A rare case of pemphigoid vegetans / 中华皮肤科杂志

A 89-year-old female patient presented with skin lesions of the groin, vulva and intergluteal sulcus for 10 months, and blisters for 3 weeks. Skin examination revealed the red-white hyperplastic plaques on the groin, vulva and intergluteal sulcus, on which mung-bean- to pea-sized erosions and blisters scattered, and several similar blisters were scattered on the right axilla and right leg, some of which were broken and covered with crusts. Histopathological examination of the skin lesion on the intergluteal sulcus showed thickened spinous layer without acantholysis, subepidermal fissures and blisters in some areas, focal papillary dermal edema with eosinophil infiltration, and perivascular infiltration composed mainly of lymphocytes in the superficial dermis. Direct immunofluorescence assay showed linear deposition of IgG and C3 at the epidermal basement membrane zone, clustered deposition of IgM in the dermis, but no IgA deposition. Indirect immunofluorescence on salt-split skin revealed that IgG and C3 were deposited on the epidermal side. Enzyme linked immunosorbent assay (ELISA) showed that serum levels of anti-BP180 and anti-BP230 antibodies were 26.92 U/ml and 68.17 U/ml respectively, and those of anti-desmoglein 1 (Dsg1) and anti-Dsg3 antibodies were normal. The patient was diagnosed with pemphigoid vegetans. After the treatment with oral methylprednisolone combined with topical halometasone ointment and tacrolimus 0.03% ointment, the skin lesions gradually subsided.

Observations on the Medium-and Long-term Efficacies of Superficial Needling Therapy for Lumbodorsal Myofacial Pain Syndrome / 上海针灸杂志

Objective To investigate the medium-and long-term clinical efficacies of superficial needling therapy for lumbodorsal myofacial pain syndrome.Method Three thousand two hundred and fifty-one patients with lumbodorsal myofacial pain syndrome were randomly allocated to a superficial needling group of 1753 cases and an acupuncturegroupof 1498 cases.Seventy-threepatients in the superficial needling group and 105 patients in the acupuncture group did not complete the required courses of treatment and were lost to follow-up.The others in the two groups completed therequiredcourses of treatment and were followed up.After three courses of treatment, the clinical therapeutic effects were compared using the pain score at the end of treatment and at three and six months and one year after.Thereturn visit rates were also compared.Result There was a significant difference in the pain score (NRS score) between the two groupsat the end of treatment (P<0.01), which was significantly lower in the superficial needling group than in the acupuncturegroup, and a difference between the twogroupsat three months after.There was no significant difference in the pain score between the two groupsat six months after and no difference between the two groupsat one year after.There were no differences in clinical the rapeutic effect and the return visit rate between the two groupsat six months and one year after.Conclusion A clinical observation with a large sample shows that superficial needling has a good short-term therapeutic effect on lumbodorsal myofacial pain syndrome and is a safe and effective method, but its medium-and long-term the rapeutic effects are notgood enough.

Study on the safety and effectiveness of an exercise prescription for patients with diabetic foot ulcer and peripheral arterial disease / 中华内分泌代谢杂志

Objective To investigate the effect of exercise prescription on foot perfusion and ulcer healing in patients with diabetic foot ulcer (DFU) accompanied with peripheral arterial disease (PAD).Methods Sixty patients with DFU and PAD were divided into exercise group and control group.The patients in the exercise group took exercise therapy training,ensuring that they could follow the exercise prescription.The patients in the control group had no exercise requirements.After the treatment for 12 weeks,ankle brachial index (ABI),transcutaneous oxygen tension (TcPO2),skin temperature,body mass index (BMI),HbA1C,and the ulcer healing rate in the two groups were compared,the satisfaction and compliance in the exercise group were evaluated,and the adverse events of the treatment were recorded.Results After the treatment for 12 weeks,the ABI,TcPO2,and foot skin temperature in the two groups increased and HbA1C decreased(P＜0.05 or P＜0.01).TcPO2 increased 5.25 mm Hg(1 mm Hg=0.133kPa),skin temperature increased 0.45℃,and BMI decreased 0.69 kg/m2 in the exercise group,while TcPO2 increased 2.59 mm Hg,skin temperature increased 0.28℃,and BMI increased 0.02 kg/m2 in the control group,showing significant differences in the three index changes between two groups (P＜0.01).The healing rate in the exercise group was higher than that in the control group (53.6％ vs 25.9％,P ＜0.05).The patients'compliance and satisfaction to the exercise therapy were 90％ and 94％,respectively.The incidence of adverse events in the exercise group had no causal relationship with the exercise prescription.Conclusion The exercise prescription in the study can improve the foot perfusion,and promote ulcer healing.It has the advantage of high safety,patients'compliance and satisfaction.