tbuckley/cabot-search huggingface dataset:
Effectiveness of sirolimus-eluting stents in emergency percutaneous coronary intervention
Authors: 刘如辉, 赵明中, 刘洋, 马文林, 邓兵, 许嘉鸿, 蒋金法, 胡大一
Journal: BMJ (2007)

目的 观察急性心肌梗死(AMI)患者经皮冠状动脉介入治疗中应用雷帕霉素洗脱支架的疗效及安全性.方法 采用对照研究方法,急诊介入治疗时将220例AMI患者分为金属裸支架组和雷帕霉素药物洗脱支架组,比较治疗1个月和6个月后两组间的死亡率、重要心脏不良事件(MACE)和6个月时靶血管重建术等情况.结果 随访1个月和6个月后,两组总死亡率和MACE发生率差异均无统计学意义.裸支架组在6个月总死亡人数为3人,均为心源性死亡,死亡率为2.8%.药物支架组6个月总死亡人数为5人,死亡率为4.5%.然而,药物支架组再狭窄率比金属裸支架组明显降低(6.0%比16.1%,P＜0.05).结论 雷帕霉素药物支架应用于AMI病变是安全有效的,与裸支架相比其能明显降低术后再狭窄率和再次血运重建率。
Investigating the tumor immune infiltrate for populations that predict immune-related adverse events (irAEs) in patients receiving PD-1 inhibitors.
Authors: Steven Michael Blum, Neal Smith, Moshe Sade-Feldman, Dennie T. Frederick, Russell William Jenkins, Justine Vanessa Cohen, Donald P. Lawrence, Meghan Mooradian, Christine Freedman, Riley Fadden, Krista M. Rubin, Sarah Richey, Keith Flaherty, Jennifer Ann Wargo, Nir Hacohen, Ryan J. Sullivan, Genevieve Marie Boland, Alexandra C Villani
Journal: Journal of Clinical Oncology (2020)

3116 Background: The mechanistic relationship between clinical benefit and immune-related adverse events (irAEs) in response to immune checkpoint inhibitors (ICIs) remains unclear, with several clinical studies reporting that irAEs are biomarkers of responses. Single-cell RNA sequencing (scRNAseq) analysis of tumors from patients with advanced melanoma before and after treatment with ICIs have identified immune cells that correlate with response to ICIs. We sought to evaluate if these populations were also associated with irAEs. Methods: A published scRNAseq data set generated with the Smart-Seq2 protocol (Sade-Feldman M, et al. Cell 2018.) was re-analyzed, stratified by two definitions of irAEs: (1) toxicity requiring systemic immunosuppression (prednisone &gt; 10mg/day) or (2) systemic immunosuppression and/or endocrinopathy. Unbiased single-cell analysis was performed, followed by sub-clustering of T cell populations. The percentage of cells in each cluster was determined on a per sample basis. Results: 13,184 immune cells from 39 samples collected from 25 patients were re-analyzed. 27 samples were from patients who did not respond to ICIs, while 12 samples came from responding patients. 21 samples came from patients who required immunosuppression, 5 samples from patients with isolated thyroiditis, and 13 samples from patients who met neither irAE criteria. Unsupervised scRNAseq analyses focused on ICI efficacy re-capitulated published associations between response and populations that included B-cells (p &lt; 0.01) and TCF7 expressing T-cells (p &lt; 0.01). While these cell populations were not associated with either definition of toxicity, we observed a non-Treg CD4 expressing T cell population (0.8-10.5% cells/sample) that positively correlated with either definition of toxicity (p &lt; 0.05) but not efficacy. Conclusions: In a patient cohort with advanced melanoma, tumor-infiltrating immune cell populations associated with response to ICI therapy were not associated with irAEs. This suggests that biomarkers of ICI response may not function as biomarkers of irAEs, and ongoing analysis will seek to validate this result. Understanding the differences between ICI response and irAEs may identify new therapeutic targets for maximizing efficacy while mitigating toxicity.
Survey on training programs of Shanghai General Practice Teacher Training Center
Authors: Jian Wang
Journal: BMJ (2013)

Objective
To assess training programs from trainees of Shanghai General Practice Teacher Training Center for further improvement.


Methods
Total 171 trainees attending the GP teacher training program in April, 2012 were selected for survey. A self-designed questionnaires were adopted in the survey. The rationality of the curriculum and training contents in the program were analyzed.


Results
Among 170 trainees who answered the questionnaires, 86 of them (51%) considered the training curriculum as very appropriate, 76 of them (9%) considered as appropriate; 97 of them (57%) thought the training forms as very vivid, 65 of them (38%) thought as vivid. The overall evaluation score for teachers was 4.64. Ninety three of the 170 trainees (55%) expressed a great willingness for training, 70 (41%) expressed as willingness. Among 170 trainees 156 (92%) preferred to learn new advances in medicine, 111(65%) preferred to learn teaching skills and theories in general practice. Thirty two trainees (19%) considered that the contents of training met the trainees' needs completely, 129 (76%) considered that most contents of training met the trainees' needs. Eighty two (48%) considered that they gained a lot after the training, 80 (47%) considered that they gained fairly. The survey showed that 147 (86%) believed the training had broadened their minds, 104 (61%) believed the training had increased their capabilities of clinical diagnosis and treatment; 53 (31%) thought the training helped raise their theoretical level. Eighty seven (51%) were very satisfied and 75 (44%) were comparatively satisfied with the training in overall evaluation.


Conclusion
The training program provided by Shanghai General Practice Teacher Training Center is basically satisfactory and trainees are benefited from the training considerably.


Key words: 
General practitioner; Teacher training; Questionnaire
Toxicities after high dose post-transplant cyclophosphamide in haploidentical donor transplants: Risk factors and impact on survival.
Authors: Dipenkumar Modi, Omar Albanyan, Seongho Kim, Abhinav Deol, Asif Alavi, Andrew Daniel Kin, Lois Jeanne Ayash, Voravit Ratanatharathorn, Joseph P. Uberti
Journal: Journal of Clinical Oncology (2020)

7545 Background: Post-transplant cyclophosphamide (pCY) when given at 50mg/kg on day +3 and +4 in haploidentical donor transplants (HIDT) leads to considerable morbidity. Information on its toxicity and impact on outcomes is limited. Methods: We analyzed 91 patients (pt) undergoing HIDT with pCY to estimate incidence and risk factors of mucositis, hemorrhagic cystitis, renal and cardiac toxicities during the first 6 months after transplant and its impact on overall survival (OS). We compared these complications with 91 pt who were matched for age, disease, disease status at transplant, conditioning regimen and received 8/8 HLA-matched transplants without pCY (non-pCY cohort). Results: Fourteen pt (15%) in non-pCY and 28 (31%) in pCY experienced hypoxia requiring oxygen (p = 0.03). Ten pt (11%) in non-pCY and 21 (23%) in pCY developed clinically significant hypotension (p = 0.05). Day +100 cumulative incidence rate (CIR) of mucositis was 59.3% for non-pCY and 84.6% for pCY (p &lt; 0.001). Seven pt (13%) in non-pCY cohort and 39 (51%) in pCY developed grade 3-4 mucositis (p &lt; 0.001). Two pt (2%) in non-pCY and 22 (24%) in pCY developed gross hematuria (p = 0.05). Day +180 CIR of hemorrhagic cystitis was 13.2% for non-pCY and 29.7% for pCY (p = 0.005). Hemorrhagic cystitis did not have an adverse impact on non-relapse mortality (NRM) and OS. Day +180 CIR of renal toxicities was 17.6% for non-pCY and 28.6% for pCY (p = 0.10). The CIR of cardiac toxicities at day +180 was 9.9% for non-pCY and 14.3% for pCY (p = 0.34). Congestive heart failure (59%) and atrial fibrillation (36%) were the most common cardio-toxicities. One-year NRM was 38.5% in pt developing cardio-toxicity in the pCY cohort compared to no cardio-toxicity (15.3% in non-pCY and 18.3% in pCY, p = 0.004). OS was inferior in pt with cardio-toxicity in non-pCY (HR 5.49, p &lt; 0.001) and pCY (HR 2.3, p = 0.03) compared to pt without cardio-toxicity. In multivariable analysis, pCY was associated with an increased risk of mucositis (HR 1.48, p = 0.03), and hemorrhagic cystitis (HR 2.67, p = 0.004). The number of infused CD34 cells was associated an increased risk of cardiac toxicity (HR 1.13, p = 0.005). pCY was not associated with higher cardiac complications, and no impact of the number of infused CD34 cells, conditioning regimen and prior transplant was observed on hemorrhagic cystitis and mucositis. Conclusions: pCY was associated with significant morbidity compared to HLA-matched non-pCY cohort. Although cardio-toxicities were similar between both groups, it was associated with worse survival.
Practice gaps and challenges integrating new immuno-oncology agents in the treatment of cancer patients in the United States: A mixed-method study.
Authors: Neal E. Ready, Aparna Raj Parikh, Patrice Lazure, Morgan Peniuta, Marianne Davies, Monica Augustyniak, Jeffrey Caterino, Robert Lewandowski, Alexander J. Lazar, Suzanne Murray
Journal: Journal of Clinical Oncology (2020)

11028 Background: Previous research has indicated challenges integrating new immuno-oncology agents (IOAs) and predictive immune biomarkers into practice. Barriers, clinical gaps and underlying causalities explaining these challenges, however, are poorly understood. Methods: A mixed-methods educational needs assessment was conducted with physicians from 6 specialties (oncology, interventional radiology, pathology, pulmonology, emergency medicine and rheumatology), clinical pharmacists, physician assistants and advanced nurse practitioners involved in the care of cancer patients in the United States. Semi-structured interviews and discussion groups were thematically analyzed to identify challenges, barriers and underlying causalities. Qualitative findings subsequently informed the development of online surveys, which served to quantify findings. The following findings pertain to oncologists. Results: A total of 660 health care providers participated in the study, in which 17 interviews and 88 surveys were completed with oncologists. Seventy-two percent reported sub-optimal knowledge of the interactions between IOAs and the tumor’s micro-environment, while 62% reported sub-optimal skills determining which IOA to select based on this information. Oncologists reported sub-optimal knowledge of best practices for using IOAs to treat cancer in presence of an autoimmune disease (74%-80% depending on condition), and sub-optimal skills weighing the risks and benefits of prescribing IOAs for these profiles (66%-77%). In addition, 50% of oncologists reported feeling overwhelmed by the volume of new IOAs being made available. Many oncologists expressed doubts regarding the clinical benefit (59%) and innovative nature (43%) of emerging IOAs. Finally, 46% reported limited skills identifying viable treatment options based on pharmacodiagnostic test reports. Barriers to having predictive biomarkers inform treatment decisions included sub-optimal communication between specialists regarding specimen requirements and desired biomarker information. Conclusions: This study demonstrates the need to further support healthcare professionals as they face challenges integrating new IOAs and predictive immune biomarkers into practice. Given the wide array of IOAs becoming available each year, addressing the knowledge, skills, confidence and attitude gaps identified in this study could help improve health care delivery and potentially optimize outcomes for cancer patients.
Clinical value of piR-36026 and piR-651 in esophageal squamous cell carcinoma.
Authors: Wei Peng, Jun Zhu, Delin Liu, Pudong Qian, Qin Zhang, Houhuai Li, Guochun Cao
Journal: Journal of Clinical Oncology (2020)

e15265 Background: Piwi-interacting RNAs (piRNAs) are a novel type of small noncoding RNAs which have important biological functions in malignant diseases. However, little is known about the clinical value of piRNAs in esophageal squamous cell carcinoma (ESCC). Hence, we demonstrated that two representative piRNAs, piR-36026 and piR-651, to dig out their clinical value in ESCC. Methods: Quantitative real-time PCR was employed to detect the levels of piR-36026 and piR-651 expression in ESCC tissues. Furthermore, the correlation between them and ESCC patients' clinicopathological characteristics were explored. Receiver operating characteristic (ROC) curves were constructed for measuring significances of piR-36026 and piR-651 for ESCC diagnosis. Results: Both of piR-36026 and piR-651 were prominently increased in ESCC tissues compared with normal. Additionally, piR-36026 was related with ESCC patients' diameter (P = 0.013), TNM stage (P = 0.027), tumor differentiation (P = 0.008) and CEA (P = 0.013); and piR-651 was associated with diameter (P = 0.005), lymph node metastasis (P = 0.002), tumor differentiation (P = 0.008) and SCC (P = 0.002). The area under the ROC curve (AUC) of piR-36026 was up to 0.8634 (95% confidence interval: 0.8171-0.9089, P &lt; 0.05). Similarly, the AUC of piR-651 was 0.8525 (95% confidence interval: 0.7804-0.9247, P &lt; 0.05). Conclusions: These results demonstrated that both piR-36026 and piR-651 may play a crucial role in ESCC oncogenesis; and they may be diagnostic biomarker for ESCC.
儿童慢性鼻窦炎伴腺样体肥大手术治疗方法对比观察
Authors: 楼正才, 蒋丽芳
Journal: BMJ (2006)

儿童慢性鼻窦炎的手术治疗一直是争论的焦点,有学者认为腺样体切除术对治疗儿童鼻窦疾病有重要作用.本科自1998年2月至2004年12月对206例伴腺样体肥大并经药物保守治疗久治不愈的儿童慢性鼻窦炎患者行鼻内镜手术治疗,对比观察两种手术方法的疗效。
First in-human study of in vivo imaging of ex vivo labeled CAR T cells with dual PET-MR.
Authors: Ritu Singla, Dominic M Wall, Samuel Anderson, Nicholas Zia, James C Korte, Lucy Kravets, Gerard McKiernan, Jeanne Butler, Amanda Gammilonghi, Jyoti Arora, Ben J Solomon, Rodney J. Hicks, Timothy Cain, Phillip K. Darcy, Carleen Cullinane, Paul J. Neeson, Rajesh Ramanathan, Ravi Shukla, Vipul Bansal, Simon J. Harrison
Journal: Journal of Clinical Oncology (2020)

3557 Background: This is a first in human in-vivo biodistribution of ex-vivo labelled CAR T cells assessed in a cohort of patients. Cells were labelled with novel Cu-64 labelled superparamagnetic iron oxide nanoparticles (SPION) and infused IV into patients with solid tumors &amp; tracked using clinical dual PET-MR. The study validates the clinical translation of CAR T cell in-vivo tracking in real time. Methods: Cu-64 radioisotope was bound to silica coated SPION using electrolysis plating with tin &amp; palladium seeding. Cellular uptake of Cu-64 SPION was facilitated with a transfecting agent. Functional assays including 51 Chromium release, cytometric bead array demonstrated that labelling process did not affect cytotoxicity &amp; cytokine secretion (TNFα &amp; IFN-g). T cells were transduced with retroviral vector constructs encoding for second-generation chimeric T-cell receptor specific for carbohydrate Lewis Y antigen. Modified T-cells were expanded ex-vivo &amp; were labelled with Cu-64 (~300 MBq) prior to re-infusion (3 x10 8 labelled cells). Scanning is performed with Siemens 3T dual PET-MR scanner. Results: In this first in human in-vivo study (HREC/16/PMCC/30) a cohort of patients received ex-vivo labelled CAR T cells to determine how many labelled cells distribute to solid tumor sites within 3-5 days. Our results demonstrate that cells can be efficiently labelled (≤60%) with high cell viability (≥85%) at a sensitivity sufficient to detect labelled cells at tumor site for up to 5 days. An observed trend in SUV mean &amp; SUV max provided insight into efficacy &amp; individual response to therapy. Early time points showed moderate uptake of labelled cells in lungs posterior basal segments without increased activity over next few days, suggesting a transient process. Mild, diffuse bone marrow &amp; relatively intense uptake of labelled cells in liver &amp; spleen suggests margination of cells to reticulo-endothelial system. Distinct PET signal at some of the tumor sites at 24 h suggests antigen specific localization &amp; time taken to reach these sites. Excretion via hepatobiliary indicated reabsorption from GI tract &amp; re-circulation of labelled cells. Minimal uptake in brain &amp; heart supported safety profile of labeling agent. Conclusions: This is first in human in-vivo study to provide highly valuable visual and dynamic data in real time and provides insight into individual responses to therapy. CAR T cell functionality largely remain unchanged due to labeling process. The findings indicate that labelled cells traffic to tumor sites at later time points &amp; remain persistent for extended period of time.
Effects of 75 gram glucose oral tolerance test and standard meal test on insulin secretion function of islets of Langerhans and free fatty acid in patients with type 2 diabetes mellitus
Authors: 孙琦, 曾静波, 于康, 李玉秀, 刘秋英, 秦薇, 潘清蓉, 王姮
Journal: BMJ (2007)

目的 观察2型糖尿病患者75 g葡萄糖耐量试验(OGTT)和标准餐试验对胰岛素分泌功能和游离脂肪酸变化的影响.方法 76例病情稳定的2型糖尿病患者接受75 g OGTT试验,1周后再接受标准餐试验,观察空腹及口服75 g葡萄糖或标准餐后30、60、120、和180 min时血糖、胰岛素、C肽、游离脂肪酸(FFA)和血脂(胆固醇、甘油三酯、高密度脂蛋白和低密度脂蛋白胆固醇)水平.结果 OGTT与标准餐试验餐后血糖,餐后30 min为(15.3±3.5)与(9.9±3.4)mmol/L,60 min为(18.2±4.8)与(12.8±4.0)mmol/L,120 min为(16.3±5.8)与(12.2±4.9)mmol/L,180 min为(10.6±5.4)与(9.5±4.5)mmol/L,两者比较,差异有统计学意义(F=28.1,P＜0.01);胰岛素水平,餐后30 min为(29±27)与(19±17)μU/L,60 min为(41±31)与(31±19)μU/L,120 min为(38±34)与(42±37)μU/L,180 min为(16±12)与(23±23)μU/L,两者比较,差异有统计学意义(F=8.1,P＜0.01).而C肽水平的变化差异无统计学意义.血清FFA水平变化标准餐试验高于OGTT,差异有统计学意义(F=4.0,P＜0.05);多因素回归分析显示FFA水平与胰岛素敏感性之间的关联具有临界统计学意义(P=0.06),偏相关系数为0.607;而与受试者因素、甘油三酯、胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇之间无关联.结论 选择标准餐作为刺激物评价2型糖尿病患者胰岛素分泌功能,可减轻患者胰岛的负担,且能够改善胰岛素的敏感性,减少对血FFA水平的影响。
Altered expression of IL-1β in peripheral blood from gout patients and its association with gouty arthritis
Authors: Lingqin Li, Yufeng Qing, Quanbo Zhang
Journal: BMJ (2015)

Objective
To explore the role of interleukin (IL)-1β in the pathogenesis of gout.


Methods
Real-time quantitative polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay(ELISA) were used to measure the expression of IL-1β mRNA in peripheral blood mononuclear cells (PBMCs) and IL-1β in plasma samples from 120 acute gouty (AG) arthritis, 70 chronic gouty (CG) arthritis, 80 intercritical gouty (IG) arthritis patients and 96 healthy control subjects respectively.


Results
The expression of PBMCs IL-1β mRNA and plasma concentration of IL-1β were both much higher in gout patients than those in controls (P<0.01, respectively). And the plasma levels of IL-1β mRNA and IL-1β significantly increased in the AG group compared with CG and IG groups (P<0.01, respectively) and much higher in the CG group than those in the IG group.Positive correlations existed between plasma concentration of IL-1β and the levels of white blood cell, neutrophil, monocyte, erythrocyte sedimentation rate, blood uric acid, globulin and PBMCs IL-1β mRNA (P<0.01, respectively) while negative correlation between plasma IL-1β and plasma level of apolipoprotein in gout patients (P<0.05).


Conclusion
Elevated plasma level of IL-1β may be involved in the pathogenesis of acute and chronic gouty arthritis.


Key words: 
Arthritis, gouty; Interleukin 1β
腹部闭合性多脏器损伤86例分析
Authors: 齐春生, 侯新华, 王希水
Journal: BMJ (2004)

我院1991～2002年收治腹部闭合性多脏器损伤患者86例,报告如下. 1.临床资料:86例中男74例,女12例,6～68岁,平均39岁,占同期腹部闭合性损伤的17.7%(86/485),其中车祸伤53例.本组死亡24例,手术前死亡8例,术后1～15 d死亡16例。
Survey on learning resources of knowledge and problem solving of chronic diseases prevention and treatment in community physicians of Zhejiang Province
Authors: Xiao-ling Xu, Xin-hua Tang, Jing Yan, Wei Yu, Yi-feng Zhang, Jian-yong Luo, Qing-ming Liu
Journal: BMJ (2013)

Objective
To survey the learning resources of knowledge and problem solving of chronic disease prevention and treatment in community physicians.


Methods
A questionnaire survey was carried out among 891 community physicians who attended the Training course of Hypertension Community Control Technology from January 2011 to December 2012 in Zhejiang Province; to survey the influencing factors of their clinical ability and the problems of routine training.


Results
Total 855 effective questionnaires were returned. The main findings: 35.2% (301/855) obtained the knowledge of chronic disease diagnosis and treatment from routing training courses, 17.8% (152/855) from reading professional books and 17.2% (147/855) from the guidance from senior doctors. Different level hospitals and community doctors knowledge acquisition ways of title was different, and there was a statistically difference between them (P<0.05). When encountering clinical problem, 36.5% (23/63) senior physicians would seek answer from professional books and 31.7% (20/63) from clinical guidelines; 27.1% (68/251) doctors with middle title and 29.4% (159/541) junior doctors would mainly consult senior doctors. 30.1% (257/855) doctors thought heavy work load prevented them from further improvement of clinical skills, 28.3% (242/855) attributed it to difficulty to obtain advices from experts, 13.5% (115/855) attributed to difficulty in understanding the clinical practice guidelines, and 13.1% (112/855) attributed to less opportunity to attend professional conferences. The main defects of routine training were the contents not relevant to clinical practice, training time and place inappropriate.


Conclusions
Routine training is the leading way for primary care physicians to get professional knowledge about chronic disease, but the existing training mode and content need to be improved.


Key words: 
Chronic diseases; Community physicians; Questionnaires
Effect of folic acid supplementation on stroke prevention: a meta-analysis
Authors: Mingchao Li, Lijun Wang, Qiantao Cheng, Xiangyang Cao
Journal: BMJ (2014)

Objective
To conduct a meta-analysis based on relevant, up-to-date published randomized trials to further examine the effect of folic acid supplementation on the risks of stroke.


Methods
We searched all randomized trials in the Pubmed, Embase, Cochrane Libarary, OVID, Sinomed, Wanfang database and CNKI from 1966 to 2013.Relative risk (RR) was used as a measure of the effect of folic acid supplementation on the risks of stroke with a fixed effect model. The analysis was further stratified by the influencing factors of treatment efficacies.


Results
The data were collected from 15 randomized trials of folic acid in which stroke was reported as one of endpoints. Folic acid supplementation significantly reduced the risk of stroke by 8% (RR=0.92, 95%CI: 0.80-0.99, P=0.03). In stratified analyses, greater beneficial effect was seen in those trials with no fortification grain of 0.92(95%CI: 0.80-0.99, P=0.04), a treatment duration of >36 months (RR=0.92, 95%CI: 0.85-1.00, P=0.05), low dosage of folic acid (RR=0.92, 95%CI: 0.85-1.00, P=0.05). RR for the trials with reduced homocysteine concentration of 20% or more was 9%(RR=0.91, 95%CI: 0.83-0.99, P=0.03)


Conclusions
Folic acid supplementation is effective in stroke prevention. In addition, greater beneficial effect may be obtained with a lower long-term dosage of folic acid.


Key words: 
Folic acid; Stroke; Meta-analysis