Therapy-related B-lymphoblastic leukemia (B-ALL) following treatment for multiple myeloma is a rare occurrence. Despite its rarity and the lack of recognition by the World Health Organization as a distinct disease entity, previous publications indicate its possible emergence following myeloma treatment.

The patient is a 65-year-old gentleman with a history of IgG kappa multiple myeloma, status post multiple lines of therapy. The patient presented with a fever, and a complete blood count showed cytopenia. Bone marrow morphologic evaluation revealed numerous blasts. Immunophenotypic analysis demonstrated that these blasts were B lymphoblasts, despite MYC and unusual surface kappa light chain expression. A diagnosis of B-ALL with surface kappa light chain expression post-myeloma treatment was made. Ancillary studies indicated that the B-ALL and the previous myeloma were clonally unrelated. Next-generation gene sequencing revealed pathogenic mutations in KDM6A and KRAS.

This case highlights the potential for therapy-related B-ALL following myeloma treatment, a phenomenon deserving further investigation. The expression of surface light chain in blasts can present a diagnostic pitfall.

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy characterized by distinct histological subtypes and a poor prognosis. Among these, the micropapillary pattern, typically observed focally, has been associated with worse outcomes in various cancers. This study aimed to evaluate the prognostic significance of the micropapillary pattern in PDAC, focusing on its percentage within the tumor and its impact on overall survival.

A retrospective analysis was conducted on 71 patients with surgically resected PDAC. Micropapillary patterns were categorized based on their percentage within the tumor (≥20%) and compared to non-micropapillary cases. Demographic, clinical, and histological data, including tumor nodule metastasis stage, tumor grade, peripancreatic fat tissue invasion, and resection margin status, were analyzed. Survival data were assessed using Kaplan-Meier and Cox proportional hazards models. A p-value < 0.05 was considered statistically significant.

The cohort included 28 female and 43 male patients, with a mean age of 63.25 years. Of the 71 cases, 23.9% (n = 17) exhibited a micropapillary pattern. The median overall survival for the micropapillary group was eight months, compared to 18 months for the non-micropapillary group (p = 0.017). Multivariate analysis revealed that the micropapillary group had an increased risk of mortality (hazard ratio = 1.892, p = 0.042), independent of tumor nodule metastasis stage.

Our findings indicate that the micropapillary pattern, even when present in as little as 20% of the tumor, serves as an independent prognostic factor for decreased survival in PDAC. Incorporating the percentage of the micropapillary pattern into pathology reports could provide valuable insights into the tumor’s biological behavior, potentially enhancing patient management strategies.

In recent years, it has been found that Lycium barbarum can repair liver damage and promote liver regeneration. Additionally, the polysaccharides contained in Lycium barbarum have anticancer properties and can induce apoptosis in cancer cells. Molecular docking, a mature computer-aided method, is widely used in drug discovery. This study aimed to verify the efficacy of active ingredients of Lycium barbarum in the treatment of liver cancer by molecular docking.

The effect of the active ingredients of Lycium barbarum in the treatment of liver cancer was verified by molecular docking, based on a previous study that examined the impact of Lycium barbarum on liver cancer using network pharmacology.

The binding energies of the key active ingredients and core targets were all less than −5.0 kcal/mol (1 kcal = 4.184 J), with most of them being less than −7.0 kcal/mol. This indicates that the key active ingredients and core targets have good binding ability, with most demonstrating strong binding affinity.

Most of the active ingredients in wolfberry can spontaneously bind to the core target protein, thereby playing a therapeutic role in liver cancer.

Ginseng, a traditional Chinese medicinal herb, has been used for centuries to enhance vitality and overall well-being. This review synthesizes multiple studies to summarize the latest discoveries on the immunoregulatory effects of ginseng, its role in improving patients’ quality of life, and new evidence of its antitumor properties. It concludes that ginseng and its extracts can improve patients’ quality of life and may have the potential to target tumor cells. Meanwhile, ginseng extracts significantly improve sub-health status, with an 85% improvement rate observed in young adults after 30 days of intervention. This review provides valuable new evidence for ongoing research on ginseng and its extracts.

This study investigates upper gastrointestinal tract (UGIT) involvement in patients with ulcerative colitis (UC), a condition traditionally considered limited to the colon. Although extra-colonic manifestations of UC are well recognized, UGIT issues have received less attention. This research aimed to document the clinical, endoscopic, and histopathological UGIT findings in adults with UC and assess their association with disease severity and extent.

This descriptive cross-sectional study was conducted at Ain Shams University over one year. A total of 78 UC patients underwent comprehensive clinical evaluations, including assessments of gastrointestinal complaints, medication history, disease progression, surgeries, and physical examinations. Endoscopic assessments of both the UGIT and colon were performed, accompanied by biopsies for histopathological analysis.

The study population had a mean age of 35.26 years, with a nearly equal gender distribution. Endoscopic findings revealed significant UGIT involvement: 64% of patients had esophagitis and/or gastroesophageal reflux disease, 93% had gastritis, and 80% had duodenitis. Histopathological findings showed notable inflammation, basal cell hyperplasia, and ulcerations in the esophagus, with 51.3% of patients exhibiting chronic gastritis and 38.5% testing positive for Helicobacter pylori infection. Statistical analysis demonstrated a strong association between colonic disease severity and UGIT endoscopic (p < 0.0001 and p < 0.001 in the esophagus and stomach, respectively) and histopathological (p < 0.004, p < 0.001, and p <0.005 in the esophagus, stomach, and duodenum, respectively) findings, particularly in patients with UGIT symptoms.

This study concludes that UGIT endoscopic and histopathological changes are prevalent among Egyptian UC patients, suggesting a significant link between UC and these UGIT findings.

Brain metastases from ovarian cancer (BMFOC) are rare but associated with poor prognosis. This study aimed to evaluate the efficacy and safety of Gamma Knife stereotactic radiosurgery (GKSRS) in managing patients with BMFOC.

A retrospective analysis was conducted on 22 patients with BMFOC who were treated with GKSRS between January 2015 and May 2019. The median age at the start of treatment was 57.7 years (range, 46–72 years). A total of 70 brain metastases were treated, with each patient having between one and nine metastatic tumors. The mean tumor volume was 3.6 cm3 (range, 0.1–22.7 cm3). The mean peripheral dose was 16 Gy (range, 7–20 Gy), and the mean isodose curve was 54.6% (range, 45–80%).

At 12 months post-GKSRS, 68 metastatic tumors were assessed: 32 (47.1%) showed complete response, 20 (29.4%) had partial response, 14 (20.6%) remained stable, and two (2.9%) progressed, leading to a tumor control rate of 97.1%. No acute or chronic toxicity was observed.

GKSRS appears to be an effective and well-tolerated treatment for BMFOC, offering high tumor control rates and prolonged survival in selected patients.

Patients with cirrhosis are at an increased risk of bacterial infection (BI), which is the most common precondition for acute-on-chronic liver failure (ACLF). In this study, we aimed to evaluate the ability of mitochondria-related indicators (mitochondrial mass and mitochondrial membrane potential (MMP)) of T cells in peripheral blood to predict BI and ACLF within 90 days in cirrhotic patients.

We prospectively studied mitochondria-related indicators in various T cells from 235 cirrhotic patients at the Second Hospital of Nanjing. The outcomes of interest were BI and ACLF.

The restricted cubic spline analysis showed that the MMP of CD8+ T cells had a linear relationship with the risk of BI and ACLF (both P < 0.001). Multivariable Cox regression analysis demonstrated that the MMP of CD8+ T cells was an independent risk factor for both BI and ACLF (BI: hazard ratio 0.96, 95% confidence interval 0.94–0.98; P < 0.001; ACLF: hazard ratio 0.94, 95% confidence interval 0.90–0.97; P < 0.001). The MMP of CD8+ T cells exhibited better diagnostic efficacy than traditional indices in predicting BI (C index: 0.75). The MMP of CD8+ T cells, when combined with traditional models (Child-Turcotte-Pugh and model for end-stage liver disease score), improved their diagnostic efficiency in predicting both BI and ACLF. Additionally, the MMP of CD8+ T cells showed a significant negative correlation with inflammation-related markers (P < 0.05). Mitochondrial damage and abnormally activated mitochondrial autophagy were observed in CD8+ T cells from cirrhotic patients with low MMP.

The MMP of CD8+ T cells could serve as a valuable predictor of BI and ACLF within 90 days in cirrhotic patients.

Acetaminophen (APAP) is one of the most commonly used analgesic and antipyretic medications and is generally considered safe at therapeutic doses. However, overdose remains a leading cause of acute liver failure, primarily characterized by centrilobular (zone 3) hepatic necrosis, oxidative stress, mitochondrial dysfunction, and sterile inflammation. The hepatotoxic effects of APAP are localized to the centrilobular region, where cytochrome P450 2E1 is highly expressed. Cytochrome P450 2E1 catalyzes the conversion of APAP to a toxic metabolite, N-acetyl-p-benzoquinone imine. During overdose, the liver’s detoxification capacity is overwhelmed and excess N-acetyl-p-benzoquinone imine binds to cellular proteins, initiating oxidative stress and mitochondrial injury that culminate in hepatocyte death. A central component of APAP-induced hepatotoxicity is the activation of innate immune responses, particularly via inflammasome pathways. Inflammasomes are cytosolic multiprotein complexes that detect cellular damage and trigger inflammation. Among these, the NOD-, LRR-, and pyrin domain-containing 3 (NLRP3) inflammasome plays a significant role in APAP-induced liver injury. Upon activation, the NLRP3 inflammasome promotes autocatalytic cleavage of procaspase-1 into its active form, caspase-1, which subsequently processes the pro-inflammatory cytokines pro-interleukin-1β and pro-interleukin-18 into their mature forms. These cytokines recruit additional immune cells and amplify liver inflammation, exacerbating tissue injury. Thus, the NLRP3 inflammasome serves as a key mechanistic link between the initial toxic insult and the ensuing inflammatory response in APAP hepatotoxicity. This review aimed to explore the molecular mechanisms underlying APAP-induced liver injury, particularly inflammasome activation, and evaluate the current and emerging therapeutic strategies.

Coronary heart disease is an ischemic condition characterized by vascular stenosis or obstruction caused by coronary atherosclerosis, resulting in myocardial ischemia, hypoxia, or necrosis. It is one of the leading causes of death in both urban and rural populations in China. Safflower yellow pigments, the main active components of the traditional Chinese herbal medicine safflower, are primarily composed of quinochalcone compounds, including hydroxysafflor yellow A and anhydrosafflor yellow B—of which hydroxysafflor yellow A is the principal component. Studies have demonstrated that these pigments can improve myocardial ischemia, reduce ischemia-reperfusion injury, alleviate atherosclerotic damage, and address risk factors associated with coronary heart disease. This review aimed to systematically and comprehensively summarize the mechanisms of action of safflower yellow pigments and their active components in the context of coronary heart disease and its related risk factors.