A 65-year-old female patient was admitted to the First Affiliated Hospital of Anhui Medical University on July 31, 2024, due to "recurrent rash all over the body for more than 12 years and aggravation with fever for more than 20 days". The patient was previously diagnosed with acute urticaria due to full body rash with pruritus 12 years ago and treated with glucocorticoids. One year ago, she discontinued glucocorticoids at another hospital and was admitted to our hospital recently because of frequent rash and high fever. Elevated immunoglobulin M (IgM) was found from laboratory valuation and was identified as IgM kappa (IgM κ) monoclonal immunoglobulin by immunofixation electrophoresis. Cryoglobulin testing confirmed the presence of type I cryoglobulin (IgM κ type) in the blood. The patient was treated with oral colchicine tablets of 0.75 mg qd during hospitalization, resulting in partial remission. After discharge, the patient was treated with oral colchicine tablets 0.5 mg bid for maintenance treatment, and underwent regular outpatient follow-up every other month. By January 2025, the patient′s outpatient medical record showed that the rash was mostly controlled. If IgM κ type monoclonal immunoglobulin is present in the blood of patients with unexplained skin lesions, cryoglobulinemia needs to be considered clinically.

Objective:To explore the level of triglyceride-glucose (TyG) index and its effect and clinical value in predicting breast cancer.Methods:A retrospective case-control study was conducted. A total of 700 patients with breast tumors who underwent surgical treatment in the Inner Mongolia Autonomous Region People's Hospital from July 2021 to June 2024 were selected, and finally 625 patients were included, including 388 patients with benign breast tumors and 237 patients with breast cancer, and all lesions were determined to be benign or malignant by pathology after surgery. Triglyceride and blood glucose data were collected to calculate the TyG index. The correlation between TyG index and occurrence of breast cancer was analyzed by univariate and multivariate binary logistic regression models. With postoperative pathological diagnosis as the gold standard, the receiver operating characteristic (ROC) curve was used to evaluate the efficacy of TyG index in distinguishing breast cancer from benign breast tumors.Results:The age of patients in the breast cancer group and the benign breast tumor group was (57±12) years old and (42±12) years old, respectively. There were statistically significant differences in the distributions of patients between the two groups in terms of nationality, marital status, height, body mass, body mass index (BMI), cholesterol, low-density lipoprotein cholesterol, triglyceride, blood glucose levels, and color ultrasound Breast Imaging Report and Data System (BI-RADS) classification (all P < 0.05), and there was no statistically significant difference in the level of high-density lipoprotein cholesterol between the two groups ( P > 0.05); the TyG index in the breast cancer group was higher than that in the benign breast tumor group (8.6±0.6 vs. 8.4±0.6), and the difference was statistically significant ( P <0.001). Logistic regression analysis showed that in the model with only the TyG index as a variable, the risk of breast cancer increased with the increase of TyG index [ OR = 1.97, 95% CI: 1.48-2.63, P < 0.001, Hosmer-Lemeshow (HL) test P = 0.077]; in the model with 6 variables including TyG index, nationality, marriage, height, body mass and BMI, the risk of breast cancer increased with the increase of TyG index ( OR = 1.47, 95% CI: 1.08-2.00, P = 0.015, HL test P = 0.832); however, after adding age and BI-RADS classification variables, although the TyG index was still an independent influencing factor for the occurrence of breast cancer ( OR = 0.58, 95% CI: 0.35-0.96, P = 0.033, HL test P = 0.165), the rise of TyG index was an independent protective factor for the occurrence of breast cancer; in the two variable models including TyG index and BI-RADS classification, the TyG index was not an independent influencing factor for the occurrence of breast cancer ( OR = 1.10, 95% CI: 0.72-1.70, P = 0.659), suggesting that the TyG index may not be able to assist in the diagnosis of breast cancer by ultrasound. ROC curve analysis showed that the area under the curve to distinguish breast cancer and benign breast tumor according to the TyG index was 0.623, the optimal critical value of the TyG index was 8.51, the corresponding sensitivity was 59.5%, and the specificity was 62.4%. Conclusions:The TyG index of breast cancer patients is higher than that of benign breast tumor patients. Breast tumor patients with elevated TyG index have an increased risk of breast cancer, which may be a potential non-invasive biomarker of breast cancer.

Breast cancer is the most common type of cancer among women. Although chemotherapy has extended the survival time of patients with breast cancer, the cardiovascular complications caused by chemotherapy drugs are on the rise, which limits the clinical use of anthracycline drugs. At present, it is believed that the mechanisms of cardiac adverse reactions induced by anthracycline drugs may be related with oxidative stress, topoisomerase inhibitor 2, abnormal expression of non-coded RNA in cells, induction of autophagy and apoptosis in myocardial cells, and other various cell death pathways. This article reviews the relationship between insulin-like growth factor receptor 2 and cardiac adverse reactions induced by anthracycline drugs.

A 65-year-old female patient was admitted to the First Affiliated Hospital of Anhui Medical University on July 31, 2024, due to "recurrent rash all over the body for more than 12 years and aggravation with fever for more than 20 days". The patient was previously diagnosed with acute urticaria due to full body rash with pruritus 12 years ago and treated with glucocorticoids. One year ago, she discontinued glucocorticoids at another hospital and was admitted to our hospital recently because of frequent rash and high fever. Elevated immunoglobulin M (IgM) was found from laboratory valuation and was identified as IgM kappa (IgM κ) monoclonal immunoglobulin by immunofixation electrophoresis. Cryoglobulin testing confirmed the presence of type I cryoglobulin (IgM κ type) in the blood. The patient was treated with oral colchicine tablets of 0.75 mg qd during hospitalization, resulting in partial remission. After discharge, the patient was treated with oral colchicine tablets 0.5 mg bid for maintenance treatment, and underwent regular outpatient follow-up every other month. By January 2025, the patient′s outpatient medical record showed that the rash was mostly controlled. If IgM κ type monoclonal immunoglobulin is present in the blood of patients with unexplained skin lesions, cryoglobulinemia needs to be considered clinically.

Objective:To explore the level of triglyceride-glucose (TyG) index and its effect and clinical value in predicting breast cancer.Methods:A retrospective case-control study was conducted. A total of 700 patients with breast tumors who underwent surgical treatment in the Inner Mongolia Autonomous Region People's Hospital from July 2021 to June 2024 were selected, and finally 625 patients were included, including 388 patients with benign breast tumors and 237 patients with breast cancer, and all lesions were determined to be benign or malignant by pathology after surgery. Triglyceride and blood glucose data were collected to calculate the TyG index. The correlation between TyG index and occurrence of breast cancer was analyzed by univariate and multivariate binary logistic regression models. With postoperative pathological diagnosis as the gold standard, the receiver operating characteristic (ROC) curve was used to evaluate the efficacy of TyG index in distinguishing breast cancer from benign breast tumors.Results:The age of patients in the breast cancer group and the benign breast tumor group was (57±12) years old and (42±12) years old, respectively. There were statistically significant differences in the distributions of patients between the two groups in terms of nationality, marital status, height, body mass, body mass index (BMI), cholesterol, low-density lipoprotein cholesterol, triglyceride, blood glucose levels, and color ultrasound Breast Imaging Report and Data System (BI-RADS) classification (all P < 0.05), and there was no statistically significant difference in the level of high-density lipoprotein cholesterol between the two groups ( P > 0.05); the TyG index in the breast cancer group was higher than that in the benign breast tumor group (8.6±0.6 vs. 8.4±0.6), and the difference was statistically significant ( P <0.001). Logistic regression analysis showed that in the model with only the TyG index as a variable, the risk of breast cancer increased with the increase of TyG index [ OR = 1.97, 95% CI: 1.48-2.63, P < 0.001, Hosmer-Lemeshow (HL) test P = 0.077]; in the model with 6 variables including TyG index, nationality, marriage, height, body mass and BMI, the risk of breast cancer increased with the increase of TyG index ( OR = 1.47, 95% CI: 1.08-2.00, P = 0.015, HL test P = 0.832); however, after adding age and BI-RADS classification variables, although the TyG index was still an independent influencing factor for the occurrence of breast cancer ( OR = 0.58, 95% CI: 0.35-0.96, P = 0.033, HL test P = 0.165), the rise of TyG index was an independent protective factor for the occurrence of breast cancer; in the two variable models including TyG index and BI-RADS classification, the TyG index was not an independent influencing factor for the occurrence of breast cancer ( OR = 1.10, 95% CI: 0.72-1.70, P = 0.659), suggesting that the TyG index may not be able to assist in the diagnosis of breast cancer by ultrasound. ROC curve analysis showed that the area under the curve to distinguish breast cancer and benign breast tumor according to the TyG index was 0.623, the optimal critical value of the TyG index was 8.51, the corresponding sensitivity was 59.5%, and the specificity was 62.4%. Conclusions:The TyG index of breast cancer patients is higher than that of benign breast tumor patients. Breast tumor patients with elevated TyG index have an increased risk of breast cancer, which may be a potential non-invasive biomarker of breast cancer.

Breast cancer is the most common type of cancer among women. Although chemotherapy has extended the survival time of patients with breast cancer, the cardiovascular complications caused by chemotherapy drugs are on the rise, which limits the clinical use of anthracycline drugs. At present, it is believed that the mechanisms of cardiac adverse reactions induced by anthracycline drugs may be related with oxidative stress, topoisomerase inhibitor 2, abnormal expression of non-coded RNA in cells, induction of autophagy and apoptosis in myocardial cells, and other various cell death pathways. This article reviews the relationship between insulin-like growth factor receptor 2 and cardiac adverse reactions induced by anthracycline drugs.

BACKGROUND:Previous studies have confirmed that the new compound cottonrose hibiscus leaf gel plaster has a good effect in the treatment of acute soft tissue swelling. OBJECTIVE:To observe the clinical efficacy of compound cottonrose hibiscus leaf gel plaster in the treatment of synovitis of the knee joint. METHODS:Seventy-two patients with knee synovitis were selected from Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from December 2019 to May 2021.These patients were randomly divided into a trial group and a control group,with 36 cases in each group.The trial group was treated with compound cottonrose hibiscus leaf gel plaster,once a day,12 hours each time,while the control group was treated with Diclofenac Diethylamine Emulgel,twice a day.After 28 days of treatment,visual analog scale score,WOMAC Osteoarthritis Index score,quality of life score(SF-36),thickness of knee synovium and comprehensive curative effect were compared between the two groups. RESULTS AND CONCLUSION:(1)Visual analog scale scores after treatment were lower than those before treatment(P<0.05).Visual analog scale scores in the trial group after 7,14 and 28 days of treatment were lower than those in the control group(P<0.05).The WOMAC Osteoarthritis Index scores of the two groups after treatment were lower than those before treatment(P<0.05),and the WOMAC Osteoarthritis Index scores in the trial group after 7,14 and 28 days of treatment were lower than those in the control group(P<0.05).(3)The SF-36 quality of life score in the two groups after 28 days of treatment was higher than that before treatment(P<0.05).SF-36 quality of life score in the trial group after 28 days of treatment was higher than that in the control group(P<0.05).(4)After 28 days of treatment,the thickness of knee synovium in the trial group was less than that in the control group(P<0.05),and the effective rate in the trial group was higher than that in the control group(P<0.05).(5)These findings indicate that compared with Diclofenac Diethylamine Emulgel,the compound cottonrose hibiscus leaf gel plaster can better relieve knee pain,enhance knee joint function,reduce synovial hyperplasia,and elevate the overall quality of life of patients.

Objective: To investigate the clinicopathological features and immunohistochemical phenotypes of gastric SMARCA4-deficient undifferentiated carcinoma, and to discuss the daily diagnostics of this entity and analyze its prognosis. Methods: The cases of gastric SMARCA4-deficient undifferentiated carcinoma diagnosed at the Department of Pathology, Peking University Cancer Hospital, China from January 2010 to August 2022 were collected. The histological sections were reviewed, the immunohistochemical results and clinicopathological features were analyzed, and relevant literature was reviewed. Results: Pure foci of undifferentiated carcinoma were seen in 7 cases, and 1 case was accompanied by a moderately differentiated tubular adenocarcinoma component. Undifferentiated carcinoma foci showed similar sheet-like or solid diffuse growth pattern, medium-sized tumor cells characterized by 1-2 nucleoli, and abundant cytoplasm and rhabdoid appearance. The average patient age was 65±8 years. Six patients were male and 2 were female. Immunohistochemical staining showed that undifferentiated carcinoma of all 8 tumors were negative for SMARCA4 (BRG1). Among 7 patients who underwent SMARCA2 (BRM) and SMARCB1 (INI1) staining, 4 cases showed loss of BRM expression, 2 cases showed weakly positive staining, and 1 case was diffusely positive, but all 7 cases were diffusely strong positive for INI1. The neuroendocrine marker, synaptophysin, was weakly positive in 5 cases, while CgA and CD56 were negative in 8 cases. Ki-67 index was more than 70%. Two cases were mismatch repair deficient and showed the loss of MLH1/PMS2 expression, while 1 case showed only MSH2 loss. PD-L1 staining showed that combined positive score (CPS)≥1 in 4 cases (CPS ranging from 1 to 55) and CPS<1 in the other 3 cases. Four patients had clinical stage Ⅳ disease. Two of them died within 3 months after diagnosis. Conclusions: Gastric SMARCA4-deficient undifferentiated carcinoma/rhabdoid carcinoma is a rare group of highly malignant tumors with a poor prognosis. Loss of the core subunit of SWI/SNF complex may be associated with the development of dedifferentiated histological pattern and aggressive tumor progression, which may be more frequently accompanied with mismatch repair deficiency.
Male ; Female ; Humans ; Carcinoma/pathology* ; Adenocarcinoma ; Colorectal Neoplasms ; Cell Differentiation ; Stomach Neoplasms ; Biomarkers, Tumor ; DNA Helicases ; Nuclear Proteins ; Transcription Factors

BACKGROUND: Previous research demonstrated that a homozygous mutation of g.136372044G>A (S12N) in caspase recruitment domain family member 9 ( CARD9 ) is critical for producing Aspergillus fumigatus -induced ( Af -induced) T helper 2 (T H 2)-mediated responses in allergic bronchopulmonary aspergillosis (ABPA). However, it remains unclear whether the CARD9S12N mutation, especially the heterozygous occurrence, predisposes the host to ABPA. METHODS: A total of 61 ABPA patients and 264 controls (including 156 healthy controls and 108 asthma patients) were recruited for sequencing the CARD9 locus to clarify whether patients with this heterozygous single-nucleotide polymorphisms are predisposed to the development of ABPA. A series of in vivo and in vitro experiments, such as quantitative real-time polymerase chain reaction, flow cytometry, and RNA isolation and quantification, were used to illuminate the involved mechanism of the disease. RESULTS: The presence of the p.S12N mutation was associated with a significant risk of ABPA in ABPA patients when compared with healthy controls and asthma patients, regardless of Aspergillus sensitivity. Relative to healthy controls without relevant allergies, the mutation of p.S12N was associated with a significant risk of ABPA (OR: 2.69 and 4.17 for GA and AA genotypes, P = 0.003 and 0.029, respectively). Compared with patients with asthma, ABPA patients had a significantly higher heterozygous mutation (GA genotype), indicating that p.S12N might be a significant ABPA-susceptibility locus ( aspergillus sensitized asthma: OR: 3.02, P = 0.009; aspergillus unsensitized asthma: OR: 2.94, P = 0.005). The mutant allele was preferentially expressed in ABPA patients with heterozygous CARD9S12N , which contributes to its functional alterations to facilitate Af -induced T H 2-mediated ABPA development. In terms of mechanism, Card9 wild-type ( Card9WT ) expression levels decreased significantly due to Af -induced decay of its messenger RNA compared to the heterozygous Card9S12N . In addition, ABPA patients with heterozygous CARD9S12N had increased Af -induced interleukin-5 production. CONCLUSION Our study provides the genetic evidence showing that the heterozygous mutation of CARD9S12N , followed by allele expression imbalance of CARD9S12N , facilitates the development of ABPA.
Humans ; Aspergillosis, Allergic Bronchopulmonary/complications* ; Aspergillus fumigatus/genetics* ; Asthma/genetics* ; Aspergillus ; Mutation/genetics* ; CARD Signaling Adaptor Proteins/genetics*

With the development of information technology and the changes in people's lifestyle, E-health has become a new way for people to receive health services and has been widely applied in the prevention and control of HIV infection, including behavioral intervention, biomedical intervention, mental health intervention, improving access to health services and so on. This paper summarizes the application of E-health intervention in HIV prevention and control both at home and abroad to provide reference for the further optimization of planning and strategies of E-health intervention in HIV infection prevention.