BACKGROUND Acquired hemophilia A (AHA) is a rare and potentially severe bleeding disordercaused by circulating autoantibodies against factor Ⅷ (FⅧ). In approximately50% of the patients, the condition is associated w...BACKGROUND Acquired hemophilia A (AHA) is a rare and potentially severe bleeding disordercaused by circulating autoantibodies against factor Ⅷ (FⅧ). In approximately50% of the patients, the condition is associated with autoimmune diseases,cancers, medication use, pregnancy, and the post-partum period. Bullous pemphigoid(BP) is a chronic autoimmune subepidermal blistering disease associatedwith tissue-bound and circulating autoantibodies against BP antigens 180 (BP180)and 230 (BP230). AHA-associated BP has a high mortality rate;hence, the understandingof this disease must improve.CASE SUMMARY A 69-year-old man presented with erythema, blisters, blood blisters, and crustsaccompanied by severe pruritus for more than 20 days, and ecchymosis andswelling on his left upper arm for 3 days. Pathological examination revealed asubepidermal blister that contained eosinophils. Laboratory tests showed that theBP180 autoantibody levels had increased, isolated activated partial thromboplastintime was notably prolonged (115.6 s), and coagulation FⅧ activity wasextremely low (< 1.0%). Furthermore, the FⅧ inhibitor titer had greatlyincreased (59.2 Bethesda units). Therefore, the patient was diagnosed as having BP associated with AHA, prescribed 0.05% topical halometasone cream, and transferred to a higher-level hospitalfor effective treatment;however, he died after 2 days.CONCLUSION AHA associated BP is rare, dangerous, and has a high mortality rate. Therefore, its timely diagnosis and effectivetreatment are necessary.展开更多
目的探索正念减压训练(mindfulness-based stress reduction,MBSR)法对空军青少年航空学校(Teenagers Aviation School of Air Force,TASAF)学生非病理性血压升高的改善作用。方法纳入2022年11月TASAF高一年度复查初测血压升高超标学生...目的探索正念减压训练(mindfulness-based stress reduction,MBSR)法对空军青少年航空学校(Teenagers Aviation School of Air Force,TASAF)学生非病理性血压升高的改善作用。方法纳入2022年11月TASAF高一年度复查初测血压升高超标学生共241名,将其随机分入MBSR组(n=121)和自行放松组(n=120)。比较2组学生临检时收缩压、舒张压和心率超标的改善程度,本研究设计量表调查受检学生身体疲劳-心理紧张积累情况。结果不同身体疲劳-心理紧张程度积分的TASAF学生初测收缩压测量值差异有统计学意义(F=15.670,P=0.012),事后两两比较结果显示身体疲劳-心理紧张程度积分越高,受检学生初测收缩压测量值越高(P均<0.05)。2组受检学生放松前的收缩压、舒张压和心率差异均无统计学意义(P均>0.05)。2组按照规定方法进行放松调节并按规定流程复测血压后,MBSR组学生放松前后收缩压差值、舒张压差值和心率差值均高于自行放松组,差异均有统计学意义(t=6.873、5.144、3.651,P=0.001、0.002、0.013)。结论MBSR法比自行放松法能更有效地改善TASAF学生血压和心率升高超标情况。可在TASAF学生中推广MBSR法,并在日常课程中加入MBSR训练内容,以提升血压和心率调节能力。展开更多
基金Supported by Traditional Chinese Medicine Research Program of Hebei Provincial Administration of Traditional Chinese Medicine,No.2025313 and No.2025448.
文摘BACKGROUND Acquired hemophilia A (AHA) is a rare and potentially severe bleeding disordercaused by circulating autoantibodies against factor Ⅷ (FⅧ). In approximately50% of the patients, the condition is associated with autoimmune diseases,cancers, medication use, pregnancy, and the post-partum period. Bullous pemphigoid(BP) is a chronic autoimmune subepidermal blistering disease associatedwith tissue-bound and circulating autoantibodies against BP antigens 180 (BP180)and 230 (BP230). AHA-associated BP has a high mortality rate;hence, the understandingof this disease must improve.CASE SUMMARY A 69-year-old man presented with erythema, blisters, blood blisters, and crustsaccompanied by severe pruritus for more than 20 days, and ecchymosis andswelling on his left upper arm for 3 days. Pathological examination revealed asubepidermal blister that contained eosinophils. Laboratory tests showed that theBP180 autoantibody levels had increased, isolated activated partial thromboplastintime was notably prolonged (115.6 s), and coagulation FⅧ activity wasextremely low (< 1.0%). Furthermore, the FⅧ inhibitor titer had greatlyincreased (59.2 Bethesda units). Therefore, the patient was diagnosed as having BP associated with AHA, prescribed 0.05% topical halometasone cream, and transferred to a higher-level hospitalfor effective treatment;however, he died after 2 days.CONCLUSION AHA associated BP is rare, dangerous, and has a high mortality rate. Therefore, its timely diagnosis and effectivetreatment are necessary.
文摘目的探索正念减压训练(mindfulness-based stress reduction,MBSR)法对空军青少年航空学校(Teenagers Aviation School of Air Force,TASAF)学生非病理性血压升高的改善作用。方法纳入2022年11月TASAF高一年度复查初测血压升高超标学生共241名,将其随机分入MBSR组(n=121)和自行放松组(n=120)。比较2组学生临检时收缩压、舒张压和心率超标的改善程度,本研究设计量表调查受检学生身体疲劳-心理紧张积累情况。结果不同身体疲劳-心理紧张程度积分的TASAF学生初测收缩压测量值差异有统计学意义(F=15.670,P=0.012),事后两两比较结果显示身体疲劳-心理紧张程度积分越高,受检学生初测收缩压测量值越高(P均<0.05)。2组受检学生放松前的收缩压、舒张压和心率差异均无统计学意义(P均>0.05)。2组按照规定方法进行放松调节并按规定流程复测血压后,MBSR组学生放松前后收缩压差值、舒张压差值和心率差值均高于自行放松组,差异均有统计学意义(t=6.873、5.144、3.651,P=0.001、0.002、0.013)。结论MBSR法比自行放松法能更有效地改善TASAF学生血压和心率升高超标情况。可在TASAF学生中推广MBSR法,并在日常课程中加入MBSR训练内容,以提升血压和心率调节能力。
