Transvenous versus open chest lead placement for resynchronization therapy in patients with heart failure： comparison of ventricular electromechanical synchronicity

Background Transvenous lead placement is the standard approach for left ventricular （LV） pacing in cardiac resynchronization ther- apy （CRT）, while the open chest access epicardial lead placement is currently the most frequently used second choice. Our study aimed to compare the ventricular electromechanical synchronicity in patients with heart failure after CRT with these two different LV pacing tech- niques. Methods We enrolled 33 consecutive patients with refractory heart failure secondly to dilated cardiomyopathy who were eligible for CRT in this study. Nineteen patients received transvenous （TV group） while 14 received open chest （OP group） LV lead pacing. Intraand inter-ventricular electromechanical synchronicity was assessed by tissue Doppler imaging （TDI） before and one year after CRT procedure. Results Before CRT procedure, the mean QRS-duration, maximum time difference to systolic peak velocity among 12 left ventricle segments （LV Ts-12）, standard deviation of time difference to systolic peak velocity of 12 left ventricle segments （LV Ts-SD）, and inter-ventficular mechanical delay （IVMD） in OP and TV group were 166 ± 17 ms and 170 ± 21 ms, 391 ±42 ms and 397 ± 36 ms, 144 ± 30 ms and 148 ± 22 ms, 58 ± 25 ms and 60 ± 36 ms, respectively （all P 〉 0.05）. At one year after the CRT, the mean QRS-duration, LV Ts-12, LV Ts-SD, and IVMD in TV and OP group were 128 ± 14 ms and 141 ± 22 ms （P = 0.031）, 136 ± 37 ms and 294 ± 119 ms （P = 0.023）, 50± 22 ms and 96 ± 34 ms （P = 0.015）, 27 ± 11 ms and 27 ± 26 ms （P = 0.86）, respectively. The LV lead implantation procedure time was 53.4±16.3 rain for OP group and 136 ± 35.1 min for TV group （P = 0.016）. The mean LV pacing threshold increased significantly from 1.7 ± 0.6 V/0.5 ms to 2.3 ± 1.6 V/0.5 ms （P 〈 0.05） in TV group while it remained stable in the OP group. Conclusions Compared to conventional endovascular approach, open chest access of LV pacing for CRT leads to better improvement of the intraventricular synchronization.

High sensitivity C-reactive protein and cardfiac resynchronization therapy in patients with advanced heart failure

Background The data on the prognostic values of high sensitivity C-reactive protein （hsCRP） levels in patients with advanced symp-tomatic heart failure （HF） receiving cardiac resynchronization therapy （CRT） are scarce. The aim of present study was to investigate the association of serum hsCRP levels with left ventricle reverse remodeling after six months of CRT as well as long-term outcome. Methods A total of 232 CRT patients were included. The assessment of hsCRP values, clinical status and echocardiographic data were performed at baseline and after six months of CRT. Long-term follow-up included all-cause mortality and hospitalizations for HF. Results During the mean follow-up periods of 31.3 ± 31.5 months, elevated hsCRP （〉3 mg/L） prior to CRT was associated with a significant 2.39-fold increase （P=0.006） in the risk of death or HF hospitalizations. At 6-month follow-up, patients who responded to CRT showed significant reductions or maintained low in hsCRP levels （–0.5 ± 4.1 mg/L reduction） compared with non-responders （1.7 ± 6.1 mg/L increase, P=0.018）. Com-pared with patients in whom 6-month hsCRP levels were reduced or remained low, patients in whom 6-month hsCRP levels were increased or maintained high experienced a significantly higher risk of subsequent death or HF hospitalizations （Log-rank P〈0.001）. The echocardio-graphic improvement was also better among patients in whom 6-month hsCRP levels were reduced or remained low compared to those in whom 6-month hsCRP levels were raised or maintained high. Conclusions Our findings demonstrated that measurement of baseline and follow-up hsCRP levels may be useful as prognostic markers for timely potential risk stratification and subsequent appropriate treatment strategies in patients with advanced HF undergoing CRT.

Impact of concomitant use of proton pump inhibitors and clopidogrel or ticagrelor on clinical outcomes in patients with acute coronary syndrome

Background There is great debate on the possible adverse interaction between proton pump inhibitors （PPIs） and clopidogrel. In ad- dition, whether the use of PPIs affects the clinical efficacy of ticagrelor remains less known. We aimed to determine the impact of concomi- tant administration of PPIs and clopidogrel or ticagrelor on clinical outcomes in patients with acute coronary syndrome （ACS） after percuta- neous coronary intervention （PCI）. Methods We retrospectively analyzed data fi＇om a ＂real world＂, international, multi-center registry between 2003 and 2014 （n = 15,401） and assessed the impact of concomitant administration of PPIs and clopidogrel or ticagrelor on 1-year composite primary endpoint （all-cause death, re-infarction, or severe bleeding） in patients with ACS after PCI. Results Of 9429 patients in the final cohort, 54.8% （n = 5165） was prescribed a PPI at discharge. Patients receiving a PPI were older, more often female, and were more likely to have comorbidities. No association was observed between PPI use and the primary endpoint for patients receiving clopidogrel （ad- justed HR： 1.036; 95% CI： 0.903-1.189） or ticagrelor （adjusted HR： 2.320; 95% CI： 0.875-45.151） （Pinteraction = 0.2004）. Similarly, use of a PPI was not associated with increased risk of all-cause death, re-infarction, or a decreased risk of severe bleeding for patients treated with either clopidogrel or ticagrelor. Conclusions In patients with ACS following PCI, concomitant use of PPIs was not associated with in- creased risk of adverse outcomes in patients receiving either clopidogrel or ticagrelor. Our findings indicate it is reasonable to use a PPI in combination with clopidogrel or ticagrelor, especially in patients with a higher risk of gastrointestinal bleeding.

Instructions to authors

GENERAL INFORMATIONWorld Jonrnal of Gastroenterology （World J Gastroenteroi ISSN 1007-9327, DOI： 10.3748） is a weekly peer reviewed, online, open-access （OA） journal supported by an editorial board of 1126 experts in gastroenterology and hepatology from 60 countries.

A novel technique to insert nasogastric tube for the anesthetized patients during cervical esophageal reconstruction

We are describing a novel technique to insert nasogastric tube （NGT） in the anesthetized patients dur- ing cervical esophageal reconstruction. Methods： Forty patients with mid and upper esophageal tumor enrolled into this study were randomly allocated into two groups （the control group, group C and the novel method group, group N）. All the patients were applied mechanical anastomosis to finish the cervical esophageal reconstruction. The procedure of NGT insertion for group C use the conventional method; well, the group N use the novel technique. Results： All the patients in group N had been finished the NGT insertion in the first attempt, and the total time for insertion was （5.05 ＋ 1.15） mins; on the contrary, for the group C, duration of insertion （min） was （24.45 ± 5.23） mins, and the successful rate of NGT insertion in the first attempt was 40% （P〈 0.05）; no one in group N had coiling/kinking, and 6/20 （30%） in group C had it （P= 0.020）. The complication rate of bleeding between the two group had no significant difference. Conclusion： For the patient with mid and upper esophageal tumor who need cervical esophageal reconstruction, this novel method can save the NGT insertion time, and make it easier with higher successful rate.

Selection, Training and Supervision of Breast Cancer Peer Educators： a literature review

Breast cancer is one of the most serious malignant and it seriously affects the quality of life and mental health of the patients. Research shows that peer education can improve breast cancer patients＇ quality of life, treatment compliance, and self-management behavior. Its selection, training and supervision are particularly important due to the core role of peer educators in peer support. This article reviewed the research status and progress in the selection, training and supervision of breast cancer peer educators abroad in order to provide references for further study.

Study of human B7 homolog 1 expression in patients with hepatitis B virus infection

AIM: To further investigate the role of human B7 homolog 1 (B7-H1) in the mechanism of persistent hepatitis B virus (HBV) infection. METHODS: Peripheral and intra-hepatic B7-H1 expression were compared by flow cytometry and immunochemical staining between two 2 distinct groups, one being chronic HBV tolerance patients (CHB-T) and the other being acute hepatitis B patients (AHB). B7-H1 mRNA expression level was also compared by real time polymerase chain reaction between CHB-T and AHB patients. The location of intra-hepatic B7-H1 and CD40 expression were analyzed by immunofluorescence. The levels of B7-H1 and CD40 expression on cultured myeloid dendritic cells (mDCs) with or without hepatitis B surface antigen (HBsAg) treatment were analyzed dynamically by flow cytometry. Intracellular interferon-γ (IFN-γ) staining and the stimulatory capacity of mDC of cultured mDC with or without HBsAg treatment were also compared by flow cytometry. RESULTS: Peripheral B7-H1 expression on mDCs was increased significantly in AHB compared to CHB-T patients (P < 0.05). In the liver tissues from CHB-T patients, B7-H1 positive cells were almost absent despite a persistently elevated serum HBsAg load. In contrast, there were indeed increased B7-H1-positive cells in situ in the liver tissue from AHB. In vitro analysis showed the parallel upregulation of B7-H1 and CD40 on CD11c+ mDCs after the onset of stimulation. Addition of recombinant hepatitis B surface antigen (rHBsAg) significantly decreased CD40 expression (P < 0.05 at 16 h, 20 h and 24 h time points). B7-H1 expression was also inhibited by rHBsAg, and the inhibition rate of CD40 was greater than that of B7-H1. This preferential inhibition of CD40 expression on mDCs by rHBsAg resulted in the dysfunction of mDCs and T cells in the mixed leucocyte reaction (MLR) system. With rHBsAg pretreatment, in a carboxyfluorescein diacetate succinimidyl ester (CFSE) labeled MLR system at a ratio of 1:5 responder cell-stimulator cell (R/S), the CFSE dim percentage of T cells decreased from 85.1% to 25.4% and decreased from 30.3% to 12.0% at 1:10 R/S. IFN-γ production by CD8+ T cells, in the MLR system, was reduced significantly by HBsAg pretreatment. At ratios of 1:5 R/S, the percentage of IFN-γ and CD8 dual positive T cells decreased from 55.2% ± 5.3% to 15.1% ±3.1% (P < 0.001), and decreased from 35.0% ± 5.1% to 7.3% ± 2.7% at ratios of 1:10 R/S (P < 0.001). CONCLUSION: B7-H1 is not a signature of immune dysfunction, but an inflammation marker. HBsAg regulate immune response by tipping the balance between B7-H1 and CD40.

《老子》第1-5章會箋

《老子》出土簡帛本已有四種,敦煌本及傳世本更有不少,異文衆多。排比異文,會而箋之,以《老》解《老》,可以解决一些疑難,有助於了解《老子》的文義、思想。如第1章中,"兩者同出",帛書本前無"此"字,當從,"兩者"應該是泛指凡對偶爲兩者;"以觀其妙"之"妙"義爲"成"。第2章闡發第1章之"兩者","爲而不恃"之"恃"當讀爲"持",與51、77章等相關。第3章"强其骨"舊多不爲人注意,其實"强"與"物壯則老,是謂不道,不道早已"之"壯"相關,説明聖人治民,雖是無爲之治,然亦是"以百姓爲芻狗",合於道然並非與民同歸於道、守柔。第4章"道沖,而用之或不盈","而"之義爲故,"或"義爲如。第5章"芻狗"讀爲"雛狗","雛"本義爲雞子,即小雞;"不仁"乃無偏私,"不屈"乃"不積"之義。

A Longitudinal Study of Job Satisfaction Among Flemish Professional Journalists

The focus of this paper is on the job satisfaction among the population of professional Flemish journalists by means of two surveys conducted in 2003 （N = 1,026） and 2008 （N = 682）. Both surveys focus on intrinsic and extrinsic variables linked to job satisfaction as well as on several predictors of job satisfaction such as type of contract, job function, age, and gender. The longitudinal perspective allows us to identify any evolutions or differences in satisfaction between 2003 and 2008. By taking into consideration previous mentioned predictors also the influence of external elements on job satisfaction can he researched. The 2003 and 2008 surveys suggest that the ＂average＂ Flemish professional journalist is fairly satisfied with the job content. However, we observe a slightly negative but non-significant shift occurring in 2008. The degree of job satisfaction seems to he related to the type of contract （freelance or employed on a permanent basis） and the job function. We noticed also a clear gender element in the discussion： Female journalists are not less satisfied but state to have more difficulties to combine the journalistic job with a private and family life.

Phosphatase and tensin homolog expression related to cetuximab effects in colorectal cancer patients: A meta-analysis

AIM: To investigate the correlation between expression of phosphatase and tensin homolog (PTEN) and cetuximab effects in colorectal cancer. METHODS: We searched PubMed, EMBASE and ASCO to identify eligible studies. Finally, 8 randomized control studies were included in the meta-analysis. STATA 10.0 Software was used to investigate heterogeneity among individual studies and to summarize all the studies. Risk ratios (RRs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess the strength of the association. RESULTS: Compared with 20 of 266 patients with loss of PTEN, 206 of 496 patients with intact PTEN protein expression had a better objective response rate to cetuximab-based therapy (RR, 4.75; 95% CI, 2.59-8.72; P < 0.001). PTEN positivity was associated with better progression-free survival (PFS) (HR, 0.675; 95% CI, 0.473-0.964; P = 0.031) but not with better overall survival (OS) (HR, 0.608; 95% CI, 0.411-0.899; P = 0.013). In patients with KRAS wild-type status, PTEN positivity did not predict a longer PFS or OS (PFS: HR, 0.707; 95% CI, 0.440-1.138; P = 0.154; OS: HR, 0.943; 95% CI, 0.646-1.377; P = 0.761). CONCLUSION: Expression of PTEN is related to the effect of cetuximab in colorectal cancer patients and should be considered in treatment with cetuximab.

Jokes in Interpreting and Principles of Interpreting

Chinese scholar Baogang illustrated in his book Introduction to Interpreting Theory that interpreting is a kind of activity that must be accompanied by a series of activities such as negotiation, discussion, argumentation, signing a contract and making acknowledgements . In interpreting, the source language usually includes some jokes in order to enliven the atmosphere. However, an interpreter doesn＇t have to interpret them all faithfully and loyally. How to interpret those jokes becomes a difficult problem for all interpreters.

Local-Scale Governance： A Review of the Zambian Approach to Fisheries Management

Despite Zambia＇s recent policies for optimizing sustainable management of fisheries, their success has been modest in practice. Artisanal and industrial fleets have led to decline in fish catches in the presence of currently prescribed management possibilities. Among other factors, excessive fishing and unsustainable fishing methods attributed to common property and free access to the resources are key. The country adopted co-management approach to fisheries management in the 1990s with a view to improve the fisheries stocks through community enforcement of fishery management regulations. Neither the success of co-management has been easy to measure nor its results appreciated. In view of overfishing, it is required to continue providing a range of empirical evidence of area-specific co-management interventions as basis for designing realistic and innovative solutions for the nation. This implies that new policies and institutions need to be developed by research to understand fisheries systems and better promote sustainable trajectories. The following review recommendation to central government is a coherent approach that uses and crystallizes the multiple interests and skills of co-management stakeholders. Most stakeholder groups have been involved in an ad hoc fashion through workshops, public meetings and consultative processes mainly organized by Department of Fisheries. Stakeholders should be involved from the design of the process to each step in the process, including the ongoing monitoring and evaluation. A form of memorandum of understanding is suggested. This will formally set out a process that acknowledges each stakeholder＇s interests and provide forums to facilitate discussion, consultation and monitoring of management activities.

Cardiac resynchronization in the elderly is beneficial, but could we implant our devices in old patients safer？

We read with interest the article by Olechowski, et aL recently published in the Journal of Geriatric Cardiology. The results of this retrospective analysis of patients under- going cardiac resynchronization therapy （CRT） device implantation are in line with previous reports, suggesting that resynchronization therapy in the elderly is feasible and may lead to significant improvement of cardiac function and clinical status.

Determination of Optimal Cash Position of Mutual Fund

Cash position, held by mutual fund with purpose to satisfy investors′ redemption, will inevitably generate certain amount of cost. In this paper, the total cost caused by cash position is divided into opportunity cost and shortage cost, and a model is constructed to describe the relationship between total cost and cash position along with investors′ purchase and redemption, from which the formula of optimal cash position is deduced. Finally, the adjustment of optimal cash position in different market situations is discussed.

Instructions to authors

GENERAL INFORMATIONWorld Journal of Gastroenterology （World J Gastroenterol ISSN 1007-9327 CN 14-1219/R） is a weekly open-access （OA） peer reviewed journal supported by an editorial board consisting of 1179 experts in gastroenterology and hepatology from 60 countries.

Analysis of the Importance of Several Aspects before the Purchase of a Wine Bottle for Comunidad Valenciana （Spain） Consumers

This paper analyses the importance of several aspects that consumers in the Comunidad Valenciana （Spain） take into account when getting a wine bottle from a shelf. These aspects are： the designation of origin, the price, design and information on the label, design and information on the back label, the point of sale, the seller advice, friends and family recommendations. The information has been obtained through survey with 400 interviews throughout Comunidad Valenciana （Spain）. These interviews were based on asking a questionnaire with closed questions. It has been seen how the most valuated aspect is the designation of origin. The second aspect in the rank is friends and family Recommendations. Price is the third most valuated aspect. The less valuated aspects are the seller advice and the point of sale. The design and information of the label is more valuated than the design and information of the back label. Results seem to show how consumers want to reduce risk before buying a wine bottle looking for aspect that they can rely on. They give more importance to family and friends recommendations than to the seller advice.

Compassion in Buddhism and Guanxi： Can There Be a Synergy for Westem Companies in China

Compassion is one of the core fundamental elements of Buddhism. The compassionate virtues are the precious qualities essential in the practice of Buddhism. On the other hand, guanxi plays a dominant role in any successful business venture in Chinese market. This paper develops the understanding of the two ancient bodies of knowledge of Buddhism and Confucianism. The attempt will be made in this paper to understand the deeper meaning of compassion in Buddhism in terms of compassionate virtues such as generosity, discipline, patience, diligence, humility, and wisdom. In guanxi, it will delve into different aspects of guanxi in terms of its background, meaning, significance, different types, intermediary, comparison with networking and ethics and success factors. This paper is based on the literature review on compassion--guanxi. The compassion literature focuses on books on Buddhism and commentaries by great Tibetan Buddhist sages. The guanxi literatures are predominately based on business research papers related to guanxi and business culture in China. The paper provides deeper meaning of compassion in Buddhism. The application of compassion to manage guanxi in China is the topic of this paper. This research is about optimizing the art of guanxi through the application of compassion which will help many non-Chinese business managers to effectively manage it. This paper is considered the first of its kind to study compassion in Buddhism and guanxi practice in China and seeks to provide the necessary framework to conduct the further research on applying compassion to build and manage better guanxi in China.

George Lamming＇s In the Castle of My Skin： A Littoral Figure Discovers Self-Identity and Authorial Language

In In the Castle of My Skin （hereafter Castle） （1983）, the littoral as trope provides a means for discovering Lamming＇s authorial license, one that speaks to postcolonial and phenomenological aims. In this semi-autobiographical novel, Lamming examines self-awareness and the process through which language and self-analysis may take shape on or be inspired by the shore＇s edge. Through the telling of personal stories, discussions of a colonial history, and with allusions to the social privations affecting the immediate community, Lamming represents the changing realities, the main characters （＂G＂ and his friends） experience as they become socially aware; he highlights this transformative rise to consciousness through the use of littoral imagery in Chapters Six, Eleven, and Fourteen. In this essay, the author explores these representations using postcolonial, psychoanalytical, and phenomenological approaches, giving particular attention to Chapter Six, the longer chapter where Lamming creates a blueprint of the issues to which he will return in Chapters Eleven and Fourteen. Castle epitomizes the ways in which the littoral as trope has the potential to symbolically impact an author＇s text, especially a means for crafting an authorial language that demonstrates a young man＇s rise to consciousness and self-actualization on the shorelines of Barbados before he emigrates abroad.

Is hyperhomocysteinemia relevant in patients with celiac disease?

AIM： TO investigate whether this might be related to the presence of hyperhomocysteinemia. METHODS： From January 1998 to December 2008, we evaluated the presence of hyperhomocysteinemia in a series of 165 adult celiac disease （CD） patients （138 females and 27 males, mean age 43 years）.RESULTS： Hyperhomocysteinemia was evident in 32 patients （19.3%）, although most of them had moderate levels （mean value 25 mcg/ml; range 15-30）. Only one patient had a history of myocardial infarction （heterozygosis for N5-N10-metil tetrahydrofolate reductase mutation）. CONCLUSION： The systematic assessment of hyperhomocysteinemia seems, at present, unjustified in CD patients.

Vocabulary Alignment in the Continuation Task of Translation

Alignment effect in language research refers to the social cognition process in which people cooperate,adjust,and adapt to each other in interaction.Through empirical study,this paper explores alignment effect in the continuation task of translation(CTOT)and its possible influence on learning of English as foreign languge(EFL).The study was carried out by means of a CTOT.Participants were chosen from non-English major freshmen of similar capacity from a university in Guangzhou.They were divided into two groups,the experimental group(EG)and the control group(CG),with 13 students each.The students in EG were asked to carefully read some English-Chinese bilingual material.Then,the 26 participants were tasked with translating the paragraphs,which followed from Chinese into English.After that,they were asked to write down the words and expressions which they found difficult.Some of the participants were interviewed one month later for a deeper understanding of their memories of the vocabulary and their opinions on the CTOT.The data were analyzed by direct comparison and non-parametric test.The results showed that vocabulary alignment does occur in CTOT.The EG members tended to take advantage of words that appeared in the bilingual reading text.If multiple words from the reading appeared,with the same contextual meaning,they tended to choose the repeated words.As for influence of vocabulary alignment on EFL learning,it seemed that CTOT could not improve the quality of the translation itself,but could assist short-term vocabulary learning though no significant help to long-term vocabulary learning was revealed.The findings of this study provide support and explanation for some features and effects of CTOT,an important form of CT.However,the nature of CTOT itself,and its role in EFL learning deserve further research.