State Administration of Foreign Experts Affairs

Implantable cardioverter-defibrillators (ICDs) are the cornerstone of sudden cardiac death prevention in cardiomyopathies, but disease-specific structural and electrophysiological substrates profoundly affect device performance and outcomes. Understanding these distinctions is critical for tailoring therapy and improving patient safety. This review examines current evidence and practical experience regarding ICD implantation, programming, and management in hypertrophic cardiomyopathy (HCM), arrhythmogenic right ventricular cardiomyopathy (ARVC), and cardiac amyloidosis (CA). We performed a structured narrative synthesis to identify phenotype-specific technical challenges, programming strategies, and complication trends. For HCM, lead placement and programming to minimize inappropriate therapies are emphasized; for ARVC, issues of lead instability, oversensing, and ATP efficacy are explored; and for CA, defibrillation thresholds, sensing difficulties, and individualized indications are discussed. ICD therapy in cardiomyopathies must be individualized, balancing arrhythmic protection against disease-specific risks and device-related complications. Tailored programming, careful system selection, and remote monitoring are key to improving outcomes. Emerging technologies such as modular and extravascular ICD systems promise safer and more phenotype-driven care.

Codonopsis javanica, a Campanulaceae herb endemic to Guizhou, is locally called "Tudangshen", its root is used in medicine to fortify spleen-qi, moisten the lung and arrest cough, and promote lactation. In June 2023, root rot of C. javanica was observed in a cultivation field in Xiuwen County (106°46'48" E, 26°53'59" N), Guizhou Province, with the estimated disease incidence ranging from 20% to 50%. The initial symptoms were light brown spots on the surface of the root, and the spots were brown or black in severe cases, and the lower end of the root and the rhizome were rotted. The aboveground portions of the leaves exhibited yellowing and wilting, followed by withering and death. The diseased root tissue (5 mm × 5 mm) was cut and disinfected with 75 % alcohol for 15 s, 5 % sodium hypochlorite treatment for 1 min, followed by three rinses with sterile distilled water. After drying, the samples were transferred onto Potato Dextrose Agar (PDA) and incubated at 28 °C in darkness for 3-5 days. Through hyphal tip culture methodology (Senanayake et al. 2020), 12 strains with similar morphology were obtained. The colonies were white to purplish red. The fungus produced two types of conidia: microconidia and macroconidia. The microconidia were ovate, without septa or 1-2 septa, and the size was 4.98-9.22 × 1.88-3.65 μm. The macroconidia were sickle-shaped, slightly curved, 1-4 septa, and the size was 21.55-37.92 × 3.10-6.50 μm. Chlamydospores were subspherical to spherical. Based on these morphological features, the isolates were suspected to be Fusarium oxysporum (Leslie et al. 2006). For molecular confirmation of the morphological identification, strain ZPJ1 was randomly selected as a representative isolate for DNA extraction. The primers ITS1/ITS4, EF1-F6/R6, and RPB2-5F/RPB2-7cR were used to amplify three genomic DNA regions including the internal transcribed spacer (ITS)(Crous et al. 2021), translation elongation factor 1-alpha (EF1)(Moslemi et al. 2017), and RNA polymerase II second largest subunit (RPB2)(Xiang et al. 2025). The sequences of ZPJ1 (accession numbers PV750775, PV759349, and PV759350 for ITS, EF1 and RPB2, respectively) were deposited in GenBank, demonstrating a sequence homology of 99 % to 100 % (546/546, 702/705, 974/978) with F. oxysporum (accession numbers PP596264, MN892354, MN457466). Based on morphological features and maximum likelihood method analyses of combined ITS, EF1, and RPB2 gene sequences, strain ZPJ1 was identified as F. oxysporum. Pathogenicity experiments were conducted in a greenhouse with a temperature ranging from 24 to 27 °C and a relative humidity of 80 %. Root wounding was performed on potted C. javanica seedlings (n = 5, 1-year-old) using a sterile needle. A spore suspension (150 mL, 1 × 106 conidia/mL) of strain ZPJ1 was inoculated onto the wounds, with an equal volume of sterile water used as the control. After 18 days, all inoculated plants developed characteristic root rot symptoms, while the plants in the control group remained healthy and did not show any symptoms of root rot disease. F. oxysporum was successfully reisolated from the symptomatic roots and identified by the morphology and the molecular methods de-scribed above, meeting Koch’s postulates. Based on current understanding, this is the first report of F. oxysporum causing root rot in C. javanica in China. These findings provide a basis for the early detection of C. javanica root rot caused by F. oxysporum and the formulation of targeted control measures.

The epidemiological transition has led to an increase in life expectancy and to a growing population of chronic patients, often with heart failure. These patients are frequently affected by comorbidities and frailty, which in turn increase the risk of disability and worsening quality of life, requiring an accurate multidimensional assessment (MDA). In this context, MDA is crucial for integrated and holistic management of elderly patients, considering not only the pathology but the patient in his complexity. MDA requires a multidisciplinary team to ensure a comprehensive and integrated assessment of the elderly patient. MDA tools assess various domains of health, using scales and validated tools to explore physical, functional, mental and socio-economic status. MDA is applied in two phases: an initial screening procedure and an in-depth analysis of individual problems for targeted interventions. MDA can be performed in various care settings, including outpatient clinics, hospitals, nursing homes, home care, and rehabilitation centers. Several studies show that MDA improves survival as well as functional and mental status, reducing hospitalization times and the frequency of institutionalization. This ANMCO position paper discusses MDA tools of older adults with chronic heart disease, highlighting the need for a holistic approach to address comorbidities and frailty in a growing population.

Relatamos o caso de uma paciente idosa com quadro de oclusão arterial aguda de membro inferior, diagnosticada e tratada com tromboembolectomia emergencial. A paciente evoluiu com complicações pós-operatórias, incluindo síndrome de reperfusão com injúria renal aguda, necessitando de suporte dialítico, além de uma infecção urinária tratada com antibioticoterapia. A evolução foi monitorada com exames laboratoriais e clínicos, culminando na alta com orientações para seguimento ambulatorial. Este caso ilustra os desafios na gestão de oclusões arteriais agudas em pacientes idosos, com enfoque nas complicações associadas ao procedimento e à hospitalização prolongada.

At the dawn of "metaclinical medicine" era, shared decision-making represents the overcoming of modern medicine guidelines and classical medicine experience. The patient's life plan, the doctor's health plan, the scientist's evidence-based plan, the administrator's plan and the beliefs of the society for healthcare options should be integrated into the shared decision-making process to avoid patient's unrealistic expectations, doctor's self-referential and defensive medicine, the science without compassion of the scientist, the administered medicine of the politician, the herd mentality of artificial intelligence. For a doctor who must evaluate according to science and conscience, it becomes difficult to make decisions about a patient who thinks that there can be "no decisions about me without me". It risks being a pure declamatory statement in the absence of clinical knowledge and the associated concept of probability. The idea of moving from informed consent to shared probability is convenient for both the doctor and the patient but not for litigation professionals. Even in metaclinical medicine, clinical decision support systems, if well governed, would facilitate the choice of the best treatment according to the definition of absolute risk reduction and the number of patients to be treated to avoid an event, leaving it up to the doctor-patient relationship the narrative and the choice of the most appropriate treatment, which also requires taking care of the emotional and compassionate aspects.

O presente estudo teve por objetivo compreender se a realização rotineira de ultrassonografia de tireoide traduz impacto na mortalidade e prognóstico de pacientes. Os nódulos de tireoide apresentam elevada frequência na população e, quando cancerígenos, representam 1% de todos os tipos de câncer diagnosticados, sendo o mais comum entre as mulheres e, segundo a American Cancer Society (ACS). O uso do ultrassom impulsionou a identificação de nódulos tireoidianos, entretanto outras técnicas como a cintilografia, tomografia computadorizada, ressonância magnética e tomografia por emissão de pósitrons também podem ser utilizadas. A ultrassonografia possui baixo custo e permite a identificação de nódulos pequenos e parâmetros sugestivos de malignidade, contudo os achados ultrassonográficos muitas vezes não se relacionam com os dados histopatológicos, ocasionando o sobrediagnóstico da doença, submetendo pacientes a procedimentos muitas vezes desnecessários. Assim, o rastreio mostra-se justificável em grupos de alto risco e que possuam indicação clínica, entretanto, mais estudos são necessários para esclarecer sua necessidade em populações de risco levemente elevado, uma vez que a literatura carece de estudos acerca do tema.

Le titre de cet ouvrage, Petit guide de créole martiniquais, interpelle le lecteur sur le fait que les auteurs, Anne Zribi-Hertz et Loïc Jean-Louis n’ont pas comme objectif de se placer en donneurs de leçons du créole martiniquais, mais en descriptivistes d’une grammaire interne, celle du co-auteur Loïc Jean-Louis. Preuve de la rigueur du travail réalisé, la grammaticalité des phrases produites par ce dernier comme support à cette description est confirmée par une enquête auprès d’une dizain...