tbuckley/cabot-search huggingface dataset:
Diagnostic value of serum ischemia modified albumin in coronary artery disease
Authors: Yi-gang Zhong, Ning-fu Wang, Hai-ying Xv, Liang Zhou, Xian-hua Ye, Guo-xin Tong, Xu-wei Hou
Journal: BMJ (2011)

Objective To assess value of serum level of ischemia modified albumin (IMA) in diagnosis for myocardial ischemia of coronary artery disease (CAD). Methods Seventy-two patients with clinically suspected myocardial ischemia of CAD admitted to The First People's Hospital of Hangzhou during November 2009 to May 2010 ready for undergoing coronary angiography, the gold standard for diagnosis of CAD, were randomly selected for the study. The patients were divided into CAD and non-CAD groups based on their coronary angiography. Serum level of IMA was determined with cobalt-albumin binding ( ACB) assay before coronary angiography, which served as diagnostic standard for CAD. Logistic regression analysis method was used to evaluate varied levels of IMA with area under the receiver operating characteristic curve (AUCROC) in diagnosis for myocardial ischemia of CAD. Results Mean level of IMA was (97 ±24) U/ml and (81 ±15) U/ml for CAD group (n =51) and non-CAD group (n =21), respectively. Sensitivity and specificity of a cut-off value of IMA 83.69 U/ml in diagnosis for myocardial ischemia of CAD was 80 percent and 57 percent, respectively, with a predictive value of a positive test 82 percent and that of a negative test 55 percent, respectively, from AUCROC. Logistic regression analysis demonstrated that both hypertension (P=0. 022, 6 = 1.421, OR=4. 141) and level of IMA (P=0.003, b= 1.780, OR=5.928) were independent predictors for CAD. Conclusions Sensitivity, specificity and predictive value of a positive test of the level of IMA are relatively high in diagnosis for myocardial ischemia of CAD, which is an independent predictor of it.

Key words: 
Coronary artery disease;  Diagnosis;  Ischemia-modified albumin
高血压患者的运动锻炼
Authors: 王增武
Journal: BMJ (2012)

高血压患者需要进行体力活动,但要注意运动的强度、持续时间和频次.运动的形式可以根据个人的爱好、体质和可获得的运动条件进行选择.无论采取何种形式的运动都要循序渐进,而且要注意运动过程中的身体感受,避免产生不利影响。
A phase II open-label, multicenter, study to evaluate the efficacy and safety of rivoceranib in subjects with recurrent or metastatic adenoid cystic carcinoma.
Authors: Hyunseok Kang, Alan Loh Ho, Jameel Muzaffar, Daniel W. Bowles, Sung-Bae Kim, Myung-Ju Ahn, Glenn J. Hanna, Francis P. Worden, Tak Yun, Steven Norton, Neil Sankar, Bhumsuk Keam
Journal: Journal of Clinical Oncology (2020)

TPS6597 Background: Adenoid cystic carcinoma (ACC) is a rare salivary gland malignancy, also found in other secretory gland sites (tracheobronchial tree, esophagus, breast, lungs, prostate, uterine cervix and vulva). Initial disease is typically treated with surgical resection and radiation, but recurrent or metastatic disease remain to be a significant challenge. There is no standard systemic therapy option for advanced ACC, although recent studies with tyrosine kinase inhibitors have shown moderate objective response and disease stabilization rates. Rivoceranib (also known as apatinib) is a potent selective inhibitor of VEGFR-2 and has been evaluated in a single arm phase II study of 59 recurrent or metastatic ACC patients in China and has demonstrated an (ORR) of 47.1% and disease control rate of 98.1. Methods: This is a phase II, open-label, multicenter[HGJ3], single arm clinical trial of oral rivoceranib (700 mg daily) in patients with recurrent or metastatic ACC of any anatomic site, not amenable to curative surgery or radiotherapy to confirm activity of rivoceranib. Subjects must have at least one evaluable lesion by RECIST v1.1 and have evidence of disease progression within the 6 months prior to study entry. Fifty-five subjects will be enrolled at 7 US sites and 4 South Korean sites. The primary endpoint is ORR assessed by investigators with a target ORR of 25% to detect a difference of 15% from the historical ORR of 10% at 1-year (this achieves 80% power with a 5% significance level). Secondary endpoints include overall survival, disease control rate, progression free survival at 6, 12 and 24 months and time to progression. Exploratory objectives include correlation between ORR and the presence of MYB/MYB-L1 fusion, pharmacokinetics evaluation, and patient-reported quality of life assessments by FACT-G. This study is open and enrolling at the time of submission. References: 1. Tchekmedyian V, Sherman EJ, Dunn L, et al. Phase II Study of Lenvatinib in Patients With Progressive, Recurrent or Metastatic Adenoid Cystic Carcinoma. Journal of clinical oncology: official journal of the American Society of Clinical Oncology 2019;37:1529-37. 2. Zhu G, Zhang L, Li R, Dou S, Yang W, Zhang C. Phase II trial of apatinib in patients with recurrent and/or metastatic adenoid cystic carcinoma of the head and neck: Updated analysis. Journal of Clinical Oncology 2018;36:6026. Clinical trial information: NCT04119453 .
Multimodal fluorescence-guided surgery of colorectal peritoneal metastases, a phase I/II clinical trial.
Authors: Jan-Marie de Gooyer, Fortuné Elekonawo, Andre J.A. Bremers, Otto Boerman, Mark Rijpkema, Johannes H.W. de Wilt
Journal: Journal of Clinical Oncology (2020)

TPS4119 Background: Successful treatment of patients with colorectal peritoneal carcinomatosis highly depends on complete surgical tumor resection of all tumor. Oncological outcomes can potentially be improved by intraoperative imaging using a tumor-targeting antibody conjugated to a fluorophore and a radiotracer. This enables preoperative radionuclide imaging, real-time intraoperative fluorescence imaging and gamma detection. In this study we investigate the feasibility, accuracy and safety of CEA-targeted preoperative SPECT/CT and intraoperative fluorescence imaging in patients with colorectal PC. Methods: In this phase I/II single arm protein dose escalation study patients with peritoneal metastases of colorectal origin who are scheduled for cytoreductive surgery and HIPEC will receive an intravenous injection of the CEA-targeting tracer 111 In-DOTA-labetuzumab-IRDye800CW. The first 15 patients will receive a single dose of 2,10 or 50 mg 6 to 7 days prior to surgery. Four to five days after injection SPECT/CT imaging of the thorax and abdomen is performed to determine intra-abdominal tumor load and detect extra-abdominal metatases. At day 6/7 after injection, standard cytoreductive surgical resection extended with real-time near-infrared fluorescence imaging and radio guidance is performed. After surgery, the peritoneal cavity will be re-examined for residual disease with fluorescence imaging. Resected specimens are analyzed microscopically, immunohistochemically (CEA and H&amp;E) and by gamma counting. Blood samples are drawn for farmacokinetics and safety analysis at 180 minutes, 4 days, 6 days and 3 weeks after tracer injection. In the phase II dose expansion cohort, 14 more patients will receive the optimal dose as determined in the phase I trial. The primary objectives of the trial are to assess the safety, feasibility and accuracy of preoperative SPECT/CT and intraoperative fluorescence imaging after administration of 111In- labetuzumab-IRDye800CW in patients with peritoneal carcinomatosis of colorectal origin who will undergo cytoreductive surgery and HIPEC. The secondary objectives are to assess whether additional malignant lesions can be visualized by fluorescence imaging after cytoreductive surgery, to assess the intensity of fluorescence in malignant and non-malignant tissue, to assess the correlation between localization of the dual-labeled antibody and CEA expression in tumor and healthy tissue and to determine blood concentrations of the dual labelled antibody at several time points in patients. Clinical trial information: NCT03699332 .
肺内小孤立结节100例临床分析
Authors: 王鲁峰
Journal: BMJ (2007)

对100例CT影像学上直径＜10 mm且有病理学诊断的肺内孤立结节患者的临床资料分析显示,肺内＜10 mm孤立结节以良性病变为主(64%,64/100);原发肺癌(25%,25/100)影像学上可藉边缘不齐、毛刺征、气管和血管受累、强化值差异等特点与良性病变鉴别;肺转移癌(11%,11/100)的影像学表现与原发肺癌相似.提示,肺内＜10 mm的孤立结节以良性肿瘤为主,其次为肺癌。
Study on deep vein thrombosis (DVT) risk factors at the time of cancer diagnosis in patients from the multicenter, prospective Cancer-Venous Thromboembolism (VTE) Registry.
Authors: Yasuo Ohashi, Masataka Ikeda, Hideo Kunitoh, Mitsuru Sasako, Takuji Okusaka, Hirofumi Mukai, Keiichi Fujiwara, Mashio Nakamura, Mari Saito-Oba, Tetsuya Kimura, Kei Ibusuki, Masato Sakon
Journal: Journal of Clinical Oncology (2020)

e19323 Background: Although the incidence of VTE is known to be high in cancer patients, many details of the frequency, risk factors, and management of VTE in patients with cancer remain unclear, especially in Asian populations. Methods: The multicenter, prospective, Cancer-VTE Registry study (UMIN000024942) aimed to clarify the actual status of VTE in cancer patients. The study enrolled patients diagnosed with colorectal, lung, stomach, breast, gynecological, or pancreatic cancer in Japan. Patients underwent VTE screening before initiating cancer treatment and were observed for 1 year. Registry objectives included the assessment of VTE prevalence and risk factors for VTE before initiating cancer treatment, real-world treatment of VTE, and frequency of new-onset events during the observation period. DVT screening was waived for those with a normal D-dimer level. Using a multivariate logistic regression model, we examined risk factors for DVT in cancer patients prior to initiating cancer treatment. Results: Of the 9726 patients enrolled, 3661 patients underwent DVT screening and 549 subjects were diagnosed with DVT. The risk factors for DVT among patients who underwent DVT screening (n=3661) are shown in the Table. Conclusions: The risk of DVT before initiating cancer treatment was clarified, and the factors strongly influencing DVT risk included age, sex, VTE history, D-dimer concentration, and hemoglobin concentration. [Table: see text]
Validity of asthma control test questionnaire at primary-care settings in China
Authors: Feng-ming Ding, Xin Zhou
Journal: BMJ (2009)

Objective The study aims to assess validity of Asthma Control Test (ACT) questionnaire at the primary-care settings in China.Methods ACT questionnaire survey and pulmonary function tests were performed for 403 asthma patients at 15 primary-care settings across China, and their status of asthma control was assessed by the specialists for asthma based on the criteria formulated in the 2006 Global Initiative for Asthma (GINA) for the role that ACT questionnaire plays in asthma screening and its cut-off score.Results ACT scores correlated with the results of specialists' rating for asthma patients, with a coefficient of correlation of 0.697.There was a statistically significant difference in ACT scores between groups of patients with varied predicted ratios of forced expiratory volume at first second (FEV1) to forced vital capacity (FVC), specialists' ratings of asthma control and adjusted treatment regimens.ACT scoring equal to or more than 20 suggested control of asthma.Conclusions ACT questionnaire can be used at the primary-care settings in China to assess asthma control.

Key words: 
Asthma;  Questionnaires;  Feasibility studies
Intratumoral exposure levels of pentaglutamated pemetrexed following treatment with LEAF-1401 and pemetrexed.
Authors: Gwangseong Kim, Angelique Nyinawabera, Zhenghong (Hannah) Xu, Jason DeFuria, Alvin Sezibera, Yanyan Cui, Bolin Geng, Khaniz Khalifa, Navreet Dhindsa, Clet Niyikiza, Victor M. Moyo
Journal: Journal of Clinical Oncology (2020)

3524 Background: The activity of pemetrexed is highly dependent on the intracellular enzyme folypolyglutamate synthase (FPGS) which adds glutamates to pemetrexed and yields very potent pemetrexed polyglutamates. Pemetrexed pentaglutamate (tetraglutamated pemetrexed) is 80-fold more potent than pemetrexed in inhibiting thymidylate synthase. Yet it is a poor drug candidate because it cannot readily cross the negatively charged cell membrane due to its own negative charge. We are developing LEAF-1401, a novel nanoliposomal encapsulation of gamma L-pentaglutamated pemetrexed. Because liposomes can readily be taken up by tumor cells, for its anti-tumor effect, LEAF-1401 can directly deliver pentaglutamated pemetrexed into tumor cells, bypassing the need for transmembrane folate carriers and FPGS which are both downregulated in resistant tumors. Methods: To measure drug levels in tumor, blood and various tissues (biodistribution), in vivo testing of LEAF-1401 and pemetrexed was conducted in a CT-26 murine colorectal carcinoma xenograft model. Animals were treated with a single dose of either LEAF-1401 (80mg/kg; equivalent to 32 mg/kg pemetrexed) or pemetrexed (118mg/kg). Tumor growth inhibition and clinical assessments were conducted. Animals were sacrificed: 5 mice per timepoint in each group and tumor, blood, liver, spleen and other tissues were harvested. Pentaglutamated pemetrexed levels were quantitatively analyzed by LC/MS/MS. Results: Compared to pemetrexed, LEAF-1401 treatment resulted in a 19-fold increase in exposure levels of pentaglutamated pemetrexed in the tumor and significant tumor growth inhibition. Plasma levels of pentaglutamated pemetrexed were high with LEAF-1401, but undetectable with pemetrexed. Like other liposomes, LEAF-1401 also resulted in accumulation of pentaglutamated pemetrexed in the liver and spleen (See Table below). Treatment appeared to be generally well tolerated. Conclusions: LEAF-1401, given at approximately a quarter of the equivalent pemetrexed dose, resulted in a 19-fold increase in pentaglutamate pemetrexed in tumor tissue compared to regular pemetrexed. LEAF-1401 represents a promising new class of novel nanoliposomal antifolates, that enhance the intratumoral delivery of potent polyglutamate antifolates, and improve antitumor activity while retaining an acceptable safety profile. [Table: see text]
家庭自测血压监测
Authors: 姚崇华
Journal: BMJ (2008)

家庭自测血压监测血压水平,不仅在就诊时可以提供有价值的信息供医生参考,而且可使患者积极参与自我保健,评价降压疗效,提高治疗的依从性,从而提高高血压的控制率.自测血压有其独特的优点,在自己熟悉的环境测量血压,无白大衣效应,更能反映平时真实的血压水平。
TALAPRO-1: Phase II study of talazoparib (TALA) in patients (pts) with DNA damage repair alterations (DDRm) and metastatic castration-resistant prostate cancer (mCRPC) – updated interim analysis (IA).
Authors: Johann S. De Bono, Niven Mehra, Celestia S. Higano, Fred Saad, Consuelo Buttigliero, Inge M. van Oort, Marielena Mata, Hsiang-Chun Chen, Cynthia G. Healy, M. Luisa Paccagnella, Akos Czibere, Karim Fizazi
Journal: Journal of Clinical Oncology (2020)

5566 Background: PARP inhibitors (PARPi) show antitumor activity in mCRPC/DDRm pts treated with novel hormonal therapy (NHT). TALAPRO-1 is an open-label study evaluating TALA (potent PARP inhibitor/trapper) in men with mCRPC/DDRm. We report a planned IA (Dec 2019). Methods: TALAPRO-1 (NCT03148795) is enrolling pts (N ≈ 100) with measurable soft tissue disease, progressive mCRPC, and DDRm likely to sensitize to PARPi ( ATM, ATR, BRCA1/2, CHEK2, FANCA, MLH1, MRE11A, NBN, PALB2, RAD51C), who received 1–2 chemotherapy regimens (≥1 taxane-based) for metastatic disease and progressed on ≥1 NHT (enzalutamide/abiraterone acetate) given for mCRPC. DDRm are defined as known/likely pathogenic variants or homozygous deletions. Pts receive oral TALA 1 mg/day (moderate renal impairment 0.75 mg/day) until radiographic progression, unacceptable toxicity, consent withdrawal or death. Primary endpoint is objective response rate (ORR). Secondary endpoints: time to OR; response duration; PSA decrease ≥50%; circulating tumor cell (CTC) count conversion (to CTC = 0 and &lt;5 per 7.5 mL blood); time to PSA progression; radiographic PFS (rPFS); overall survival; safety. A planned efficacy/safety IA was done when 60 pts with DDRm and measurable disease completed ≥6 months of TALA/no longer followed (DDR population [DDRp]). Radiographic responses are based on investigator assessments. Results: 113 pts received TALA (cutoff Dec 12, 2019); 75 pts were DDRp, had measurable disease, received ≥16 wk treatment, and were evaluable for ORR (54.7% BRCA1/2, 4.0% PALB2, 22.7% ATM; 18.7% other DDRm).All DDRp pts had prior docetaxel; 45.3% cabazitaxel. Confirmed ORR, rPFS, and composite response (investigator-assessed) in pts who received TALA for ≥16 weeks are in the table. Most common treatment-emergent adverse events: anemia (42.5%); nausea (32.7%). Conclusions: TALA monotherapy has encouraging antitumor activity in docetaxel-pretreated mCRPC pts with BRCA1/2 alterations and was generally well tolerated. Clinical trial information: NCT03148795 . [Table: see text]
Helen Salisbury: Testing times for GPs
Authors: Helen Salisbury
Journal: BMJ (2020)

Patients often turn to their GP for advice on how to stay safe in this uncertain world, to help them apply the rules to their own health condition. They expect us to have privileged access to the latest developments, but in this pandemic we find out about the next policy move only by listening to the news.

When it comes to coronavirus antigen testing, GPs have mostly been sitting on the sidelines, frustrated by being unable to request tests for symptomatic patients and not receiving the results of tests done elsewhere. It was announced this week that all patients with symptoms will be able to get an …
Effects of community management of maternal health on pregnancy outcomes
Authors: Hong-ping Huang
Journal: BMJ (2012)

The data were collected from 472 pregnant and parturient women in maternal system management at our center.All subjects were divided into the observation group (n =178 ) and the control group ( n =294) by the participation or non-participation of community management of maternal health.And the outcomes of pregnancy were analyzed for two groups.Compared with the control group,the observation group had a significantly higher correct rate of knowledge in maternal health ( P ＜ 0.01 ).The values of neonatal Apgar (5 min) score (9 ± 1 ) and breasffeeding rate (86.52％ ) increased while the caesarean rate (22.47％ ) declined (P ＜0.01 ).Community management of maternal healtb is effective in improving the pregnancy outcomes.

Key words: 
Maternal health services; Pregnancy outcome
Genomic characterization of circulating tumor DNA from Chinese advanced small-cell lung cancer to reveal potential therapeutic opportunities.
Authors: Jing Yang, Jingli Lu, Qiwen Zhang, Xiaomin Fu, Hui Chen, Xiaochen Zhao, Yuezong Bai, Xiaojian Zhang
Journal: Journal of Clinical Oncology (2020)

e21111 Background: Molecular profiling via next-generation sequencing (NGS) has been applied to select patients benefiting from targeted therapy or immunotherapy. Sequencing of blood-derived circulating tumor DNA (ctDNA) presents an alternative for advanced cancers given the challenge of obtaining tumor biopsies. We identified potentially actionable genomic alterations (GAs) in Chinese advanced small-cell lung cancer (SCLC) patients using ctDNA testing. Methods: Blood samples from 119 patients with advanced SCLC were sequenced via target deep sequencing covering 150 or 189 cancer-related genes and 100 microsatellite loci. Blood tumor mutation burden (bTMB), defined as the number of somatic single-nucleotide variants, short insertions and deletions (SNV/Indels) in examined coding region, was calculated in 93 patients. High bTMB was set to 10 that ranks top 25% in all SCLC patients. Results: The total number of GAs was 1156 in 127 genes, with an average of 9.7 GAs per sample ranging from 1 to 31. All patients harbored at least one GA and 107/119 patients had at least one GA with clinical significance. TP53 (82.4%) was the commonly altered gene followed by RB1 (57.1%), LRP1B (41.2%), FAT1 (25.2%), FAM135B (23.5%), PIK3CA (21%). GAs were detected frequently in cell cycle pathway (83.2%), PI3K/AKT/mTOR pathway (33.6%), RTK-RAS-MAPK pathway (29.4%), and DDR pathway (10.1%). Overall, 54 (45.4%) patients had alterations with therapeutic relevance, including 2 high blood microsatellite instability and 23 high bTMB that might benefit from immune checkpoint inhibitors. Actionable SNV/Indels were identified, including EGFR mutation (3), KRAS/HRAS mutation (5), DNA damage repair (DDR) pathway (4; including ATM, BRCA1, BRCA2), and PI3K/AKT/mTOR pathway (10; including PIK3CA, PTEN) that might benefit from EGFR tyrosine kinase inhibitors, RAS inhibitors, PARP inhibitors and mTOR inhibitors, respectively. We also found amplification of HER2 (3), FGFR1 (14), and MET (3) that might benefit from anti-HER2 antibodies, FGFR1 inhibitors and MET inhibitors, respectively. Conclusions: To our knowledge, this is the first large-scale analysis of blood-derived ctDNA in Chinese advanced SCLC. Potentially actionable GAs were detected in 45.4% patients. Deep sequencing of ctDNA could provide molecular profiles and might optimize treatment decision in advanced SCLC.
Does body mass index really predict the response to systemic therapies in metastatic melanoma: A multicenter study from the MelBase French National Cohort?
Authors: Yoann Di Filippo, Stéphane Dalle, Laurent Mortier, Caroline Dutriaux, Sophie Dalac, Marie Thérèse Leccia, Delphine Legoupil, Philippe Saiag, Florence Brunet-Possenti, Jean-Philippe Arnault, Eve Maubec, Florence Granel-Brocard, Julie De Quatrebarbes, Francois Aubin, Thierry Lesimple, Pierre-Emmanuel Stoebner, Wendy Lefevre, Olivier Dereure, Celeste Lebbe, Henri Montaudie
Journal: Journal of Clinical Oncology (2020)

10031 Background: Obesity is an established risk factor for several cancers and higher body mass index (BMI) is associated with poor prognosis. These data are still debated in melanoma. Furthermore, recently the concept of “obesity paradox” has emerged. In a large cohort published by McQuade JL et al, higher BMI was associated with better survival in patients with metastatic melanoma (MM) especially for those treated with targeted therapy (TT) and immune checkpoint inhibitors (ICI). We studied the association between BMI and progression-free survival (PFS) and overall survival (OS) in patients with MM treated with systemic therapies. Methods: This study was conducted from the prospective MelBase cohort (NCT02828202). Patients with MM treated with first-line ICI, TT, or CT were included. BMI was categorized by WHO criteria. Underweight patients were excluded. The co-primary outcomes were the associations between BMI and PFS or OS, stratified by treatment, sex and age. Multivariate analyses were performed. Results: A total of 1214 patients were analyzed. The majority of them were treated with ICI, followed by TT. Obese patients represented 22% of cohort (Table). Median follow-up was 13.5 months. The patients who were overweight or obese did not have different PFS (p = 0.88) or OS (p = 0.25) than patients with normal BMI. Stratifying this cohort by treatment received, age, sex and others parameters (such as LDH, number of metastatic site) did not revealed any difference. Multivariate analysis did not change the results. Conclusions: BMI was not associated with clinical outcomes in our cohort, especially in ICI and TT groups. Thus, we did not confirm the results presented by McQuade Jl et al. with a cohort quite similar in term of size. Because BMI is too simplistic and then an imperfect measure of body composition, the published data are not reproducible. We caution the oncologists, about BMI as valuable predictive marker of survival for melanoma patients. [Table: see text]
血栓性血小板减少性紫癜昏迷抢救一例
Authors: 李四强, 宫超, 田嘉玲
Journal: BMJ (2004)

患者女,50岁,因双下肢皮肤出血点3 d入院.查体:体温37.4℃,意识清楚,双下肢皮肤可见散在出血点,巩膜轻度黄染,全身浅表淋巴结不大,肝脾肋下未触及.实验室检查:白细胞6.8×109/L,红细胞2.93×1012/L,血小板36×109/L,乳酸脱氢酶781 U/L,直接胆红素9.19 μmol/L,间接胆红素43.5 μmoL/L,尿素氮11.16 μmol/L,骨髓增生活跃,中晚幼红细胞多见,并见花瓣、盔形、三角形破碎红细胞.
Abstract 16289: Combinational Cell Therapy With BM-MSC/HGF-eMSC Injectable Platform Can Improve Cardiac Function After Myocardial Infarction
Authors: Ju Ha Seo, Bong-woo Park, Yu-mi Cho, Seok-Won Kim, Jinah Jang, Sang Hoon Park, Sung Mook Kim, Brandon S Ra, Hun-Jun Park, Dong-Woo Cho
Journal: Circulation (2017)

Background: In myocardial infarction (MI), although treatments with mesenchymal stem cells (MSCs) have been widely attempted, these stem cell therapies have limited differentiation potentials and p...