BACKGROUND Hematidrosis is an extremely rare and enigmatic condition characterized by spontaneous bleeding through intact skin or mucosa,typically occurring in response to severe emotional stress.Although its exact pa...BACKGROUND Hematidrosis is an extremely rare and enigmatic condition characterized by spontaneous bleeding through intact skin or mucosa,typically occurring in response to severe emotional stress.Although its exact pathophysiology remains unclear,the condition is thought to involve sympathetic nervous system overactivation and capillary fragility,leading to blood extravasation via sweat glands or hair follicles.AIM To evaluate the efficacy and safety of beta-blockers,particularly propranolol,in the management of hematidrosis.METHODS A systematic literature search was conducted in January 2024 across six major databases to identify studies published between 2014 and 2024 that reported the use of beta-blockers in patients with hematidrosis.Eligible studies included clinical case reports or case series that described beta-blocker treatment outcomes.Data were synthesized narratively in accordance with the PRISMA 2020 guidelines.RESULTS Twenty studies met the inclusion criteria.Among them,propranolol was the most frequently prescribed beta-blocker and was associated with symptomatic improvement in over 75%of cases.Some studies also reported enhanced outcomes when beta-blockers were used in conjunction with psychotherapy.Reported adverse effects were minimal,and treatment was generally well-tolerated.However,the available evidence remains limited to low-level observational data,mostly case reports and small case series.CONCLUSION Beta-blockers,especially propranolol,appear to be an effective and well-tolerated treatment option for hematidrosis,particularly in stress-induced presentations.Despite promising findings,the evidence base is constrained by the lack of high-quality studies.Future research should focus on prospective,controlled trials to establish standardized diagnostic and treatment protocols for this rare condition.展开更多
Fulminant myocarditis is an acute diffuse inflammatory disease of myocardium.It is characterized by acute onset,rapid progress and high risk of death.Its pathogenesis involves excessive immune activation of the innate...Fulminant myocarditis is an acute diffuse inflammatory disease of myocardium.It is characterized by acute onset,rapid progress and high risk of death.Its pathogenesis involves excessive immune activation of the innate immune system and formation of inflammatory storm.According to China’s practical experience,the adoption of the“life support-based comprehensive treatment regimen”(with mechanical circulation support and immunomodulation therapy as the core)can significantly improve the survival rate and long-term prognosis.Special emphasis is placed on very early identification,very early diagnosis,very early prediction and very early treatment.展开更多
To the Editor:Acute lung injury(ALI)is a debilitating lung disease characterized by pulmonary edema,diffuse alveolar damage,and uncontrolled neutrophil infiltration^(1).Severe cases of ALI can potentially lead to the ...To the Editor:Acute lung injury(ALI)is a debilitating lung disease characterized by pulmonary edema,diffuse alveolar damage,and uncontrolled neutrophil infiltration^(1).Severe cases of ALI can potentially lead to the development of acute respiratory distress syndrome(ARDS),which can lead to impaired respiratory function,multiorgan dysfunction,and an extremely high mortality rate^(2-4).ALI may be caused by various factors,including aspiration,severe pneumonia,sepsis,trauma,fatty embolism,pancreatitis,and blood transfusion^(3).Current clinical approaches to treating ALI/ARDS include mechanical ventilation,extracorporeal membrane oxygenation(ECMO),and other supportive therapies^(5,6).Therefore,ALI/ARDS is an urgent problem that needs to be addressed in the field of respiratory critical care and innovative mechanisms and therapies^(6).展开更多
文摘BACKGROUND Hematidrosis is an extremely rare and enigmatic condition characterized by spontaneous bleeding through intact skin or mucosa,typically occurring in response to severe emotional stress.Although its exact pathophysiology remains unclear,the condition is thought to involve sympathetic nervous system overactivation and capillary fragility,leading to blood extravasation via sweat glands or hair follicles.AIM To evaluate the efficacy and safety of beta-blockers,particularly propranolol,in the management of hematidrosis.METHODS A systematic literature search was conducted in January 2024 across six major databases to identify studies published between 2014 and 2024 that reported the use of beta-blockers in patients with hematidrosis.Eligible studies included clinical case reports or case series that described beta-blocker treatment outcomes.Data were synthesized narratively in accordance with the PRISMA 2020 guidelines.RESULTS Twenty studies met the inclusion criteria.Among them,propranolol was the most frequently prescribed beta-blocker and was associated with symptomatic improvement in over 75%of cases.Some studies also reported enhanced outcomes when beta-blockers were used in conjunction with psychotherapy.Reported adverse effects were minimal,and treatment was generally well-tolerated.However,the available evidence remains limited to low-level observational data,mostly case reports and small case series.CONCLUSION Beta-blockers,especially propranolol,appear to be an effective and well-tolerated treatment option for hematidrosis,particularly in stress-induced presentations.Despite promising findings,the evidence base is constrained by the lack of high-quality studies.Future research should focus on prospective,controlled trials to establish standardized diagnostic and treatment protocols for this rare condition.
基金supported in part by the National Natural Science Foundation of China(81790624,81630010)Top-Notch Talent Program of Hubei Province and Tongji Hospital(2021YBJRC005)。
文摘Fulminant myocarditis is an acute diffuse inflammatory disease of myocardium.It is characterized by acute onset,rapid progress and high risk of death.Its pathogenesis involves excessive immune activation of the innate immune system and formation of inflammatory storm.According to China’s practical experience,the adoption of the“life support-based comprehensive treatment regimen”(with mechanical circulation support and immunomodulation therapy as the core)can significantly improve the survival rate and long-term prognosis.Special emphasis is placed on very early identification,very early diagnosis,very early prediction and very early treatment.
基金National Natural Science Foundation of China(No.82274069,82030116,and 82141212)China Postdoctoral Science Foundation(No.2022M720095 and 2023T160434)Young Elite Scientists Sponsorship Programby China Association of Chinese Medicine(No.2022-QNRC2-B09).
文摘To the Editor:Acute lung injury(ALI)is a debilitating lung disease characterized by pulmonary edema,diffuse alveolar damage,and uncontrolled neutrophil infiltration^(1).Severe cases of ALI can potentially lead to the development of acute respiratory distress syndrome(ARDS),which can lead to impaired respiratory function,multiorgan dysfunction,and an extremely high mortality rate^(2-4).ALI may be caused by various factors,including aspiration,severe pneumonia,sepsis,trauma,fatty embolism,pancreatitis,and blood transfusion^(3).Current clinical approaches to treating ALI/ARDS include mechanical ventilation,extracorporeal membrane oxygenation(ECMO),and other supportive therapies^(5,6).Therefore,ALI/ARDS is an urgent problem that needs to be addressed in the field of respiratory critical care and innovative mechanisms and therapies^(6).
