Eosinophilic fasciitis difficult to differentiate from scleroderma:A case report

BACKGROUND Eosinophilic fasciitis(EF)is a rare connective tissue disease that can cause swelling and sclerosis of the extremities,and special attention is needed to differentiate EF from systemic sclerosis.Misdiagnosis or omission markedly delays treatment of EF,and severe skin sclerosis in advanced stages can cause joint contracture and tendon retraction,worsening the patient's prognosis and quality of life.CASE SUMMARY We report a case of EF in a young woman diagnosed by tissue biopsy,confirming the difficulty of differential diagnosis with scleroderma.CONCLUSION Focusing on skin manifestations,completing tissue biopsy and radiography can help diagnose EF effectively.Clinicians should enhance their understanding of the differences between EF and scleroderma,and early diagnosis and standardized treatment can improve the prognosis of patients with EF.

Improved biopsy accuracy in Barrett's esophagus with a transparent cap

AIM:To evaluate the efficacy of endoscopy with a transparent cap on biopsy positioning in Barrett’s esophagus(BE).METHODS:One hundred and sixty-eight patients with suspected BE at endoscopy were enrolled in our study from November 2007 to December 2009 and divided into two groups:transparent cap group(n=60)and control group(n=108).Endoscopy with or without a transparent cap and subsequent biopsy of suspected lesions were performed by five experienced endoscopists in our hospital.In both groups,two biopsy specimens were taken from each patient,and the columnar epithelium or goblet cells in histological assessment were used as the diagnostic standard for BE.RESULTS:In the transparent cap group,41 cases were tongue type,while 17 and two cases were identified as island type and circumferential type,respectively.In the control group,65 tongue-type cases were confirmed,with 38 island-type and five circumferential-type cases.Moreover,there was no significant difference with regard to the composition of endoscopic BE types in the two groups(P>0.05).In the biopsy specimens,BE was detected in 50 cases in the transparent cap group(83.3%,50/60),whereas the detection rate in the control group(69.4%,75/108)was lower compared to that in the transparent cap group(P<0.05).In addition,goblet cells were recognized in only eight cases(all with columnar epithelium)(8/60,13.3%)in the transparent cap group,with 11 cases in the control group.CONCLUSION:Transparent cap-fitted endoscopy can guide biopsy positioning in BE without other accompanying complications,thus increasing the detection rate of BE.

The value of real-time three-dimensional echocardiography in evaluating left ventricular function for different degrees of heart failure

Objective:To explore the value and feasibility of real-time three-dimensional echocardiography(RT-3DE)in evaluating left ventricular function in patients with different degrees of heart failure.Methods:The 60 heart failure patients in the case group were divided into three subgroups according to the New York Heart Association(NYHA)classification:12 cases of cardiac function gradeⅡ,35 cases of cardiac function gradeⅢ,13 cases of cardiac function grade IV,and the other 30 cases of healthy subjects as control group.Compare the left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),and left ventricular 16,12,and 6 segments reaching the minimum systolic volume time standard deviation standardized value(Tmsv SD%),left ventricular 16,12 and 6 segments reaching the minimum systolic volume time standardized values of the maximum difference(Tmsv DIF%),analysis of the correlation between the above left ventricular function-related parameters and cardiac function grading.Results:(1)There were statistically significant differences in LVEDV and LVESV between each group(p<0.001).There was no statistically significant difference in LVEF between the cardiac function gradeⅡgroup and the control group,and between the grade IV group and the gradeⅢgroup(p=0.094 and 0.246).(2)compared with the control group,all parameters related to RT-3DE evaluation of left ventricular synchronization were prolonged in the case group,and the difference was statistically significant(p<0.001).The differences of Tmsv 16-SD%and Tmsv 16-DIF%in each subgroup of the case group were statistically significant(p<0.001).(3)LVEF was negatively correlated with NYHA classification of cardiac function(rs=-0.779,p<0.001),and LVEDV,LVESV,Tmsv 16-SD%,Tmsv 12-SD%,Tmsv 6-SD%,Tmsv 16-DIF%,Tmsv 12-DIF%,Tmsv 6-DIF%were positively correlated with NYHA function classification,showing strong correlation(rs=0.710,0.785,0.885,0.675,0.605,0.885,0.695,0.622,p<0.001),among them,Tmsv 16-SD%and Tmsv 16-Dif%have the highest correlation.Conclusion:RT-3DE can comprehensively evaluate the impairment of cardiac function.The measured parameters of left ventricular function are strongly correlated with cardiac function classification,which has impo-rtant application value for clinical judgment of the severity of heartfailure.

Application of contrast agent injection device in real-time threedimensional hysterosalpingo-contrast sonography

Objective:To investigate the correlation between the peak pressure of contrast agent injection and tubal patency during real-time three-dimensional hysterosalpingo-contrast sonography.Methods:Seventy female patients who underwent real-time three-dimensional hysterosalpingo-contrast sonography of uterine and oviduct in the department of ultrasound medicine in our hospital were selected to measure the peak pressure in the examination process through the pressure injection device of contrast agent,to compare the pressure differences of different obturability patency degree of oviduct,and to draw a ROC curve to determine the optimal cut-off value of the peak pressure.Results:According to the different patency degree of fallopian tubes,the contrast results were divided into three groups:bilateral tubes unobstructed group,unilateral tube lesioned group and bilateral tubes lesioned group.The peak pressures of the three groups were(34.69±9.30)KPa,(52.71±18.55)KPa and(73.88±11.01)KPa,respectively.The area under the peak pressure ROC curve(AUC)of the"unilateral tube lesioned group"and"bilateral tubes lesioned group"was 0.785,the optimal cut-off value of the peak pressure was 51.90KPa,the area under the peak pressure ROC curve(AUC)of the"unilateral tube lesioned group"and"bilateral tubes lesioned group"was 0.851,and the optimal cut-off value of the peak pressure was 73.50KPa.Conclusion:The peak pressure of contrast agent injection in RT-3D-HyCoSy can be used as a quantitative index to deduce the patency degree of oviduct.There is a correlation between the peak pressure and the tubal patency.

Study on the Mechanism of Qingre Huoxue Prescription in the Intervention and Treatment of Acute Myocardial Infarction Based on Network Pharmacology

Objective:The objective is to study the mechanism of Qingre Huoxue prescription in the intervention and treatment of acute myocardial infarction(AMI)based on the method of network pharmacology.Materials and Methods:Five databases were used to screen the chemical compounds and targets of Ligusticum wallichii(chuanxiong),Radix Paeoniae Rubra(chishao),Lignum acronychiae(jiangxiang),Safflower(honghua),Salvia miltiorrhiza(danshen),Scutellaria baicalensis(huangqin),and Ilex pubescens(mao dong qing)in Qingre Huoxue prescription.Furthermore,Cytoscape-V3.2.1 software was used to construct the drug-component-target network.Functional protein association networks'database and the Database for Annotation,Visualization,and Integrated Discovery(DAVID)were used to visualize the protein interaction,pathway enrichment,and analysis.Results:A total of 44 active ingredients were screened out in Qingre Huoxue prescription.Among them,178 targets and 41 compounds related to Qingre Huoxue prescription's function in treating AMI were obtained.After the analysis of the drug-component-action target network on Qingre Huoxue prescription,14 key compounds and nine key targets with three scores above average were obtained.In addition,pathway enrichment and biological processes were conducted with the aid of the DAVID;and 8 related pathways and 10 biological processes were associated with AMI and related diseases;the PI3 K-AKT signaling pathway,MAPK signaling pathway,and HIF-1 signaling pathway are the main pathways of Qingre Huoxue prescription for the treatment of AMI and related diseases.Conclusion:Qingre Huoxue prescription could treat AMI by multiple components,targets,and pathways.This study provides ideas and theoretical basis for further clinical studies on Qingre Huoxue prescription in treating AMI.