tbuckley/cabot-search huggingface dataset:
Phase II trial of biweekly carboplatin and nab-paclitaxel with concurrent radiotherapy for patients with locally advanced unresectable stage III non-small cell lung cancer.
Authors: Hisashi Tanaka, Fumihiko Okumura, Chiori Tabe, Yoshiko Ishioka, Masamichi Itoga, Kageaki Taima, Yukihiro Hasegawa, Junichi Yokouchi, Shingo Takanashi, Masahiko Aoki, Sadatomo Tasaka
Journal: Journal of Clinical Oncology (2020)

e21078 Background: Concurrent chemoradiotherapy (CCRT) is the standard treatment for patients with locally advanced non-small cell lung cell cancer (LA-NSCLC). We previously reported the phase I study of biweekly carboplatin and nab-paclitaxel (nab-PTX) with RT. Recommended dose for phase II study was carboplatin (AUC 4) and nab-PTX (100 mg/m 2 ) (J Clin Oncol 2015 suppl; abstr 7529). Here we report the phase II part designed to assess the efficacy of biweekly carboplatin and nab-PTX with concurrent RT (UMIN000023802). Methods: Patients with inoperable stage Ⅲ NSCLC were treated with carboplatin (AUC 4) and nab-PTX 100 mg/m 2 on days 1, 15, and 29. Thoracic radiotherapy was administered from day 1 to a total dose of 60 Gy in 30 fractions. Consolidation chemotherapy after CCRT was 2 cycles of carboplatin (AUC 6) on day 1 and nab-PTX 100 mg/m 2 on days 1, 8, and 15. The primary endpoint for the phase II part is 2-year overall survival (OS) rate. Assuming an expected survival rate was 60% and a lower limit was 35% (alfa 0.05, beta 0.2). Secondary endpoints were the objective response rate (ORR), progression-free survival (PFS), OS, and safety profile. Results: A total of 28 patients (median age 66 years, male 94%) were enrolled. Of the evaluable patients (n = 28), the rate of 2-year OS was 67.8% (95% CI: 49.3–82.1). The ORR was 96%, a median follow-up time was 33.2 months. Median PFS was 18.2 months (95% CI 13.1–not reached), and median OS was not reached (95% CI, 25.6–not reached). The most common toxicities of grade 3 or higher were neutropenia (60.5%), anemia (14.2%), thrombocytopenia (7.6%) and pneumonitis (3.6%). Conclusions: This study achieved the primary endpoint. Biweekly carboplatin and nab-PTX with concurrent RT therapy was well tolerated and promising systemic antitumor activity for patients with LA-NSCLC. Clinical trial information: 000023802 .
Clinical advances of hemophagocytic syndrome
Authors: Yanfang Liu, Jianhua Zhang
Journal: BMJ (2016)

Hemophagocytic syndrome is a group of fatal immune function disorder, which can be divided into primary and secondary HPS. The disease is complex, lacking of specificity, difficult in diagnosis with quick progress, high mortality and poor prognosis. The diagnosis is mainly based on the HPS-2004 diagnostic criteria, etoposide, dexamethasone and cyclosporine would be first chosen for treatment. This article reviews the clinical advances on etiology, diagnosis, treatment and prognosis of hemophagocytic syndrome.


Key words: 
Lymphohistiocytosis hemophagocytic; Diagnosis; Treatment
Evaluation indicators of community nursing quality: an investigation on needs
Authors: Chun-yan Zhao, Wei-qun Liu
Journal: BMJ (2011)

Twelve community nursing managers were interviewed.The consensus was reached that there should be 4 main themes concerning evaluation indicators of community nursing quality:necessity,content,format and expectation.The interviewed nursing managers expressed their need for a system of community nursing quality evaluation,and those indicators should be comprehensive,concrete and practical.The format of evaluation should facilitate the development of nursing quality and the criteria should meet the requirements of Minister of Health and international standards.

Key words: 
Nursing administration research; Evaluation studies
Development of a stop light tool using the bellarmine norton assessment tool (BNAT) for physical therapy referral.
Authors: Catherine Elizabeth Crandell, Christopher Jon Wingard, Sarah Elizabeth Quinn, Kate Elise Amin, Katie Marie Brownschidle, Donna Dahm, Lauren Huebler, Kelsey Lynn Mayo, John Turner Hamm
Journal: Journal of Clinical Oncology (2020)

e19067 Background: Individuals with cancer experience fatigue, pain and decline in function. The Bellarmine Norton Assessment Tool (BNAT) was developed to give an objective measure identifying a person’s overall functional ability through a variety of physical assessments focused on mobility and strength. The purpose of this study was to develop a referral tool to provide health care professionals an easy determinant for physical therapy referrals. The referral tool was designed as a Red, Yellow, Green light for easy interpretation and use. Methods: The BNAT is composed of 1 self-reported physical activity question and 4 objective tests: 2-Minute Step Test (2MST); 30-Second Sit-to-Stand; Timed Arm Curl; and Timed Up and Go. A previously collected data set of BNAT scores was utilized to develop the referral tool with the poorest performance corresponding to Red and the best corresponding to Green. Three variations of normative scaling examined optimal distribution for classification. The first model averaged normative data of 70-74 age group of healthy individuals. No participants in our study achieved 50% of population norms. Therefore, the Green light represented 35% of the normative values, the Yellow light ranged from 15-34% and the Red light identified &lt; 15%. A second model used frequency histograms for each BNAT elements. Groupings were made based on the natural break of the data to depict the Red, Yellow or Green light. A third approach combined normative and frequency distribution for each element as compared to the respective BNAT scores. The outcome assigned BNAT score of 1 and 2 to Red light, 3 to Yellow light and 4 and 5 to Green light. Except for the 2MST, these models were similar for the cutoff between color categories. The third model best fit the study population with respect to the individual’s total BNAT score. Results: Of the 161 subjects, 47 subjects (29%) fell into the Red category, 81 (50%) into Yellow and 33 (21%) into Green. Using this scaling system for the total BNAT score, 13 score combinations result in Red light, 6 scores for Yellow light and 6 scores for Green light. Regardless of the model, most individuals were assigned a Yellow light. Conclusions: The literature is void of functional cut off scores and normative distributive data for the oncology population. We defined a referral tool with scaling based off normative scores and functional assessments that reflect the distribution of oncology patients. The third model may be used as a simple referral tool among multiple health care professionals aiding in a referral for physical therapy.
Evans综合征26例临床分析
Authors: 蔡广理, 叶俊彬, 陈伟丰
Journal: BMJ (2006)

回顾性分析我院1993年1月至2004年12月诊治的26例Evas综合征患者的临床资料.其中女24例,男2例;病因未明确者17例,继发性9例,其中继发于系统性红斑狼疮7例,均为女性.26例均给予糖皮质激素为主的治疗方案(泼尼松+达那唑)治疗.结果显示,完全缓解14例,部分缓解10例,总有效率92.3%.18例随访1年,复发13例.上述治疗无效或复发者中7例继加用环孢素治疗,完全缓解6例,部分缓解1例;再随访1年,未见复发。
Pretherapeutic <sup>68</sup>Ga-DOTATATE PET SUV predictors of survival of radionuclide therapy for metastatic neuroendocrine tumors.
Authors: Rahul Ladwa, David A. Pattison, Jye Smith, Steven Goodman, Matthew E. Burge, Stephen Rose, Nicholas Dowson, David Wyld
Journal: Journal of Clinical Oncology (2020)

4609 Background: Peptide receptor radionuclide therapy (PRRT) is an effective treatment option in patients with advanced neuroendocrine tumours (NETs). Patients are pre-selected based on 68 Gallium-DOTA-(0-Tyr3)-octreotate Positron Emission Tomography ( 68 Ga-DOTATATE PET) uptake. The level of uptake in tumour on the baseline 68 Ga-DOTATATE PET scan has been explored as a predictor of response in NETs with inconclusive evidence. The aim of this study is to determine the correlation between 68 Ga-DOTATATE PET SUV parameters to survival outcomes. Methods: We retrospectively analysed 142 lesions (up to five lesions per patient) in 73 patients with NET undergoing PRRT with 177 Lutetium octreotate (8.0-8.3GBq) and pretherapeutic 68 Ga-DOTATATE PET/CT in a single institution. Standardised uptake values (SUVs) max and mean were correlated with progression-free survival (PFS) and overall survival (OS). Results: A total of 73 patients were included in the analysis. The median age was 63 (28-89) years. NET origin was gastroenteric (49%), pancreatic [pNET] (38%), bronchial (10%) and other (3%). Ki-67 proliferation index ( &lt; 3%: 36%, 3-20%: 36%, &gt; 20%- &lt; 50%: 8%, unknown: 21%) was seen. Pretherapeutic SUV max but not SUV mean was higher in pNETs (P = 0.04). No difference was seen with Ki-67 index. The median PFS was 32 (95%CI: 26-38) months. Median PFS was reduced with increasing ECOG performance status [PS] (P= 0.029), increasing tumour grade (P = 0.003), increasing Ki-67 proliferation index (P = 0.013), reduced SUV max (P= 0.003), reduced SUV mean (P= 0.001). Multivariate analysis confirmed SUV mean (HR =-1.71 [95%CI: -2.66- -0.80]; P&lt;0.01) and Ki-67 index (HR = 1.11 [1.06-1.17]; P &lt; 0.01) as maintaining significance when incorporating ECOG PS (HR = 1.96 [0.68-5.47]; P = 0.22). The mean OS was 40 [37-44] months. A higher SUV max (SUV max &lt; 30: 34 [30-40] months vs SUV max &gt; 30: 48 [44-51]; P&lt;0.01) and higher SUV mean (SUV mean &lt; 20: 33 [28-39] months vs SUV mean &gt; 20: 47 [43-51]; P&lt;0.01) were associated with improved mean OS. Mean OS was not affected by ECOG performance status (P = 0.896), primary site of origin (P = 0.567) and Ki-67 index (P = 0.110). Conclusions: 68 Ga-DOTATATE PET SUV measures correlated with an improved PFS on multivariate analysis as well as improved OS in this select group of patients suitable for PRRT. Those patients with lower SUV mean may benefit from escalation of therapy such as increasing administered therapeutic activity.
Survey on knowledge of stress urinary incontinence in postpartum women in Shanghai Meilong district
Authors: Hongmei Huan, Jianwei Lyu, Shanzhu Zhu, Suxia Jiang, Na Li
Journal: BMJ (2018)

Objective
To survey the prevalence of stress urinary incontinence (SUI) and related knowledge among postpartum women in Shanghai Melong district.


Methods
A questionnaire survey on the knowledge of stress urinary incontinence was conducted among 317 postpartum women who were home visited by Meilong Community Health Service Center between March 2017 and June 2017. The self-designed questionnaire included the general situation (age, height, weight, occupation, menstrual history), pregnancy and childbirth, and knowledge of SUI; the International Consultation on Incontinence Questionnaire Short form (ICIQ-SF) was also used. Total 317 questionnaires were distributed and 313 valid ones were retrieved (98.73%).


Results
The prevalence of SUI in the participants was 26.84% (84/313). Multivariate logistic regression showed that BMI≥24 kg/m2(OR=6.24, 95% CI: 3.41-11.41), complicated metabolic syndrome (OR=9.84, 95% CI: 2.77-34.96) and birth weight of previous child ≥4 kg (OR=0.09, 95% CI: 0.04-0.19) is independent risk factors for the development of SUI. The average SUI knowledge score was (10.39 + 8.65) points, only 26.20% (82/313) of the participants knew Kegel training (score 5.99±1.60). The SUI knowledge level of postpartum women was associated with educational level (F=12.41), occupation (F=9.06), income (F=4.05), reproductive history (F=10.98) and presence of urinary incontinence symptom(F=22.31)(all P<0.05).


Conclusion
The knowledge level of maternal stress urinary incontinence in Meilong district is relatively low, and the publicity of SUI and pelvic floor rehabilitation knowledge should be enhanced for the pregnant women.


Key words: 
Urinary incontinence, stress; Prevalence; Cognition; Puerpera
A few points on the guideline for primary care of chronic obstructive pulmonary disease(2018)
Authors: Yahong Chen
Journal: BMJ (2018)

《慢性阻塞性肺疾病基层诊疗指南（2018年）》的编制参考了多项已发布指南和基层临床实际，现就本部指南中有关诊断流程、稳定期的病情评估和治疗及基层转诊、分级管理等多方面的亮点、特点做简要说明，以利于读者更好地理解及应用该指南。
17-year incidence trends of anal squamous cell carcinoma.
Authors: Khushali Jhaveri, Salim Surani, Shailja Shah, Shailesh S. Talati, Maya Shah
Journal: Journal of Clinical Oncology (2020)

4058 Background: Anal Cancer is a rare neoplasm with 9 out of 10 cases being Anal Squamous Cell Carcinoma (SCCA). We did a population-based analysis to assess the incidence trends in patients with SCCA and identify any significant change in the direction of trends using the Surveillance, Epidemiology, and End Results (SEER) database. Methods: Data was extracted from SEER database for the years 2000-2016 for the US population, across all gender, ages, and races. Joinpoint regression models of SCCA incidence were fitted to identify any discrete joints (year) that represent statistically significant changes in the direction of the trend. The average annual percentage change (APC) in the age-adjusted incidence rate in the pre- and post-joinpoint era were measured. Subgroup analysis for gender, ages, and races was also done. Results: 27,721 new adult cases of SCCA were identified from 2000 to 2016. The incidence was higher amongst females (62.44%) compared to males (37.56%) with the white population contributing 85.41% to incidence compared to black (11.84%) and other (2.75%) population. The age-based incidence rate for different groups has been mentioned in Table. A significant jointpoint for SCCA incidence was observed in 2009. The APC was 4.6% (3.5-5.6 95% CI) in 2000-2009 which reduced to 2.1% (0.7-3.4 95% CI) in 2009-2016 indicating a 54% relative reduction in the average annual APC in the US population after 2009. Subgroup analysis revealed significant joinpoints for incidence decrease in Ages 40-59, 80 and above and females of all ages. No significant changes in APC were seen when stratified by race (Refer to Table). Conclusions: Our study, in our knowledge, is the first study assessing incidence trends of SCCA over 17-years. The overall incidence of SCCA is increasing but a statistically significant trend towards decreasing rate of growth in incidence was observed in 2009 and later. Further studies are needed to analyze the causality of such changes in the trend of SCCA. [Table: see text]
Research advance in pregnancy with systemic lupus erythematosus
Authors: 孙莉, 李新功
Journal: BMJ (2005)

系统性红斑狼疮(systemic lupus erythematosus,SLE)是一种自身免疫性疾病,具有多系统、多脏器损害.据我国初步调查,其发病率为75.4/10万[1].因好发于育龄妇女,所以SLE对妊娠的影响以及妊娠对SLE病程的影响一直备受关注.作者收集了1999年至2004年的相关文献并进行分析,现将对SLE和妊娠之间相互影响的认识及SLE患者妊娠期治疗、监护的研究进展综述如下。
Oral Biologic Delivery: Advances Toward Oral Subunit, DNA, and mRNA Vaccines and the Potential for Mass Vaccination During Pandemics
Authors: Jacob William Coffey, Gaurav Das Gaiha, Giovanni Traverso
Journal: The Annual Review of Pharmacology and Toxicology (2020)

Oral vaccination enables pain-free and self-administrable vaccine delivery for rapid mass vaccination during pandemic outbreaks. Furthermore, it elicits systemic and mucosal immune responses. This protects against infection at mucosal surfaces, which may further enhance protection and minimize the spread of disease. The gastrointestinal (GI) tract presents a number of prospective mucosal inductive sites for vaccine targeting, including the oral cavity, stomach, and small intestine. However, currently available oral vaccines are effectively limited to live-attenuated and inactivated vaccines against enteric diseases. The GI tract poses a number of challenges,including degradative processes that digest biologics and mucosal barriers that limit their absorption. This review summarizes the approaches currently under development and future opportunities for oral vaccine delivery to established (intestinal) and relatively new (oral cavity, stomach) mucosal targets. Special consideration is given to recent advances in oral biologic delivery that offer promise as future platforms for the administration of oral vaccines.
Metastatic-free intervals and risk of breast cancer-specific mortality among patients with hormone receptor-positive breast cancer: A population-based analysis from the Surveillance, Epidemiology, and End Results registries.
Authors: Gregory Sampang Calip, Ernest H Law, Colin Hubbard, Nadia Azmi Nabulsi, Alemseged Ayele Asfaw, Inyoung Lee, Jifang Zhou, Jenilee Cueto, Debanjali Mitra
Journal: Journal of Clinical Oncology (2020)

e13034 Background: Patients successfully treated for hormone receptor (HR)-positive early breast cancer remain at risk of recurrence and metastatic disease even after extended periods of disease-free years. Whether prolonged metastatic-free intervals ultimately confer a benefit to breast cancer-specific survival is not well understood. This study aimed to investigate metastatic-free intervals and risk of breast cancer-specific mortality among patients with HR-positive breast cancer after adjuvant therapy. Methods: We conducted a retrospective cohort study of women aged 18 years and older diagnosed with recurrent metastatic HR-positive breast cancer between 1990 and 2016 in the Surveillance, Epidemiology, and End Results registries. Patients with longitudinal information on primary stage I-III HR-positive breast cancer through the occurrence of metastatic disease and survival were included. Risks of breast cancer-specific mortality associated with metastatic-free intervals (defined as time from primary breast cancer diagnosis to metastasis) of ≥5 years compared to &lt; 5 years were estimated. Fine and Gray competing risks regression models were used to calculate subdistribution hazard ratios (SHR) and 95% confidence intervals (CI). Results: Among 1,057 women with HR-positive breast cancer with a median age of 54 years at primary breast cancer diagnosis and 62 years at metastatic progression, 65% of women had a metastatic-free disease interval ≥5 years, whereas 35% had an interval of &lt; 5 years. Overall, patients with metastatic-free intervals &lt; 5 years had a five-year breast cancer-specific survival rate of 31% compared to 52% in women with intervals of ≥5 years. In multivariable analyses adjusted for age, race, diagnosis year, grade, treatment and sites of metastasis, patients with intervals of ≥5 years had decreased risk of breast cancer-specific mortality (SHR = 0.72, 95% CI 0.58-0.89, P = 0.002) compared to women with metastatic-free intervals of &lt; 5 years. Conclusions: In this population-based study, rates of cancer-specific mortality among patients who experienced metastatic recurrence of HR-positive breast cancer were lower in women with metastatic-free intervals of 5 years or more. The results of this study may inform patient-clinician discussions surrounding prognosis and treatment selection among HR-positive patients.
Systemic immune-inflammation index to predict survival in muscle-infiltrating urothelial carcinoma.
Authors: Jana Obertova, Patrik Palacka, Dalibor Gallik, Jan Slopovsky, Michal Chovanec, Boris Kollárik, Katarina Rejlekova, Valentina De Angelis, Zuzana Sycova-Mila, Nikola Hapakova, Michal Mego
Journal: Journal of Clinical Oncology (2020)

e17022 Background: Systemic immune-inflammation index (SII) is a prognostic factor in patients with metastatic urothelial cancer (MUC). The objective of this prospective study was to evaluate the prognostic value of the SII at baseline before neoadjuvant cisplatin-based chemotherapy start in patients with muscle-infiltrating urothelial cancer (MIUC). Methods: Seventy-two patients (49 men) with MIUC (71 bladder, 1 upper tract) were treated with cisplatin-based neoadjuvant chemotherapy (NACT). Thitrty-nine patients (pts.) underwent radical cystectomy (RC), 18 pts. external radiotherapy (EXRT) with concomitant cisplatin chemotherapy, and 15 pts. had no local treatment (NLT) afterwards. SII was defined as PxN/L, based on platelets (P), neutrophils (N) and lymphocytes (L) counts. This study population was dichotomized by median SII into low and high groups. Disease-free survival (DFS) and overall survival (OS) were estimated by Kaplan-Meier method and compared with logrank test. Results: At median follow-up of 13 months (range 2-40), 26 pts. relapsed and 24 of them died. Pts. with low SII at baseline had better DFS and OS compared to those with high SII (NR vs. 19 months, HR = 0.37, 95% CI 0.17-0.88, P = 0.0185 for DFS, 31 months vs. 20 months, HR = 0.43, 95% CI 0.19-0.98, P = 0.052 for OS, respectively). Subgroup analysis showed significant benefit for EXRT regarding of SII, however no differences were observed in both, RC and NL. Conclusions: The level of SII at baseline before neoadjuvant cisplatin-based chemotherapy initiation predicted survival in MIUC pts. Based on the level of SII, stratification of pts. into clinical trials could be possible. Pts. with high level of SII might be the candidates for the different therapeutic approaches. Key Words: Muscle-Infiltrating Urothelial Carcinoma. Systemic Immune-Inflammation Index. Neoadjuvant Chemotherapy. Disease-Free Survival. Overall Survival.
ROS new function for ECT imaging observation of sustained <sup>99m</sup>TC-labeled cytarabine in liver cancer patient with hydrogen peroxide.
Authors: Guoqin Zheng, Yan Han, Jian Zhang, Bian Li, Dong Chen, Ming Zhao, Qiang Fu, Yanfei Wu, Baofa Yu
Journal: Journal of Clinical Oncology (2020)

e15568 Background: To investigate the sustaining time of 99m Tc labeled cytarabine in the tumor of liver cancer patients by ROS under ECT imaging instrument. Methods: A liver cancer patient with 2 lesions in the liver was enrolled in this study. After obtaining informed consent and excluding relevant contraindications, two tumors in the liver of the patient were guided by single photon emission computed tomography (ECT). Injecting the drug, the tumor was injected with 99m TC-labeled cytarabine solution as control, the tumor was injected with 99m TC-labeled cytarabine + hydrogen peroxide solution (ROS) as experimental, and the two tumor masses were detected by ECT imaging, with an intensity of 1h as background. The drug retention rate was calculated by caculated of deduction of the baseline (minus background) at 1h, 3h, and 23h. Results: The patient was detected by ECT on the right laid down position. The area of the region of interest was 679 account by Gama detector, and the background level of the liver was 494 account. The acquisition time was about 400 seconds as a standard acquisition. The ECT imaging showed that the labeling rate of 99m TC-labeled cytarabine was about 100%. The drug of 99m TC-labeled cytarabineretentionrates in tumor lesions with ROS at 1 hours, 3 hours, and 23 hours were 97.83%, 81.63%, and 60.72%, respectively; the drug retention rates in tumor lesions without ROS at 1 hours, 3 hours, and 23 hours were 44.74%, 15.87%, and 0, respectively. Conclusions: The ROS can hold drug in the tumor long time after the intratumoral injection of drugs with ROS whichoxidant with the extracellular matrix and interstitial of the tumor to cause degeneration and deformation so that drug of Ara-C sustaining in tumor for a long time, and the tumor cells are also degenerated and necrotic and died, so that high concentrations of cytarabine are embedded between the denatured tumor tissues and cells. The drug slowly released from the inside to the outside to kill tumor cells. IT is further confirmed that the ROS is a sustained release agent intratumorally injection and it can significantly increase the residence time of 99m Tc-labeled cytarabine in the tumor, prolong the drug action time of cytarabine, and improve the effect of killing tumor cells.
针刺配合促通技术治疗脑卒中偏瘫50例疗效对比观察
Authors: 蔡文通, 赵桂华
Journal: BMJ (2007)

脑卒中是一种发病率、死亡率和致残率很高的疾病,根据新近的流行病学资料,我国脑卒中发病150万人/年,存活的600万患者中,残障率高达75%,给患者家庭和社会带来沉重负担.早期积极康复治疗是提高偏瘫患者生存质量、促使其重返社会的有效方法。