The importance of inspection in clinical cardiology: Frank's sign

The Frank''s sign (FS) is a diagonal earlobe crease running from the tragus to the edge of the auricle. In this case, we describe a 71 years‐old male patient with FS who presented to the emergency department complaining of epigastric pain. A non‐ST elevation myocardial infarction was diagnosed.     

Variable Genomic Landscapes of Advanced Melanomas with Heavy Pigmentation

BackgroundIn the current study, we examined the real-world prevalence of highly pigmented advanced melanomas (HPMel) and the clinicopathologic, genomic, and ICPI biomarker signatures of this class of tumors.Materials and MethodsOur case archive of clinical melanoma samples for which the ordering physician requested testing for both PD-L1 immunohistochemistry (IHC) and comprehensive genomic profiling (CGP) was screened for HPMel cases, as well as for non-pigmented or lightly pigmented advanced melanoma cases (LPMel).ResultsOf the 1268 consecutive melanoma biopsies in our archive that had been submitted for PD-L1 IHC, 13.0% (165/1268) were HPMel and 87.0% (1103/1268) were LPMel. In the HPMel cohort, we saw a significantly lower tumor mutational burden (TMB, median 8.8 mutations/Mb) than in the LPMel group (11.4 mut/Mb), although there was substantial overlap. In examining characteristic secondary genomic alterations (GA), we found that the frequencies of GA in TERTp, CDKN2A, TP53, and PTEN were significantly lower in the HPMel cases than in LPMel. A higher rate of GA in CTNNB1, APC, PRKAR1A, and KIT was identified in the HPMel cohort compared with LPMel.ConclusionsIn this study, we quantified the failure rates of melanoma samples for PD-L1 testing due to high melanin pigmentation and showed that CGP can be used in these patients to identify biomarkers that can guide treatment decisions for HPMel patients. Using this practical clinical definition for tumor pigmentation, our results indicate that HPMel are frequent at 13% of melanoma samples, and in general appear molecularly less developed, with a lower TMB and less frequent secondary GA of melanoma progression.     

Evaluation of the anti-proliferative properties of selected psoriasis-treating Chinese medicines on cultured HaCaT cells

Psoriasis is a chronic inflammatory skin disorder, which affects approximately 2-3% of the population worldwide. The current conventional therapy cannot offer satisfactory clinical results for most of the patients, largely due to the fact that many anti-psoriatic drugs have serious side effects and psoriasis is prone to developing drug resistance after long term exposure. Traditionally, Chinese herbal medicine has been extensively used to treat psoriasis and produced promising clinical results; however, its underlying mechanisms of action have not been systematically investigated. The aim of this study was to investigate those Chinese medicinal materials, which are commonly prescribed in Chinese medicine practice for psoriasis, for their anti-proliferative effects on HaCaT cells in vitro. Sixty Chinese medicinal materials were selected and extracted with 80% aqueous ethanol. The dry extracts were evaluated for their anti-proliferative activities by microplate SRB and MTT assays. Three Chinese medicinal materials i.e. the root of Rubia cordifolia L. (Rubiaceae), Realgar and the rhizome of Coptis chinensis Franch. (Ranunculaceae) were found to have significant anti-proliferative effects, with IC(50) being 1.4, 6.6 and 23.4 microg/ml, respectively as measured by MTT assay. While Realgar was also able to modestly inhibit the growth of Hs-68 cells in vitro, Rubia cordifolia and Coptis chinensis did not exert cytotoxicity to this human fibroblast cell line.     

奇乳海参中两个具有抗真菌活性的三萜皂苷

目的：研究奇乳海参体内的化学成分，寻找结构新颖具有抗真菌活性的三萜皂苷类成分。方法：应用多种色谱分离技术对奇乳海参体内的化学成分进行分离纯化，根据化合物的理化性质，波谱数据及化学方法鉴定其结构。结果：分离得到2个三萜皂苷化合物，分别为axilogoside A（1）和holothurin B（2），并对其抗真菌活性进行了研究（4≤MIC80≤16μg·mL^-1）。结论：化合物1为一新的三萜皂苷化舍物，化合物2为首次从奇乳海参中分离得到，它们均显示一定的抗真菌活性。