tbuckley/cabot-search huggingface dataset:
Stage II high-risk colon cancer: A retrospective analysis of the benefit of chemotherapy in patient subgroups based on the risk factor.
Authors: Linu Abraham Jacob
Journal: Journal of Clinical Oncology (2020)

e16068 Background: Adjuvant chemotherapy is routinely recommended for patients with high risk stage II colon cancer. However the risk conferred by each high risk feature (HRF) may be different. This study was done to analyze the magnitude of benefit of chemotherapy in individual HRF patient subgroups. Methods: Resected stage II colon cancer patients during the period January 2012 to March 2018 were retrospectively analyzed for risk features, chemotherapy treatment and survival. Statistical analysis was done with SPSS 16.0. Results: A total of 41 patients were identified as having pathological stage II colon cancer during the study period - 63.4% were males and 36.6%, females. 68.3% had left sided tumor while 31.7% had right sided tumor. 29.3% had none of the high risk features and received no adjuvant chemotherapy. 70.7% patients had at least one of the high risk features and received adjuvant chemotherapy with fluoropyrimidine ± oxaliplatin. 90.2%, 7.3% and 2.5% had stage IIA, IIB and IIC disease respectively. 36.6%, 43.9% and 19.5% had grade I, II and III tumors respectively. Lymphovascular invasion (LVI) and perineural invasion (PNI) were present in 14.6% and 19.5% patients respectively. 29.3% had inadequate lymph node dissection. 22.0% patients had elevated CEA prior to surgery and 4.9% patients had presented with intestinal obstruction. After a minimum follow up period of 20 months the median disease free survival (DFS) was 26 months for the entire cohort. Left sided tumors had significantly prolonged median DFS compared to the right sided tumors (31 vs 26 months; p = 0.05). Median DFS was 24 months for the high risk group compared to 33 months for the low risk group (p = 0.002). On subset analysis T4 HRF subgroup had superior DFS, while LVI HRF subgroup had inferior DFS both of which were statistically significant. Conclusions: Magnitude of chemotherapy benefit was highest in the T4 subgroup, while it was lowest in the LVI subgroup in resected stage II high risk colon cancer [Table: see text]
Association of BRCA alteration (alt) type with real-world (RW) outcomes to PARP inhibitors (PARPi) in patients (pts) with metastatic castrate-resistant prostate cancer (mCRPC).
Authors: Emmanuel S. Antonarakis, Russell Madison, Jeremy Snider, Tamara Snow, Ethan Sokol, Jon Chung, Margaret Elizabeth McCusker, Gaurav Singal, Brian Michael Alexander, Emily Castellanos, Jeffrey Venstrom, Alexa Betzig Schrock, Jeffrey S. Ross
Journal: Journal of Clinical Oncology (2020)

5527 Background: Inactivating alts in BRCA1/2 result in homologous recombination deficiency and are predictive of PARPi response in mCRPC. BRCA reversion mutations, which restore the protein function, are frequently observed in acquired resistance to PARPi. In tumors harboring homozygous gene deletions ( BRCAdel) reversions cannot develop; thus, we hypothesize that BRCAdel pts may have prolonged benefit from PARPi compared to pts harboring other BRCA alterations. Methods: Pts were included from the Flatiron Health (FH)-Foundation Medicine (FMI) de-identified clinico-genomic database (CGDB). Inclusion criteria were diagnosis of mCRPC, treatment in the FH network and an FMI comprehensive genomic profiling result between 1/1/2011 - 9/30/2019. Time to therapy discontinuation (TTD) and overall survival (OS) from start of PARPi were estimated with Kaplan-Meier analysis and unadjusted/adjusted (age at PARPi initiation, line number, practice type) hazard ratios (HR/aHR) from Cox proportional hazards models adjusted for survival bias. Results: Out of 829 mCRPC cases, BRCA1/2 alts were detected in 15 (1.8%) and 71 (8.6%) respectively, with 2 cases included in both groups. 26% of BRCAalts were BRCAdel, 67% were coding mutations, and 7% were genomic rearrangements. 25 (28%) BRCAalt pts were treated with PARPi, 11/25 in the 1st or 2nd line setting including 43% of BRCAdel and 44% of other BRCAalt cohorts. Median age at PARPi initiation was 70 yrs and 88% were treated in community practices. TTD was significantly longer in the BRCAdel (n = 7) cohort vs. other BRCAalt cohort (n = 18) (22.7 vs. 9.2 months; HR: 0.16 [0.03-0.74]; aHR: 0.13 [0.02 – 0.92]) while a statistically nonsignificant difference in median OS was observed (31.5 vs. 11.9 months; HR: 0.20 [0.02-1.58]; aHR: 0.24 [0.02-3.15]). In comparison, no statistically significant difference in TTD was observed for BRCAdel (n= 7) vs. other BRCAalts (n=19) pts treated with 1st line hormonal therapies (abiraterone or enzalutamide) (3.4 vs. 5.7 months; HR: 1.16 [0.45-2.98]; aHR: 0.72 [0.25-2.10]). Follow up analysis with more pts and somatic/germline status and zygosity of BRCAalts will be presented. Conclusions: These data suggest a differential benefit from PARPi therapy across BRCAalt subgroups. This observation may in part be explained by the inability to develop reversion mutations to restore BRCA function in tumors with BRCAdel. Further studies are warranted to fully assess the association of BRCAalt type with outcomes to PARPi-based treatments.
Consensus molecular subtypes in colorectal cancer differ by geographic region.
Authors: Krittiya Korphaisarn, Michael Lam, Jonathan M. Loree, Erika Ruiz, Samuel Aguiar, Scott Kopetz
Journal: Journal of Clinical Oncology (2020)

4061 Background: The consensus molecular subtypes (CMS) have emerged as a novel classification in colorectal cancer (CRC). However, these subtypes, were mostly derived from a US/European population, and have scant data in other ethnic groups. This study aimed to demonstrate molecular subtypes of CRC across geographic regions. Methods: Formalin fixed paraffin embedded (FFPE) tissue from untreated patients with stage II-III colon cancer from Brazil, Canada, Mexico, Thailand, and the US were evaluated. Gene expression profiling was performed at the University of Texas MD Anderson Cancer Center using NanoString’s nCounter technology and an optimized classifier for FFPE. Results: A total of 366 samples were included in this study, evenly distributed between the 5 international sites. While the US population matched previously reported distributions, the distribution of CMS subtypes varied substantially by region (P &lt; 0.0001). While CMS1 was still associated with right-sided tumors (P &lt; 0.001) and deficient mismatch repair (dMMR) (P &lt; 0.001), the prevalence varied between 8% in Brazil to 30% in Mexico. CMS2 was found vary from 14% in Mexico to 47% in Brazil. The metabolic CMS3 subtype was present in only 3% in Thailand, but as high as 19% in Brazil. CMS4 was confirmed to be associated with higher stage (P = 0.047), and the prevalence was lowest in Brazil (14%) compared to 44% and 49% in US and Mexico, respectively. Expansion of study cohort is ongoing. Conclusions: CMS subtype prevalence differs substantially by geographic region in CRC. These variations suggest that transcriptomic-defined disease biology in international populations may be more heterogeneous than previously appreciated. Further studies in global populations are required to validate and extend these findings, which may have important impact for novel therapeutic development.
Dysregulation of type I interferon responses in COVID-19
Authors: Dhiraj Acharya, GuanQun Liu, Michaela U. Gack
Journal: Nature reviews. Immunology (2020)

Infection with SARS-CoV-2 can lead to excessive production of pro-inflammatory cytokines, but the production of type I interferons, which are key antiviral mediators, is reportedly blunted. Here, we discuss how imbalanced interferon responses may contribute to the pathology of COVID-19. In this Comment, Michaela Gack and colleagues discuss how the dysregulation of type I interferon responses may contribute to COVID-19 pathology.
A phase II study of oraxol in the treatment of unresectable cutaneous angiosarcoma.
Authors: Vinod Ravi, Michael Wagner, Tom Wei-Wu Chen, Herbert H. F. Loong, Robert Gary Mennel, Chueh-Chuan Yen, Glen Clack, David Cutler, Min-Fun Rudolf Kwan, Wing Kai Chan
Journal: Journal of Clinical Oncology (2020)

11517 Background: Oraxol is a combination of oral paclitaxel and a novel oral P-glycoprotein inhibitor, HM30181A. Cutaneous angiosarcomas are highly aggressive malignant tumors with poor prognosis. Currently there is no FDA-approved treatment. Methods: This is an open label study evaluating the activity, safety and tolerability of Oraxol 205mg/m 2 administered orally, once daily, for 3 consecutive days per week. Planned treatment is for 25 weeks. Subjects included in this study had not received prior therapy with a taxane and did not have metastatic disease. Tumour response was evaluated at 6 weekly intervals using RECIST and photography. A Simon two stage design was used. Results: 18 of 24 enrolled patients (pts); male/female 11/7; median age 77 years (range 56-93), were evaluable at time of analysis. Subjects were recruited during an 18 month period, from Aug-2018 to Jan-2020. Best objective response rates were: CR 22% (n = 4), PR 11% (n = 2), SD 67% (n = 12), PD 0%. 42% of pts with SD had durability &gt; 13 weeks (range 13-25). Median PFS was 38 weeks. All pts remain alive at time of reporting. Furthermore, 5 pts (28%) who had inoperable lesions were deemed operable after Oraxol and received surgical resection. Oraxol was generally well tolerated. Most common adverse events (AEs) G&gt;3 were: diarrhea (n = 1), fatigue (n = 3), neutropenia (n = 9), leucopenia (n = 5), lymphopenia (n = 5). Serious AEs were G3 pneumonia in 2 subjects and G4 neutropenia in 2 subjects, one of which was febrile. All events fully resolved. Neuropathy was uncommon: n = 2 (G1 = 1 @ day 10, G2 = 1 @ day 64). Dose reductions were recorded in 7 subjects. 2 subjects discontinued treatment due to AEs; both asymptomatic pneumonitis seen on CT, which recovered after discontinuation. Following the initial positive results, the protocol has been amended to change the maximum recruitment of subjects from 25 to 43. Conclusions: Oraxol provides an orally administered treatment option for angiosarcoma, with a high and durable clinical benefit rate (CR + PR+ long SD). It is generally well tolerated even in an older patient population; particularly with respect to the the low incidence of neuropathy compared to IV paclitaxel. Recruitment is ongoing. Clinical trial information: NCT03544567 . [Table: see text]
Ondansetron Use in Pregnancy and Congenital Malformations—Reply
Authors: Krista F. Huybrechts, Sonia Hernandez-Diaz, Brian T. Bateman
Journal: JAMA (2020)

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Contribution of history-taking, physical examination and laboratory investigation to diagnoses for medical outpatients
Authors: Dong Wu, Jia-lin Chen, Wei-gang Fang
Journal: BMJ (2010)

Objective To quantitatively evaluate relative contribution of medical history,physical examination and laboratory investigation to diagnoses for medical outpatients.Methods In total,145 medical visitors to the outpatient department of Peking Union Medical College Hospital (PUMCH) during October 10 to 16,2008 were recruited and followed-up for 12 months.Results Nineteen of 145 visitors (13.1%) were lost during the period of follow-up and diagnoses were established for 86 of them (68.3%)finally with medical history and for 20 (15.9%) with physical examination or laboratory investigation,respectively.Confidence index of internists in their correct diagnosis increased to 7.3 with medical history and to 7.9 and 8.7 with physical examination and laboratory investigation in average,respectively.Conclusions Most visitors to internal medicine department could be diagnosed correctly with medical history only.On the basis of physical diagnosis,selection of adequate laboratory investigation for them is critical to improvement of clinical diagnosis.

Key words: 
Diagnosis; Medical history taking; Physical examination; Outpatients
Use of computed tomography in evaluating prognosis for infants with hypoxic ischemic encepholopathy
Authors: 包蕾, 余加林, 徐天鹤
Journal: BMJ (2004)

目的 探讨CT检查对判断新生儿缺氧缺血性脑病(HIE)预后的价值.方法对85例HIE患儿分别在生后1周内、2周～2个月、3～6个月、1～1.5岁进行CT检查;同时在生后12～14 d进行新生儿行为神经测定;在1～1.5岁测定发育商判断预后.结果生后1周内CT结果分度为重度者预后不良率为40.9%(9/22),为中度者预后不良率为5.7%(3/52);2个月时CT随访结果异常者预后不良率为60.0%(6/10);CT结果中度且12～14 d的NBNA评分≥35分与<35分者的预后差异无显著性,CT结果重度且12～14 d 的NBNA评分<35分者有72.7%(8/11)预后不良.结论生后1周内CT分度及生后1个月左右随访结果,同时结合临床、生后12～14 d NBNA 评分对判断HIE患儿的预后、制定治疗方案及疗程有重要意义。
血CD41、CD62P与2型糖尿病患者颈动脉内膜中层厚度的关系
Authors: 涂燕平, 雷梦觉, 龚爱斌, 魏伟荣, 王凌玲, 艾文伟
Journal: BMJ (2006)

众所周知,胰岛素抵抗、高胰岛素血症、脂代谢异常是导致糖尿病患者动脉粥样硬化的危险因素,近年有报道, 胰岛素抵抗、脂代谢异常使血小板活化程度增加,在动脉粥样硬化的形成中具有重要的作用[1,2].本研究采用流式细胞仪检测糖尿病患者活化血小板标志物αⅡb整合素(CD41)和P- 选择素(CD62P),用超声测量颈动脉内膜中层厚度,探讨血CD41、CD62P与糖尿病动脉硬化发生发展的关系。
Real-world usage and outcomes for patients treated with immune checkpoint inhibitors across multiple treatment indications in the Veterans Affairs system.
Authors: Jennifer La, David Cheng, Nhan Do, Mary T. Brophy, Nathanael Fillmore, David P. Tuck
Journal: Journal of Clinical Oncology (2020)

e15063 Background: Increasingly broad patient groups are being treated with immune checkpoint inhibitors (ICIs) in clinical practice, but few studies have assessed their usage and outcomes in large, comprehensive real-world cohorts. In this study, we identified patients who received ICI therapy through April 2019 in the Veterans Affairs (VA) system. We described patient characteristics and assessed survival outcomes for patients across multiple treatment indications based on the cancer type and line of therapy. Methods: We conducted a retrospective analysis using electronic health record data captured from VA facilities nationwide. Patients treated with ICI were identified based on pharmacy and orders records. The associated cancer type and line of therapy (first line 1L or later line 2L+) was ascertained based on data on patients’ treatment history, administrative codes, and VA cancer registry records. The distribution of time from ICI treatment initiation to death was separately assessed by treatment indication using Kaplan-Meier estimates. Results: We identified 13,276 patients treated with ICI. The mean age was 69 years old. A majority of patients were male (97.2%) and white (76.9%), and a substantial minority were African-American (16.9%). Among patients treated with ICI for an identifiable cancer type, the most common cancer types included non-small lung cancer (NSCLC; 47.2%), melanoma (22.2%), renal cell carcinoma (RCC; 6.7%), squamous cell carcinoma of the head and neck (SCCHN; 10.4%), and urothelial cancer (6.4%). For major treatment indications, VA patients generally exhibited lower rates of survival than those reported in many ICI clinical trials, but the results are more comparable to those in trials among a subgroup of non-frail patients. Conclusions: This study describes ICI utilization and outcomes across multiple tumor types in a real-world population at the VA. The results offer evidence on the utilization and performance of ICIs in a real-world population. In addition, this work establishes a platform for further analyses of ICI outcomes in real-world practice at the VA. [Table: see text]
Genomic landscape of malignant peripheral nerve sheath tumor (MPNST)-like melanoma.
Authors: Thiago Pimentel Muniz, Hadas Sorotsky, Yada Kanjanapan, April A. N. Rose, Daniel Vilarim Araujo, Alexander Fortuna, Danny K. Ghazarian, Zaid Saeed Kamil, Trevor John Pugh, Michelle Mah, Madhuran Thiagarajah, Anna Spreafico, David Hogg
Journal: Journal of Clinical Oncology (2020)

e22072 Background: Malignant Peripheral Nerve Sheath Tumor (MPNST)-like melanoma is a rare entity wherein cutaneous melanoma mimics histomorphological features of MPNST. The genomic landscape of MPNST-like melanoma has not been previously described. We report the genomic findings of 6 patients diagnosed with MPNST-like melanoma. Methods: We identified consecutive patients with confirmed histological diagnosis of MPNST-like melanoma. Archival tissue was submitted for whole exome and transcriptome sequencing analysis and genomic findings were compared to publicly available data on the genomic landscape of both melanoma and limited genetic descriptions of MPNST. Results: Six patients diagnosed with MPNST-like melanoma between November 2002 and July 2018 had archival tissue available (8 samples). Mean age at diagnosis was 60.5 years (38-74). The mean tumor mutational burden (TMB) was 35.72 mutations/exon coding megabase, ranging from 4.27 to 86.36. NF1 alterations were found in 4 (67%) of cases: one had 3 truncating mutations (W696 + X1870_splice + R1590C) associated with NF1 amplification, one had a deep deletion and another two had truncating mutations (I1908L and W696 + A1530V). Two tumors had non-V600 BRAF mutations that predict alteration in kinase function. We observed deletions of cell cycle regulators: CDKN2A and CDKN2B in 33%; and ZNF331 (19q13.42) in 83% of cases. SERPINB4 (18q21.3), described previously as a tumor suppressor in oral squamous cell carcinomas, was deleted in all samples. The patient with NF1 amplification and truncating mutations received immunotherapy due to metastatic disease and achieved a complete response; his tumor had a TMB of 72.6. Another patient who died of metastatic melanoma, treated with chemotherapy in the pre-immunotherapy era, lacked any NF1 mutation but had a Q61K NRAS mutation; the tumor had a TMB of 15. The remaining patients were treated with surgical resection alone and continue on follow-up. Conclusions: MPNST-like melanoma shares some frequently altered genes in cutaneous melanoma but possesses an excess of NF-1 mutations or deletions, in keeping with its neural-like phenotype. The high frequency of SERPINB4 alterations suggests a critical tumor suppressor role in this subtype of melanoma, warranting further investigation. Additionally, cell cycle dysregulation caused by deletion of ZNF331 and CDKN2A/B may be important in MPNST-like melanoma carcinogenesis.
基层医院继发性高血压误诊六例分析
Authors: 沈景红, 任婕
Journal: BMJ (2009)

继发性高血压是指由某些确定的疾病或病因引起的血压升高,约占所有高血压的5%[1].继发性高血压缺乏特异性的临床表现,易误诊、漏诊.现对我院2003年5月至2009年3月收住院的6例因原发性醛固酮增多症(简称原醛)及肾动脉狭窄致继发性高血压的资料进行分析,以提高基层医生对继发性高血压的认识。
正确认识人生长激素缺乏性矮小症
Authors: 潘慧, 史轶蘩
Journal: BMJ (2006)

随着人民生活水平的提高,孩子们的平均身高呈明显增加趋势,但全社会对身高的期望值也随之升高,由此越来越多的孩子加入了因身材相对矮小而苦恼的人群.目前临床上以标准差法和身高百分位法来判断身材矮小,即当患儿身高较同地区、同种族、同性别、同年龄身材正常儿童平均身高低2个标准差,或者身高小于该人群儿童身高第3个百分位,诊为身材矮小。
天疱疮四例临床分析
Authors: 刘洁, 王涛, 陈金波, 曾跃平, 张涛, 晋红中, 王宝玺
Journal: BMJ (2008)

天疱疮是一种慢性、复发性、自身免疫性皮肤病,以皮肤及黏膜上出现松弛性水疱,尼氏征阳性为主要表现.患者体内存在针对桥粒芯蛋白(dsg)的自身抗体,主要为dsg 1或dsg 3.临床分型包括寻常型、增殖型、落叶型、红斑型、副肿瘤型和IgA天疱疮.本次结合4例不同类型的天疱疮病例对本病的临床表现、发病机制、诊断及治疗进行讨论。
Phase II study of nivolumab and ipilimumab for advanced rare genitourinary cancers.
Authors: Bradley Alexander McGregor, Matthew T Campbell, Wanling Xie, Subrina Farah, Mehmet Asim Bilen, Guru Sonpavde, Kerry L. Kilbridge, Atish Dipankar Choudhury, Amir Mortazavi, Amishi Yogesh Shah, Aradhana M. Venkatesan, Glenn Bubley, Arlene O. Siefker-Radtke, Rana R. McKay, Toni K. Choueiri
Journal: Journal of Clinical Oncology (2020)

5018 Background: Patients with rare genitourinary malignancies (Bladder cancer of variant histologies (BCVH), adrenal tumors, chemotherapy refractory germ cell tumors (CRGCT), penile carcinoma and prostate cancer of variant histology (PCVH)) have poor outcomes. Nivolumab and ipilimumab has demonstrated safety and efficacy in genitourinary malignancies. In this multicenter, single arm, multi-cohort phase II trial we evaluated the efficacy of nivolumab and ipilimumab in pts with advanced rare genitourinary cancers (NCT 03333616). Herein, we report the results of the fully accrued BCVH, adrenal and other cohorts. Methods: Eligible pts had a metastatic rare genitourinary malignancy, ECOG performance status of 0-2 and no prior immune checkpoint inhibitor exposure; aside from CRGCT pts could be treatment naïve. Eligible pts received nivolumab 3 mg/kg and ipilimumab 1 mg/kg intravenously every 3 weeks for 4 doses with continued nivolumab 480 mg IV every 4 weeks. The primary endpoint was overall response rate (ORR) by RECIST 1.1. Results: 56 pts were enrolled at 6 institutions between 4/2018 and 7/2019 in 3 cohorts: BCVH (N = 19), adrenal tumors (n = 18) and other tumors (n = 19). Median follow-up was 9.9 (range &lt; 1~21) months. 28(50%) pts received all 4 doses of nivolumab and ipilimumab. 25 pts received nivolumab maintenance at a median of 4 (range 1-18) cycles. ORR in entire cohort was 16% (n = 9: 2 CR 7 PR, Table); 67% of responders (6/9) maintained response greater than 9 months. Median PFS was 2.8 (2.7-5.2) months. 22 pts (39%) developed treatment-related ≥ grade 3 toxicity; 23% required high dose steroids (≥40 mg prednisone or equivalent) and 15 (27%) pts discontinued treatment due to an AE. Grade 5 toxicity occurred in 3 pts; 1 death was treatment related. Conclusions: Nivolumab and ipilimumab resulted in objective responses in a subset of pts with rare GU malignancies, especially in BCVH. Biomarkers are being evaluated and an additional cohort exploring the activity in genitourinary tumors with neuroendocrine differentiation is ongoing. This combination warrants further investigation in these pts with substantial unmet needs. Clinical trial information: NCT 03333616 . [Table: see text]
小剂量利尿剂治疗糖尿病合并轻中度高血压112例
Authors: 彭小雨, 邱妙龄
Journal: BMJ (2004)

用小剂量双氢克尿噻治疗糖尿病合并轻中度高血压112例.停用对血压有影响的药物,双氢克尿噻25 mg/d, 每天测血压2次, 试验开始时和开始后每周测定1次血脂、血糖、血钾、尿酸、尿素氮.结果治疗第1周末、第8周末患者收缩压及舒张压均有显著下降,差异有显著性,血糖、血钾等指标无显著变化。
Prevention and early intervention of chronic obstructive pulmonary disease
Authors: Huizhuo Jia
Journal: BMJ (2018)

慢性阻塞性肺疾病(慢阻肺)是世界第三大致死性疾病，晚期和重度慢阻肺患者死亡率高，预后差。对无症状患者进行早期干预是未来慢阻肺防治的趋势之一。然而，慢阻肺具有异质性，病因及病理机制复杂，个体对治疗的反应不尽相同。因此，对慢阻肺进行早期干预首先需要了解慢阻肺的早期诊断和特点。
Significance of renal biopsy for type 2 diabetes complicated with non-diabetic renal disease
Authors: Ai-ping Zhang, Yi-kai Hou, Yan-xia Wang, Shu-mei Shi, Yao-hai Ding, Yun-shan Guo, Lei Zhang, Zhen Li
Journal: BMJ (2013)

Objective
To analyze the relationship between pathological diagnosis and clinical manifestation and elucidate the significance of renal biopsy on the diagnosis of type 2 diabetics complicated with non-diabetic renal disease (NDRD).


Methods
The clinicopathological data of 81 type 2 diabetics complicated with renal injury underwent renal biopsy.


Results
Patients with type 2 diabetic mellitus (DM) or diabetic nephropathy (DN) might be complicated with various kinds of non-diabetic renal injury. Among them, 44 subjects (54%) with type 2 diabetes complicated with NDRD were classified as group A, 32 cases (40%) with DN only group B and the remaining 5 cases (6%) with DN complicated with NDRD group C. Their pathological characteristics paralleled the clinical manifestations of renal disease.


Conclusion
It is difficult to differentiate patients with DM complicated with NDRD, DN, or DN complicated with NDRD. Therefore renal biopsy is an important differentiating method for analyzing renal pathological types and changes of patients.


Key words: 
Dabetic nephropathy; Diabetes mellitus, type 2; Biopsy，needle