His bundle pacing versus left bundle branch pacing on ventricular function in atrial fibrillation patients referred for pacing:a prospective crossover comparison

BACKGROUND His bundle pacing(HBP)and left bundle branch pacing(LBBP)both provide physiologic pacing which maintain left ventricular synchrony.They both improve heart failure(HF)symptoms in atrial fibrillation(AF)patients.We aimed to assess the intra-patient comparison of ventricular function and remodeling as well as leads parameters corresponding to two pacing modalities in AF patients referred for pacing in intermediate term.METHODS Uncontrolled tachycardia AF patients with both leads implantation successfully were randomized to either modality.Echocardiographic measurements,New York Heart Association(NYHA)classification,quality-of-life assessments and leads parameters were obtained at baseline and at each 6-month follow up.Left ventricular function including the left ventricular endosystolic volume(LVESV),left ventricular ejection fraction(LVEF)and right ventricular(RV)function quantified by tricuspid annular plane systolic excursion(TAPSE)were all assessed.RESULTS Consecutively twenty-eight patients implanted with both HBP and LBBP leads successfully were enrolled(69.1±8.1 years,53.6% male,LVEF 59.2%±13.7%).The LVESV was improved by both pacing modalities in all patients(n=23)and the LVEF was improved in patients with baseline LVEF at less than 50%(n=6).The TAPSE was improved by HBP but not LBBP(n=23).CONCLUSION In this crossover comparison between HBP and LBBP,LBBP was found to have an equivalent effect on LV function and remodeling but better and more stable parameters in AF patients with uncontrolled ventricular rates referred for atrioventricular node(AVN)ablation.HBP could be preferred in patients with reduced TAPSE at baseline rather than LBBP.

Eye metastasis in lung adenocarcinoma mimicking anterior scleritis:A case report

BACKGROUND The eye is a rare site for lung cancer metastasis. Indeed, ocular metastasis is one of the greatest challenges to quality of life in a cancer patient. Here we present a patient with lung adenocarcinoma and ocular metastasis.CASE SUMMARY The patient was a 70-year-old man diagnosed with lung adenocarcinoma who developed eye metastasis mimicking anterior scleritis. Brain magnetic resonance imaging showed an abnormal signal in the right eye. Based on next generation sequencing of the surgical specimen, the patient was shown to have a KRAS point mutation(p.G12D).CONCLUSION Multidiscipline expertise collaboration is needed to make the early diagnosis and determine the prompt treatment in patients. We hope to increase the awareness of the possibility of lung cancer metastasizing to the eye.

The impact of the COVID-19 outbreak on Australia’s public health and medical industry in 2020

In 2020,the sudden new crown(COVID-19)virus swept the world.Countries have adopted different epidemic prevention measures.The COVID-19 has brought an extraordinary impact on the economic and social health of all countries.Australia,located in the southern hemisphere,promptly adopted the closure and other epidemic prevention policies in late January.The whole people mobilized to actively fight against the epidemic.Compared with the passive immunization of developed countries such as the United Kingdom and the United States,it has experienced several twists and turns and achieved relatively successful results.However,the epidemic has profoundly affected public health and medical care.They are mainly manifested in mental and psychological,hand hygiene,respiratory diseases,surgical spectrum,cancer screening,and changes in national leadership’s response methods and medical insurance policies.Australia’s early physical distancing measures,relatively high per capita testing rates,political stability,national wealth and geographic isolation are among the explanatory factors.The country’s response to the COVID-19 pandemic has,thus far,been among the most successful in the world.

Academic integrity disputes in China:a narrative case study

Because the research paper of Alzheimer's disease(AD)new drug(GV-971)was suspected to be fraudulent,the author filed a lawsuit for infringement of reputation.A court in Shanghai rejected the lawsuit.Legal documents openly support academic disputes and criticism.The FDA's approval of the listing of a new AD drug(aducanumab)is also full of controversy,and some scholars suspect that there are problems with clinical data(of course there are scholars who support the listing).Falsification of scientific research and papers is not uncommon in China.In 2021,more than 400 people were publicly investigated for falsification of papers(these papers published in SCI journals).The reason for the prevalence of falsification was related to the promotion policy,evaluation system and economic interests.Academic fraud was a serious waste of funds and corrupted the academic atmosphere.And hinder the development of science and technology.In the past two years,the government has successively promulgated a series of scientific research and academic integrity norms,prohibiting the use of scientific research funds in international predatory journals,advocating the purification of the academic environment,and conducive to genuine innovative research.The court respects science,administration does not interfere with academics,and advocates peer review.The first-instance judgment may be a landmark event for China.

Current status and innovation attempt of compiling textbooks of Chinese medicine in medical colleges in China

At present,there are two modes in the compilation of textbooks of traditional Chinese medicine,one is stuck in one's own way and the other is to copy Western medicine completely.The reason is that the textbooks of traditional Chinese medicine colleges and universities are reduced into a hodger with no purpose,or the other is to cater to Western medicine system and give up the academic system of traditional Chinese medicine and lose the essence of traditional Chinese medicine.Through the"diagnosis and treatment strategy"and"knowledge link"of the new Chinese medicine textbooks,the author tries to make a breakthrough in the compilation,and puts forward the compilation ideas of rectifying the position of Chinese medicine textbooks,starting from the learning thinking of Western medicine students,and reflecting the characteristics of Chinese medicine and modern research results.

Analysis of the situation and root causes of racial discrimination among Asian Americans during the COVID-19 epidemic

Looking back on the U.S.epidemic situation the past two and a half years.The Trump administration’s previous policy of"non-resistance to the novel coronavirus disease 2019(COVID-19)"resulted in the loss of control of the COVID-19(coronavirus disease 2019)epidemic,rising deaths,and economic shrinking.Behaviors such as racism and xenophobia against Asian descent have become increasingly apparent in the United States and globally.When people are struggling to cope with the raging epidemic of the COVID-19 epidemic and are eager to return to normal life and work as soon as possible,the recognition of human universal values and mutual respect among various races are particularly important.Racism and xenophobia have caused a series of inequalities.The COVID-19 epidemic pandemic requires special attention and vigilance.On February 12,2021,the new U.S.President Biden,in his video congratulating the traditional Chinese New Year,addressed racism,harassment and hatred.U.S.President Joe Biden said,"This is completely wrong.Everyone,regardless of their race.Whatever the language,background,religion,or language they speak,they all deserve equal treatment and due dignity."It is hoped that the new US President(Joseph Robinette Biden)can eliminate the"white supremacy"racism and promote equality and harmony among all races.This paper analyzes the historical roots of racial discrimination in the United States,especially the suffering of Chinese Americans.

Wnt signaling:Essential roles in osteoblast differentiation,bone metabolism and therapeutic implications for bone and skeletal disorders

Wnt signaling executes an indispensable performance in osteoblast differentiation,bone development,homeostasis,and remodeling.Wnt signals trigger the intracellular Wnt signaling cascade to initiate regulating the implication of b-catenin in the bone environment.Going through the novel discoveries done via high-throughput sequencing technologies on ge-netic mouse models,we highlighted the significant contribution of Wnt ligands,co-receptors,inhibitors,their related skeletal phenotypes in mouse models and the similar bone disorders clinically observed in human beings.Moreover,the crosstalk between Wnt signaling pathway and BMP,TGF-b,FGF,Hippo,Hedgehog,Notch and PDGF signaling pathways is thoroughly demonstrated to be the underlying gene regulatory network that orchestrates osteoblast dif-ferentiation and bone development.We also introspected the significance of Wnt signaling transduction in the reorganization of cellular metabolism by stimulating glycolysis,glutamine catabolism,and fatty acid oxidation in osteoblast-lineage cells that display an important reg-ulatory arbor in the cellular bioenergetics of the bone.Throughout this evaluation,most to date therapeutical approaches towards osteoporosis and other bone maladies found in human beings,are formulated with an aspiration to holistically revamp the present clinical applica-tions involving various monoclonal antibodies therapies that lack specificity,efficacy,and safety into more requisite advanced therapeutics that satisfy these three requirements for further clinical considerations.Conclusively,our review provides comprehensive scientific findings related to the fundamental significance of Wnt signaling cascades in skeletal system and the underlying gene regulatory network with other signaling pathways enlightening re-searchers with the possibility to further integrate the identified target molecules into thera-peutic strategies for skeletal disorders treatment in the clinic.

Development and validation of a risk-prediction model for immune-related adverse events in patients with non-small-cell lung cancer receiving PD-1/PD-L1 inhibitors

Lung cancer remains the leading cause of cancer deaths worldwide and is the most common cancer in males.Immune-checkpoint inhibitors(ICIs)that target programmed cell death protein-1(PD-1)or programmed cell death-ligand 1(PD-L1)have achieved impressive efficacy in the treatment of non-small-cell lung cancer(NSCLC)(Pardoll,2012;Champiat et al.,2016;Gao et al.,2022).Although ICIs are usually well tolerated,they are often accompanied by immune-related adverse events(irAEs)(Doroshow et al.,2019).Non-specific activation of the immune system produces off-target immune and inflammatory responses that can affect virtually any organ or system(O'Kane et al.,2017;Puzanov et al.,2017).

温针灸联合推拿治疗膝关节骨性关节炎的疗效观察

目的观察温针灸联合推拿治疗膝骨关节炎(KOA)的临床疗效。方法将60例KOA患者按照随机数字表法分为观察组和对照组,每组30例。对照组患者给予温针灸治疗;观察组在对照组基础上加用推拿治疗。隔日治疗1次,共治疗10次。治疗前后进行视觉模拟量表(VAS)、西安大略与麦克马斯特大学骨关节炎指数(WOMAC)评分及股四头肌表面肌电信号采集。结果对照组总有效率为76.7%,观察组总有效率为90.0%,组间差异有统计学意义(P<0.05)。两组治疗后WOMAC评分、VAS评分均有改善,股四头肌积分肌电值、中位频率均有提高,组内差异均有统计学意义(P<0.05)。治疗后,观察组VAS及WOMAC评分低于对照组,组间差异有统计学意义(P<0.05);观察组股四头肌功能改善优于对照组,积分肌电值、中位频率显著高于对照组(P<0.05)。结论温针灸联合推拿能有效减轻KOA患者疼痛,改善关节日常活动功能,增强股四头肌表面肌电活动信号。

推拿配合热敏灸治疗颞下颌关节紊乱病临床观察

目的:观察推拿配合热敏灸治疗颞下颌关节功能紊乱(temporomandibular disorders,TMD)的临床疗效。方法:将50例TMD患者随机分为治疗组和对照组,每组25例。治疗组采用推拿加热敏灸治疗,对照组采用药物治疗。通过对比治疗前、后患者Fricton颞下颌关节紊乱指数及治疗后两组临床疗效进行评价。结果:治疗前两组患者Fricton颞下颌关节紊乱指数组间比较差异无统计学意义(P>0.05)。治疗1个疗程后两组患者Fricton颞下颌关节紊乱指数均较治疗前显著改善(P<0.01),且治疗组改善优于对照组(P<0.01)。治疗组总有效率显著高于对照组(P<0.01)。结论:推拿配合热敏灸治疗TMD疗效确切,安全无毒副作用,值得临床推广应用。

Syndecan 4-c-ros oncogene 1 fusion as a mechanism of acquired resistance in epidermal growth factor receptor mutant lung adenocarcinoma

To the Editor:A 37-year-old Chinese woman,a nonsmoker,presented with adenocarcinoma of the left lung(stage IV)[Figure 1A],malignant pleural effusion,and multiple bone metastases in December 2014.Deoxyribonucleic acid sequencing of the tumor biopsy revealed an epidermal growth factor receptor(EGFR)exon 19 deletion,and treatment with gefitinib was consequently initiated in December 2014.There were no treatmentrelated side effects except for a grade 1 rash,and stable disease was achieved.Unfortunately,the patient did not experience long-term benefits and developed disease progression after only two months.A follow-up examination showed that extracranial disease and a small intracranial lesion had developed gradually.The patient then received whole-brain radiotherapy(30 Gy in ten fractions)and four cycles of single-agent pemetrexed in April 2015.Stable disease was achieved,which coincided with an improvement in the patient’s cough,shortness of breath,and general condition.The chemotherapy course was changed to two cycles of pemetrexed combined with cisplatin.A partial response(PR)was achieved,and the patient was treated with 14 cycles of pemetrexed alone as maintenance chemotherapy.The follow-up evaluations showed the patient’s condition to be stable;however,the patient’s disease progressed after 23 months.A computed tomography(CT)scan in March 2017 revealed that both the lung lesion and the malignant pleural effusion had increased in size[Figure 1B].The subsequent biopsy specimen was subjected to next-generation sequencing(NGS)and a Syndecan 4-c-ros oncogene 1(SDC4-ROS1)rearrangement was detected[Figure 1C].The patient then received crizotinib in April 2017,and a PR was achieved[Figure 1D].A CT scan done in August 2018 indicated the progression of the primary lesion in the left lung and malignant pleural effusion.However,the growth of the remaining lesions remained stable.

Single-cell detection by enhancement of fluorescence in waveguides for cancer diagnosis and therapy

Cancer is one of the most common diseases to threaten human health.If individuals are diagnosed with malignant tumors via a single cell,medical workers are greatly advantageous to early diagnose and intervene in malignant tumors therapy.In this paper,we propose a fluorescence detection map to rapidly distinguish whether the chromosomes of a cell are normal or abnormal by detecting the fluorescent intensity of a single cell.Herein,we draw a map from a single cell with an abnormal number of chromosomes that is monitored in real time.Moreover,this way offers precise and prompt detection of the surviving of cancer cells at or near the site of the tumor after treatments for cancer,which can achieve personalized cancer diagnosis and therapy.Therefore,cancer recurrences and metastasis can be effectively identified,utilizing this ultrasensitive detection method of an abnormal chromosome number.

推拿联合脐疗治疗老年功能性便秘的临床研究

目的观察推拿联合脐疗治疗肺脾气虚型老年功能性便秘的临床疗效。方法将60例符合纳入标准的患者按照随机数字表法分为对照组和观察组,每组30例。对照组患者口服乳果糖口服溶液,观察组患者接受推拿和脐部贴敷治疗。治疗2周后观察患者Wexner便秘评分量表(WCGS)和患者生存质量问卷(PAC-QOL)评分,并比较两组有效率。结果治疗2周后,观察组总有效率为90.0%,对照组为76.7%,两组差异有统计学意义(P<00.05)。治疗前两组WCGS和PAC-QOL评分差异均无统计学意义(P>0.05);治疗2周后两组患者的WCGS和PAC-QOL评分均下降,与本组治疗前均有统计学差异(P<0.05),且观察组两项评分均低于对照组(P<0.05)。结论推拿联合脐疗治疗老年功能性便秘疗效确切,且能提高患者生活质量,其疗效优于口服乳果糖口服液。

High-throughput sequencing detection and ensartinib treatment of lung cancer harboring NTRK1 fusion

Dear Editor,Although fusion events involving neurotrophic receptor tyrosine kinase 1,2,and 3 genes(NTRK1,NTRK2,and NTRK3,encoding TRKA/B/C respectively)were found in diverse tumor types,only 0.1%-0.3%of lung cancer patients harbor an NTRK(and mostly NTRK1)fusion as the primary oncogenic event[1].Such low prevalence may be partially due to the limited availability of first-line assays for detecting rare fusion events[2].Immunohistochemistry is limited by sensitivity and variable tissue background,and fluorescence in-situ hybridization falls short of elucidating functional significance such as the identity of the partner or structure of the transcript.While DNA next-generation sequencing(NGS)is suitable for mutation calling(single nucleotide variation[SNV]and insertion-or-deletion[indel]),and RNA NGS is particularly effective in detecting fusions[3],routinely performing these two assays together is labor-intensive.As a solution,we have developed a single NGS assay(PANO-Seq)for unified RNA/DNA target enrichment library preparation[4],which takes about 12 hours and $10 to prepare.