Postgraduate Medical Journal最新文献

{"title":"Genetic causality of circulating inflammatory proteins and plasma metabolites in coronary atherosclerosis.","authors":"Runji Chen, Daifei Shen, Shiwan Wu, Yanhong Zhang, Shu Ye","doi":"10.1093/postmj/qgaf145","DOIUrl":"https://doi.org/10.1093/postmj/qgaf145","url":null,"abstract":"<p><strong>Background: </strong>Coronary atherosclerosis is a leading cause of cardiovascular disease and death worldwide. Despite progress in understanding its pathogenesis, the roles of circulating inflammatory proteins and plasma metabolites are complex and not fully elucidated. Existing Mendelian randomization (MR) studies often target isolated biomarkers, lacking comprehensive and mechanistic insights. This study uses MR to clarify the genetic causal relationships between circulating inflammatory proteins, plasma metabolites, and coronary atherosclerosis, and to explore potential mediation pathways.</p><p><strong>Methods: </strong>Two-sample MR identified causal associations, while mediation analysis assessed whether plasma metabolites mediate the effects of inflammatory proteins on coronary atherosclerosis. Sensitivity analyses included Cochrane's Q test and MR-Egger intercept.</p><p><strong>Results: </strong>Our analysis identified 11 circulating inflammatory proteins and 102 plasma metabolites associated with coronary atherosclerosis. Additionally, the genetic variants associated with elevated levels of eukaryotic translation initiation factor 4E-binding protein 1 (OR = 1.0590, 95% CI: 1.0050-1.1170) were found to increase the risk of coronary atherosclerosis through modulation of octadecanedioate and octadecanedioylcarnitine (C18-DC) levels, while leukemia inhibitory factor receptor (OR = 0.9400, 95% CI: 0.8890-0.9930)-associated variants reduced its risk through modulation of campesterol levels. Mediation analyses revealed that octadecanedioate levels (Mediated pro-portion = 18.5%), C18-DC levels (Mediated proportion = 21.6%) and campesterol levels (Mediated proportion = 26.7%) mediated these effects.</p><p><strong>Conclusions: </strong>This study provides new insights into the genetic and metabolic mechanisms underlying coronary atherosclerosis, extending beyond traditional biomarkers. The findings highlight potential therapeutic targets of coronary atherosclerosis and related metabolic disorders. Key messages What is already known on this topic: Coronary atherosclerosis, a leading cause of cardiovascular disease, has been linked to inflammatory proteins and plasma metabolites. However, the complexity of these relationships, particularly the genetic and metabolic mechanisms underlying the disease, remains poorly understood. Existing studies have largely focused on individual biomarkers and their associations with atherosclerosis, lacking comprehensive assessments and insights into potential mediation pathways. What this study adds: This study utilizes Mendelian randomization to identify genetic causal relationships between 11 circulating inflammatory proteins and 102 plasma metabolites with coronary atherosclerosis. It provides novel insights into the mediation roles of metabolites like octadecanedioate, C18-DC, and campesterol in the disease's progression. How this study might affect research, practice, or policy: By uncovering geneti","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective study on Mohs micrographic surgery combined with adjuvant radiotherapy in the treatment of extramammary Paget's disease: analysis of 87 patients.","authors":"Min Zhang, Xianshu Gao, Tianjing Gao, Hang Li, Xueqing Sheng, Mengmeng Su, Chenghao Jia","doi":"10.1093/postmj/qgaf109","DOIUrl":"https://doi.org/10.1093/postmj/qgaf109","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective study assessed the effectiveness of Mohs micrographic surgery (MMS) combined with adjuvant radiotherapy for the treatment of extramammary Paget's disease (EMPD).</p><p><strong>Methods: </strong>This retrospective study included 87 patients with pathologically confirmed EMPD and complete follow-up data who were treated at the Radiation Therapy Department of Peking University First Hospital between January 2012 and December 2021. The surgical approach for the primary lesion involved MMS, followed by postoperative radiotherapy with doses ranging from 50 to 60 Gy administered over 25-30 fractions. Lymph node dissection was performed on selected patients exhibiting clinical lymphatic metastasis. The primary endpoint of this study was the disease-specific survival (DSS) rate, while secondary endpoints included local recurrence-free survival (LRFS). Survival rates were calculated using the Kaplan-Meier method and statistically analyzed using the log-rank test.</p><p><strong>Results: </strong>The study population comprised 78 men and 9 women. The median age was 65 years (range: 44-84). The median follow-up period was 71 months (range: 5-139). The 1-, 3-, 5-, and 10-year DSS rates were 99%, 95%, 92%, and 92%, respectively. The LRFS rates at 1, 3, 5, and 10 years were 100%, 100%, 97%, and 94%, respectively. The LNM rates at 1, 3, 5, and 10 years were 1.1%, 2.3%, 5.7%, and 5.7%, respectively. The DM rates at 1, 3, 5, and 10 years were 1.1%, 5.7%, 8.0%, and 9.2%, respectively.</p><p><strong>Conclusion: </strong>The combination of MMS and adjuvant radiotherapy offers excellent local control in the treatment of extramammary Paget's disease. Key messages What is already known on this topic: Surgical excision is the established primary treatment for extramammary Paget's Disease (EMPD). However, the role of adjuvant radiotherapy in improving outcomes was not definitively established. What this study adds: This study provides robust evidence that adjuvant radiotherapy combined with surgical excision significantly improves local disease control rates in EMPD compared to surgery alone. How this study might affect practice: These findings strongly support the integration of adjuvant radiotherapy into the standard management paradigm for EMPD, particularly for cases with risk factors for local recurrence.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foundation allocation for underserved areas.","authors":"Waqas Hussain, Kirsty Alexander, Chris Isles","doi":"10.1093/postmj/qgaf148","DOIUrl":"https://doi.org/10.1093/postmj/qgaf148","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging surveillance after breast cancer: is it time for risk-stratification?","authors":"Gaurav Jyoti Bansal, Harshita Agarwal","doi":"10.1093/postmj/qgaf149","DOIUrl":"https://doi.org/10.1093/postmj/qgaf149","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new non-invasive detector for coronary microvascular dysfunction: exercise stress high-frequency QRS electrocardiogram.","authors":"Jianyuan Pan, Ming Liu, Dan Li, Siteng Wang, Zhewen Wang, Jinsheng Hua, Xiangyong Kong, Hongwu Chen, Yitong Ma, Hao Hu, Likun Ma","doi":"10.1093/postmj/qgaf131","DOIUrl":"10.1093/postmj/qgaf131","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the diagnostic value of the exercise stress high-frequency QRS (HFQRS) electrocardiogram in coronary microvascular dysfunction.</p><p><strong>Methods: </strong>We consecutively enrolled patients aged 20 years or older with chest pain between January 2022 and January 2024, all of them underwent HFQRS analysis and coronary angiography. The sensitivity, specificity, and positive predictive value of HFQRS for predicting coronary microcirculatory dysfunction were calculated using coronary angiography-based microvascular resistance (caIMR) ≥25.1 as the gold standard for determining coronary microcirculatory dysfunction. We used the area under the ROC curve (AUC) to evaluate the predictive accuracy of HFQRS and the diagnostic value of exercise HFQRS for coronary microvascular dysfunction (CMVD).</p><p><strong>Results: </strong>A total of 139 patients were included. We found a moderate correlation between the caIMR values and the number of positive HFQRS leads. (R = 0.757, P < .001). Multifactorial logistic regression analysis showed that the number of positive leads on the HFQRS was an independent predictor of caIMR (9.17, CI 1.02-82.73, P = .048). The area under the ROC curve for the prediction of caIMR by the number of positive HFQRS leads was 0.81 (95% CI 0.73-0.89). The sensitivity, specificity, negative predictive value, and positive predictive value of HFQRS for the prediction of coronary microcirculatory dysfunction were 0.686, 0.971, 0.986, and 0.500, respectively.</p><p><strong>Conclusions: </strong>Our study found that exercise HFQRS is an important predictor of coronary microvascular disease, that there is a correlation between the number of positive exercise HFQRS leads and CMVD, and that exercise stress HFQRS is a noninvasive and reliable indicator for the diagnosis of CMVD.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144965990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Path to parenthood for medical residents and fellows: the impact of leave policies on parent trainees at Oregon Health and Science University.","authors":"Eline Lenne, Marie Soller, Gillian Lashen, Stephanie Dukhovny, Alinda Reimer, Susanne Klawetter, Emily Carter","doi":"10.1093/postmj/qgaf124","DOIUrl":"10.1093/postmj/qgaf124","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Residents and fellows in graduate medical education (GME) programs across the USA often complete training during childbearing years, presenting challenges for pregnant and parenting trainees balancing work and family. Institutional policies must better support these trainees. Previous studies show supported trainees experience reduced burnout, better health, and improved patient outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study assessed the experiences and unmet needs of pregnant and parenting GME trainees and presents their recommendations for improved support.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Using a sequential explanatory mixed-methods design, we examined the unmet needs and challenges of pregnant and parenting trainees, and their recommendations for improvement. We distributed a survey to all GME trainees across all specialties at Oregon Health and Science University (OHSU) in 2023. Ninety-eight out of 160 eligible participants completed the survey (~60% response rate).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Despite existing policies, trainees at Oregon Health and Science University faced persistent challenges. We identified three themes and related recommendations from our analysis of quantitative and open-ended survey data: (1) Leave and coverage-barriers to adequate parental leave and inconsistent enforcement of GME policies; [2] Lactation-meeting breast/chest-feeding goals required immense effort due to limited resources; and [3] Health and childcare-existing policies negatively impacted fertility, childcare access, and mental health. Respondents recommended standardized, flexible leave policies; transparent processes for work adjustments and planning; improved access to private, well-equipped lactation spaces; and tailored mental health and wellness programs to support the perinatal period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Barriers persist for trainees starting families. Institutional leaders have actionable opportunities to improve equity and institutional support of parenting trainees. Key messages What is already known on this topic: GME trainees face significant challenges during childbearing years, including inconsistent parental leave policies, limited institutional support, and increased risk of stress and burnout, which negatively impact their health and patient-care outcomes. What this study adds: This study contributes trainees' recommendations for institutional reforms necessary to address persistent gaps in support for parenting trainees, such as insufficient parental leave, inadequate lactation accommodations, and barriers to mental health care. How this study might affect research, practice, or policy: Incorporating trainee perspectives is crucial to developing effective interventions. Institutions and national standards should prioritize equitable parental leave, flexible scheduling, and comprehensive supports to foster a culture that aligns with trainees' personal and professional goals. Re","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144965954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning models based on adipocyte fatty acid-binding protein help predict the chronic and lethal outcomes of patients with drug-induced liver injury.","authors":"Haoshuang Fu, Shuying Song, Hong Zhao, Bingying Du, Yaoxing Chen, Yuelin Xiao, Xinya Zang, Rongtao Lai, Ruidong Mo, Yan Huang, Tianhui Zhou, Qing Xie","doi":"10.1093/postmj/qgaf142","DOIUrl":"https://doi.org/10.1093/postmj/qgaf142","url":null,"abstract":"<p><strong>Purpose: </strong>Some patients with drug-induced liver injury (DILI) would progress into chronicity or lethal. Although adipocyte fatty acid-binding protein (AFABP) is essential in liver diseases, its role in DILI is unknown. We aimed to investigate their association and construct predictive models for chronic/lethal DILI using machine learning.</p><p><strong>Methods: </strong>DILI patients (n = 331) were enrolled and categorized into recovery (n = 213), chronicity (n = 89), or death/liver transplantation (LT) group (n = 29) based on 6-month follow-up. ELISA and immunohistochemistry were used to determine serum and hepatic AFABP levels, respectively. Patients were randomly divided into training (70%) and validation (30%) cohorts. Machine learning models were constructed for chronic and death/LT outcomes based on serum AFABP. Furthermore, the performance of previous models and constructed models were evaluated for predicting death/LT outcome.</p><p><strong>Results: </strong>The AFABP level was associated with the progression of DILI patients, whatever in serum or liver. The Extreme Gradient Boosting model presented the best predictive performance for chronic DILI, with the AUROC of 0.87 (95%CI = 0.82-0.91) in training cohort and AUROC of 0.90 (95%CI = 0.82-0.95) in validation cohort. The logistic regression model presented the best predictive performance for death/LT outcome, with the AUROC of 0.90 (95%CI = 0.85-0.94) in training cohort and AUROC of 0.92 (95%CI = 0.83-0.96) in validation cohort. Furthermore, it showed better predictive performance for death/LT outcome than previous models.</p><p><strong>Conclusion: </strong>Serum AFABP level was associated with DILI progression, and machine learning models based on AFABP accurately predicted DILI outcomes, potentially assisting clinical management. Key messages What is already known on this topic: The chronic and lethal drug-induced liver injury (DILI) harms human health. Although adipocyte fatty acid-binding protein (AFABP) is essential in liver diseases, its role in DILI is unknown. We aimed to investigate their association and construct predictive models for chronic/lethal DILI using machine learning. What this study adds: The AFABP was associated with the progression of DILI patients, whatever in serum or liver. The Extreme Gradient Boosting model presented the best predictive performance for chronic DILI. The logistic regression model presented the best predictive performance for lethal DILI. Furthermore, it showed better predictive performance for lethal DILI than previous models. How this study might affect research, practice, or policy: We demonstrated that serum AFABP level was associated with the progression of DILI, and constructed accurate machine learning models to predict DILI outcomes based on serum AFABP, which could assist the clinical management of DILI patients.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144965956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the role of cathepsins in depression: a Mendelian randomization study.","authors":"Guifeng Zhuo, Wei Chen, Fengsheng Xu, Xiaomin Zhu, Jinzhi Zhang, Mingyang Su, Yulan Fu, Xiangyi Chen, Lin Wu","doi":"10.1093/postmj/qgaf104","DOIUrl":"https://doi.org/10.1093/postmj/qgaf104","url":null,"abstract":"<p><strong>Objective: </strong>Depression is a prevalent psychological disorder involving complex pathogenesis mechanisms. Cathepsins may play a significant role in the pathogenesis of depression, yet the exact impact of cathepsins on the risk of developing depression remains unclear. The objective of this research was to examine the cause-and-effect link between cathepsins and the susceptibility to depression through the application of Mendelian randomization (MR) techniques.</p><p><strong>Methods: </strong>Univariate MR, bidirectional MR, and multivariable MR were employed to study this causal relationship. Additionally, horizontal pleiotropy, heterogeneity, and sensitivity assessments were performed on the results obtained from MR.</p><p><strong>Results: </strong>The univariate MR analysis indicated that elevated levels of cathepsin S increase the risk of depression. Conversely, the reverse MR analysis showed no causal relationship between depression, serving as an exposure dataset, and nine types of cathepsins. The multivariable MR analysis, based on nine types of cathepsins, revealed that increased expression levels of cathepsin S and F are associated with an increased risk of depression.</p><p><strong>Conclusion: </strong>A positive causal relationship has been identified between cathepsin S and cathepsin F and the risk of depression. Consequently, individuals exhibiting elevated levels of cathepsin S and F should be vigilant regarding their mental health to mitigate the potential risk of developing depression in the future. Key message What is already known on this topic Depression is a prevalent psychological disorder involving complex pathogenesis mechanisms. Cathepsins may play a significant role in the pathogenesis of depression, yet the exact impact of cathepsins on the risk of developing depression remains unclear. What this study adds This study presents the inaugural univariate and multivariate Mendelian randomization analysis examining the association between cathepsins and depression, identifying a positive causal relationship between cathepsins S and F and the risk of developing depression. How this study might affect research, practice, or policy Individuals exhibiting elevated levels of cathepsin S and F should prioritize monitoring their mental health to mitigate the potential risk of developing depression in the future.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mind of artificial intelligence and machine-a fact or fiction?","authors":"Souvik Dubey, Subhankar Chatterjee, Ritwik Ghosh, Samya Sengupta, Mahua Jana Dubey","doi":"10.1093/postmj/qgaf140","DOIUrl":"https://doi.org/10.1093/postmj/qgaf140","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144965988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and pathological features of 209 cases of pilomatricoma in children: a retrospective study.","authors":"Zishang Guo, Hailin Wang, Pengjie Wan, Huan He, Zhuo Chen, Dan Deng","doi":"10.1093/postmj/qgaf139","DOIUrl":"https://doi.org/10.1093/postmj/qgaf139","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Pilomatricoma, albeit benign, may have a potential impact on children's appearance and health. Clinical practice has revealed variations in the clinical manifestations, anatomical locations, and sizes of pilomatricoma among different pediatric patients. However, few studies have comprehensively summarized the correlations between these features and treatment efficacy, which is crucial for enhancing clinicians' understanding and diagnostic accuracy of the disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to comprehensively analyze the clinical characteristics, ultrasonographic and pathological features, and treatment outcomes of pilomatricoma in Chinese pediatric patients at a single pediatric dermatology surgery center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective study was conducted on the medical histories of 209 Chinese children who underwent surgical excision with subsequent pathological confirmation of pilomatricoma at Shanghai Children's Medical Center between January 2023 and January 2024. We carried out a multidimensional analysis integrating clinical, ultrasonographic, and histopathological features.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Pilomatricoma exhibits distinct clinical, ultrasonographic, and pathological characteristics in children. Key findings included: (i) Female predominance in limb/trunk involvement (34.5% vs 17.3% in males, P ≤ .01); (ii) Head/neck localization decreasing with age; (iii) Characteristic ultrasonographic patterns (88.2% calcification detection rate); (iv) No recurrence following complete excision.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our findings demonstrate distinct gender-based anatomical distribution patterns and excellent surgical outcomes for pediatric pilomatricoma. The integration of high-frequency ultrasonography with clinical evaluation significantly enhances diagnostic accuracy, potentially reducing unnecessary interventions in this population. These findings provide critical references for clinicians regarding disease characteristics and diagnostic optimization. Key messages What is already known: Pilomatricoma is a benign hair matrix-derived tumor with diverse clinical presentations, often leading to misdiagnosis. Previous studies have reported its association with Wnt/β-catenin pathway mutations and a predilection for the head/neck region in children, but comprehensive analyses of gender-specific anatomical distribution and diagnostic optimization are lacking. What this study adds: This large pediatric cohort reveals gender differences in anatomical involvement (female predominance in limb/trunk lesions) and demonstrates that high-frequency ultrasonography (88.2% calcification detection) significantly improves preoperative diagnostic accuracy (71.3% vs. historical rates of 16%-43%). How this study might affect research, practice, or policy: The findings advocate for integrating ultrasonography into clinical workflows to reduce misdiagnosis and unnecessary i","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144965993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}