tbuckley/cabot-search huggingface dataset:
Effect of sarcopenia on skeletal muscle and cardiac function in elderly patients with chronic heart failure
Authors: Shuanli Xin, Fenghui Jiao, Chao Chang, Xiufeng Zhao, Kailong Meng, Lijun Liu, Liying Han, Lihong Zhang
Journal: BMJ (2019)

Objective
To investigate the effect of sarcopenia on the skeletal muscle and cardiac function in elderly patients with chronic heart failure (CHF).


Methods
Sixty patients with CHF and sarcopenia and 60 sex and age-matched CHF patients without sarcopenia were enrolled from September 2014 to December 2015. The skeletal mass was evaluated by fat-free mass index (FFMI) and muscle function was evaluated by gait speed (GS), hand strength (HS) and the simple physical performance battery (SPPB). The cardiac function was accessed by a 6-min walk distance (6-MWD) and left ventricular ejection fraction (LVEF). Furthermore, the serum inflammation cytokines IL-6, TNF-α, and skeletal muscle biomarker C1q were measured.


Results
The CHF patients with sarcopenia had lower values for skeletal muscle mass: FFMI [(17.68±0.74) vs. (18.34±0.54)kg/m2, F=33.696, P<0.05] and lower muscle function: HS [(17.26±4.20) vs. (28.85±6.43)kg, F=136.54, P<0.05], GS [(0.65±0.11) vs. (0.90±0.10)m/s, F=-12.922, P<0.05], SPPB [(6.45±2.07) vs. (7.65±1.76), t=-3.452, P<0.05]. And the cardiac function decreased significantly in patients with sarcopenia: 6-MWD [(253.76±72.62) vs. (340.91±55.78)m, F=54.350, P<0.05], LVEF [(39.12±7.02)vs. (43.83±5.81)%, t=16.060, P<0.05]. Serum IL-6/TNF-α/C1q levels were significantly elevated: IL-6[(14.12±1.40) vs. (13.46±1.06) ng/L, F=8.513, P<0.05], TNF-α [(443.43±28.06) vs. (299.37±21.53)ng/L, t=31.556, P<0.05], C1q[(578.92±23.63) vs. (504.11±41.77)ng/L, F=145.78, P<0.05].


Conclusion
The CHF patients with sarcopenia present less skeletal muscle mass, poorer skeletal function and reduced cardiac function, and higher inflammation levels.


Key words: 
Heart failure; Aged; Complement C1q; Sarcopenia
Encephalitis with positive LGI1 antibody: a clinical analysis of 4 cases
Authors: Junhua Gao, Bowen Zheng, Wurong Li, Yuming Huang, Wenqing Wu
Journal: BMJ (2020)

The clinical manifestations,serum and cerebrospinal fluid (CSF) results,EEG and imaging findings of 4 cases of encephalitis with positive leucine-rich glioma inactivated protein 1 (LGI1)antibody admited from March 2017 to January 2019 were retrospectively analyzed.All 4 patients were males with a mean age of (42±17) years.Two patients had faciobrachial dystonic seizure(FBDS)as the main symptom,and 3 patients had epilepsy.There were normal blood sodium and no memory deficits in all 4 patients.The LGI1 antibody was positive in the serum and negative in the CSE.The longest diagnosis time was 5 months.The head MRIs were normal in 3 patients;and abnormal signals in the right basal ganglia were found in one case,and the lesicl became smaller after the treatment.Chest CT,abdominal CT,and pelvic CT did not detect tumors.All patients were treated with gamma globulin and glucocorticoids,they all had good prognosis.LGI1 antibody-positive encephalitis is mainly characterized by epilepsy. ldentifying FBDS would be helpful for early diagnosis.Timely treatments often result in good clinical prognosis.

Key words: 
Limbic encephalitis; Leucine-rich glioma-inactivated 1 antibody; Faciobrachialdystonic seizures; Epilepsy
Stereotactic body radiation therapy (SBRT) in a developing country: Patterns of failure and response rates.
Authors: Daniel Przybysz
Journal: Journal of Clinical Oncology (2020)

e21010 Background: Surgery remains the treatment of choice for early stage lung cancer. For patients without clinical conditions or those who refuse to this procedure, Stereotactic Body Radiation Therapy (SBRT) is the treatment of choice. It is important to understand the patterns of treatment response and toxicities within this practice. Therefore, we aim to analyze and review our data on lung SBRT for Non-Small Cell Lung Cancer (NSCLC) treated in our institution. Purpose: To describe response and toxicity patterns for NSCLC treatment with SBRT in a single third world country private institution. Methods: We retrospectively collected and analyzed data from patients treated at a single private institution in Rio de Janeiro between January 2017 and May 2019. Inclusion criteria were histopathological diagnosis of NSCLC, 18 years old or older, SBRT treatment, who were closely followed-up according to international guidelines. All data was analyzed and reviewed by the radiation oncologist and medical oncologist responsible, as well as kept in a reliable way for future comparisons. Results: 121 patients were analyzed. 77 were excluded. Only patients diagnosed with NSCLC from 2017 to 2019 who received SBRT as primary treatment. The average age was 74 (56-94). The highest prevalence among patients were females 68% (n = 30). 26 patients were smokers (59%), 4 non-smokers (9%) and 14 patients were not recorded in the medical records. Molecular assessment for non-smokers will not be described in this study. Adenocarcinoma was the most common subtype (77%, n = 35), 15% were squamous cell carcinoma subtype (n = 7), 4.4% poorly differentiated (n = 2). The patients were distributed between early stage lung cancer and metastatic disease - foreseeing oligometastatic disease being continuously treated as potentially curable. 11 patients are not classified in the medical record. Twelve patients had metastasis: central nervous system (33%), lung (41%), bone (8.3%) and patients with more than two metastases 16.6% (bone and CNS, bone and lung). Eleven patients had adjuvant chemotherapy (QT) 25%. Ten of the patients (22%) had toxicities, all with different doses and SBRT fractions. Among them, cough was the most prevalent (40%); nausea / vomiting and rash accounted for 30%; pneumonitis accounted for 17%; and mucositis in 10% of patients. Of the 44 patients, 7 died. Conclusions: The study data corroborates the worldwide published literature. SBRT in treating early stage lung cancer is a safe and effective treatment modality, with acceptable low-grade toxicities and high response rates.
Updated results of a phase I/II prospective dose escalation trial evaluating safety and efficacy of combination <sup>177</sup>Lu PSMA 617 and idronoxil in men with mCRPC post androgen signalling inhibition and taxane chemotherapy (LuPIN trial).
Authors: Louise Emmett, Sarennya Pathmanandavel, Megan Crumbaker, Christopher Rofe, Andrew On Wah Yam, Bao Ho, Wai Ling Chan, Shikha Sharma, Joanne Keane, Adam James Hickey, Karen Fullard, Kamonwan Kongrak, Lalith Ratnayake, John A. Violet, Arun Azad, Peter Eu, Andrew Nguyen, Anthony M. Joshua
Journal: Journal of Clinical Oncology (2020)

5557 Background: There is no established standard of care post cabazitaxel in men with mCRPC. Ongoing trials in 177 LuPSMA-617 have demonstrated good efficacy and safety, but synergistic combinations may further improve treatment responses. Idronoxil (NOX66) inhibits external NADH oxidase type 2 with downstream pro-apoptotic actions including radio-sensitization. Herein we present updated results and an additional cohort of a prospective single arm phase I/II dose escalation/expansion trial of LuPSMA-617 and NOX66 in mCRPC. Methods: Men with progressive mCRPC post androgen signalling inhibition (ASI) and 2 lines of taxane chemotherapy were considered eligible. Key inclusion criteria included PSMA PET/CT intensity SUV max &gt; 15 with no discordant disease on FDG PET/CT, Hb &gt;10, Platelets &gt;100 and GFR &gt;40mls/min. Enrolled patients received up to 6 doses of 177 Lu-PSMA 617 (7.5Gbq) day 1 every 6 weeks in combination with NOX66 days 1-10 each cycle. Cohort 1 (n=8) received 400mg NOX66. Cohorts 2 and 3 subsequently received 800mg and 1200mg of NOX66, respectively, following safety reviews. Data regarding safety, efficacy, pain scores, and QOL were collected. Results: 32 men were enrolled in cohorts 1&amp;2 (November 2017 – June 2019) and 24 in cohort 3 (August 2019-February 2020). To date there have been no dose-limiting toxicities. Data for cohort 3 are immature. For cohorts 1 &amp; 2: 31/32 men received ≥2 cycles, with 12/32 (47%) completing 6 cycles. Any PSA response was seen in 84% (27/32), with a PSA response &gt; 50% in 62.5% (20/32). Median PSA PFS is 6.1 months Of men with increased baseline pain scores ≥3 (24/32), 50% (12/24) had a clinically significant reduction in pain indicators. Adverse events are summarized below. Updated results for cohorts 1 and 2 and preliminary results of cohort 3 will be presented. Conclusions: Combination LuPSMA-617 + NOX 66 appears safe and efficacious in men with heavily pre-treated end stage mCRPC. Clinical trial information: ACTRN12618001073291 .
纤维支气管镜诊治支气管异物继发肺部感染二例
Authors: 周一平, 夏利萍, 张贵昌, 黄万钟
Journal: BMJ (2006)

例1 女,21岁,因咳嗽、咳痰6年、左胸痛1周于2002年6月10日入院.患者自6年前出现咳嗽、脓痰,量时多时少,伴少量咯血,经某院胸部CT等检查诊断为左下肺炎并胸膜肥厚,并治疗好转.此后经常咳痰,劳累、受凉后咳黄痰,但很少发热、咯血。
融汇中西 注重国情:解读中国《妊娠和产后甲状腺疾病诊治指南》
Authors: 单忠艳
Journal: BMJ (2012)

妊娠期甲状腺疾病因其对母胎的危害、诊断和治疗的特殊性,而备受关注.最近由中华医学会内分泌学分会和中华医学会围产医学分会联合编撰的中国《妊娠和产后甲状腺疾病诊治指南》,为临床诊治妊娠和产后甲状腺疾病提供了科学的依据.本文就妊娠甲状腺功能异常的诊断、治疗和筛查问题,解读《指南》。
Prevalence of human leukocyte antigen-B27 supertype in the context of positively charged neoepitopes and association with PD-L1 as an immune escape mechanism.
Authors: Charlene Marie Fares, Amy Lauren Cummings, Matthew Karl Theisen, Jaklin Gukasyan, Jackson P Lind-Lebuffe, Wisdom O Akingbemi, Debory Y Li, Paige M Brodrick, Nawal M Yessuf, Chantal Ava Barksdale, Deborah J.L. Wong, Aaron Elliott Lisberg, Edward B. Garon
Journal: Journal of Clinical Oncology (2020)

3083 Background: Recent evidence suggests efficacy of immune checkpoint blockade may be influenced by human leukocyte antigen (HLA)-B. HLA-B27 supertype has an electronegative binding pocket which favorably binds and displays neoepitopes harboring positively charged amino acids (AAs). Based on immune surveillance, we postulate that B27 tumors that have favorable neoepitopes should face negative selective pressure, and B27 tumors with favorable neoepitopes that develop could be more likely to upregulate immune escape mechanisms. Here we evaluate the relationship between prevalence of B27 and positively charged neoepitopes and assess association between positively charged neoepitopes and expression of PD-L1. Methods: TCGA datasets from head and neck squamous cell (HNSC), lung squamous cell (LUSC), and melanoma (SKCM) patients were evaluated. HLA alleles were determined with OptiType and supertype was based on 2008 criteria. Nonsynonymous mutations were annotated with Ensembl VEP and VAtools. pVAC-Seq using NetMHCpan algorithm predicted neoepitopes 9 AAs in length. Favorable B27 neoepitopes were defined as those having new positively charged AA substitutions (H/K/R) from negative or uncharged wildtype AAs. RNA-seq data for the PD-L1 gene were normalized on transcripts per million and log2 transformed. Linear regression tests were performed between PD-L1 gene expression values and fraction of nonsynonymous mutations resulting in neoepitopes with new positively charged AAs in patients with B27. Results: Data from 497 HNSC, 494 LUSC, and 468 SKCM patients were analyzed. B27 was observed in 20.1%, 23.2%, and 26.5% of HNSC, LUSC, and SKCM patients, respectively, with a significant difference seen between HNSC and SKCM by chi-square test (χ² = 5.14, p = .023). Of new charged AAs resulting from nonsynonymous mutations, 76.3% in HNSC, 74.0% in LUSC, and 72.0% in SKCM were positively charged (p &lt; .05 between all histologies, paired t-tests). In B27 patients, association between PD-L1 gene expression and fraction of neoepitopes with new positively charged AAs was seen in HNSC (r = 0.25 p = .036) and SKCM (r = 0.30 p = .007), but not LUSC (r = -0.12 p = .296). Conclusions: With increasing fraction of positively charged neoepitopes, a decrease in prevalence of B27 was observed, suggesting improved binding and immune elimination of tumors with favorable neoepitopes. In B27 tumors that develop despite having favorable neoepitopes, upregulation of PD-L1 could be a putative mechanism to evade immune detection.
Clinical effect of iliac artery interventional chemotherapy combination with bladder perfusion for high level of bladder urothelial carcinoma
Authors: Jiansen Chen, Ming Li, Yueqing Wu, Mao Tang, null Akberomer, Zetian Tang, Xinwu Guo, Jinqian Li, Kesong Qin, Jiwei Ye, Zhiyuan Ma, Yuanjing Shen, Ye Chen, Yuan Li
Journal: International Journal of Surgery (2017)
Analysis of cognition and behavior in postpartum rehabilitation of pelvic floor
Authors: Zhengcheng Zhang, Caiyun Li, Jingye Mao
Journal: BMJ (2015)

From January 2014 to June 2014, a total of 178 primiparas and biparas scheduled for a 42-day postpartum follow-up visit at our hospital were examined. And their pelvic floor dysfunctions were evaluated according to the surveys of incontinence impact questionnaire, short form (IIQ-7), pelvic floor impact questionnaire-7 (PFIQ-7) and pelvic organ prolapse/urinary incontinence sexual questionnaire (PlSQ.12). And 130 primiparas and 48 biparas lacked an understanding of performance, prevention and treatment for postpartum pelvic floor dysfunction. And two groups showed no significant difference. The self-discovery and detection rates of decreased pelvic myodynamic were 9.2% and 14.6% in primiparas versus 10.4% and 16.7% in biparas. The self-discovery and detection rates of pelvic organ prolapse were 0.8% and 2.3% in primiparas versus 0.0% and 8.3% in biparas. And the difference was statistically significant. Most related knowledge came from parents and colleagues in 53.1%(95/178) and doctors and nurses in 15.5% (27/178). Only about 44.4%(12/27) women with prominent symptoms of pelvic floor dysfunction requested treatments. Therefore the related knowledge of postpartum pelvic floor dysfunction should be strengthened.


Key words: 
Postnatal Care; Pelvic floor
糖尿病肾脏病患者的医学营养治疗
Authors: 张郁苒, 袁伟杰
Journal: BMJ (2010)

糖尿病肾脏病(diabetic kidney disease,DKD)已经成为我国终末期肾衰竭的重要病因.当肾功能逐渐丧失后,代谢废物的积聚将进一步加重心脑血管病变,使DKD死亡风险进一步提高。
Survey on employment intention of medical students in China
Authors: Huiling Xia, Zhigang Pan, Tianhao Wang, Jian Wang, Jie Gu, Hua Yang
Journal: BMJ (2019)

Objective
To survey the employment intention of medical students of five-year program in China.


Methods
A self-administered questionnaire survey on the employment intention was conducted among grade-5 medical students of 5-year program in 8 medical schools from January to June 2017, 395 participants (161 males and 234 females) were selected by stratified random cluster sampling method.


Results
The survey showed that 57.65% (226/392) respondents would return hometown after graduation as their first choice, 20.66% (81/392) preferred to work in large cities, only 0.76% (3/292) chose the Western and rural areas; 20.05% (78/389) responders were willing to be a general practitioner working at the community health center, 56.55% (220/389) did not decide, while 23.40% (91/389) did not want to be general practitioner. Students from rural areas vs. from urban areas (24.30% vs.15.08%), whose parents with lower educational level vs. higher educational level (30.62% vs. 25.71%), from medical school in Western regions vs. in Eastern regions (28.65% vs. 11.68%) were more willing to choose general practice (P 0.05). Students who knew grassroots employment policies were more willing to be general practitioners (25.48% vs.13.02%, P<0.05).


Conclusion
The survey shows that the employment intention to be a general practitioner is stronger than before among medical students. But it is still need to take necessary measures to attract more medical graduates to work as general practitioners in grass-roots communities.


Key words: 
Career choice; Questionnaire; General practice
Correlation between TMB and MSI in patients with solid tumors.
Authors: ZHENG ZHAO, Wentao Li, Xing Zhang, Minhui Ge, Chao Song
Journal: Journal of Clinical Oncology (2020)

e15169 Background: Both oftumor mutational burden (TMB) and microsatellite instability (MSI) are promising predictive biomarkers for immunotherapy in cancer treatment. However, the association between TMB and MSI with solid tumors was not well investigated especially in East Asian patients. Herein, the relationships for characterizing TMB and MSI in major cancer types were made. Methods: TMB and MSI were measured by 539 genes panel via NGS in tumor tissues. The TMB were calculated as the numbers of synonymous and nonsynonymous mutations, and InDels per megabase in coding regions. MSI was the gain or loss of nucleotides from repetitive DNA and the criteria of MSI-H were defined as above 10% positive of the 195 tested microsatellites sites, and this method was totally consistent with conventional MSI-PCR testing in Research and development sample verification. The relationships between TMB and MSI of 874 patients with solid tumors including 174 patients with liver cancer, 32 patients with bile duct cancer, 54 patients with gastric cancer, 119 patients with colorectal cancer, 27 patients with pancreatic cancer, 32 patients with melanoma, 25 patients with glioma and 411 patients with lung cancer cases were performed by Spearman rank correlation analysis via SPSS v22.0. Results: There was no significant correlation between TMB and MSI in total patients with solid tumors (r = 0.061, p = 0.073). Significantly correlations were observed in patients with colorectal cancer (r = 0.248, p = 0.006) and pancreatic cancer (r = 0.397, p = 0.040). Meanwhile, no significant correlations between TMB and MSI were identified in patients with liver cancer (r = -0.016, p = 0.830), bile duct cancer (r = 0.325, p = 0.070), gastric cancer (r = 0.209, p = 0.130), melanoma (r = -0.057, p = 0.757), glioma (r = 0.009, p = 0.967) and lung cancer (r = 0.015, p = 0.758). Interestingly, total eleven cases were confirmed as MSI high in patients with colorectal cancer, glioma and lung cancer all presented phenotypes of TMB high. Conclusions: We demonstrated the presence of tumor-specific properties correlations between TMB and MSI and provided new insights to use them as biomarkers in immunotherapy. As a retrospective study with a relatively small population, the conclusions of this study needed to be verified with a larger sample.
Reliability and correlations among quality measures for lung, breast, and colorectal cancer.
Authors: Jessica Cleveland, Mary Beth Landrum, Alexi A. Wright, Gabriel A. Brooks, Jose Zubizarreta, Nancy Lynn Keating
Journal: Journal of Clinical Oncology (2020)

2073 Background: Alternative payment models for oncology seek to improve quality and reduce spending. Yet the ability to measure high-quality care across oncology practices remains uncertain. We characterized quality of care for oncology practices using registry and claims-based measures of processes, utilization, end-of-life care, and survival and assessed correlations of practice-level performance across measure type and cancers. Methods: Using SEER-Medicare data, we studied individuals with newly diagnosed lung (N = 95,635), breast (N = 78,736), or colorectal (CRC, N = 51,385) cancers in 2010-2015 treated in oncology practices with ≥20 patients (502, 492, and 347 practices, respectively). We measured receipt of guideline-recommended treatment and surveillance (processes), hospitalizations or emergency department visits during 6-month chemotherapy episodes (utilization), care intensity in the last month of life (EOL), and 12-month survival (lung and CRC only). We calculated summary process, utilization, and EOL measures for each patient (number of measures met divided by the number for which the patient was eligible). We used hierarchical linear models with practice-level random effects to estimate summary measures and survival for each practice. We calculated practice-level reliability (a measurement’s reproducibility) for each measure based on the between-measure variance, within-measure variance, and sample size. Results: Few practices had ≥20 patients eligible for most measures (38%, 37%, and 31% of practices had ≥20 patients for any lung, breast, and CRC measures, respectively). Measure reliability was low. Only 13%, 7%, and 20% of measures for lung, breast, and CRC, respectively, had a median reliability across practices ≥0.7. Among practices with ≥20 patients with summary measures of each type within cancer, correlations across measure types were low (all correlation coefficients (r)≤0.21 except a weak correlation of the CRC process summary measure with 1-year CRC survival, r = 0.38, p &lt; 0.001). Summary process measures were minimally or not correlated across cancer type (lung, breast, CRC; all correlation coefficients ≤0.16). Conclusions: Claims-based measures of care processes, utilization, EOL care, and survival are limited by small numbers of fee-for-service Medicare patients across practices, even after pooling 6 years of data. Measures have poor reliability and are poorly correlated across measure or cancer type. Additional research is needed to identify reliable quality measures for practice-level alternate payment models.
Association between Helicobacter pylori infection and glycosylated hemoglobin levels
Authors: An-nan Liu
Journal: BMJ (2013)

The health check-up results of 11 514 subjects in 2011 at Beijing Hospital were retrospectively analyzed, including the results of 13C urea breath test for detection of Helicobacter pylori (Hp) and HbA1c test. The results showed that the prevalence rate of Hp infection was significantly higher in females (31.77%) than that of males (29.36%) (χ2=7.355, P<0.05); the highest prevalence was found in 35-60 y age group (31.17%). Hp positive rates in subjects with body mass index (BMI)≥28 kg/m2 and central obesity were 31.55% and 30.44%, respectively; there were no significant differences from those with normal weight and non central obesity. Subjects with positive Hp infection had higher levels of HbA1c, compared to those with negative Hp infection (t=-2.276, P=0.01). In subjects with BMI≥24 kg/m2 and central obesity, HbA1c level was higher in Hp positive subjects than that in Hp negative ones (P<0.05). Diabetes mellitus was positively associated with Hp infection (OR 1.282; 95%CI 0.941-1.799), particularly in obese patients (OR 1.459; 95%CI 1.070-2.071). The results indicate that Hp may be involved in the impairment of glucose regulation, particularly in those with higher body mass index.


Key words: 
Helicobacter pylori; Hemoglobin A, glycosylated