A Meta-analysis of Major Complications between Traditional Pacemakers and Leadless Pacemakers

Objectives:We aim to compare the major complications between leadless pacemakers and traditional pacemakers.Background:Leadless pacemakers,which are increasingly used in clinical practice,have several advantages compared with traditional pacemakers in avoiding pocket-and lead-related complications.However,the clinical effect of leadless pacemakers remains controversial.Methods:PubMed,Embase,the Cochrane Central Register of Controlled Trials(CENTRAL),the CNKI database,and the Wanfang database were searched from July 2013 to December 2019.Studies comparing leadless pacemakers and traditional pacemakers were included.The primary end point was major complications.The secondary end points were cardiac perforation/pericardial effusion,device revision or extraction,loss of device function,and death.Results:Six studies fulfi lled the inclusion criteria.Only four of the six studies reported data on major complications.Leadless pacemakers were associated with a lower incidence of major complications(risk ratio 0.33,95%confi dence interval 0.25–0.44,P<0.00001,I²=49%).We extracted data on cardiac perforation/pericardial effusion,device revision or extraction,loss of device function,and death from six studies.Our meta-analysis showed that leadless pacemakers have a higher risk of cardiac perforation or pericardial effusion(risk ratio 4.28,95%confi dence interval 1.66–11.08,P=0.003,I²=0%).No statistically signifi cant differences were found for mortality,device revision or extraction,and loss of device function.Conclusion:Compared with traditional pacemakers,leadless pacemakers have a signifi cantly decreased risk of major complications,but have a higher risk of cardiac perforation or pericardial effusion.

Relationship between epithelial to mesenchymaltransition and chemoresistance of lung cancer

Objective： The aim of this study was to explore the correlation between epithelial to mesenchymal transition （EMT） and chemoresistance of non-small-cell lung cancer （NSCLC）. Methods： In vitro, the drug resistance index of cisplatin resistant lung adenocarcinoma cell line （A549/DDP） was detected by CCK-8 assay; the morphological change between A549/ DDP cells and lung adenocarcinoma cells （A549） was observed by phase contrast microscope; expression of EMT markers （including E-cadherin and vimentin） and resistance protein, excision repair cross-complementing 1 （ERCC1） was detected by immunocytochemistry. The expression of E-cadherin, vimentin and ERCC1 was investigated by immunohistochemistry in 120 cases of NSCLC, half of that were treated with pre-operative neoadjuvant chemotherapy （neoadjuvant chemotherapy group）, and the other underwent surgery alone （simple surgery group）. Results： There was a significant difference between the ICso （half maximal inhibitory concentration） of A549/DDP cells （5.20） and A549 cells （1.88） （P 〈 0.05）, and the drug resistance index of A549/DDP cells was 2.77. Compared with A549 cells, A549/DDP cells increased expression of ERCC1 （P 〈 0.05）. Moreover, A549/DDP cells showed morphological and phenotypic changes consistent with EMT： with spindle-shaped morphology, and decreased expression of E-cadherin and increased expression of vimentin. Immunohistochemistry showed significant positive correlation between the expression of ERCCI and vimentin （r = 0.496, 0.332, P 〈 0.05）, and significant negative correlation between the ERCCI and E-cadherin （r = -0.403, -0.295, P 〈 0.05） in neoadjuvant chemotherapy group and simple surgery group. In addition, compared with simple surgery group, the expression of ERCC1 （P = 0.003） and vimentin （P = 0.004） was significantly increased, and the expression of E-cadherin was decreased in neoadjuvant chemotherapy group （P = 0.032）. Cenclusion： A549/DDP cells acquired cisplatin-resistance and occurred EMT simultaneously; the phenomenon of chemoresistance and EMT was caused more easily in neoadjuvant chemotherapy group. As such, we further confirmed the close correlation between chemoresistance and EMT of NSCLC, and provided theoretical basis for the targeting therapy with EMT regulatory factor for chemoresistant NSCLC patients.

An Important Insect of the Genus Pseudips: Pseudips mexicanus Hopkins

At present, there are three species of Pseudips known in the world, and P. mexicanus is an important one. The paper mainly introduced the taxonomic status, morphological characteristics and biological characteristics of P. mexicanus, and provided a key to P. mexicanus and its allied species. There is no distribution of P. mexicanus in China, and the results can provide the reference for further study of the insect.

Prenatal Diagnosis of a Giant Epignathus in the Second Trimester and Immediate Successful Management at Birth:A Case Report

Epignathus is an extremely rare congenital oropharyngeal teratoma.Here,we report a case of epignathus without intracranial extension in a fetus.The mass was first found by ultrasonography at 22 gestational weeks.Serial ultrasound examinations and magnetic resonance imaging confirmed that the fetus had neither central nervous system involvement nor abnormal nose or tooth.The baby was delivered at 37 weeks and six days of gestation via cesarean section set up for ex-utero intrapartum treatment.The postnatal pathologic examination confirmed the presence of mature tissues predominantly containing ectopic central nervous tissue,osseous tissue,and bronchial mucosal tissue.Most cases of epignathus are associated with malformation and death.Ultrasound and magnetic resonance imaging prenatal assessments are very important to facilitate counseling and understand prognosis.In conclusion,the ex-utero intrapartum treatment procedure is a good approach to improve the survival of infants with epignathus.