Introduction  Several studies have shown an inconsistent relationship between postimplantation pocket hematoma and cardiac implantable electronic device (CIED) infection. In this study, we performed a systematic review and meta‐analysis to explore the effect of postimplantation hematoma and the risk of CIED infection. Methods  We searched the databases of MEDLINE and EMBASE from inception to March 2020. Included studies were cohort studies, case‐control studies, cross‐sectional studies, and randomized controlled trials that reported incidence of postimplantation pocket hematoma and CIED infection during the follow‐up period. CIED infection was defined as either a device‐related local or systemic infection. Data from each study were combined using the random effects, generic inverse variance method of Der Simonian and Laird to calculate odds ratios (OR) and 95% confidence intervals (CI). Results Fourteen studies were included in final analysis, involving a total of 28 319 participants. In random‐effect model, we found that postimplantation pocket hematoma significantly increases the risk of overall CIED infection (OR = 6.30, 95% CI: 3.87‐10.24, I2 = 49.3%). There was no publication bias observed in the funnel plot as well as no small‐study effect observed in Egger’s test. Conclusions Our meta‐analysis demonstrated that postimplantation pocket hematoma significantly increases the risk of CIED infection. Precaution should be taken during device implantation to reduce postimplantation hematoma and subsequent CIED infection.

BackgroundAnaplastic lymphoma kinase (ALK) gene rearrangement is detected in 3 % to 13 % of non-small cell lung carcinoma patients, and these patients benefit from ALK inhibitors. The aim of this study was to determine the prevalence, the clinical and histological characteristics and the treatment outcomes of ALK-rearranged lung adenocarcinoma using immunohistochemistry (IHC) IHC, reverse transcription polymerase chain reaction (RT-PCR) and fluorescence in situ hybridization (FISH) methodologies.MethodsA total of 268 pulmonary adenocarcinoma patients were screened for ALK expression by ALK IHC, which was confirmed by FISH and/or RT-PCR for ALK gene rearrangement. The treatment outcomes of ALK-rearranged patients were retrospectively reviewed.ResultsALK gene rearrangement was identified in 26 cases (9.7 %) with no EGFR co-mutation, and it showed significant associations with younger age, female sex and non-smoker status (p < 0.05). A cribriform growth pattern was identified as the dominant histologic feature, and a solid signet ring cell component was focally present in a minority of the cases. Among 12 ALK-rearranged patients with conventional treatment, seven cases in the early stage of disease were cured and alive, and five patients in the late stage of the disease progressed and died, with a median overall survival (OS) at 14 months. Of the 14 patients receiving crizotinib, all of them had clinical benefit from crizotinib treatment, with one patient having a complete response (CR), 12 patients having a partial response (PR) and one patient having stable disease (SD). On the cutoff date, six of 14 patients were continuing crizotinib treatment with a median time of response of 7.5 (3–13) months, while eight patients had disease progression, and five of them died with a median OS at 8 months.ConclusionALK gene rearrangement tended to occur in younger, non-smoking, female patients. ALK IHC is a reliable screening method to detect ALK gene rearrangement. Crizotinib therapy provided treatment benefit in ALK-rearranged adenocarcinoma patients especially in advanced stages of the disease.

Atrial fibrillation (AF) is the most common sustained arrhythmia worldwide and is associated with increased mortality and morbidity. 1 A rate-control strategy is an effective treatment strategy for patients with AF as rapid ventricular response can contribute to left ventricular dysfunction and increased mortality. 2 However, data supporting the selection of rate-control medications are still lacking. We conducted a systematic review and metaanalysis to evaluate and compare mortality rates among beta-blocker (BB), calcium channel blocker (CCB), and digoxin for patients with AF undergoing rate-control strategy.