Binzhou Medical College Hospital

Anomalous aortic origin of the coronary artery (AAOCA) is a relatively rare congenital coronary anomaly identified as a common cause of exercise-induced cardiac syncope and sudden death in young individuals. In most cases, the coronary artery courses between the aorta and pulmonary artery, exhibiting an intramural trajectory within the aortic wall. Herein, we present a case of an 11-year-old girl with AAOCA manifesting with sudden-onset syncope complicated by myocardial infarction as the initial symptom, along with a discussion of the underlying pathogenesis. This case is important as it highlights the fact that comprehensive coronary artery evaluation combined with high-quality imaging modalities is critical to enhance the diagnostic accuracy of coronary anomalies. As such, TTE should be established as an important first-line tool within a multimodality imaging pathway. for AAOCA.

ABSTRACTAims/IntroductionLeukocytes are implicated in the inflammatory cascades of diabetic retinopathy (DR), but their causal roles remain ambiguous. This study employed a two‐sample Mendelian randomization (MR) analysis to dissect the causal effects of circulating leukocyte counts on DR risk.Materials and MethodsWe utilized summary statistics from large‐scale genome‐wide association studies (GWAS) for five leukocyte subtypes and DR in European‐ancestry populations. The inverse‐variance weighted (IVW) method was primary, supported by comprehensive sensitivity analyses including MR‐Egger, weighted median, and the MR‐Pleiotropy Residual Sum and Outlier (MR‐PRESSO) test to ensure result robustness.ResultsA total of 2,136 leukocyte‐related SNPs were extracted as instrumental variables for causal inference. MR analysis revealed that increased lymphocyte counts are associated with reduced DR risk (IVW OR = 0.93, 95% CI = 0.86–0.99, P = 0.03), while the initial association between higher eosinophil counts and DR risk (IVW OR = 1.11, 95% CI = 1.03–1.19, P < 0.01) was attenuated following correction for outliers. No significant associations were observed for basophil, monocyte, or neutrophil counts. Sensitivity analyses found no evidence of pleiotropy or substantial influence from single SNPs.ConclusionsOur findings provide genetic evidence supporting a potential causal association between lymphocyte counts and diabetic retinopathy risk, while the association for eosinophil counts was attenuated after correction for outliers. These results highlight the importance of further investigating the physiological role of lymphocytes in diabetic retinopathy to inform effective prevention and treatment strategies.

Traditional Chinese medicine (TCM) serves as a significant adjunct to chemical treatment for chronic diseases. For instance, the administration of Baitouweng decoction (BTWD) has proven effective in the treatment of ulcerative colitis. However, the limited understanding of its pharmacokinetics (PK) has impeded its widespread use. Chinese Bama miniature pigs possess anatomical and physiological similarities to the human body, making them a valuable model for investigating PK properties. Consequently, the identification of PK properties in Bama miniature pigs can provide valuable insights for guiding the clinical application of BTWD in humans. To facilitate this research, a rapid and sensitive UPLC-MS/MS method has been developed for the simultaneous quantification of eleven active ingredients of BTWD in plasma. Chromatographic separation was conducted using an Acquity UPLC HSS T3 C18 column and a gradient mobile phase comprising acetonitrile and water (containing 0.1% acetic acid). The methodology was validated in accordance with the FDA Bioanalytical Method Validation Guidance for Industry. The lower limit of quantitation fell within the range of 0.60-2.01 ng/mL. Pharmacokinetic studies indicated that coptisine chloride, berberine, columbamine, phellodendrine, and obacunone exhibited low Cmax, while fraxetin, esculin, fraxin, and pulchinenoside B4 were rapidly absorbed and eliminated from the plasma. These findings have implications for the development of effective components in BTWD and the adjustment of clinical dosage regimens.

Pleural mesothelioma (PM) with pericardial involvement is extremely rare. We now report a rare case of malignant PM with constrictive pericarditis as the first presentation. A 59-year-old male diagnosed with constrictive pericarditis underwent pericardiectomy and pericardial pathology revealed mesothelial hyperplasia. Eight months after surgery, the patient was admitted to the hospital with chest tightness and wheezing for 5 days. Computed tomography scan of the chest showed a left lung expansion insufficiency, limited bilateral pleural thickening, pericardial thickening with a small amount of pericardial effusion, and multiple enlarged lymph nodes in the mediastinum, bilateral supraclavicular fossa, bilateral cervical roots, and right axilla. The pleural malignancy should be possibly considered. Pathology after pleural puncture showed malignant PM. Pathology after left supraclavicular lymph node puncture biopsy showed metastatic malignant mesothelioma. The diagnosis of this patient was clear. Although malignant PM rarely involves the pericardial constriction, we cannot ignore the fact that malignant PM involves the pericardium. The patient has been diagnosed with constrictive pericarditis, accompanied by pleural thickening and pleural effusion. Without other pathogenic factors, pleural biopsy should be aggressively performed in patients with constrictive pericarditis to determine the cause.

Invasion, metastasis, and recurrence are the most common causes of death in patients with hepatocellular carcinoma (HCC) and are therefore critical factors for both therapy and prognosis. Current methods for diagnosis of HCC rely mainly on serological markers such as alpha-fetoprotein and liver enzymes, together with physical assessment and imaging techniques. The availability of more accurate serum markers may facilitate screening and early diagnosis, which will improve prognosis. This retrospective cohort analysis included 50 consecutive patients with cirrhosis and single or multifocal HCC and 40 control subjects with no liver disease or risk factors for viral hepatitis. Expression of epidermal growth factor-like domain 7 (EGFL7), osteopontin (OPN), and prostaglandin E2 (PGE2) were detected using an enzyme-linked immunosorbent assay. The mean serum levels of EGFL7, OPN, and PGE2 in the HCC group were 132.11 pg/mL, 11.77 ng/mL, and 179.37 pg/mL, respectively, which were all significantly higher than the levels in the control group (23.03 pg/mL, 2.31 ng/mL, and 47.36 pg/mL, respectively; P < 0.001). Serum levels of EGFL7, OPN, and PGE2 levels may thus be useful for screening and surveillance of HCC among high-risk populations, and have the potential to improve prognosis of these patients.

Journal Article Association analysis of filaggrin gene mutations and atopic dermatitis in Northern China Get access L. Ma, L. Ma State Key Department of Dermatology, No. 1 Hospital of China Medical University, 155 North Nanjing Street, Shenyang 110001, ChinaDepartment of Dermatology, Binzhou Medical College Hospital, Binzhou, China Search for other works by this author on: Oxford Academic Google Scholar L. Zhang, L. Zhang State Key Department of Dermatology, No. 1 Hospital of China Medical University, 155 North Nanjing Street, Shenyang 110001, China Search for other works by this author on: Oxford Academic Google Scholar Z‐H. Di, Z‐H. Di Department of Dermatology, Shengjing Hospital of China Medical University, Shenyang, China Search for other works by this author on: Oxford Academic Google Scholar L‐P. Zhao, L‐P. Zhao Department of Dermatology, The General Hospital of Shenyang Military Command, Shenyang, China Search for other works by this author on: Oxford Academic Google Scholar Y‐N. Lu, Y‐N. Lu Department of Dermatology, Shengjing Hospital of China Medical University, Shenyang, China Search for other works by this author on: Oxford Academic Google Scholar J. Xu, J. Xu Department of Dermatology, Shengjing Hospital of China Medical University, Shenyang, China Search for other works by this author on: Oxford Academic Google Scholar H‐D. Chen, H‐D. Chen State Key Department of Dermatology, No. 1 Hospital of China Medical University, 155 North Nanjing Street, Shenyang 110001, China Search for other works by this author on: Oxford Academic Google Scholar X‐H. Gao X‐H. Gao State Key Department of Dermatology, No. 1 Hospital of China Medical University, 155 North Nanjing Street, Shenyang 110001, China Xing‐Hua Gao. E‐mail: gaobarry@hotmail.com Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 162, Issue 1, 1 January 2010, Pages 225–227, https://doi.org/10.1111/j.1365-2133.2009.09539.x Published: 01 January 2010

Malignant melanoma (MM) is one of the most deadly cancers[1]. Although the disease accounts for only about 4% of skin cancer related cases, it is responsible for about 79% of skin cancer deaths[2]. Early diagnosis of MM is, therefore, essential for appropriate treatment decision and, in turn, may give patients the best chance for prolonged survival[3-5]. About 6% to 8% of malignant melanomas lack typical pigmentation and tend to be managed as benign lesions, making accurate early diagnosis difficult[6]. Though subungual MM is rare, representing between 0.7% to 3.5% of all malignant melanomas in the general population[7], delays in diagnosis and misdiagnosis result in a poorer prognosis than MM at other sites[8]. We report a case of amelanotic subungual melanoma with distant lymph nodes metastasis which mimicked hemangioma. The clinical features and differential diagnosis should alert both dermatologists and other physicians to this infrequently seen malignancy.

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