tbuckley/cabot-search huggingface dataset:
TheraP: A randomised phase II trial of <sup>177</sup>Lu-PSMA-617 (LuPSMA) theranostic versus cabazitaxel in metastatic castration resistant prostate cancer (mCRPC) progressing after docetaxel: Initial results (ANZUP protocol 1603).
Authors: Michael S Hofman, Louise Emmett, Shahneen Kaur Sandhu, Amir Iravani, Anthony M. Joshua, Jeffrey C. Goh, David A. Pattison, Thean Hsiang Tan, Ian D. Kirkwood, Siobhan Ng, Roslyn J. Francis, Craig Gedye, Natalie K. Rutherford, Alison Yan Zhang, Margaret Mary McJannett, Martin R. Stockler, John A. Violet, Scott Williams, Andrew James Martin, Ian D. Davis
Journal: Journal of Clinical Oncology (2020)

5500 Background: LuPSMA is a radiolabeled small molecule that delivers therapeutic β-radiation to PSMA-expressing tumors. Encouraging efficacy and safety has been shown in non-randomized studies of mCRPC. TheraP is a randomized phase II trial comparing LuPSMA vs cabazitaxel in men with mCRPC progressing after docetaxel. Methods: Men with mCRPC, and imaging with 68 Ga-PSMA-11 and 18 F-FDG PET/CT that confirmed high PSMA-expression and no sites of FDG-positive/PSMA-negative disease, were randomly assigned (1:1) to LuPSMA (6-8GBq q6weeks up to 6 cycles) vs cabazitaxel (20mg/m 2 q3weeks up to 10 cycles); stratified by disease burden (&gt;20 vs ≤20 sites), prior novel antiandrogens (NAA; abiraterone or enzalutamide), and study site. The primary endpoint was PSA response rate (PSA50-RR) defined by ≥50% reduction. Secondary efficacy endpoints included PSA-progression-free survival (PSA-PFS) and overall survival (OS). Data cut-off was 31DEC19 at this first pre-specified analysis. Results: 200 (median age 72 y, prior NAA 91%, &gt;20 lesions 78%) of 291 PET screened men were randomised to LuPSMA (N=99) or cabazitaxel (N=101). 17 patients withdrew or died before receiving study treatment (1 LuPSMA vs 16 cabazitaxel). The PSA50-RR was higher in those assigned LuPSMA than cabazitaxel (65/99 [66%; 95%CI 56-75] vs 37/101 [37%; 95%CI 27-46]; P&lt;0.001). At a median follow-up of 11.3 months, LuPSMA significantly improved PSA-PFS (HR 0.63, 95%CI 0.45-0.88, P=0.007; 143 events with next pre-specified analysis planned after 170 events). Efficacy results were similar when analyses were restricted to per-protocol treated men. OS data remains immature (57 deaths). Grade III-IV adverse events (AEs) occurred in 31/98 (32%) LuPSMA-treated men vs 42/85 (49%) in cabazitaxel-treated men. Discontinuations for toxicity occurred in 1/98 (1%) LuPSMA vs 3/85 (4%) cabazitaxel-treated. There were no treatment-related deaths. Conclusions: In men with docetaxel-treated mCRPC, LuPSMA was more active (PSA50-RR) than cabazitaxel with relatively fewer G3-4 AEs and PSA-PFS favoring LuPSMA. Clinical trial information: NCT03392428 .
Application of capsule endoscopy in diagnosis of obscure gastrointestinal bleeding
Authors: Cheng-cheng Gao, Cheng-cheng Ren, Shang-nong Wu, Rui Xie
Journal: BMJ (2011)

Clinical data of 83 patients with obscure gastrointestinal bleeding (OGIB) undergoing capsule endoscopy were reviewed retrospectively. The results showed that the overall detection rate of gastrointestinal lesions for OGIB by capsule endoscopy was 81.9％ (68/83), most lesions (77. 1％, 64/83 )were located in small intestine. Of all the small intestinal lesions, arteriovenous malformation (AVM) was the most common (22 cases, 26.5％ ),followed by small intestinal space-occupying lesion (18 cases,21.7％ ) and single or multiple ulcers of small intestine ( 16 cases, 19. 3％ ). Four cases (4. 8％ ) had lesions outside of the small intestine. Small intestinal AVM was the leading cause of OGIB in patients ＞ 50 y,space-occupying lesion was the most common in patients aged 30 -50 y, while ulcer was the leading cause in patients ＜ 30 y. Bowel obstruction was not found in this group of patients. The results indicate that capsule endoscopy has great diagnostic value in detecting causes of OGIB. Small intestinal AVM is the most common cause of OGIB, followed by space-occupying lesion and ulcer.

Key words: 
Capsule endoscopes;  Gastrointestinal hemorrhage
Doctor-patient communication under Jauhari Window
Authors: Caiying Ge, Wei Peng, Zhili Li, Ming Kong, Xinying Zhao, Wenjuan Gao, Hao Wu
Journal: BMJ (2017)

Effective doctor-patient communication not only affects the doctor-patient relationship, but also affects the normal medical practice. Johari window is referred to as the  self consciousness discovery-feedback model or  information exchange process management tool . This article introduces the relationship between self-exposure and experience feedback by doctors and patients. As a skill and theory about communication, Johari widow can help doctors to better understand their patients and to improve their ability of communication.


Key words: 
Physician patient relationship; Johari Window
腹腔镜手术治疗异位妊娠临床分析
Authors: 王燕, 程毓芝
Journal: BMJ (2005)

回顾分析我院近6年来应用腹腔镜治疗异位妊娠的842例患者病历资料,结果显示腹腔镜手术对异位妊娠的诊断正确率为99.5%,手术成功率为98.0%.由此可见,腹腔镜不仅是异位妊娠诊断的金标准,而且还可作为治疗的首选方式,包括大量腹腔内出血的患者。
Incidence and risk factors of spontaneous hemorrhagic transformation in cardioembolism and large artery atherosclerotic infarction
Authors: Meijuan Xiao, Weiyong Yin, Zusen Ye, Yungang Cao, Bei Shao
Journal: BMJ (2014)

To explore the incidence and risk factors for spontaneous hemorrhagic transformation (HT) of cardioembolism (CE, n=150) and large artery atherosclerotic infarction (LAA, n=370). The incidence of HT was 29.3% in CE. And it was significantly higher than 9.7% (P<0.05). Infarct size, low-density lipoprotein-cholesterol (LDL-C) and admission National Institutes of Health Stroke Scale (NIHSS) score were independent predictors of spontaneous hemorrhagic transformation in LAA. OR values were 3.92, 2.96 and 1.45 respectively. Infarct size, admission NIHSS score and random blood glucose level were independent predictors of spontaneous hemorrhagic transformation in CE. OR values were 4.86, 2.42 and 1.42 respectively. As compared with LAA, CE was more prone to HT. LAA and CE-related factors of hemorrhagic transformation are not completely identical.


Key words: 
Cerebral infarction; Spontaneous hemorrhagic transformation; Risk factors
Abstract 15952: MSCS Induce Regulatory Tr1 Cells and Mitigate Inflammation in Abdominal Aortic Aneurysm
Authors: Linden A Green, Keisin S Wang, Ashley A Gutwein, Natalie A Drucker, Clifford S Babbey, Raghu A Motaganahalli, Andres A Fajardo, Michael P Murphy
Journal: Circulation (2018)

Objective: Abdominal aortic aneurysm (AAA) is increasingly viewed as an autoimmune disease, but no mechanism has yet been identified. Currently, the use of cell-based therapy in the form of anti-in...
An in silico comparative planning study investigating the predicted benefit of dysphagia-optimised volumetric arc therapy (Do-VMAT), relative to standard VMAT (S-VMAT), to reduce radiotherapy-associated dysphagia (RAD) in oropharyngeal cancers (OPC).
Authors: Imran Petkar, Alex Dunlop, Dualta McQuaid, Christopher Nutting
Journal: Journal of Clinical Oncology (2020)

e18540 Background: RAD is a significant treatment-related functional morbidity in OPC and is associated with irradiation of the pharyngeal constrictor muscle (PCM). This study investigated whether a novel PCM-sparing Do-VMAT technique reduced the risk of RAD, compared to S-VMAT. Methods: Twenty OPC patients who previously underwent radiotherapy (RT) to bilateral neck were selected for this retrospective study. For each patient, S-VMAT and Do-VMAT plans were created. In both arms, the mucosal and nodal tumour received 65 Gy while the remaining oropharynx and at-risk nodal levels received 54 Gy; delivered in 30 fractions over 6 weeks. For Do-VMAT, a mandatory mean dose constraint of &lt; 50 Gy to the volume of the combined superior (SPCM) and middle PCM (MPCM) together with an optimal dose constraint of &lt; 20 Gy to the volume of inferior PCM (IPCM), lying outside the high-dose clinical target volume, were additionally defined and optimised to minimise PCM dose. Normal tissue complication probabilities for physician-scored RAD at 6 months (RAD 6M ) were determined as per the model by Christianen et al in which the 2 variables were mean dose to SPCM and supraglottic larynx (SGL). Statistical analysis was performed using paired t tests. Results: All plans had adequate target volume coverage, and dose to critical organs were within acceptable parameters. Dose to the parotid and submandibular glands were similar between the 2 RT techniques. The mean integral dose was 110.8 Gy-litre (standard deviation 17.1) with S-VMAT and 103.4 Gy-litre (15.4) with Do-VMAT, p &lt; 0.001. With Do-VMAT, the average of the mean dose to PCM, SPCM, MPCM, IPCM, and SGL were 9.3 Gy (1.4), 4.7 Gy (1.7), 7.4 Gy (3.6), 22.7 Gy (4.1), and 2.6 Gy (2.3) respectively lower than S-VMAT (p &lt; 0.001 for all). The mean predicted risk for RAD 6M was 31.0 % (4.4) with S-VMAT, and 23.9 % (3.8) with Do-VMAT, p &lt; 0.001. The absolute reduction in estimated toxicity risk with Do-VMAT was &gt; 5 %, the minimally clinically important difference, in every patient. Conclusions: Do-VMAT demonstrated clinically relevant reductions in the predicted risk of RAD, compared to S-VMAT, by reducing dose to the PCM in OPC. The clinical benefits of Do-VMAT is being prospectively evaluated in DARS (CRUK/14/014), a randomised phase III study.
Barriers identified in a patient navigation program for starting and completing definitive radiotherapy treatment in a limited resource setting.
Authors: Carolina Martins Vieira, Lindsay Krush, Paul E. Goss, Angelica Nogueira Rodrigues
Journal: Journal of Clinical Oncology (2020)

e19018 Background: In addition to limited radiotherapy (RT) resources, there is enormous complexity involved in the registration process for attending RT services in Brazil. The process involves so many steps that, in combination with the lack of information and guidance, makes the patients often get lost within the system. Hospital das Clínicas da UFMG (HC UFMG) is a teaching hospital that belongs to the 3rd largest university in Brazil and, despite its important cancer center, it does not have its own radiotherapy center. That makes the RT process even more complex, since the patient ends up receiving chemotherapy in one center and RT in another, a common scenario in low- and middle-income countries (LMICs).Thus, it is necessary to optimize the scarce resources available, taking also into account the social difficulties involved. Patient barriers to accessing care were evaluated throughout a patient navigation (PN) study in Brazil, in order to better help the navigator identify areas of possible intervention. Methods: In a pilot study (non-randomized) carried out in partnership with the Global Cancer Institute, patients with cancer of the cervix, rectum, esophagus, anal canal, head and neck, lung, and prostate who were considered candidates for neoadjuvant or definitive RT were evaluated and questionnaires were applied to identify obstacles for RT, in order to guide a PN program and help to orient health policies. Results: Seventy-three patients were interviewed (1 excluded). The majority had locally advanced disease, the most prevalent sites being esophagus, head and neck and rectum. The most common barriers are shown in the table. 100% of the patients reported at least one obstacle, 93% between 2 and 7 obstacles and 1 patient quoted 13 of them. Conclusions: Proper identification of barriers involved in treatment, especially in a low resource setting is mandatory in order to guide PN program`s goals and establish public health demands. Many barriers identified may be overcome with PN programs in LMICs. [Table: see text]
阻塞性睡眠呼吸暂停与糖尿病专家共识
Authors: 中华医学会呼吸病学分会睡眠学组, 中华医学会糖尿病学分会
Journal: BMJ (2010)

一、前言阻塞性睡眠呼吸暂停(OSA)在2型糖尿病患者中很常见[1],两者在临床、流行病学和发病机制方面具有相关性,且独立于肥胖之外.目前2型糖尿病对健康的危害已为人们所认识,而OSA 对健康的危害及其所带来的医疗负担还远没有被人们认识.因此需要通过各学科的努力使人们认识到OSA与2型糖尿病的关系,并着手采取实际行动。
A survey on status of diabetes-related knowledge among general physicians in Shanghai Pudong New Area
Authors: Chun-yan Zhao, Ya-fang Ni, Hui Huang, Xu Li, Bo Feng
Journal: BMJ (2010)

To evaluate the status of diabetes-related knowledge and training requirement among general physicians,a questionnaire survey was conducted in 676 general physicians from 32 primary medical institutions and 5 secondary hospitals of Shanghai Pudong New Area.48.2% (261/541) of the surveyees had bachelor degree and most of them worked in secondary hospitals or primary medical institutions in affluent areas.The awareness rate of diabetic knowledge among the surveyeos was 51.6%,and there were significant differences in the awareness rate of diabetes-related knowledge between different levels of hospitals and physicians with different academic background.Only 26.6% of physicians received diabetes-related continuing education or training,there was a popular request for professional training from the surveyed physicians.

Key words: 
Diabetes;  Community health services
Communicational skills in application of interRAI
Authors: Haiyan Xie, Fan He, Yu Liu, Sujuan Zhou, Yue Sha
Journal: BMJ (2017)

Comprehensive geriatric assessment (CGA) is widely used for creating tailored individual care plans for seniors who usually are suffering from multiple diseases, frailty, disability and cognition decline. Skilled communicators are of importance for high-quality clinical data collection. Communication skills used in CGA are summarized in this article by reviewing related references and combining practical experiences in the process of applying international resident assessment instruments (interRAI).


Key words: 
Comprehensive geriatric assessment; Communication; Skills; Resident assessment instrument
The function of vasculogenesis during the repair of avascular necrosis of the femoral head
Authors: 石少辉, 李子荣
Journal: BMJ (2007)

股骨头缺血性坏死(avascular necrosis of the femoral head,AVNFH)是指股骨头的骨细胞、骨髓造血细胞及脂肪细胞(即骨的活性成分)在一种或多种因素的作用下发生缺血性改变,引起细胞坏死的病理过程.该病常见于20～50岁青壮年,虽然引起AVNFH的因素多种多样,但其病理改变基本相同:股骨头血液循环障碍导致股骨头缺血性坏死,以及随后出现的修复反应。
CT abdomen only for active surveillance in patient with stage I germ cell tumor.
Authors: Hamed Ahmadi, Anne K. Schuckman, Sumeet Bhanvadia, Hooman Djaladat, Siamak Daneshmand
Journal: Journal of Clinical Oncology (2020)

e17064 Background: Surveillance of stage I GCTs includes periodic imaging of chest, abdomen and pelvis. Currently the AUA guidelines recommends CT scan of the abdomen with or without the pelvis as well as chest x ray during active surveillance for these patients. Efforts to modify the surveillance protocols aim to minimize radiation exposure in this young patient population. Per our institutional protocol, we limit cross sectional imaging to CT of the abdomen only during surveillance of stage I disease. Here we report our outcomes to determine whether any recurrence was missed or delayed based on this protocol. Methods: All patient with clinical stage I GCT who have been under active surveillance and completed at least 2 year follow up at our institution were selected using our institutional testis cancer database. Clinical and demographic information were reviewed including recurrence pattern and tumor marker status at time of recurrence. Results: A total of 89 patients who had complete follow up information in the database were included in the study. 49/89 (55%) patients had non-seminoma or mixed GCT histology. 5/89 (5%) patients had history of cryptorchidism and 16/89 (18%) patients had history of inguinal surgery. 14/89 (15%) had relapse at a median of 6.8 months. Recurrence was first detected on surveillance imaging (Imaging recurrence) in 11/14 (78%), by rising tumor markers (marker recurrence) in 2/14 (14%), and on physical exam (clinical recurrence) in 1/14 (7%) patients. Of patients with marker or clinical recurrence, only one had evidence of retroperitoneal recurrence which was detectable by CT abdomen and the other two had lung metastasis detected by chest X ray. Only one patient with imaging recurrence had pelvic lymphadenopathy which was large enough to be seen on CT abdomen. Conclusions: CT scan of the abdomen only in combination with chest imaging, tumor markers and physical exam detected 100% of recurrences in this series. CT pelvis can be safely omitted during active surveillance of stage I GCT. Future modification in guidelines for surveillance protocols of stage I GCT may be warranted with further mounting evidence.
腋下副乳房40例诊治分析
Authors: 王艳清
Journal: BMJ (2008)

副乳房是一种临床上并不少见的先天性乳腺发育异常,又称多乳房症,是指除正常的一对乳房,另有1个或多个乳房.多位于腋窝及腋前线,其次为胸壁和腹股沟,以腋窝部位的副乳房最多见,占98.1%[1]。
Factors related to efficacy of lamivudin re-treatment in HBeAg-positive patients with relapsing hepatitis B after drug withdrawal
Authors: Zheng Wang, Yuanwang Qiu, Li Zhou, Lihua Huang, Bo Zhang, Wei Xue, Tingting Su, Yiguang Li
Journal: BMJ (2016)

Objective
To explore the factors related to efficacy of lamivudin (LAM) re-treatment in HBeAg-positive patients with hepatitis B relapse after LAM withdrawal.


Methods
Sixty HBeAg-positive patients with relapsing chronic hepatitis B (CHB) after LAM withdrawal were enrolled in this study. All patients received LAM re-treatment for 52 weeks, and the factors related to efficacy were analyzed.


Results
After 52-week LAM re-treatment, the overall ALT normalization rates, HBV DNA negative rates and HBeAg seroconversion rates were 77%(46/60), 78% (47/60) and 38%(23/60), respectively. Above indicators in patients with relapse≤36 weeks after LAM withdrawal were lower than those with relapse >36 weeks [68% (27/40) vs. 19/20(χ2=5.04, P=0.023), 70% (28/40) vs. 19/20(χ2=4.91, P=0.043), 28%(11/40) vs. 12/20(χ2= 5.96, P=0.024)], in patients with age >50 years were lower than those with age ≤50 years [52%(11/21) vs. 90%(35/39) (χ2=10.65, P=0.003), 62%(13/21) vs. 87%(34/39)(χ2=5.14, P=0.045), 19%(4/21) vs. 49%(19/39)(χ2=5.08, P=0.029)], in patients with baseline ALT level>1 times the upper limit of normal (ULN) and HBV DNA>6.0 log10 copies/ml were lower than those with low baseline HBV DNA levels [62%(21/34) vs. 96%(25/26)(χ2=9.74, P=0.002), 68%(23/34) vs. 92%(24/26)(χ2=5.28, P=0.028), 26%(9/34) vs. 54% (14/26)(χ2=4.67, P=0.037)], in patients with detectable serum HBV DNA by PCR at week 12 than those without [55%(12/22) vs. 89%(34/38)(χ2=9.50, P=0.004), 55%(12/22) vs. 92%(35/38)(χ2=11.58, P=0.002), 18%(4/22) vs. 50%(19/38)(χ2=5.97, P=0.026)].


Conclusions
Shorter time to HBV DNA relapse, older age are unfavorable factors related to effectiveness of LAM re-treatment in HBeAg-positive patients with HBV relapse after drug withdrawal.


Key words: 
Hepatitis B, chronic; Lamivudine; Recurrence; Retreatment
Antibiotics prescribed to medical patients visiting polyclinic at 2008 Beijing Olympic Village
Authors: Dong Wu
Journal: BMJ (2010)

Objective To evaluate prescribing antibiotics in medical patients visiting the polyclinic at 2008 Beijing Olympic Village for its further reasonable use. Methods Clinical prescriptions for all the medical patients at the polyclinic were reviewed retrospectively. Consistency between antibiotics prescriptions and their indications formulated before 2008 Beijing Olympic Games was evaluated, as well as related factors for their overuse. Results In total, 1537 patients visited the polyclinic and 1233 recipes were prescribed,with 956 patients (62. 2% ) with infections, including 809 (52. 6% ) of respiratory infections. One hundred and forty-nine of 1537 patients (9. 7% ) were treated with antibiotics, accounting for 12. 1 percent of all prescriptions, and 43 cases (28.9%) were identified as antibiotics overuse, including 39 cases with respiratory infections. Prevalence of antibiotics overuse was significantly more for patients of domestic employees than that for non-employees (34. 6% vs. 14.3% , P <0. 01 ), with art independent association between them (OR 3.07, 95% CI 1.11 - 8. 50). Conclusions Although the polyclinic has successfully reduced unnecessary antibiotics use, their overuse remains to be reduced, and physicians' strict adhesion to indications for antibiotics use and patient education are essential for their rational use in primary care of China.

Key words: 
Physicians; family;  Respiratory tract infections;  Anti-bacterial agents
Association between gut microbiome and T lymphocytes among different primary tumor sites of patients with metastatic colorectal cancer.
Authors: Lingyun Sun, Yunzi Yan, Dongmei Chen, Jun J. Mao, Yufei Yang
Journal: Journal of Clinical Oncology (2020)

e16013 Background: Different primary tumor sites could impact colorectal cancer (CRC)’s survival outcomes and treatment effects. Previous studies had found that gut micro-biome distributions were different between left and right colon cancer(LCC, RCC). Out study aimed to further investigate the association between micro-biome and T lymphocytes among different tumor sites of patients with metastatic CRC. Methods: Between April 2018 and Mars 2019, we enrolled 40 metastatic CRC patients in Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China. We collected patients’ stool samples for micro-biome analysis by 16s rRNA sequencing approaches, as well as patients’ blood samples to analyses T lymphocyte subsets by flow cytometry methods. The study had been proved by ethics committee of Xiyuan Hospital (2016XLA122-1). All patients consented before enrollment. Results: Among 40 patients, 28% were female, with average age of 63±15 years old. There were 10 RCC, 9 LCC and 21 rectal cancer(RC) patients. Alpha diversity analysis showed that sobs index of the micro-biome of patients with RC and RC was significantly higher than whom were RCC(254.89±99, 247±89 versus.[vs.]101.17±51, p= 0.001). PCoA analysis on OTU level detected that first principal component[PC1] (26.24%) could be separated significantly between RCC and LCC( p= 0.048), as well as between RC and RCC (PC1,14.17%, p= 0.024). Community analysis showed that the proportion of Bacteroidetes was significantly higher in patients with RCC than whom with LCC and RC( p= 0.009). Conversely, the proportion of Firmicutes, Proteobacteria and Verrucomicrobia were higher in LCC patients than others( p= 0.37, 0.047 and 0.032 respectively). Canonical Correlation Analysis (CCA) analysis proved that the CD4+ and CD8+ T cells counts were environmental factors, which were significantly associated with certain micro-biome and samples from different tumor sites( p= 0.037 and 0.01 respectively). Trends showed that CD4+ T cells were positively related with samples of RC and bacteria parabacteroides and bifidobacterium, while CD8+ T cells were positively related with samples of RCC and bacteria Lachnospira, Sutterella and Bacteroides. Conclusions: In our study, we found that patients with LCC and RC had more beneficial gut micro-biome than whom with RCC. In addition, such difference might be associated with body T cell immunity.
Undergraduate course of general practice in higher medical education
Authors: Yi-ni He, Lian-hong Zhang, Shuang Wang, Ping Shi, Xiao-song Yu
Journal: BMJ (2009)

Data were analyzed from self-filled questionnaires for the students who took the elective course of general practice in China Medical University. 95.5% of students thought it was necessary to study general practice in the college. 0-10 was used to score the degree of how they want to choose general practice as a career, the median was 0 before they had the class and the median was 5 after the class (Wilcoxon rank test, P<0.01). But there were still some places need to be improved in terms of curriculum design, teaching methods and community practice. The General Practice teaching need to be innovated and the teaching mode should be different from the traditional one.

Key words: 
Education,medical,undergraduate;  General practice