A case of a successful post-transcatheter aortic valve replacement His bundle pacing

Dear editor,Transcatheter aortic valve replacement (TAVR) is a safe and effective treatment for severe aortic valve stenosis and aortic regurgitation. Multiple randomized trials have proved its therapeutic advantages in patients at any level of surgical risks.

Pomolidomide for relapsed/refractory light chain amyloidosis after resistance to both bortezomib and daratumumab:A case report

BACKGROUND Immunoglobulin light chain(AL)amyloidosis is a rare disease characterized by deposition of ALs essentially in any organ or tissue,with cardiac involvement being very frequent(61%).Early diagnosis is of high importance because early initiation of treatment in AL amyloidosis may improve outcomes.Despite the administration of immunotherapeutic agents,in particular bortezomib and daratumumab,which have improved the outcomes of AL amyloidosis,antiplasma cell therapy remains suboptimal for some patients.CASE SUMMARY We report the case of a 55-year-old man presenting with heart failure who was diagnosed with cardiac AL amyloidosis by an endomyocardial biopsy.He experienced a short-term hematological remission with no organ response after being administered a bortezomib-daratumumab containing regimen.The treatment was switched to pomolidomide due to pulmonary involvement and progressive pleural effusion,in which flow cytometry analysis showed abnormal plasma cells.After two cycles of this regimen,the pleural effusion was controlled effectively with no recurrence.CONCLUSION This case emphasizes the crucial role of endomyocardial biopsy in early diagnosis of cardiac amyloidosis and suggests that pomolidomide may be an effective treatment for patients with AL amyloidosis that is relapsed/refractory to both bortezomib and daratumumab.

Effect of laparoscopic radical resection of colorectal cancer on immune status and CRP in patients

Objective: To investigate the effect of laparoscopic radical resection of colorectal cancer on the immune status and CRP. Methods: A total of 90 patients with colorectal cancer treated in our hospital from January 2017 to June 2017 were randomly divided into the observation group and the control group, each with 45 cases. The observation group received laparoscopic surgery, while the control group was given open surgery. The changes of immune indexes and CRP in two groups before and after 3 d and after 7 d were compared. Results: (1) In the control group, the postoperative 3 d and postoperative 7 d, CRP index were (7.87±2.01) mg/dL, (2.81±1.03) mg/dL, the observation group postoperative 3 d and postoperative 7 d, CRP index were (7.01±1.33) mg/dL, (1.59±0.81) mg/dL, compared with before treatment, the difference was statistically significant. The CRP in the observation group postoperative 7 d were significantly lower than those in the control group at the same time period, the difference was significant. The IgM and IgG index level of control group postoperative 3 d respectively (137.04±23.46) IU/mL and (114.36±27.18) IU/mL, compared with preoperative and observation group postoperative 3 d index level (163.07±30.19) IU/mL, (130.24±31.16) IU/mL decreased significantly, the difference was significant. (2) The control group postoperative 3 d CD4+and CD8+index level were respectively (0.49±0.05)×109/L, (0.29±0.08)×109/L. CD8+index level of 7 d after operation was (0.31±0.10)×109/L, which were significantly decreased than 1 d before operation and significantly lower than the same period of observation group indicator level (0.59±0.09)×109/L, (0.35±0.11)×109/L, (0.37±0.12)×109/L, the differences were statistically significant. Conclusion: Compared with open surgery, laparoscopic surgery has less influence on the immune function of patients, and has less inflammatory and stress damage, so it is worthy of clinical application.

A new method for studying the 3D transient flow of misaligned journal bearings in flexible rotor-bearing systems

The effects of journal misalignment on the transient flow of a finite grooved journal bearing are presented in this study. A new 3D computational fluid dynamics (CFD) analysis method is applied. Also, the quasi-coupling calculation of transient fluid dynamics of oil film in journal bearing and rotor dynamics is considered in the analysis. Based on the structured mesh, a new approach for mesh movement is proposed to update the mesh volume when the journal moves during the fluid dynamics simula- tion of an oil film. Existing dynamic mesh models provided by FLUENT are not suitable for the transient oil flow in journal bearings. The movement of the journal is obtained by solving the moving equations of the rotor-bearing system with the calculated film pressure as the boundary condition of the load. The data exchange between fluid dynamics and rotor dynamics is realized by data files. Results obtained from the CFD model were consistent with previous experimental results on misaligned journal bearings. Film pressure, oil film force, friction torque, misalignment moment and attitude angle were calculated and compared for mis- aligned and aligned journal bearings. The results indicate that bearing performances are greatly affected by misalignment which is caused by unbalanced excitation, and the CFD method based on the fluid-structure interaction (FSI) technique can effectively predict the transient flow field of a misaligned journal bearing in a rotor-bearing system.

太极锻炼对血脂的临床疗效:随机对照试验的meta分析（英文）

目的:探讨太极锻炼是否能改善血脂水平。创新点:明确太极锻炼对血脂的影响,为非药物调脂治疗提供新手段。方法:通过筛选太极锻炼持续4周以上,PEDro评分3分以上,且观察太极锻炼对血脂影响的成人随机对照试验,meta分析太极锻炼对总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯的影响。结论:通过meta分析最终入选的6项研究(共445例患者)的结果显示,太极锻炼能显著降低血甘油三酯水平,且有降低总胆固醇的趋势,但是对于低密度脂蛋白胆固醇和高密度脂蛋白胆固醇未发现有明显影响。

弹性空心圆柱体中对称与非对称导波的磁致伸缩换能器激励（英文）

目的：超声导波是一种有潜力的无损检测方法，磁致伸缩换能器是一种重要的导波换能器。利用经典的简正模态展开法分析弹性空心圆柱体在磁致伸缩载荷下的激励响应，包括磁致伸缩局部载荷、轴向阵列载荷和圆周阵列载荷。空心圆柱体在磁致伸缩载荷作用下的扰动分析将为磁致伸缩换能器以及换能器阵的进一步发展提供理论依据。创新点：1．利用简正模态展开方法，讨论弹性空心圆柱体在磁致伸缩载荷作用下的扰动分析和激励响应；2．通过数值仿真和试验研究，验证空心圆柱体在磁致伸缩局部载荷、轴向阵列载荷和圆周阵列载荷作用下不同的激励响应，得到有效的结论。方法：1．通过理论推导，构建典型磁致伸缩换能器数学模型（公式（15）和（17））；2．通过理论推导，建立弹性空心圆柱体在磁致伸缩局部载荷、轴向阵列载荷和圆周阵列载荷作用下的波源分析模型（公式（25～26）、（30～31）和（34～35）），求解得到典型载荷形式下的激励响应（图6～8和11～13）；3．通过仿真模拟和试验研究，对空心圆柱体在不同磁致伸缩载荷作用下的激励响应进行验证（图14～21）。结论：1．磁致伸缩局部载荷能够激励产生同一族的导波模态，但是不具有良好的频率选择性和相速度选择性，轴对称载荷仅能激励轴对称模态；2．磁致伸缩轴向阵列载荷具有良好的频率选择性和相速度选择性，中心频率和中心相速度取决于阵列单元间距，对导波模态控制非常有益；3．磁致伸缩圆周阵列载荷能够激励周向阶次为阵列单元数整数倍的导波模态。