tbuckley/cabot-search huggingface dataset:
Phase II expansion cohort in colorectal cancer to evaluate the safety and tolerability of RRx-001 blood mix.
Authors: George A. Fisher, Scott Caroen, Bryan Oronsky, Jeannie Williams, Tony R. Reid
Journal: Journal of Clinical Oncology (2020)

e16144 Background: In a 34 patient randomized Phase 2 trial in 3 rd /4 th line colorectal cancer called ROCKET (NCT02096354) of RRx-001 + irinotecan versus regorafenib + irinotecan, RRx-001 + irinotecan demonstrated improved overall survival (OS) (8.6 vs 4.7 months) and progression free survival 2 (PFS2) (7.5 vs. 1.7 months) compared to the regorafenib control arm. The main adverse event attributed to RRx-001 treatment, which involved once weekly peripheral or central infusion, was a painful infusion-related superficial phlebitis in 80% of patients. Following the randomized portion of the ROCKET trial, another 18 colorectal patients were enrolled in an expansion cohort to evaluate the safety and tolerability of an RRx-001 “blood mix”, the objective of which was mitigation of the phlebitic complications of direct RRx-001 infusion. Methods: Therapy consisted of intravenous administration of RRx-001 at 4 mg once weekly via blood mix until progression followed by intravenous infusion of irinotecan at 180 mg/m 2 on day 1 in a 21-day cycle. Results: The median OS and PFS2 were 6.3 and 5.2 months, respectively, which was similar to that of RRx-001 administered by direct infusion in the randomized part of the trial. No patients experienced phlebitis. The adverse event profile was otherwise unchanged compared with direct IV infusion of RRx-001. Conclusions: The results of this expansion cohort demonstrate similar activity of RRx-001 given by blood mix followed by irinotecan to RRx-001 given by direct IV infusion followed by irinotecan.RRx-001 alleviated the pain that had been observed in the direct IV infusion and therefore allowed for a shorter infusion time without any apparent compromise in activity (based on OS/PFS2 comparability to earlier results). Finally, since phlebitis in theory may progress to deep venous thrombosis or suppurative thrombophlebitis in hypercoagulable and immunosuppressed cancer patients, blood mix RRx-001 is the preferred method of infusion. Clinical trial information: NCT02096354 .
The epidemiology of pre-hospital emergency medical care in Nanxing District of Shanghai
Authors: Hai-long Zhou, Hai-wen Yu, Li-jie Cao, Pei-lin Zhong
Journal: BMJ (2008)

Objective The pre-hospital data of 839 emergency patients who were admitted to Naxiang Emergency Center of Shanghai from Dec 11 2006 to Jun 11 2007 were analyzed.The first five causes of emergency call were trauma,diseases of newborns,neuron-system diseases.eardio-vascuIar diseases and digestive diseases.The epidemiological data including gender,age of patients,distance to emergency site,duration of ambulance dispatch,results of first aid.etc were also presented in the paper.These data would be helpful for improving pre-hospital medical care of emergency patients.

Key words: 
Emergency medical services; Epidemiology
Prognostic significance of hormone receptor (ER/PR) status in endometrial carcinoma in black women: Implications with lymph node metastasis.
Authors: Manan Shah, Sanjay R Jain, Gabriela Oprea, Saba Shafi
Journal: Journal of Clinical Oncology (2020)

e18099 Background: Histological examination of tumor tissues is necessary for deciding if endometrial surgery should include lymph node sampling. Studies have demonstrated that loss of estrogen and progesterone receptors (ER/ PR) independently predicts lymph node metastasis and poor prognosis. African American females in comparison to their Caucasian counterparts are diagnosed at a later stage, with higher grade, poorer prognostic histological types and worse outcomes. Our study aimed to investigate if the correlation between hormone receptor status and lymph node metastasis holds true in African American females which could aid in treatment strategies. Methods: We reviewed African American females (n = 70) diagnosed with Endometrial Cancer at our institution from 2015-2018 including endometrioid/non-endometrioid histology, FIGO stage I-IV, grade 1-3 for ER/PR receptors and presence or absence of pelvic lymph nodes based on preoperative endometrial curettage and post-surgical pathology specimens. Statistical analyses were performed using Fisher’s Exact test exploring associations between categorical variables (ER/PR and Lymph nodes Metastasis). All statistical tests were two-sided and considered significant if P value &lt; 0.05. Results: The mean age of our sample was 61 ± 13 years. Mean BMI was 36±10kg/m 2 . Majority of our patients were postmenopausal (59 out of 70, 84%). FIGO Stage 1 and 2 constituted 72% (50 out of 70). Endometrioid histology constituted 39 out of 70 (55%) cases and non-endometrioid histology which includes serous, mixed and carcinosarcomas constituted 45% of the cases. Loss of estrogen receptor(ER-) was observed in 19 of 70 patients (27%) and loss of progesterone receptor(PR-) was seen in 22 patients (31%) which was significantly associated with lymph node metastasis (p value &lt; 0.05).On subgroup analyses significant association was observed between PR+ and absence of lymph node metastasis in cases of endometrioid cancer (p value &lt; 0.05) . Nevertheless, there was no statistical significant association (P value .10) between ER receptors and lymph node metastasis in patients with endometrioid cancer. In non-endometrioid histology both ER- and PR- were found to have statistical significant lymph node involvement. Conclusions: Loss of ER and PR receptors independently predicts lymph node metastasis in endometrial cancers in African American females.
Prevention of chemotherapy-induced ovarian failure by ganodotropin releasing hormone-analogue
Authors: 郭奕倩, 白文佩
Journal: BMJ (2010)

随着医学科学的进步,化学治疗(化疗)技术日益成熟,化疗后生存率也逐步提高,但化疗药物可以造成许多女性血液病及肿瘤患者出现卵巢功能早衰(premature ovarian failure,POF),严重影响其生存质量.据报道,患乳腺癌的患者中25%为40岁以下的女性,而不孕是乳腺癌化疗药物对这类人群最常见的长期不良反应。
A knowledge, attitudes and practices survey for medical trainees about cancer in the LGBTQ community.
Authors: Alankrita Taneja, Sabrina Stark, Bhavin Chokshi, Rashid Alhusain
Journal: Journal of Clinical Oncology (2020)

e19073 Background: The purpose of our study was to assess the extent of knowledge, attitudes and practices regarding cancer in the LGBTQ community among medical students and resident physicians at the Detroit Medical Centre/Wayne State University program. Methods: A 15 question validated survey was electronically provided to medical students and resident physicians. The survey included questions that assessed the knowledge, attitudes and practices regarding cancer in the LGBTQ community. Respondents selected a choice based on a 5 item rating scale that ranged from "strongly agree" to "strongly disagree." In addition, participant demographics including training level and gender/sexual identity were collected. Descriptive statistics (counts and percentages) were used to quantify survey responses. Results: A total of 110 responses were received. The respondents consisted of 77% medical students as well as 8.2% interns and 13.7% senior residents in the department of internal medicine. Five percent of the responders reported having rotations in Corktown Health Center, which is an LGBTQ clinic. Majority (82.7%) reported that they were heterosexual while the rest were homosexual, bisexual, pansexual or preferred not to say. In terms of knowledge, one third of the responders reported being well informed on the health needs of LGBTQ patients. While majority (82.1%) believed that LGBTQ patients avoid accessing healthcare, 7% of the respondents disagreed that transgender individuals are less likely to have health insurance. In terms of attitudes, majority (97%) agreed that the LGBTQ population has unique health risks. 82% of the responders believe that it is important to know the gender identity and the sexual orientation of the patients to provide the best care, however only 30% practiced actively inquiring about a patient’s sexual orientation when taking a history. One third of the responders assume that the patient is heterosexual upon first encounter. Ninety five percent of medical trainees agreed that formal education needs to be provided in medical school or as part of residency curriculum on LGBTQ health needs. Conclusions: Our survey shows that there is a gap in knowledge and practices of medical trainees about health needs of the LGBTQ population. Majority of the respondents believe that training about cancer in the LGBTQ population needs to be integrated into medical school or residency curriculum. Exclusion of LGBTQ- specific health needs from medical school and residency curricula contributes to cancer related health inequities faced by this population.
Multi-disciplinary team for diagnosis and treatment of inflammatory bowel disease
Authors: Saizheng Lin, Jianting Cai, Yan Chen
Journal: BMJ (2016)

Inflammatory bowel disease (IBD) is a group of chronic non-specific inflammatory conditions of the intestine with unknown etiology.IBD has variety of intestinal manifestations and complications and there is lack of gold standard for diagnosis, so the disease should be diagnosed on the basis of clinical manifestations, endoscopic findings and histopathological examination.Most patients require surgical treatment and long-term maintenance of medication.Multi-disciplinary team (MDT), consisting of gastroenterologist, general surgeon, anorectal surgeon, nutritionist and psychologist, is needed for individualized treatment of patients.This article introduces the MDT model of diagnosis and treatment, and its application in inflammatory bowel disease.


Key words: 
Inflammatory bowel disease; Multi-disciplinary team
麻疹合并肝损伤59例临床分析
Authors: 崔凤芹, 王海艳, 毛敬珍
Journal: BMJ (2007)

我院2006年1月至6月收治麻疹72例,其中合并肝脏损伤的59例,报道如下. 1.临床资料:男32例,女27例,年龄6个月至39岁,其中6个月～5岁者占60%(35例),6～19岁占13%(8例),≥20岁的占27%(16例).全部病例按人民卫生出版社彭文伟主编的《传染病学》第6版标准诊断为典型麻疹.
Phase I/II study of T-DM1 alone versus T-DM1 and metronomic temozolomide in secondary prevention of HER2-positive breast cancer brain metastases following stereotactic radiosurgery.
Authors: Alexandra Dos Santos Zimmer, Seth M. Steinberg, DeeDee Kay Smart, Mark R. Gilbert, Terri Armstrong, Eric Burton, Nicole D. Houston, Nadia Biassou, Brunilde Gril, Priscilla Kaliopi Brastianos, Scott L Carter, David Lyden, Stanley Lipkowitz, Patricia Schriver Steeg
Journal: Journal of Clinical Oncology (2020)

TPS2572 Background: We demonstrated that low doses of temozolomide (TMZ) administered in a prophylactic, metronomic fashion significantly prevented development of brain metastases in murine models of breast cancer. Based on these findings, we developed a secondary-prevention clinical trial. Methods: Phase I is a standard 3+3 design: T-DM1 3.6mg/kg IV every 21 days plus TMZ 30, 40 or 50 mg/m2 daily, to identify the maximum tolerated dose (MTD) of the combination, and is completing accrual, with 9 patients accrued, currently on the third and last dose level. Phase II will randomize patients to T-DM1 3.6mg/kg versus T-DM1 3.6mg/kg plus TMZ at recommended phase 2 dose (RP2D), to evaluate if addition of TMZ improves the recurrence-free incidence from distant new brain metastases at one year from 50% to 65%. Patients will undergo radiology guided lumbar puncture at baseline and after 6 weeks of treatment (C3D1) for correlative studies, brain MRI, systemic restaging CTs, and questionnaires for evaluation of symptoms and quality of life. Eligibility: HER2+ breast cancer with brain metastases (up to 10 lesions), treated with SRS and/or resection ≤12 weeks before enrollment, no leptomeningeal metastases, no previous WBRT, ECOG ≤2 and adequate organ and marrow function. Biomarkers, including cell free DNA from CSF, serum and tumor block, exosomal DNA, serum markers for neuroinflammation, and patient reported outcomes, will be analyzed in an exploratory fashion. Target accrual: up to 18 patients in phase I and 98 in phase II. Clinical trial information: NCT03190967 .
Identification of potential predictive biomarkers of rapid progression and rapid response to anti-PD1 treatment by gene profiling analysis in metastatic melanoma patients.
Authors: Domenico Mallardo, Antonio M Grimaldi, Mariaelena Capone, Nicholas Bayless, Gabriele Madonna, Lucia Festino, Maria Grazia Vitale, Claudia Trojaniello, Vito Vanella, Marcello Curvietto, Assunta Esposito, Marco Palla, Luigi Scarpato, Ernesta Cavalcanti, Corrado Caraco, SuFey Ong, Sarah Warren, Alessandra Cesano, Paolo Antonio Ascierto, Ester Simeone
Journal: Journal of Clinical Oncology (2020)

e22068 Background: Anti-PD-1 agents represent a standard treatment for melanoma patients. However, most patients fail to respond, showing in some cases very rapid disease progression. At moment, there are no effective biomarkers that can predict patient's clinical benefit. The aim of this study is to retrospectively identify gene profiling biomarkers that could help to select melanoma patients who most likely respond to anti-PD-1 therapy. Methods: We defined as fast responder (FR) or fast progressor (FP) patients who got clinical response or clinical progression after two cycles of therapy. We collected data from 44 metastatic melanoma patients (21 FR and 23 FP) treated in first-line with anti-PD1 monotherapy (nivolumab or pembrolizumab) at National Cancer Institute of Naples, Italy. Gene expression profiling analysis was performed using NanoString IO 360 panels on PBMCs collected at baseline from 18 patients (10 FR and 8 FP). Patients with ECOG≥2 were excluded. They were all IV stage (5 M1a, 1 M1b, 12 M1c) of which 15 were B-RAF wild-type (83%) and 3 were B-RAF mutated (17%). Statistical associations between treatment response and gene score variables were estimated by Student’s T tests and correction for multiple comparisons by the Benjamini-Hochberg method. Results: Patterns of gene expression were assessed for correlation to response. We compared PBMCs nanostring analysis between FR and FP patients. We found a higher expression of KRas, CD39, IFI16, IL18, FCGR2A, IL1RN, MAP3K8, TLR5, TLR8, MyD88 and NF-kB in FP patients (all with p-value ≤0.005), most of them related to cell proliferation and immunosuppressive mechanism. Instead we found a higher expression of PRF1, PIK3R1, HLA-DPA1, HLA-DRB1, HLA-DOA, CD45RA, LDHB, KIR3DL2, CD2, CD28, CD7, CD27 in FR patients (all with p-value ≤0.01), most of them related to priming and cytolysis. Conclusions: These preliminary data obtained through gene profiling analysis on baseline PBMCs of melanoma patients suggest that a specific gene signature may discriminate FR or FP patients. Our study provides rationale for further investigating gene profiling signature as a potential association for response to immunotherapy.
非甾类抗炎药在类风湿关节炎治疗中的应用
Authors: 张江林
Journal: BMJ (2005)

非甾类抗炎药(NSAIDs)指不含皮质类固醇激素的抗炎止痛药,在类风湿关节炎(RA)的治疗中,是关节止痛、消肿的一线治疗,可以缓解RA的症状,但也可能带来胃肠道损伤等各种副作用,所以合理使用NSAIDs在RA的治疗中至关重要[1]。
Necessity and strategy of scientific research in General Practice
Authors: Yuan Lu, Zhaoxin Wang, Jianwei Shi, Chengdong Ji, Ying Pan, Hanzhi Zhang, Jianjun Han, Dehua Yu
Journal: BMJ (2017)

全科医学的科研目的是解决与全科医学相关的实际问题。通过分析国内全科医学的科研现状，从医学发展、学科发展和个人发展的角度阐述全科医生开展科学研究的必要性，并提出通过强化科研意识、加大科研管理和提高科研能力等促进全科医生开展科学研究的策略建议。
应用递增剂量方法提高患者对卡托普利的耐受性
Authors: 龚树春, 徐南图
Journal: BMJ (2004)

卡托普利(captopril)是目前使用最广的抗高血压药之一,由于可致刺激性干咳,使一部分患者使用受到限制.我们自2001年6月～ 2003年6月对82例因卡托普利副作用而中断用药的高血压患者采用递增剂量方法,提高其对卡托普利耐受性,报告如下。
Effectiveness of brief-focused cognitive behavioral therapy in the reduction of cancer-related distress and emotive problems: A comparative study.
Authors: Alessandro Rossi, Maria Marconi, Stefania Mannarini, India Minelli, Silvia Bianchi, Claudio Verusio
Journal: Journal of Clinical Oncology (2020)

e24169 Background: In recent years, there was an increase of cognitive-behavioral therapy (CBT) oriented brief-focused psychological intervention protocols for the reduction of cancer-related emotive difficulties that oncological patients have to face almost every day and that could have a negative impact on medical treatment (Di Matteo, Lepper &amp; Croghan, 2006; NCCN, 2015). Thus, this study aimed to determine the effectiveness of a 10-session brief CBT (B-CBT-P) compared with a control group (CG). Methods: Participants ( n = 67; mean age = 63.11, SD = 12.1, 35 female) enrolled at the Oncology Day Hospital at the “Presidio Ospedaliero” of Saronno, ASST Valle Olona, Italy who undertook (B-CBT-P: n = 34) or non-undertook (CG: n = 33) a psychotherapy intervention – with one of two different psychologists (authors MM and MI) to avoid potential biases. Participants were tested with the Distress Thermometer and the Problem List (DT&amp;PL) at the baseline (T1; overall McDonald’s omega = .90), at the end of the 10-sessions B-CBT-P (T2; overall McDonald’s omega = .89). Results: A multilevel-multivariate repeated measure regression analysis was performed – controlling for age, type and localization of tumor, and therapist. In line with psychotherapy protocol, results showed no statistical significant changes for ‘practical problems’ ( p = 0.0497 ns), ‘spiritual problems’ ( p = 0.321 ns), and ‘physical problems’ ( p = 0.206). Results revealed a statistical significance reduction of ‘relationships problems’ ( p = 0.015; pooled Cohen’s d = 0.341), ‘emotive problems’ ( p = 0.012; pooled Cohen’s d = 0.349), and the distress thermometer ( p = 0.008; pooled Cohen’s d = 0.373). Conclusions: Considering that emotive and relational problems, as well as distress, occurs frequently among oncological patients, this study is into an important area. Results suggest that B-CBT-P is statistically and clinically effective to improve the emotive and relational sphere of oncological patients. However, the small effect sizes found suggest that these short protocols may not be sufficient to bring important changes in the patient's life. This study opens up to the idea of improving these protocols so that the cancer patient can improve his quality of life – even with a few psychotherapy sessions.
Efficacy of Saccharomyces boulardii in treatment of candida esophagitis
Authors: Qiutang Xiong, Xing Chen, Zhifeng Wang, Lang He, Chengyi Qu
Journal: BMJ (2017)

The efficacy and safety of Saccharomyces boulardii in treatment of candida esophagitis was investigated by a single center, prospective, open label and non-inferiority trial. Eighty nine patients with candida esophagitis attending in Shanxi Provincial People′s Hospital during April 2015 to March 2016 were randomly divided into Saccharomyces boulardii group (45 cases) and nystatin group (44 cases), and oral Saccharomyces boulardii powder and Nystatin tablets were given to two groups respectively. The curative effect was evaluated by gastroscopy after the treatment. The results showed that the cure rate of Saccharomyces boulardii group and nystatin group was 68.9%(31/45)and 63.6%(28/44), and the Saccharomyces boulardii was noi inferior to nystatin (χ2=3.027, P 0.05]. The incidence of adverse reactions in boulardii group was significantly lower than that in nystatin group [2.2%(1/45) vs. 22.7%(10/44), χ2=8.636, P<0.05]. The study suggests that the cure rate of Saccharomyces boulardii is not inferior to nystatin in treatment of candida esophagitis, while the incidence of adverse reactions of Saccharomyces boulardii is lower.


Key words: 
Candida; Esophagitis; Saccharomyces; Nystatin
痤疮的诊断和治疗
Authors: 蔡林
Journal: BMJ (2010)

痤疮是一种毛囊、皮脂腺的慢性炎症,好发于青春期,俗称青春痘.痤疮的病因包括皮脂腺皮脂的分泌率增加;毛囊、皮脂腺导管开口不通畅;痤疮丙酸杆菌过度增殖;炎症反应;与遗传、药物(含碘剂、溴剂的药物及长期口服激素)、某些化妆品(含激素成分)及环境因素和精神因素有关。
Effect of alogliptin on albuminuria in patients with early type 2 diabetic nephropathy and related mechanism
Authors: Wencong Li, Hong Miao, Lei Zhu, Jinpeng Ma, Xiangxiang Wang, Li Zhang, Peng Fu, Haijiao Wang, Hao Li
Journal: BMJ (2019)

Objective
To investigate the effect of alogliptin on albuminuria in patients with early type 2 diabetic kidney disease (DKD) and the related mechanism.


Methods
One hundred patients with early DKD admitted in our hospital from May 2016 to May 2017 were randomly divided into two groups with 50 cases in each group. Patients in the control group were given metformin and gliclazide, while those in study group were given metformin and alogliptin, the treatment lasted for 24 weeks. The changes of urinary albumin-to-creatinine ratio (UACR), stromal cell-derived factor-1α (SDF-1α) and the fasting plasma glucose (FPG), 2-h postprandial plasma glucose (2 hPPG), glycosylated hemoglobin(HbA1c) were measured before and after the treatment in two groups.


Results
There were no significant differences in HbA1c [(8.17±0.46)% vs. (8.29±0.48)%], UACR[(109±53) vs. (105±48)mg/g], SDF-1α [(1.21±0.3 9) vs. (1.17±0.35)μg/L] levels before treatment between two groups (t=0.343, 0.464, 0.075, all P>0.05). After treatment, the HbA1c levels were significantly decreased in both groups (t=2.293, 2.302, all P=0.03) and there was no significant difference between two groups[(6.82±0.75)% vs. (6.93±0.79)%, t=0.295, P=0.77]; the UACR levels were significantly reduced in both groups, but the level of study group was significantly lower than that of control group [(82±38) vs.(94±47) mg/g, t=3.320, P 0.05].


Conclusion
Alogliptin can effectively control the blood glucose, reduce urine albumin excretion and protect renal function in patients with early type 2 diabetic nephropathy, which is associated with the increased SDF-1α levels.


Key words: 
Diabetic nephropathies; Dipeptidyl-peptidase Ⅳ inhibitors; Urinary albumin- to-creatinineratio; Albuminuria; Stromal cell-derived factor-1α
Leveraging real world data and AIML to inform smart patient care in oncology.
Authors: Li Zhou, Rob Steen, Lynn Lu
Journal: Journal of Clinical Oncology (2020)

e20002 Background: Identifying optimal therapy options can help maximize treatment outcomes. Finding ways to help improve treatment decision is of great value to achieve better patient care. With the availability of robust patient real world data and the application of state of the art Artificial Intelligence and Machine Learning (AIML) technology, new opportunities have emerged for a broad spectrum of research needs from oncology R&amp;D to commercialization. To illustrate the above advancements, this study identified patients diagnosed with CLL who may progress to next line of treatment in the near future (e.g. future 3 months). More importantly, we can identify treatment patterns which are more effective in treating different types of CLL patients. Methods: This study includes multiple steps which have already been analyzed for feasibility: 1. Collect CLL patients. IQVIA's real world data contains ~60,000 active CLL treated patients. ~2,000 patients have progressed line of treatment in 3 month. 2. Define patients into positive and negative cohorts based on those who have/have not advanced to line L2+. 3. Determine patient profiles based on treatment regimens, symptoms, lab tests, doctor visits, hospital visits, and co-morbidity, etc. 4. Select patient and treatment features to fit an AIML predictive model. 5. Test different algorithms to achieve best model results and validate model performance. 6. Score and classify CLL patients into high and low probability based on the predictive model. 7. Match patients based on feature importance and compare regimens between positive and negative cohort. Results: Model accuracy is above 90%. Top clinical features are calculated for each patient. Optimum treatment patterns between high and low probability patients are identified, with controlling patient key features. Conclusions: Conclusions from this study is expected to yield deeper insight into more tailored treatments by patient type. CLL patients started with oral therapy(targeting) have better response than other treatments.