tbuckley/cabot-search huggingface dataset:
Compliance to medications among hypertensive patients in a rural community, Beijing
Authors: 陈静静, 侯春玲, 赵挪安, 彭晓霞
Journal: BMJ (2011)

Objective To understand use of blood pressure-lowering medications and to identify factors contributing to their compliance among hypertensive patients at a community health-care service center under Huairou County Hospital, Beijing to improve community management for hypertensive therapy.Methods Medical records of hypertensive patients who visited Qiaozizhen community health-care service center in Huairou county, Beijing during June 2008 to May 2009 were analyzed and 849 of them were interviewed using a pre-tested, structured questionnaire with most closed ended questions included to understand their use of anti-hypertensive drugs and its related factors. Results In 849 hypertensive patients under community management, 78.92% percent (670/849) took anti-hypertensive drugs, 72.54%percent (486/670) in good compliance with drug treatment, and 29. 63 percent (144/486) under guidance of their general practitioners or visited secondary-care hospitals or above, 62. 14 percent (302/486) took drugs by themselves and 8. 23 percent (40/486) took drugs following advice by their relatives or other hypertensive patients. The most common used drugs in 503 hypertensive patients who could remember names of the drugs included reserpine compound tablets, reserpine and triamterene compound tablets (302/503, 60. 04% ) and calcium-channel blockers ( 181/503,35.98% ). Overall, blood pressure was under control in ( 289/849,34. 04% ) percent of those with community management, and( 189/486, 38. 89% ) percent of them kept in a good compliance, significantly higher than that in those with poor compliance (48/179,26. 82% ) (P =0. 0032). Results of multivariate logistic regression analysis showed that drug compliance associated mainly with complications of hypertension ( OR of 4. 423 and 95% CI of ORs 2. 141 - 9. 137). Conclusions Drug compliance among hypertensive patients is still poor in rural Beijing, most with reserpine compound tablets.It is necessary to pay more attention to health education among hypertensive patients, particularly about when to start drug-taking and how to take drugs in a scientific way-regularly and complying with physicians'prescription.

Key words: 
Hypertension ;  Disease management ;  Rural health services ;
Expression of migration and invasion inhibitory protein (MIIP) in gastric adenocarcinoma and its clinicopathological significance
Authors: Min Tang, Hui Wang, Li Ding, Fang Fang, Jun Du
Journal: BMJ (2017)

Objective
To investigate the expression of migration and invasion inhibitory protein (MIIP) in gastric adenocarcinoma and its clinicopathological significance.


Methods
The expression of MIIP was detected in 90 samples of gastric adenocarcinoma and 90 samples of normal gastric tissues by tissue microarray and immunohistochemical method. The correlation of MIIP expression with clinicopathological parameters and prognosis of gastric adenocarcinoma patients was analyzed.


Results
The expression level of MIIP in gastric adenocarcinoma tissues was significantly lower than that in normal gastric tissues [30.0%(27/90)vs. 55.6%(50/90), χ2=12.006, P=0.001]. The down-regulated expression of MIIP in gastric adenocarcinoma tissues was significantly associated with larger tumor mass (χ2=4.116, P=0.042), higher T stage (χ2= 6.752, P=0.009 ), lymph nodes metastasis (χ2=7.234, P=0.007) and higher TNM stage (χ2=7.608, P=0.006). The 5-year overall survival rate was significantly higher in patients with high expression of MIIP than those with low expression (χ2=11.378, P=0.001). The tumor mass (OR=0.570, P=0.043), T stage (OR=0.213, P=0.036) and the expression level of MIIP (OR=1.967, P=0.042) were the independent predictors for prognosis of gastric adenocarcinoma.


Conclusions
The low expression level of MIIP is associated with poor prognosis in gastric adenocarcinomas.


Key words: 
Gastric cancer; Adenocarcinoma; Prognosis; Migration and invasion inhibitory protein
Three-year follow-up of treatment-naïve and previously treated patients with Waldenström macroglobulinemia (WM) receiving single-agent zanubrutinib.
Authors: Constantine Si Lun Tam, Stephen Opat, Paula Marlton, David Gottlieb, David Simpson, Gavin Cull, David Ritchie, Emma Verner, Javier Munoz, Alessandra Tedeschi, Jane Huang, William Novotny, Ziwen Tan, Eric Holmgren, Siminder K. Atwal, John Francis Seymour, Andrew Warwick Roberts, Judith Trotman
Journal: Journal of Clinical Oncology (2020)

8051 Background: Inhibitors of Bruton tyrosine kinase (BTK) have established therapeutic activity in patients with WM. Zanubrutinib, a potent and selective BTK inhibitor was evaluated in a phase 1/2 study in treatment-naïve (TN) and relapsed/refractory (R/R) patients with WM. Methods: Patients had TN or R/R WM and required treatment as per International Workshop on WM (IWWM) criteria. Treatment consisted of oral zanubrutinib at 160 mg twice daily (n = 50) or 320 mg once daily (n = 23) until disease progression or unacceptable toxicity. Efficacy endpoints included the proportion of patients achieving a complete response (CR) or very good partial response (VGPR) in accordance with IWWM-6 criteria. Efficacy analyses were conducted on the 73 patients evaluable (24 TN, 49 R/R). Results: Between September 2014 and August 2018, 77 patients with WM (24 TN and 53 R/R) began treatment with zanubrutinib (55% aged &gt; 65 years; 21% aged &gt; 75 years). At a median follow up of 32.7 months, 73% remain on treatment. Reasons for treatment discontinuation included adverse events (AE) in 13% (only one related), disease progression (10.4%), and other (3.9%). Results are presented for TN and R/R combined. The overall response rate was 96% and VGPR/CR rate was 45%. The rates of VGPR/CR increased over time; 22% at 6 mos, 33% at 12 months and 45% at 24 months. Three-year progression-free survival (PFS) was 81%, and overall survival (OS) was 85%. The most commonly reported AEs were upper respiratory tract infection (52%), contusion (33%, all grade 1) and cough (22%). AEs of interest include neutropenia (18.2%), major hemorrhage (4%), atrial fibrillation/flutter (5%), and grade 3 diarrhea (3%). Conclusions: Long-term follow up with continued zanubrutinib treatment demonstrated deep and durable responses in the majority of WM patients. The rates of VGPR/CR increased with prolonged therapy. Disease progression was uncommon. The safety profile of long-term zanubrutinib therapy in these patients was tolerable. Clinical trial information: NCT02343120 . [Table: see text]
Comparative analysis of different treatment option of pelvic abscess
Authors: Jie Gao
Journal: BMJ (2014)

A total of 78 pelvic abscess cases were confirmed by operation retrospectively. Group A underwent celiotomy (n=30) while group B laparoscopic surgery (n=48). Medical history, clinical symptoms and outcomes were analyzed. Operative durations of groups A and B were (90±21) and (70±14) min, the amount of hemorrhage (70±24) and (46±24) ml and wound dehiscence rate 20% and 0 respectively. There was significant inter-group difference. And the efficacy of group B was better than that of group A. The postoperative recurrence rate was 13% and 4% and there was no significant difference. Laparoscopic surgery is suitable for treating pelvic abscess. It is mini-invasive, has a quick recovery and does not increase operative complications.


Key words: 
Pelvic abscess; Laparoscopes
Application of preoperative CT-guided Hook-wire localization of pulmonary nodules in thoracoscopic lobectomy of lung
Authors: Yusheng Shu, Weigang Zhao, Weiping Shi
Journal: BMJ (2015)

Objective
To evaluate the application of preoperative CT-guided Hook-wire localization of pulmonary nodules in thoracoscopic lobectomy of lung.


Method
Twenty eight patients with 31 pulmonary nodules of ground-glass opacity (GGO) detected by CT scan were admitted in our hospital from December 2008 to December 2013, including 17 males and 11 females with an average age of 55. The lesions were located by CT-guided Hook-wire technique, and lobectomy plus lymphadenectomy or pulmonary wedge resection were performed according to the results of fast frozen pathology. The characteristics of pulmonary nodules and general condition of the patients were analyzed.


Results
Among 31 nodules, 19 were malignant and 12 benign with an average size of (1.8±0.6) cm and thickness of (1.2±0.4) cm. The vertical distance from pleural to nodules was (1.5±0.7) cm and the insert depth of needle was (2.5±0.9) cm. The time for CT-guided Hook-wire localization was (16.5±5.2) min. The operation time for pulmonary wedge resection and pulmonary lobectomy was (18.5±5.5) min and (54.7±12.5) min, respectively. Intraoperative frozen section showed malignant tumors in 18 patients (19 GGO nodules), lobectomy plus lymphadenectomy were performed in 16 cases; 2 patients did not undergo pulmonary lobectomy because of poor physical condition or 2 GGO nodules in different lobes. There were no operation complications in this series. Postoperative pathologic findings of 31 nodules showed 9 cases of adenocarcinoma, 10 bronchioloalveolar carcinoma, 5 atypical adenomatous hyperplasia, 2 epithelioid hemangioendothelioma, 2 chronic inflammation, 1 hamartoma, 1 inflammatory pseudotumor and 1 sarcoidosis. The average postoperative hospital stay was (6.6±1.9) days.


Conclusions
Endoscopic resection of pulmonary GGO nodules with CT-guided Hook-wire localization technique is feasible and safe, with less complications and less time consuming.


Key words: 
Surgery, computer-assisted; Tomography, X-ray computed; Solitary pulmonary nodule; Hook-wire; Ground-glass opacity
Research progress on risk factors of osteoporotic fractures in patients with rheumatoid arthritis
Authors: Wen Liu
Journal: BMJ (2016)

Rheumatoid arthritis is a autoimmune diseases characterized as joint chronic synovitis, and is accompanied with systemic damage. Osteoporotic fracture is one of the common complications of rheumatoid arthritis, which may decrease quality of life, and even increase the mortality of patients. Variety of factors may be associated with the occurrence of osteoporotic fractures in rheumatoid arthritis patients. In this article, through the literature review we discuss the risk factors of osteoporotic fracture, including vitamin D deficiency, lower limb muscle strength and balance ability in rheumatoid arthritis patients.


Key words: 
Arthritis, rheumatoid; Osteoporotic fracture
呼吸机相关肺炎病原菌及药敏学分析
Authors: 郭桂芳, 谭薇, 刘新梅, 牟美玲
Journal: BMJ (2009)

呼吸机相关肺炎(ventilator associated pneumonia,VAP)是机械通气过程中常见的并发症,为深入了解VAP病原菌的分布特点及耐药情况,对我院68例VAP患者的病原菌及药敏学报告进行分析。
Inhaled tiotropium in the treatment of stable chronic obstructive pulmonary disease patients complicated with pulmonary hypertension
Authors: Pei-ying Wang, Zeng-lian Tian
Journal: BMJ (2012)

Objective To explore the curative effect of inhaled tiotropium upon patients of stable chronic obstructive pulmonary disease (COPD) complicated with pulmonary hypertension.Methods A total of 76 patients (Male/Female =51/25) of stable COPD complicated with pulmonary hypertension were recruited from January 2010 to June 2011.According to table of random digit,they were divided into test group (n =38,M/F =26/12) and control group (n =38,M/F =25/13).Patients of control group inhaled formoterol powder 4.5 μg bid,took oral theophylline sustained-release tablets 0.1 g hid.According to the demand of patient's condition,anti-infective agents and sticky phlegm lyticagent were used.Patients of test group inhaled tiotropium dry powder (18 μg,qd) in addition to the above regimen.All changes in six-minute walk test (SMWT),pulmonary arterial systolic pressure and panting symptom score were recorded at the end of 16 weeks and compared with the baseline.The primary endpoint was the changes in exercise capacity as assessed by SMWT and pulmonary arterial systolic pressure.Safety and tolerance were also investigated.Intent-to-treat and per-protocol analyses were performed.Results After a follow-up period of 16 weeks,both pulmonary arterial systolic pressure and panting symptom score decreased and SMWT walking distance increased (45 ± 16) m in the test group.Compared with the control group,the difference had statistical significance (P ＜ 0.05) and obvious adverse reaction did not occur.Conclusions For patients of stable COPD complicated with pulmonary hypertension,inhaled tiotropium dry powder decreases pulmonary pressure to various extents and improves exercise tolerance and panting symptom.And tolerance is satisfactory.

Key words: 
Pulmonary disease, chronic obstructive;  Hypertension,pulmonary;  Tiotropium
A phase II study of lorlatinib in patients (pts) with ALK-positive (ALK+) lung cancer with brain-only progression.
Authors: Ibiayi Dagogo-Jack, Geoffrey R. Oxnard, Jessica Fink, Gianluca Diubaldi, Caitlyn Helms, Justin F. Gainor, Michael S. Rabin, Rebecca Suk Heist, Jessica Jiyeong Lin, Jennifer Ackil, Alona Muzikansky, Alice Tsang Shaw
Journal: Journal of Clinical Oncology (2020)

9595 Background: Lorlatinib is a 3 rd -generation ALK tyrosine kinase inhibitor (TKI) developed to penetrate the central nervous system (CNS) and overcome resistance to 2 nd -generation (2 nd -gen) ALK TKIs. In a phase II study, lorlatinib demonstrated significant intracranial (IC) activity after failure of 2 nd -gen TKIs. As treatment discontinuation for extracranial (EC) progression can confound assessment of durability of IC response, we performed a phase II study (NCT02927340) to selectively evaluate lorlatinib activity in ALK+ pts with CNS-only disease. Methods: Between 11/2016 and 1/2019, 22 pts with IC progression on an ALK TKI with no other sites of measurable disease were enrolled at 2 institutions. Pts received lorlatinib at a starting dose of 100 mg QD. The primary endpoint was the IC disease control rate (DCR) at 12 weeks per modified RECIST v1.1. Secondary endpoints were IC objective response rate (ORR), duration of response (DOR), and progression-free survival (PFS). Results: Of the 22 pts enrolled, 21 (95%) had progressed on a 2 nd -gen ALK TKI and 14 (64%) had previously received CNS radiation (median 21.1 months between radiation and lorlatinib). Median number of prior ALK TKIs was 2 (range 1-4). As of the data cutoff of 12/15/19, median follow-up was 14 months. At 12 weeks, the IC-DCR was 95%, including 8 pts with stable disease. Best IC ORR was 59% with 6 complete and 7 partial responses. Nine (41%) pts relapsed on study, including 3 IC-only, 5 EC-only, and 1 combined relapse. Four pts continued treatment beyond EC-only progression. Although median IC DOR and PFS were not estimable due to few progression events, the IC progression-free rate at 12 months was 81% (95% CI: 53%-94%). Twelve pts have discontinued study treatment due to progression (n = 6), edema (n = 1), pulmonary hypertension (n = 1), or transition to commercial lorlatinib (n = 4). Conclusions: Lorlatinib induces durable intracranial responses in pts with CNS-only progression on 2 nd -gen ALK TKIs, suggesting that CNS-specific relapses are primarily driven by ALK-dependent mechanisms. Further studies are needed to characterize the molecular basis of sensitivity to lorlatinib in this unique subgroup of pts with ALK+ lung cancer. Clinical trial information: NCT02927340 .
Cut the weeds and dig up the roots: clip-and-snare assisted endoscopic mucosal resection of a rectal neuroendocrine tumor
Authors: Wei-hui Liu, Shi Liu, Ying Gong, Hideki Kobara, Shi-Bin Guo, Jian Gong
Journal: Endoscopy (2020)

Endoscopic submucosal dissection (ESD) has been the preferred treatment of small gastrointestinal neuroendocrine tumors (NETs) (≤ 10 mm) without muscularis propria invasion [1]; however, the requirements of special instruments and complex skills have limited its widespread application [2]. In this regard, we developed a simple clip-and-snare assisted endoscopic mucosal resection (CS-EMR) technique for complete removal of a rectal NET ([Video 1]).
Survey on depression status of elderly residents in a Shanghai community
Authors: 刘春辉, 刘申, 祝墡珠, 丁训镭, 季建林
Journal: BMJ (2010)

Surveys on depression status of elderly population in a community of Shanghai Jing'an District were carried out in 2005 and 2008 respectively. The cluster sampling method was used in the study,1731 and 2315 community residents aged 60 -89 were selected in two surveys. The depression status was evaluated with geriatric depression scale (GDS). During the first survey 297 out of 1731 people were identified as depression with a prevalence rate of 17. 2%; during the second survey 374 out of 2315 people were found to have depression with a prevalence rate of 16. 2%. The factors related to depression status included family support, hobby, ability of self-taking care, family finance and chronic diseases.

Key words: 
Depression ;  Questionnaires ;
Efficacy of standard triple therapy combined with probiotics for Helicobacter pylori infection in duodenal ulcer
Authors: Weibin Peng, Haiying Rong, Weihong Sha, Yuqiang Nie, Yali Zhu, Yuansheng Yang, Ruiqing Li, Ming Zhang
Journal: BMJ (2017)

Objective
To evaluate the efficacy of standard triple therapy combined with probiotics for Helicobacter pylori (H. pylori) infection in duodenal ulcer.


Methods
Two hundred and twenty five patients with H. pylori-infected duodenal ulcer were randomly assigned to receive the treatment with standard triple therapy (triple group, n=75), quadruple therapy (colloidal bismuth subcitrate combined with standard triple therapy) (quadruple group, n=75) or probiotics combined with standard triple therapy (bifidobacterium and lactobacillus combined with standard triple therapy) (probiotics group, n=75) for 14 days. The gastroscopy and 13C urea breath test were performed in all patients and the adverse reactions were observed 4 weeks after treatment.


Results
The healing rate of duodenal ulcer in probiotics group was significantly higher than those in triple and quadruple groups (80.8% vs. 46.15%, 80.80% vs. 63.49%; P=0.000, 0.024, respectively). With intention to treat analysis, the H. pylori eradication rate in probiotics group was 85.33%, which was significantly higher than that in triple group (61.33%, P=0.001) and in quadruple group (72.00%, P=0.046). With per-protocol analysis, the H. pylori eradication rates were 85.71% in probiotics group and 87.67% in quadruple group (P=0.737), but both were higher than that in triple group(70.77%; P=0.014, 0.041, respectively). The incidence of adverse reactions including constipation, taste distortion and bloating in probiotics group was significantly lower than those in the other two groups.


Conclusions
Bifidobacterium and lactobacillus triple live bacteria combined with standard triple therapy can increases the H. pylori eradication rate and duodenal ulcer healing rate with high compliance and low adverse reactions in patients with H. pylori-infected duodenal ulcer.


Key words: 
Helicobacter pylori; Therapy; Probiotics
Efficacies of fluid resuscitation plus continuous veno-venous hemofiltration in the treatment of septic shock
Authors: Chunli Zhao, Zhiyang Dong, Yang He, Shuting Liu, Ying Liu
Journal: BMJ (2015)

A total of 58 patients with simple septic shock were recruited from intensive care unit and divided into control group (n=28) and treatment group (n=30) according to treatment modalities. The control group was routinely treated. The treatment group received continuous veno-venous hemofiltration (CVVH) for 10-14 days plus routine measures. After 3 days, the score of acute physiology and chronic health evaluation-Ⅱ (APACHE-Ⅱ) of the treatment group was better than that of the control group (P<0.01). And sequential organ failure assessment (SOFA), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVEDS) and left ventricular ejection fraction (LVEF) improved significantly (P<0.05). And the relevant blood biochemical parameters improved significantly better than the control group (P<0.05). In the group CVVH, there were mortality (n=7, 23%) and multiple organ failure (MODS) (n=6, 20%); In the control group, mortality (n=14, 50%) and MODS (n=13, 46%). The mortality rate had inter-group differences of statistical significance (χ2=4.38, P<0.05). Thus early volume resuscitation plus CVVH had excellent curative efficacies for septic shock.


Key words: 
Shock, sepsis; Continuous veno-venous hemofiltration
Utility of immune checkpoint inhibitors (ICI) in 3 patients (pts) with sarcomas of antigen presenting cells (follicular dendritic cell sarcoma [FDCS], histiocytic sarcoma [HS]).
Authors: Mee-young Lee, Carolina Bernabe Ramirez, Daniel C. Ramirez, Robert G. Maki
Journal: Journal of Clinical Oncology (2020)

e23574 Background: FDCS and HS are rare tumors arising from sustentacular cells of the lymph node, rather than lymphocytes. Surgical resection is often employed in case of localized disease, but for unresectable disease, anthracycline-based therapy is commonly used. PD-L1 staining is reportedly positive in 50-80% of FDCS. As a result, we treated 3 patients (pts) with ICI ipilimumab and nivolumab (Ipi/Nivo), and demonstrated the activity of these agents in these rare cancers. Methods: Two FDCS pts and one HS pt, all with B symptoms at the start of treatment, received Ipi/Nivo in the approved dose/schedule (Table). The HS patient was HIV(+) with undetectable viral load on treatment. One FDCS patient received radiation therapy to an active site of disease during immunotherapy. We reimaged patients every 2 months for the first 6 months, then less frequently. PDL-1 IHC and mutation data were available in all cases. Results: Mutation burden varied from low to intermediate; mutations in kinase genes were also observed. Case 1 (FDCS) demonstrated RECIST 1.1 complete response, but also received radiation, and Case 2 (FDCS) had RECIST partial response. Both continue on treatment 9 months after initiation. Case 3 (HS) demonstrated a minor response to treatment, then disease worsened after 4 months, and he subsequently received radiation to the residual site of disease. All patients showed resolution of B symptoms on ICI. Conclusions: We treated these pts with ICI based on their role as antigen presenting cells, as well as their high PD-L1 expression. We speculate that FDCS and related tumors such as HS represent extreme examples of cancers that have evidence of tertiary lymphoid structures, increasingly recognized as important in ICI responsiveness. Prospective clinical trials of ICI in these diagnoses will help us understand the basis of immune responses to ICI in other cancers. [Table: see text]