tbuckley/cabot-search huggingface dataset:
临床证据（四）—焦虑障碍的治疗效果
Authors: 李春波, ChristopherGale
Journal: BMJ (2001)

背景知识定义 广泛性焦虑障碍 (ｇｅｎｅｒａｌｉｓｅｄａｎｘｉｅｔｙｄｉｓｏｒｄｅｒ ,ＧＡＤ)指持续 6个月以上的多数日子里 ,伴下列症状和体征 :运动性紧张增加 (疲乏、颤抖、坐立不安、肌肉紧张 ) ;自主神经系统兴奋 (呼吸急促、心率加快、口干、手冷、头昏 ) ,但无惊恐发作 ;警觉增高 (神经紧张感、易惊跳、注意力集中缺损 )。发病率 /患病率 对ＧＡＤ发病率和患病率的评估有些问题。ＧＡＤ与其他焦虑障碍和抑郁症有较高的共病性1。进一步讲 ,在流行病学研究中使用测量方法的可信度仍不尽如人意2 。美国的一项研究应用ＤＳＭ ＩＩＩ Ｒ标准 ,推测每 2 0人中就有 1人在一生中会发生ＧＡＤ3
Abstract 2759: Elevated Coronary Calcium Scores Measured by Multi-Slice Computed Tomography are Associated with Low Response to Clopidogrel in Patients with Stable Angina pectoris
Authors: Christof Burgstahler, Tobias Geisler, Stephan Lindemann, Anja Reimann, Harald Brodoefel, Ilias Tsiflikas, Andreas F Kopp, Meinrad Gawaz, Stephen Schroeder
Journal: Circulation (2007)

Cardiac multi-detector computed tomography (MDCT) with retrospective ECG-gating permits the determination and quantification of coronary calcifications. High calcium scores are known to be associated with elevated all-cause mortality. Moreover, low response to clopidogrel influences cardiovascular outcome after coronary stent placement. We sought to evaluate whether elevated calcium scores are associated with a low response to clopidogrel. Methods 62 patients were enrolled in this trial (52 male, mean age 64.8 ± 8.9 years). Coronary calcium scoring (expressed as Agatston score equivalent, ASE) was measured with multi-slice computed tomography (Sensation 64™ [n=19] and Somatom Definition ™ [n=43], Siemens, Forchheim, Germany) prior to stent implantation. Responsiveness to clopidogrel was assessed by ADP (20 micromol/L)-induced aggregometry at least 6 h after administration of a loading dose of 600 mg clopidogrel. Results Median calcium score was 736 ASE [range 0 –3126] and mean platelet inhibition was 35±19% [range 0 –70]. There was a significant negative correlation between ASE and response to clopidogrel (r 2 =0.135, p=0.0033, slope 7.809 ± 2.549). Patients within the first quartile of ASE had significantly better response to clopidogrel than other patients (p&lt;0.05). Establishing a threshold of 200 ASE responsiveness to clopidogrel could be predicted with a positive predictive value of 80% and a specificity of 91%. Conclusions We could demonstrate that elevated ASE is associated with a low response to clopidogrel. Patients with a low coronary plaque burden are more likely to have a good response to clopidogrel. Coronary calcium scoring might help to identify low responders to clopidogrel prior to stent placement and aggregometry.
Abstract 1715: Prognosis of Patients Under Chronic Clopidogrel Therapy while Suffering an Acute Coronary Syndrome
Authors: Laurent Bonello, Axel de Labriolle, Gilles Lemesle, Probal Roy, Daniel H Steinberg, Tina L Pinto Slottow, Zhenyi Zue, Rebecca Torguson, William Suddath, Lowell Satler, Kenneth Kent, Augusto Pichard, Ron Waksman
Journal: Circulation (2008)

Background: Chronic clopidogrel therapy (CCT) has been shown to be beneficial in decreasing the frequency of major adverse cardiovascular events (MACE) in coronary artery disease. However, some patients suffer an acute coronary syndrome (ACS) despite CCT. Objective : To assess the prognosis of patients suffering an ACS while on CCT compared to patients naive to clopidogrel. Method: Retrospective analysis of propensity matched cohorts of patients undergoing PCI for an ACS was performed. Patients under CCT before the ACS were matched 1:2 with patients not under CCT before the ACS. The primary endpoint was a composite of cardiac death and myocardial infarction (MI) at 1-year follow-up. A cohort of 2325 patients undergoing PCI for an ACS was studied. Among them, 256 patients were taking CCT for &gt; 1 month at the time of the ACS and 2069 weren’t taking clopidogrel prior to the ACS. After propensity score matching 1:2, the 2 groups included, respectively, 84 and 168 patients. Results: Patients in both groups had similar rates of previous MI (no CCT vs CCT 47.6 vs 48.8%; p = 0.86) or PCI (40.5 vs 40.5%; p = 1). There was no difference in drug use on discharge between the 2 groups; in particular for thienopyridines (94 vs 96.4%; p = 0.6). At 1-year follow-up, patients under CCT before the ACS exhibited a worse prognosis than patients who were not under CCT prior to the ACS, with a higher rate of cardiac death and MI (14.2 vs 5.5%; p = 0.015). Conclusions: This study suggests that patients suffering an ACS while under CCT have a poor long-term prognosis, which could be linked to clopidogrel low response.
Abstract 3654: Semaphorin3E is a Novel Angiogenic Regulator
Authors: Junji Moriya, Tohru Minamino, Kaoru Tateno, Masayuki Orimo, Hideyuki Miyauchi, Sho Okada, Ippei Shimizu, Aika Nojima, Masataka Yokoyama, Issei Komuro
Journal: Circulation (2008)

Semaphorin3E (sema3E) and its specific receptor plexinD1 are known to regulate the patterning of vessels during embryogenesis. However, it remains unclear whether these molecules are involved in postnatal angiogenesis. To elucidate the role of sema3E/plexinD1, we performed in vitro assay using human umbilical vein endothelial cells (HUVECs). Treatment with vascular endothelial growth factor (VEGF) increased proliferation and tube formation and this increase was significantly inhibited by sema3E. Moreover, treatment with the plexinD1-Fc fusion protein antagonized this anti-angiogenic activity of sema3E. Western blot analyses revealed that sema3E suppressed VEGF-induced phosphorylation of VEGFR2, suggesting that sema3E negatively regulates angiogenesis by inhibiting the VEGF signaling pathway. Expression of sema3E and plexinD1 was markedly upregulated in ischemic limbs. Immunohistochemistry showed that sema3E was expressed by the arterioles, myocytes, and capillary endothelial cells in ischemic tissue. Introduction of the plexinD1-Fc gene into ischemic limbs led to significant improvement of blood flow recovery and an increase in the number of CD31-positive cells. It has been reported that other members of the sema3 family are transcriptionally regulated by p53, a tumor suppressor protein that inhibits neovascularization in tumors. Consistent with these reports, forced expression of p53 was found to upregulate sema3E expression in HUVECs. We also found that the expression of p53 was markedly increased in ischemic limbs and that this increase was further enhanced in ischemic tissues of diabetic mice. Consequently, expression of sema3E was significantly higher in ischemic limbs of diabetic mice than in control mice, and the blood flow recovery after ischemia was strongly impaired in these mice even though treated with VEGF. In contrast, treatment with both VEGF and PlexinD1-Fc markedly improved blood flow recovery in diabetic mice. These results indicate that sema3E/plexinD1 negatively regulates postnatal angiogenesis under the regulation of p53 and suggest that inhibition of sema3E would be a novel strategy for therapeutic angiogenesis, especially when VEGF treatment is ineffective.
Serial Measurement of Monocyte Chemoattractant Protein-1 After Acute Coronary Syndromes
Authors: James A. de Lemos, David A. Morrow, Michael A. Blazing, Petr Jarolim, Stephen D. Wiviott, Marc S. Sabatine, Robert M. Califf, Eugene Braunwald
Journal: Journal of the American College of Cardiology (2007)
Prolonged extracorporeal membrane oxygenation and lung transplantation for isolated pulmonary anti-GBM (Goodpasture) disease
Authors: Antoine Legras, Pierre Mordant, Nicolas Brechot, Alain Bel, Véronique Boussaud, Romain Guillemain, Bernard Cholley, Laure Gibault, Françoise Le Pimpec-Barthes, Alain Combes
Journal: Intensive Care Medicine (2015)
Abstract 1928: Differences In Vascular Response Following Sirolimus And Paclitaxel Eluting Stents
Authors: Gaku Nakazawa, Michael Joner, Aloke V Finn, Elena Ladich, Erik K Mont, Robert Kutys, Allen Burke, Frank D Kolodgie, Renu Virmani
Journal: Circulation (2007)

Background Clinical randomized trials have reported different late loss between sirolimus-(Cypher) and paclitaxel- (Taxus) eluting stents however, the mechanism for this difference have not been fu...
Abstract 282: Anemia, High LDH, Hyperglycemia, and Low pH on Admission Are Associated With Poor Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Treated With Hypothermia Therapy From Multicenter Hypothermia Registry in Japan: J-PULSE-Hypo Registry
Authors: Kazunori Kashiwase, Yasunori Ueda, Naohiro Yonemoto, Hiroyuki Yokoyama, Ken Nagao, Hiroshi Nonogi, J-PULSE-Hypo Investigators
Journal: Circulation (2010)

Background:  Although mild hypothermia (MH) has neurological benefits for patients with return of spontaneous circulation (ROSC) after out-of-hospital ventricular fibrillation cardiac arrest, there are limited data about predictors of good neurological outcome in these patients.   Method:  Five years (2005–2009) data were available for 452 patients treated with MH in the multicenter registry in Japan (J-Pulse-Hypo). We included 389 patients with initial blood examination and atrial gas sampling. We examined the relationship between initial blood examination data and neurological outcome. Primary end point of this study was favorable neurologic outcome (cerebral performance category (CPC) 1 and 2) rate at 30 days.   Result:  According to neurologic outcome at 30 days, we divided all cases into two groups: the favorable outcome group (n=221) and the unfavorable outcome group (n=168). Favorable outcome rate at 30 days was 56.8%. By the multiple logistic regression analysis, age, witness of cardiac arrest, ROSC before admission, hematocrit (HCT), lactate dehydrogenase (LDH), glucose (BS), and pH were revealed as the independent predictors of 30 days favorable outcome. Cutoff values of age, HCT, LDH, BS and pH were obtained by receiver operating characteristic (ROC) curve (shown in Table).   Conclusion:  Anemia, high LDH, hyperglycemia, and low pH on admission were significantly associated with poor neurological outcome even among patients treated with hypothermia therapy.
Barrett‘s食管：仍是一个谜——随诊仅限于适合手术者
Authors: 姚方
Journal: BMJ (2002)

195 0年 ,Ｂａｒｒｅｔｔ写了篇文章以澄清食管炎这个易于混淆的概念 ,“食管炎一词常常对某些人来说意味着一种意思 ,而对另一些人则意味着另一种相当不同的意思”1。Ｂａｒｒｅｔｔ认为胃粘膜延伸到食管是先天性食管缩短的结果。现在人们把食管内有柱状排列的上皮称为Ｂａｒｒｅｔｔ′ｓ食管。它常与慢性胃 食管返流性疾病并存 ,并增加食管腺癌发生的危险性2 。至于如何定量这种危险性 ,什么是最佳的早期诊断方法 ,仍是目前争论的焦点。内镜下食管远端呈珍珠色 ,很容易与胃近端的鲑肉样红色部分区分开来 ,这就是所谓的“Ｚ线”或鳞柱状上皮交界。然而 ,存在严重炎症、裂孔疝或食管炎伴食管狭窄的患者 ,Ｚ线的位置
Patient-Centered Imaging
Authors: Andrew J. Einstein, Daniel S. Berman, James K. Min, Robert C. Hendel, Thomas C. Gerber, J. Jeffrey Carr, Manuel D. Cerqueira, S. James Cullom, Robert DeKemp, Neal W. Dickert, Sharmila Dorbala, Reza Fazel, Ernest V. Garcia, Raymond J. Gibbons, Sandra S. Halliburton, Jörg Hausleiter, Gary V. Heller, Scott Jerome, John R. Lesser, Gilbert L. Raff, Peter Tilkemeier, Kim A. Williams, Leslee J. Shaw
Journal: Journal of the American College of Cardiology (2014)
Abstract 9898: Weight Loss Decreases High Sensitivity C-Reactive Protein Irrespective of Dietary Composition
Authors: Jacinda M Nicklas, Frank M Sacks, Steven R Smith, George A Bray, Meryl S LeBoff, Paul M Ridker
Journal: Circulation (2011)

Introduction: Randomized trials indicate that statins reduce the inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) by 20-40%. Although not as widely publicized, diet-induced weight loss also reduces hsCRP. However, the magnitude of this effect in overweight individuals is uncertain and little is known about how diets differing in fat, protein, or carbohydrate composition modify this effect. Hypothesis: Weight loss will decrease hsCRP in overweight individuals, and diets lower in carbohydrate will be most effective. Methods: POUNDS (Preventing Overweight Using Novel Dietary Strategies) LOST was a 2 year trial of overweight and obese adults randomly allocated to 1 of 4 weight loss diets with targeted percentages of energy derived from fat, protein, and carbohydrates (20, 15, 65%; 20, 25, 55%; 40, 15, 45%; 40, 25, 35%, respectively). hsCRP was measured at baseline, 6, and 24 months among 710 participants, and data on adiposity as measured by dual X-ray absorptiometry (N=340) or abdominal computed tomography (N=126) were also evaluated as potential correlates of hsCRP change. Results: At 6 months, hsCRP was reduced in all trial participants by a median 25% (IQR +7%, -50%), weight by 7% (IQR -3%, -11%), and waist circumference by 6% (IQR -3%, -10%) (all P&lt;.002) with no significant differences observed according to randomized dietary composition. Irrespective of diet composition, the percent change in hsCRP at 6 and 24 months correlated modestly with change in weight, waist circumference, fasting insulin, fasting glucose, HOMA, and most lipid levels. Reductions in hsCRP persisted throughout the study period despite an approximate 50% regain of weight by 24 months. In imaging studies, the percent change in hsCRP at 24 months significantly correlated with changes in percent total body fat (r=0.42), as well as absolute changes in total abdominal adiposity (r=0.52), subcutaneous abdominal adiposity (r=0.52), and visceral adiposity (r=0.47) (all P&lt;.001). Conclusion: Weight loss, regardless of dietary composition, reduces hsCRP with a magnitude of effect similar to statin therapy. As is recommended for individuals with elevated LDL cholesterol, the first intervention for those with elevated hsCRP should be weight loss via caloric restriction.
Abstract 19862: HDL Stimulates Endothelial CAT-1 Expression and L-Arginine Uptake: A Novel Mechanism Leading to Endothelial-Protective Effects of HDL That is Profoundly Altered in Patients With Coronary Disease
Authors: Christian Besler, Kathrin Heinrich, Viktoria Makrides, Meliana Riwanto, Sokrates Stein, Francois Verrey, Thomas F Luscher, Ulf Landmesser
Journal: Circulation (2010)

Background: Endothelial nitric oxide synthase (eNOS)-derived nitric oxide (NO) exerts important anti-atherogenic effects. High-density lipoprotein from healthy subjects (HDLHS) stimulates endothelial NO production; however, the underlying mechanisms remain to be further defined. In the present study we therefore characterized the effects of HDLHS and HDL from patients with coronary disease (HDLCAD) on cationic amino acid transporter-1 (CAT-1), the main endothelial L-arginine transporter, and endothelial uptake of L-arginine, the substrate of eNOS. Methods: HDLHS (n=15) and HDLCAD (n=20) was isolated by sequential ultracentrifugation. The effects of HDL on endothelial mRNA and protein expression of CAT-1 were determined, and cellular localization of CAT-1 was examined by confocal microscopy. NO production was measured by electron spin resonance spectroscopy. Endothelial L-arginine uptake was determined after [3H]-labeling of L-arginine. The role of CAT-1 for HDL-dependent endothelial L-arginine uptake and ...
Metagenomic Surveys of Gut Microbiota
Authors: Rahul Shubhra Mandal, Sudipto Saha, Santasabuj Das
Journal: Genomics Proteomics & Bioinformatics (2015)

Abstract Gut microbiota of higher vertebrates is host-specific. The number and diversity of the organisms residing within the gut ecosystem are defined by physiological and environmental factors, such as host genotype, habitat, and diet. Recently, culture-independent sequencing techniques have added a new dimension to the study of gut microbiota and the challenge to analyze the large volume of sequencing data is increasingly addressed by the development of novel computational tools and methods. Interestingly, gut microbiota maintains a constant relative abundance at operational taxonomic unit (OTU) levels and altered bacterial abundance has been associated with complex diseases such as symptomatic atherosclerosis, type 2 diabetes, obesity, and colorectal cancer. Therefore, the study of gut microbial population has emerged as an important field of research in order to ultimately achieve better health. In addition, there is a spontaneous, non-linear, and dynamic interaction among different bacterial species residing in the gut. Thus, predicting the influence of perturbed microbe–microbe interaction network on health can aid in developing novel therapeutics. Here, we summarize the population abundance of gut microbiota and its variation in different clinical states, computational tools available to analyze the pyrosequencing data, and gut microbe–microbe interaction networks.
Methylene Diphosphonate Uptake in a Case of Vertebral Hemangioma
Authors: Amit Bhoil, Bhagwant Rai Mittal, Chidambaram Natrajan Balasubramanian Harisankar, Anish Bhattacharya, Paramjeet Singh, Sameer Aggarwal
Journal: Clinical Nuclear Medicine (2011)

Osseous hemangiomas are usually asymptomatic. Symptomatic hemangiomas are rare and represent approximately 1% of all cases. Hemangiomas usually present as photopenic defects in methylene diphosphonate (MDP) bone scintigraphy. MDP uptake in vertebral hemangiomas is extremely rare. We report a 20-year-old woman who presented with upper back pain. MDP bone scan showed focus of MDP uptake in the seventh dorsal vertebra. SPECT/CT localized the uptake to vertebral body and transverse process with CT findings suggestive of hemangioma. Further, MRI also confirmed hemangioma in the same location.
精神分裂症：是一种遗传性突触病吗？——谷氨酸能突触可能是其主要病变部位
Authors: Michael, Owen, O＇Donovan, Paul, Harrison, 孟晓梅（译）, 许贤豪（校）
Journal: BMJ (2005)

了解精神分裂症的病因和发病机理是精神病学研究的主要任务之一。迄今为止，这方面的研究进展缓慢，少数几个已明确的论点之一是易感性的个体差异主要与遗传有关。。但由于与精神分裂症相关的基因尚未得到可靠鉴定，因此尚未用于神经生物学。这种情况使人们开始重新评价现有的精神分裂症发病机理的假说。
Abstract 17079: Pattern and Regional Variability of Left Ventricular Cavity Remodeling in Various Loading Condition: 3D Echocardiographic Analysis
Authors: Yong Hyun Park, Mark D Handschumacher, Arthur E Weyman, Xin Zeng, Timothy C Tan, Marcia B Leavitt, Judy Hung
Journal: Circulation (2014)

Introduction: LV internal dimension (LVID) measured at the basal level is used to follow LV adaptation to pressure or volume load. However, this single dimension method is subject to high variability and may not reflect LV changes due to differential LV remodeling. We aimed to perform detailed 3D analysis of LV shape to highlight differential LV remodeling, in order to optimize existing 2D measures.

Methods: 90 patients were analyzed and grouped based on type of LV overload (20 severe aortic stenosis (AS), 20 dilated cardiomyopathy (DCM), 15 severe aortic regurgitation (AR), 15 severe mitral regurgitation (MR) and 20 normal). Regional variations in LV cavity pattern was identified from 3D images by calculating LVID using summation of radii at every 3 degrees of rotational angle at 100 positions along the LV long axis. The rotational angle (X-axis) was mapped as a function of the position along the LV from base to apex (Y-axis), to obtain a color map representation of regional LV changes based on LVID changes (Fig left). Position from base to apex was grouped into quintiles and standard deviations (SD) of LVID at each position calculated.

Results: All groups, including normal, consistently showed the greatest variation in measured LVIDs within the 1st quintile position (1-20; basal level) and the least variation within the 3rd quintile position (41-60; mid ventricle)(3.03±0.97mm vs 1.96±0.88mm; p<0.001; Fig right). The variation in the 1st quintile is greater in the presence of LV overload with pressure overload (AS) showing the most variation. Importantly, Quintile 1 had significantly lower correlation with LV volume than Quintile 2-4 (R2=0.77 vs R2=0.88-0.91; p<0.001).

Conclusion: LVID measurements made within the the basal portion of the LV was subject to greatest variability particularly in the presence of LV overload. However measurements made at the mid-ventricular level are more likely to be reproducible and show better correlation with volumes.

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Positron emission tomography as a noninvasive tool to monitor soft tissue sarcoma patients under therapy with trabectedin.
Authors: B. Kasper, T. Schmitt, A. Dimitrakopoulou-Strauss, A. D. Ho, G. Egerer
Journal: Journal of Clinical Oncology (2010)

e20526 Background: We used 2-deoxy-2-[18F] fluoro-D-glucose (FDG) positron emission tomography (PET) to evaluate the FDG uptake in patients with metastatic soft tissue sarcoma (STS) undergoing therapy with Ecteinascidin-743 (ET-743, Trabectedin, Yondelis). Methods: The exploratory analysis at the University of Heidelberg included nine patients with metastatic STS receiving a minimum of one cycle of treatment with trabectedin. Patients were examined using PET prior to onset of therapy and after completion of one or three cycles of trabectedin. Restaging according to the Response Evaluation Criteria in Solid Tumors (RECIST) was performed in parallel using computed tomography (CT) and/or magnetic resonance imaging (MRI) and served for reference. Results: Clinical outcome of nine evaluable patients was as follows: one patient with partial response (PR), three patients with stable disease (SD), and five patients with progressive disease (PD). The median progression-free survival from the date of therapy induction for all patients was 3.9 months [range: 0-10] with a median follow-up of 5.6 months [range: 1-10]. The median average standardized uptake value (SUV) prior to onset of therapy with trabectedin was 7.6 [range: 1.2-19.3] versus 5.8 [range: 1.4-20.1] after treatment. The median SUVmax was 14.1 [range: 4.5-28.7] prior to therapy with trabectedin versus 16.1 [range: 6.1-32.4] following treatment. A more than 40% decrease of the SUV of sequential PET examination could be demonstrated for one responding patient in PR (SUV: 6.7 > 3.5, decrease of 48 % ; SUVmax: 13.5 > 6.1, decrease of 54 %), whereas patients with SD or PD showed a stable SUV, but no increase in SUV. Conclusions: This small series of patients being treated with trabectedin and monitored using sequential PET imaging demonstrated SUV stabilization in nearly all analysed patients. More patient data will have to be collected to validate these findings. No significant financial relationships to disclose.
Seeking medical justice
Authors: Frank W Arnold
Journal: BMJ (2008)

With reference to Heath,1 existing secondary care restrictions have already contributed to avoidable deaths among failed asylum seekers.1 2 There is no evidence that they have saved money, except perhaps by deterring people who are still entitled to care from seeking it. Removing the right of general practitioners to register failed asylum seekers will extend the damage to individual and public health and the ethos of our profession. These steps …
A multimodal nano agent for image-guided cancer surgery
Authors: Jinzi Zheng, Nidal Muhanna, Raquel De Souza, Hironobu Wada, Harley Chan, Margarete K. Akens, Takashi Anayama, Kazuhiro Yasufuku, Stefano Serra, Jonathan Irish, Christine Allen, David Jaffray
Journal: Biomaterials (2015)

Intraoperative imaging technologies including computed tomography and fluorescence optical imaging are becoming routine tools in the cancer surgery operating room. They constitute an enabling platform for high performance surgical resections that assure local control while minimizing morbidity. New contrast agents that can increase the sensitivity and visualization power of existing intraoperative imaging techniques will further enhance their clinical benefit. We report here the development, detection and visualization of a dual-modality computed tomography and near-infrared fluorescence nano liposomal agent (CF800) in multiple preclinical animal models of cancer. We describe the successful application of this agent for combined preoperative computed tomography based three-dimensional surgical planning and intraoperative target mapping (>200 Hounsfield Units enhancement), as well as near-infrared fluorescence guided resection (>5-fold tumor-to-background ratio). These results strongly support the clinical advancement of this agent for image-guided surgery with potential to improve lesion localization, margin delineation and metastatic lymph node detection.