo-contrast-sonography in diagnosis of fallopian tube infertility
Authors: Yu-guo Zhang, Hua Shi, Li-dan Hao, fia-qi Hu
Journal: BMJ (2012)

Seventy eight infertile women were examined by three dimensional hysterosalpingocontrast-sonography(3D-HyCoSy) and X-ray hysterosalingography (HSG) to observe flowing condition of fallopian tube.With the laparoscopy as gold standard,the sensitivity,specificity,positive predictive value and negative predictive value of 3D-HyCoSy in diagnosis of fallopian tube infertility were 94.7％,83.7％,93.9％ and 82.4％ ; those for HSG were 96.4％,82.6％,92.3％,93.0％ and 90.5％,respectively.U test showed that two methods had good consistency. The results suggested that 3D-HyCoSy provides an effective method in evaluation of fallopian tube pathology for infertile women.

Key words: 
Hysterosalpingography;  Fallopian obstruction
药疹诱发富尼埃坏疽一例
Authors: 杨洪波, 尹保会
Journal: BMJ (2005)

患者男,42岁,因阴囊部位疼痛、破溃20 d入院.1个月前患者因头痛、咳嗽口服复方新诺明等药物,4 d后阴囊部位出现钱币大小浮肿性紫红斑,中央有水疱,无糜烂,伴瘙痒.在当地医院诊断为固定性药疹,给予抗过敏及外用药治疗.1 周后患者阴囊皮疹加重并出现溃疡,疼痛剧烈,伴发热,体温39℃.于当地医院住院予抗感染及局部清创,体温恢复正常,但阴囊皮肤大片坏死.于2002年3月12日转入我院.既往无糖尿病史.查体:体温37.2℃,血压130/85 mm Hg(1 mm Hg=0.133 kPa),阴囊肿胀,有大片溃疡,深达精索内筋膜层,表面有浆性渗出,边缘为潜行性,触痛明显.实验室检查:白细胞 12×1012/L,血糖5.85 mmol/L.细菌培养:大肠杆菌.入院诊断:富尼埃(Fournier)坏疽.入院后予抗感染及支持疗法,每日换药清除坏死组织,肉芽组织新鲜后,行创面植皮.26 d后痊愈出院。
Genome Wide Association Study (GWAS) of cognitive impairment after blood or marrow transplantation (BMT) for hematologic malignancy.
Authors: Noha Sharafeldin, Purnima Singh, Alysia Bosworth, Akinyemi I Ojesina, Jianqing Zhang, Yanjun Chen, Sunita K. Patel, Xuexia Wang, Liton Francisco, Stephen J. Forman, F. Lennie Wong, Smita Bhatia
Journal: Journal of Clinical Oncology (2020)

1536 Background: Cognitive impairment is prevalent in hematologic malignancy patients treated with BMT (autologous: 18.7%; allogeneic: 35.7%; Sharafeldin JCO; 2018). Given the inter-individual variability in risk of cognitive impairment in this population, we investigated the role of genetic susceptibility using a genome-wide single nucleotide polymorphism (SNP) array platform to identify novel genetic associations. Methods: Discovery: Cognitive function was assessed objectively in 239 adult BMT recipients at pre-specified timepoints: pre-BMT and at 6 mo, 1y, 2y, and 3y post-BMT. A global deficit score (GDS - a summary score of 14 standardized neuropsychological tests) was computed for each patient; a higher score indicated greater cognitive impairment. SNPs passing standard quality control filters ( &gt; 1.4M) were used for analysis. Linear mixed effects models used GDS as the outcome, adjusted for age, sex, BMT type, baseline cognitive reserve, and the first four principal components. We used additive, codominant, and genotype models and an adjusted genome-wide significance threshold of 1.25 x 10 −8 . Replication: An independent cohort of 544 BMT survivors (192 cases with self-endorsed cognitive problems and 352 controls without) was used for replication. Results: Discovery: Median age at BMT was 51.3y; primary diagnoses: 47% leukemia, 32% lymphoma, 21% multiple myeloma; 57% males; 69% non-Hispanic whites: 50% allogeneic BMT, median GDS score = 0.22 (range 0-2). Forty-four SNPs were significantly associated with increased GDS (additive model: 3 SNPs; codominant model: 20 SNPs; genotype model: 21 SNPs). Estimates ranged from increase in GDS score by 0.28 points for each additional copy of risk allele, p = 1.07 x 10 −8 to increase in GDS score by 1.82 points for two copies of risk allele, p = 2.3 x 10 −11 . Replication: Median age at BMT was 44y; primary diagnoses: 32% leukemia, 49% lymphoma, 19% multiple myeloma; 54% males; 80% non-Hispanic whites: 34% allogeneic BMT. Three SNPs were successfully replicated: rs116334183 resides within lncRNA-SEMA6D-2, which facilitates neuronal migration; rs13286152 86kb downstream of TLE-1, which promotes neuronal survival; and rs12486041 0.36Mb downstream from lncRNA-SPTSSB-1, which regulates sphingolipid production in neuronal axons and 0.36Mb upstream from TOMM22P6 linked to neural repair. Conclusions: In this first GWAS of cognitive impairment post-BMT, we identify 3 SNPs with plausible links to genes implicated in neuronal integrity. Functional studies are currently underway.
Knowledge of osteoporosis and related health education among Beijing community residents
Authors: Su Yu, Xueping Du, Yange Sun, Quan Xue, Qi Shen, Daiying Shao
Journal: BMJ (2017)

Objective
To investigate the awareness of osteoporosis and to evaluate the effect of related health education among Beijing community residents.


Methods
Total 1 000 patients, who visited in 4 community health service centers in Beijing from June to December 2011, were selected as study participants. The questionnaire survey on the awareness of osteoporosis was conducted in all participants, and the items of questionnaire included the risk factors, symptoms, prevalence of osteoporosis, the recommended daily calcium intake and risk of falls. Five hundred participants in 2 health service centers were designated as intervention group and 500 in another health service centers as control group. In intervention group the health education of osteoporosis was conducted every 2 to 3 months and the outpatient follow-up was provided every 2 months; the contents of health education included the clinical manifestation, prevention and control of osteoporosis, and the prevention of fall. In control group only the general outpatient consultation and referral were provided. The second questionnaire survey was conducted 2 years after intervention, the results were compared with baseline and the intervention effect was evaluated.


Results
Before intervention, 58.0%(580/1 000)participants had exercise, 43.1%(431/1 000)participants took calcium supplement and vitamin D, and 12.1%(121/1 000)took medication following doctor's advance. The rates of fall prevention and administration of calcium vitamin D in intervention group before intervention [27.8% (139/500) and 38.7% (194/500)] were lower than those in control group [33.8% (308/500) and 47.5% (237/500)]. After two-years of intervention the adoption rate of health behavior in intervention group was improved markedly, the highest one was diet control [increased by 38.4%(192/500)]and the lowest one was medication [increased by 17.3%(87/500)]. Compared to control group the diet control rate in intervention group was significantly higher [74.0%(370/500) vs. 23.6%(108/457), χ2=261.887, P=0.000]. In addition, unhealthy behaviors were also reduced: 55.0% participants reduced caffeine consumption and 72.2% participants reduced sodium intake in intervention group.


Conclusion
The awareness of osteoporosis among Beijing community residents is not satisfactory, but intervention focusing on osteoporosis prevention education is effective to change their behavior.


Key words: 
Osteoporosis; Health behavior; Intervention studies
A randomized trial of a palliative care intervention for patients on phase I studies.
Authors: Thomas J. Smith, Vincent Chung, Mark T. Hughes, Marianna Koczywas, Nilofer Saba Azad, Louise Knight, Rhonda Cooper, Nora Ruel, Betty R. Ferrell
Journal: Journal of Clinical Oncology (2020)

12001 Background: The purpose of this study was to test a Palliative Care Intervention for patients with solid tumors enrolled in phase I therapeutic trials. Methods: This randomized trial compared patients accrued to phase I Clinical Trials in groups of Usual Care compared to a Palliative Care Intervention (PCI) in two comprehensive cancer centers. The PCI included assessment of quality of life (QOL) and symptoms, an interdisciplinary meeting to discuss the care plan, including goals of care, and two nurse-delivered teaching sessions. Subjects (n=479) were followed for 24 weeks, with 12 weeks as the primary outcome point. Results: Outcomes revealed that relative to Usual Care, PCI subjects showed less Psychological Distress (1.9 in Intervention and 1.2 in Control pts, p=0.03) and a trend toward improved QOL (3.7 versus 1.6, p=0.07), with differences between sites. We observed high rates of symptom-management admissions (41.3%) and low rates of Advance Directive completion (39%), and use of supportive care services including hospice (30.7%, for only1.2 months duration), despite a median survival for all patients in both groups of 10.1 months from initiating a phase 1 study until death. Patient satisfaction with oncology care was already high at baseline, and we did not see clinically significant changes in those scores by week 12. Conclusions: Palliative care interventions can improve QOL outcomes and distress for patients participating in phase 1 trials. Greater integration of PC is needed to provide quality care to these patients and to support transitions from treatment to supportive care, especially at the end of life. Clinical trial information: NCT01828775 .
Clinical significance of BIM-deletion polymorphism on chemoradiotherapy in patients with non-small cell lung cancer.
Authors: Yu Wakabayashi, Takeshi Masuda, Taku Nakashima, Kazunori Fujitaka, Kakuhiro Yamaguchi, Shinjiro Sakamoto, Yoshihumi Nishimura, Yasushi Horimasu, Shintaro Miyamoto, Tadashi Senoo, Hiroshi Iwamoto, Shinichiro Ohshimo, Hironobu Hamada, Noboru Hattori
Journal: Journal of Clinical Oncology (2020)

e21536 Background: The standard treatment for locally advanced non-small cell lung cancer (NSCLC) is chemoradiotherapy (CRT) followed by anti-programmed cell death-ligand 1 (PD-L1) drug therapy. BIM deletion induces apoptosis suppression and the effect of epidermal growth factor-tyrosine kinase inhibitor is reportedly attenuated in EGFR-mutated NSCLC patients with BIM deletion. This study retrospectively examined the effects of BIM deletion on CRT or PD-1 treatment in patients with NSCLC. Methods: Among patients with unresectable NSCLC at Higashi-Hiroshima Medical Center and Hiroshima University Hospital between April 1994 and April 2018, we enrolled those treated with CRT or chemotherapy using carboplatin + paclitaxel or cisplatin + vinorelbine, or PD-1 antibody treatment. Results: Of 1,224 patients with unresectable NSCLC, 88, 80, and 79 underwent CRT, chemotherapy, or PD-1 antibody treatments, respectively. Within these treatment groups, 15 (17%), 15 (19%) and 11 (14%) patients, respectively, had BIM deletion. Among patients receiving CRT, the progression-free survival and overall survival were significantly shorter in those with BIM deletion than in those without (150 vs. 254 days, p = 0.003; 429 vs. 710 days, p = 0.03). Moreover, multivariate Cox regression analysis showed BIM deletion to be an independent factor for anti-tumor effect or prognosis (hazard ratio [95% confidence interval] 2.042, [1.112–4.039], p = 0.029; 2.414, [1.063–4.984], p = 0.036). These results were not observed in the chemotherapy and PD-1 treatment groups. To confirm the association between radiation therapy effect and BIM deletion, we performed in vitro experiments using two NSCLC cell lines (A549 and EBC-1). Suppressed BIM expression using siRNA (instead of BIM deletion) in these cells showed significantly suppressed antitumor effect and apoptosis 48 hours after 30-Gy irradiation but not chemotherapy. Conclusions: We showed that BIM deletion is an independent anti-tumor effect or prognostic factor for CRT. The results also indicated that BIM deletion was associated with the effects of radiation but not chemotherapy or PD-1 antibody treatment.
Research progress of flexor tendon injury of the fingers
Authors: Yue Liu, Heng Zhang
Journal: BMJ (2018)

The flexor tendon and pulley system injuries of fingers are relatively common. Injuries to those structures may lead to different degrees of dysfunction, and some injuries may be missed or misdiagnosed in its early stage, resulting in delayed functional recovery, and reduced quality of life. The article is to describe the normal anatomic structure, mechanisms of injury and its imaging features, and the related research progress of the finger flexor tendon system.


Key words: 
Magnetic resonance imaging; Finger injuries; Flexor tendon; Pulley system; Injury