Distinct lipid profile in haemolytic anaemia-related gallstones compared with the general gallstone.

BACKGROUND: Pigment gallstones are not uncommon among patients with chronic haemolytic anaemia. But their clinical characteristics have not been described in detail and not been directly compared with the general gallstone population. METHODS: Patients at Peking Union Medical College Hospital with haemolytic anaemia and subsequent gallstones from January 2012 to December 2022 were included. Cases were matched (1:2) based on age, sex and location of stones to randomly select non-anaemia patients with gallstones (controls). RESULTS: Screening 899 cases of gallstones, we finally included 76 cases and 152 controls. Total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) for cases were 3.02 ± 0.98 mmol/L, 0.89 ± 0.30 mmol/L and 1.58 ± 0.70 mmol/L, respectively, significantly lower than those in the control group (all p < 0.001). TC and HDL were both lower than the normal range, but triglyceride and LDL were within the normal range. Multiple stones were significantly more common for cases (n = 59, 78%) than for controls (n = 44, 29%, p < 0.001). The mean diameter of the maximal gallstone was 1.2 ± 0.6 cm and 1.5 ± 1.0 cm for cases and controls (p = 0.120), respectively. Stones in the elderly (p = 0.002 for univariate analysis, and 0.001 for multivariate analysis) and stones in the bile duct (p = 0.005 for univariate analysis, and 0.009 for multivariate analysis) were found to occur in a shorter period after anaemia. CONCLUSION: The lipid profile of haemolytic anaemia with gallstones was distinct, low TC, low HDL, and increased-to-normal LDL, compared with the general gallstone population. Patients with haemolytic anaemia were recommended an abdominal ultrasound if aged older than 50 years, with more frequent follow-up visits.KEY MESSAGESClinical characteristics of gallstones following chronic haemolytic anaemia were described and compared with the general gallstone population.The lipid profiles were distinctly different between the patients with gallstones following chronic haemolytic anaemia and the general gallstone population.Elder patients were complicated with gallstones in a shorter period after anaemia and thus were recommended an abdominal ultrasound if aged older than 50 years, with more frequent follow-up visits.

Presumed radiological diagnosis of solid pseudopapillary tumors: do we really know what we are watching?

OBJECTIVES: Little is known about the clinicians' ability to ascertain the identity of a pancreatic lesion as solid pseudopapillary tumors (SPT)preoperatively. We led this retrospective study to figure out the disease spectrum that mimic SPT, the key features of SPT and the accuracy of CT and MRI in characterizing them. METHODS: Radiological and clinical database at a tertiary pancreatic disease center (Peking Union Medical College Hospital) was searched for patients who received CT or MRI with a presumed radiological diagnosis of SPT. Those patients' clinical information and final pathological diagnosis were collected. RESULTS: During 2018.10-2021.12, 200 patients had a presumed radiological diagnosis of SPT, and 132 of them had unambiguous pathological diagnosis. SPT were confirmed in only 63.6% (84/132), while the others had a variety of neoplastic and nonneoplastic lesions, including pancreatic neuroendocrine tumors (n = 15), pseudocysts (n = 4), mucinous cystic neoplasms (n = 4), serous cystadenomas (n = 3), neural sheath tumors (n = 3), lymphoepithelial cysts (n = 2), and several very rare pathologies (n = 17). Of note, 11.4% (15/132) of those were benign or nonneoplastic lesions, while 6.8% (9/132) were neoplasms with highly aggressive nature, or pancreatic metastases, which require systematic evaluation and staging instead of upfront surgery. Retrospective radiological analysis based on key imaging features, clinical history and laboratory findings had an improved diagnostic accuracy of 78.5% with CT and 77.8% with MRI. CONCLUSIONS: There is a broad disease spectrum mimicking SPT at CT and MRI. Key imaging features, clinical information and laboratory findings must be integrated to improve the diagnostic accuracy.

[Gene cloning and sequencing of chicken anemia virus(CAV) isolated from Harbin].

A Chicken anemia virus has been isolated from a chicken flock in Harbin of China. The genome of the ivrus was cloned through polymerase chain reaction(PCR) and sequence of the genome was analyzed. The cycle genome is made of 2298 base pairs including three overlapping open reading frames(vp1, vp2, vp3) and a regulative region. Comparing sequence of the genome through BLAST in GenBank, this sequence exhibits 96.9% identity with other genome of CA Vs and least. Multiple alignment of this genome of this virus, 26p4, strain isolated in Germany, strain isolated in Malaysia and Cux-1 found that this sequence exhibits 98.2% (42/2298), 98.2% (42/2298), 96.9% (72/2298) and 97.5% (60/2319) identify with them, respectively. A new CAV strain was isolated and it has better identify with CAV isolated in Europe countries than is Asia country Malaysia. Multiple alignment of VP1, VP2, VP3 of 26p4, strain isolated in Germany, strain isolated in Malaysia, Cux-1 and strain isolated in Harbin of China found the VP2 the most conservative.