Clinical effect of acupoint application with turmeric blistering moxibustion plaster on post-stroke hemiplegic shoulder pain / 中国针灸

OBJECTIVES@#To observe the effects of acupoint application with turmeric blistering moxibustion plaster on pain, shoulder range of motion (ROM) and upper limb motor function in the patients with post-stroke hemiplegic shoulder pain (PSHSP).@*METHODS@#Eighty-two patients with PSHSP were randomly divided into an observation group (41 cases, 1 case was eliminated, 4 cases dropped out) and a control group (41 cases, 2 cases were eliminated and 2 cases dropped out). The routine treatment, nursing care and rehabilitation training were performed in the control group. On the basis of the intervention as the control group, in the observation group, the turmeric blistering moxibustion plaster was applied to bilateral ashi points, Jianyu (LI 15), Jianliao (TE 14), Binao (LI 14), Shousanli (LI 10) and Hegu (LI 4), once a day, remained for 6 hours each time. This moxibustion therapy was operated 5 times weekly, one course of treatment consisted of 2 weeks and 2 courses were required. Separately, before treatment and after 2 and 4 weeks of treatment, the score of visual analogue scale (VAS), shoulder ROM and the score of upper limbs in Fugl-Meyer assessment (U-FMA) were observed in the two groups.@*RESULTS@#VAS scores were lower (P<0.05), ROM in shoulder flexion, abduction, internal rotation and external rotation was larger (P<0.05), and U-FMA scores were higher (P<0.05) after 2 and 4 weeks of treatment when compared with those before treatment in the two groups. After 4 weeks of treatment, VAS score decreased (P<0.05), and ROM in shoulder flexion, abduction, internal rotation, external rotation and U-FMA score increased (P<0.05) in comparison with those after 2 weeks of treatment in either group. In the observation group, VAS scores were dropped (P<0.05) after 2 and 4 weeks of treatment respectively, and ROM of shoulder flexion and abduction enlarged after 2 weeks of treatment (P<0.05) when compared with those in the control group. After 4 weeks of treatment, ROM in shoulder flexion, abduction, internal rotation and external rotation in the observation group was larger (P<0.05) and U-FMA score was higher (P<0.05) than those in the control group.@*CONCLUSIONS@#Acupoint application with turmeric blistering moxibustion plaster may effectively reduce the degree of shoulder pain and improve the shoulder range of motion and the upper limb motor function in the patients with post-stroke hemiplegic shoulder pain.

Effects of blistering cupping combined with thunder-fire moxibustion on the efficacy and airway remodeling of cold-wheezing syndrome in bronchial asthma / 中国针灸

OBJECTIVE@#To investigate the clinical efficacy of the combined application of blistering cupping with thunder-fire moxibustion in treating bronchial asthma of cold-wheezing syndrome, and its influences on airway remodeling, inflammatory factors, lung function, and quality of life on the base of conventional western medicine treatment.@*METHODS@#A total of 76 patients with bronchial asthma of cold-wheezing syndrome were randomly divided into an observation group and a control group, 38 cases in each group. In the control group, the basic treatment was used, i.e. budesonide formoterol powder inhalation. In the observation group, on the basis of the treatment as the control group, blistering cupping combined with thunder-fire moxibustion was supplemented, Dazhui (GV 14), Danzhong (CV 17) and bilateral Feishu (BL 13), Gaohuang (BL 43), and Zhongfu (LU 1) were selected; blistering cupping was administered once a day and thunder-fire moxibustion was given twice a day. One course of treatment was composed of 7 days in both groups, and 2 courses of treatment were required. Before and after treatment, the airway remodeling indexes (matrix metalloproteinase-9 [MMP-9], tissue inhibitor of matrix metalloproteinase-1 [TIMP-1], and transforming growth factor-β1 [TGF-β1]) and inflammatory indexes (interleukin [IL] -1β、IL-25) were detected by using radioimmunoassay in the patients of the two groups. The lung function, traditional Chinese medicine symptom score, and asthma quality of life questionnaire (AQLQ) score were observed in the patients of the two groups.@*RESULTS@#After treatment, the serum levels of MMP-9, TIMP-1, TGF-β1, IL-1β, IL-25, peak expiratory flow (PEFR), traditional Chinese medicine symptom scores, and AQLQ scores were decreased compared with those before treatment in the patients of the two groups (P<0.05), and the results in the observation group were lower than those in the control group (P<0.05). After treatment, the first second forced expiratory volume (FEV1) and peak expiratory flow rate (PEF) were increased compared with those before treatment in the two groups (P<0.05), and the results in the observation group were higher than those in the control group (P<0.05).@*CONCLUSION@#On the basis of the conventional western medicine treatment, the combination of blistering cupping with thunder-fire moxibustion can effectively ameliorate the clinical symptoms of patients, reduce inflammatory levels, inhibit airway remodeling and improve the lung function and quality of life in the patients with bronchial asthma.

Subcorneal pustular dermatosis type of IgA Pemphigus in a 35-year-old female: A case report

Introduction@#IgA pemphigus is a rare, distinct variant of Pemphigus characterized by vesiculopustular eruptions mediated by IgA autoantibodies targeting keratinocyte cell surface antigens, desmocollins 1-3 and sometimes desmogleins 1 and 3. Its classical features have been described in literature but atypical cases have also been documented. This report presents such case posing a diagnostic dilemma.@*Case Report@#A 35-year-old female presented with a 16-year history of intermittent eruptions of multiple hyperpigmented, annular and circinate, desquamating plaques and coalescing flaccid pustules on erythematous bases on the scalp, neck, trunk, and extremities. Histopathologic examination revealed subcorneal pustular dermatitis, and direct immunofluorescence was positive for granular intercellular IgG and IgA deposits in the epidermis. Antinuclear antibody test was negative and C3 level was normal. Antibody tests against desmogleins 1 and 3 were both negative. Topical potent corticosteroid therapy resulted in complete resolution of all lesions in three weeks.@*Conclusion@#Diagnostic dilemmas arise when laboratory results do not correlate with clinical findings. Findings of IgA autoantibodies in patients with pemphigus-like skin eruptions led to the diagnosis of subcorneal pustular dermatosis type of IgA pemphigus. Dapsone is the treatment of choice although topical potent corticosteroid alone may provide complete remission in some cases, avoiding the potential adverse effects of systemic therapy

Treatment conundrum: A case of recalcitrant Epidermolysis Bullosa Acquisita (EBA) in a 50-year-old Filipino male

Introduction@#Epidermolysis Bullosa Acquisita (EBA) is a rare autoimmune blistering disease which presents in the skin and mucous membranes. The decrease in anchoring fibrils in the basement membrane zone causes separation of the epidermis from the dermis, resulting in its blistering presentation. The treatment plan will depend on the severity of the disease. The first-line treatment for mild EBA includes topical corticosteroids and immunomodulators such as dapsone and colchicine; while severe cases of EBA may be given intravenous immunoglobulins, systemic steroids, and immunosuppressants such as azathioprine and cyclophosphamide. @*Case Report@#This is a case of a 50-year-old Filipino male who presented with a 2-year history of vesicles and tense bullae which evolved into papules, plaques and erosions with scarring and milia formation on the scalp and trauma-prone areas of the trunk and extremities. Clinical examination revealed multiple, well-defined, irregularly shaped erythematous papules and plaques with crusts, scales, erosions, pearl-like milia and scarring on the chest, back, upper, and lower extremities. The oral mucosa was moist with some ulcers on the tongue. Histopathologic examination using Hematoxylin and Eosin (H&E) stain revealed the absence of the epidermis with retention of dermal papillae suggestive of subepidermal clefting. Further examination with direct immunofluorescence (DIF) revealed monoclonal immunoglobulin (IgG) deposits demonstrating an intense linear fluorescent band at the dermoepidermal junction, consistent with Epidermolysis Bullosa Acquisita. Overall, the combined administration of prednisone, azathioprine, and colchicine resulted only in transient and incomplete resolution of lesions in this case of EBA.@*Conclusion@#The management of EBA is mostly supportive with the goal of minimizing complications. Combination treatments using steroids, colchicine, and azathioprine have been reported with various results. Its management remains challenging as most cases are refractory to treatment.

Effect mechanism of blistering moxibustion on visceral hypersensitivity of irritable bowel syndrome in mice based on 5-HT signal pathway / 中国针灸

OBJECTIVE@#To observe the effect of blistering moxibustion on the expression levels of 5-hydroxytyptamine (5-HT) and its receptors of the colon tissue in the mice with visceral hypersensitivity of irritable bowel syndrome (IBS), so as to explore the effect mechanism of blistering moxibustion in treatment of IBS.@*METHODS@#Forty SPF-grade newborn Kunming mice were randomly divided into a normal group, a model group, an antagonist group and a blistering moxibustion group, 10 mice in each one. Before modeling, the injection with 0.2 mL parachlorophenylalanine (PCPA) was given on the lateral ventricle in the antagonist group. The endorectal glacial acetic acid stimulation combined with tail clipping was used to prepare the model of visceral hypersensitivity of IBS in the model group, the antagonist group and the blistering moxibustion group. After modeling, in the blistering moxibustion group, the intervention with blistering moxibustion was exerted at "Zhongwan" (CV 12), "Tianshu" (ST 25) and "Zusanli" (ST 36), once herbal irritant plaster at each acupoint, for 2 h each time, once a week, consecutively for 3 weeks. Abdominal withdrawal reflex (AWR) score and electromyographic (EMG) amplitude of abdominal muscles were adopted to evaluate the visceral hypersensitivity. HE staining was applied to observe the morphological changes in colon tissue, and immunohistochemistry was to determine the expression levels of 5-HT and its receptors.@*RESULTS@#Compared with the normal group, EMG amplitude of abdominal muscles was increased under 20, 40 mm Hg (1 mm Hg=0.133 kPa) in the model group (P<0.05), AWR scores and EMG amplitude of abdominal muscles under 60, 80 mm Hg were all increased in the model group (P<0.05). In comparison with the model group, EMG amplitude of abdominal muscles was reduced under 20 mm Hg in the blistering moxibustion group (P<0.05), AWR scores were increased under 40 mm Hg in both the blistering moxibustion group and the antagonist group (P<0.05); AWR scores and EMG amplitude of abdominal muscles under 60, 80 mm Hg were all reduced in both the blistering moxibustion group and the antagonist group (P<0.05). Compared with the normal group, in the model group, the mucosa was slightly disturbed, while, the moderate inflammatory cells were visible in the submucosa. In comparison with the model group, the inherent glands of mucosa were regular in shape and a small number of inflammatory cells were visible in both the blistering moxibustion group and the antagonist group. In comparison with the normal group, the average positive staining area percentage (APSAP) of 5-HT and 5-HT3R of the colon tissue was increased, while, APSAP of 5-HT4R was reduced in the model group (P<0.05). Compared with the model group, APSAP of 5-HT and 5-HT3R was reduced in both the blistering moxibustion group and the antagonist group (P<0.05).@*CONCLUSION@#Blistering moxibustion can relieve the visceral hypersensitivity of the mice with visceral hypersensitive IBS and the underlying mechanism is related to the regulation of the gut-brain axis mediated by 5-HT signaling pathway.

Validation of the Malay version of Autoimmune Bullous Disease Quality of Life (ABQOL) questionnaire

@#Autoimmune blistering diseases (AIBD) represent a group of rare and chronic disorders with significant impact on quality of life (QoL). The aim of this study was to assess the validity and reliability of the Malay translation of the autoimmune bullous disease quality of life (ABQOL) questionnaire.

Blistering eruptions following isotretinoin therapy for hidradenitis suppurativa: a case report

A 33-year-old male was treated with isotretinoin (20mg daily) for hidradenitis suppurativa. After 6 weeks on the medication, he developed symmetrical erythematous tense blisters on the lower legs. Report of biopsy done was of intraepidermal blisters with superficial dermal lymphohistiocytic infitrates. He was commenced on oral prednisolone 30mg daily and Isotretinoin was withdrawn. The blisters resolved over a 2week period. The lesions of hidradenitis suppurativa were noticed to have improved with the short course of isotretionoin.

Efficacy comparison of different forms of dog-days acupoint application for prevention and treatment of chronic bronchitis / 针灸推拿医学（英文版）

Objective: To analyze the clinical effect of traditionaldog-days acupoint application and Magic Acupuncture Patch (Manji) in the prevention and treatment of chronic bronchitis (CB) in remission stage in the past five years, and explore the principle of action and effective stimulation, to provide the evidence for treating CB by acupoint application. Methods: A retrospective study was conducted on 405 patients with CB who met the inclusion criteria. All patients were treated with dog-days acupoint application or Magic Acupuncture Patch between 2013 and 2017. The clinical data of 405 patients were statistically analyzed to compare the prevention and treatment effects of dog-days acupoint application and Magic Acupuncture Patch, and different degrees of stimulation of dog-days acupoint application. Results: Among the dog-days acupoint application groups, the total effective rate was 63.6％ in the light stimulation group, 93.1％ in the moderate stimulation group, and 94.8％ in the strong stimulation group. The differences in the total effective rate between the light stimulation group and the moderate stimulation group, as well as the strong stimulation group, were statistically significant (both P<0.05). There was no significant difference in the total effective rate between the moderate stimulation group and the strong stimulation group (P>0.05). The total effective rate was 83.9％ in the dog-days acupoint application group, versus 45.4％ in the Magic Acupuncture Patch group, and there was a statistically significant difference between the two groups (P<0.05). Conclusion: The efficacy of dog-days acupoint application in the prevention and treatment of CB is better than that of Magic Acupuncture Patch; the degree of stimulation is the basis for the effect of dog-days acupoint application on prevention and treatment of CB, and the moderate and strong stimulations are more appropriate.

Pénfigo vulgar en pediatría a propósito de un caso / Pemphigus vulgaris in pediatrics: a case report

Resumen: Introducción: El pénfigo vulgar es una enfermedad grave y poco frecuente en niños. Su diagnóstico y tratamiento oportuno permite modificar el pronóstico. El objetivo es describir las características clínicas y el abordaje diagnóstico y terapéutico de esta poco frecuente enfermedad vesículo-ampollar autoinmune en niños. Caso clínico: Niño de 2 años, previamente sano. Comenzó con dermato sis generalizada con máximo lesional en región umbilical, miembros y genitales, caracterizada por ampollas, algunas denudadas con sangrado fácil, sin compromiso mucoso ni fiebre. Se diagnosticó impétigo bulloso y se indicó antibioticoterapia tópica y sistémica sin mejoría clínica. Evolucionó con extensión lesional, con compromiso de mucosas oral y anal. El estudio histológico e inmunohistoquí- mico de las lesiones y la piel perilesional confirmó pénfigo vulgar. Se inició tratamiento corticoideo e inmunomodulador con buena respuesta. Conclusiones: Dada la similitud de las manifestaciones del pénfigo vulgar con otras enfermedades infecciosas e inflamatorias de mayor prevalencia, se requiere un alto índice de sospecha para evitar demoras en el diagnóstico y el comienzo del tratamiento. En pacientes con manifestaciones vesículo ampollares de evolución no esperada, es necesaria la intercon sulta por dermatólogo y evaluar la oportunidad de biopsia de la lesión y piel perilesional, para estudio histológico e inmunofluorescencia directa, lo que permitirá la confirmación diagnóstica.

Abstract: Introduction: pemphigus vulgaris is a serious and infrequent disease in children. Its timely diagnosis and treatment allows modifying its prognosis. The objective is to describe its clinical characteristics, and the diagnostic and therapeutic approach of this uncommon autoimmune blistering disease in children. Clinical case: 2-year-old male patient, previously healthy. He initially presented generalized dermatosis with maximum lesion areas at the umbilical region, limbs and genitals; characterized by blisters, some denuded, and of easy bleeding, without mucosal involvement nor fever. Bullous im petigo was diagnosed and topical and systemic antibiotic treatment was started, showing no clinical improvement. He developed extension of the lesions with oral and anal mucosal involvement. The histologic and direct immunofluorescent study of lesions and perilesional skin confirm the diagnosis of pemphigus vulgaris. The patient started treatment with corticosteroids and immunomodulatory agents with good clinical response. Conclusions: Due to the similarity with other more prevalent infectious and inflammatory diseases, a high index of suspicion is required in order to avoid delays in the diagnosis and the start of treatment. In patients with blisters with an unexpected clinical evolu tion, it is necessary to conduct a joint evaluation with a dermatologist and to assess the opportunity of performing a biopsy of the lesion and perilesional skin for histological study and direct immunofluo rescence, which will allow diagnostic confirmation.

Lepra lepromatosa no erradicada en el perú / Leprosy lepromatosa not eradicated in peru

RESUMEN En este estudio del caso, los autores discuten la presentación de un varón de 56 años, con lepra lepromatosa multibacilar, localizado en un hospital del distrito de Trujillo. La biopsia de una de las lesiones, demostró infiltraciones difusas por macrófagos espumosos en toda su extensión; con la tinción de Ziehl - Neelsen se encuentran: bacilos ácido-alcohol resistentes sueltos o empaquetados en grupos, con índice bacilar: 6. La condición se manejó inicialmente en la comunidad como un "pénfigo ampolloso", sugiriendo que las barreras locales actualmente impiden la detección de la lepra en este sistema de atención primaria, en desarrollo. La lepra es una enfermedad multisistémica y el paciente demostró alteraciones neurológicas periféricas evidentes. Promover el conocimiento de estas manifestaciones sistémicas, evitará un retraso en el diagnóstico, a su vez disminuirá las complicaciones y eludirá la morbilidad a largo plazo. Los esfuerzos para optimizar los sistemas de detección, gestión, educación pública y profesional son esenciales, para impulsar la erradicación en estas poblaciones en riesgo.

SUMMARY In this case study, the authors discuss the presentation of a 56-year-old male in a hospital in the Trujillo district with lepromatous multibacillary leprosy. The biopsy of one of the lesions showed diffuse infiltrations by foamy macrophages in all its extension, with the stain of Ziehl - Neelsen bacilli acid resistant alcohol loose or packaged in groups, the bacilar index: 6. The condition was initially managed in the community as a "bullous pemphigus" that suggests that local barriers currently prevent the detection of leprosy in this developing primary care system. Leprosy is a multisystem disease and the patient demonstrated evident peripheral neurological alterations. Promoting the knowledge of these systemic manifestations will avoid a delay in the diagnosis, in turn will reduce complications and avoid long-term morbidity. Efforts to optimize detection systems, management and public and professional education are essential to promote eradication in these populations at risk.

Nail changes in autoimmune blistering disorders: A case-control study

Background: Pemphigus and pemphigoid disorders produce blistering cutaneous lesions. Earlier case reports state that nail involvement is uncommon in these autoimmune blistering disorders. Aims and Objectives: To study nail changes in autoimmune blistering disorders. Methods: A case-control study was conducted where 40 cases and 40 controls were evaluated for nail changes. Results: Nail changes were seen in 72.5% of cases and 17.5% of controls. The most common nail findings were paronychia and onychorrhexis. Limitations: Small sample size; short study duration; nail biopsy could not be done. Conclusion: Our findings indicate that the inflammatory nature of the blistering cutaneous disease is often reflected conspicuously in the nails.

Preliminary Analysis of the Three Major Paths in the Action of Vesiculation Moxibustion / 上海针灸杂志

From the three perspectives, skin stress response, medication-acupoint effect and neuroendocrine-immune system, this article discussed the action mechanism of vesiculation moxibustion therapy, to provide scientific evidence for the development of this therapy and to enhance its therapeutic efficacy.

Exantema vésico-ampollar por Enterovirus / Vesico-blister exanthema caused by Enterovirus

El género Enterovirus contiene un gran número de agentes virales causantes de una amplia gama de enfermedades con diversas manifestaciones cutáneas, desde erupciones maculosas, maculopapulosas, urticariales, vesiculosas hasta petequiales. Los serotipos frecuentemente asociados con exantemas son Echovirus 9, 11, 16 y 25, los Virus Coxsackie A 2, 4, 9 y 16 y los Virus Coxackie B 3-5. Se presenta a continuación el caso de un paciente de 1 año y 9 meses con exantema máculo-eritematovesicular generalizado con base eritematosa pruriginoso, hiperalgesia cutánea y descamación posterior. Se detectó por reacción en cadena de polimerasa Enterovirus de lesión ampollar

The genus Enterovirus involve a large number of viral agents that cause a wide range of diseases, which are detected by cutaneous manifestations, such as macular, maculopapular, urticarial, vesiculous and petechial eruptions. The Serotypes frequently associated with exanthems are Echovirus 9, 11, 16 and 25 and Coxsackie viruses A 2, 4, 9 and 16 and Coxsackie B 3-5 viruses. The case of a 1-year and 9-month patient with generalized erythematous-vesicular bladder rash with pruritic erythematous base, cutaneous hyperalgesia and posterior desquamation is hereby presented. IT was detected by a polymerase chain reaction in a blister injury Enterovirus

Penfigoide buloso nodular tratado exitosamente con fototerapia UVB banda angosta / Pemphigoid nodularis successfully treated with narrow band UVB phototherapy

El Penfigoide nodular es una variante clínica poco frecuente de penfigoide buloso. Corresponde a una dermatosis ampollar subepidérmica, crónica, autoinmune, caracterizada por auto anticuerpos contra antígenos específicos de hemidesmosomas en la unión dermo-epidérmica. Su incidencia es desconocida. La etiopatogenia aún no es entendida del todo. Se presenta clínicamente como una superposición de características de pénfigo buloso y prurigo nodular. El diagnóstico se basa en hallazgos clínicos e inmunopatológicos. La histopatología con inmunofluorescencia directa es el gold standard para el diagnóstico. El manejo es difícil, tiene mala respuesta a corticoides potentes locales, siendo necesario el uso de corticoides sistémicos y diferentes inmunosupresores solos o combinados junto a antihistamínicos para el manejo de prurito intenso. Se presenta un caso de pénfigo nodular, donde destaca su buena respuesta a terapia combinada con metotrexato y luz UVB de banda angosta.

Pemphigoid Nodularis is a rare clinical variant of bullous pemphigoid. It is considered an autoimmune, chronic, subepidermal blistering dermatosis, characterized by antibodies against hemidesmosome-specific antigens at the dermo-epidermal junction. Its incidence is unknown and its etiopathogenetic not fully understood. Clinically, it presents with overlapping features of bullous pemphigoid and prurigo nodularis. The diagnosis is based on clinical and immunopathological findings, being the histopathological study with immunofluorescence the gold standard. The management is difficult; since it has a poor response to local potent corticosteroids, requiring the use of systemic corticosteroids and different immunosuppressants alone or combined with antihistamines for the intense pruritus. We present a case of nodularis pemphigoid, highlighting the good response to the combination of methotrexate and phototherapy with narrow band UVB.

Lupus ampolloso: un verdadero reto diagnóstico y terapéutico / Lupus bullous: a true diagnostic and therapeutic challenge

El lupus eritematoso sistémico (LES) esuna enfermedad de tipo autoinmune en donde existen múltiples factores que inducen una respuesta inmunológica no controlada en un individuo que genéticamente está predispuesto, presentándose una variedad de manifestaciones clínicas que muchas veces se convierten en un verdadero reto diagnóstico y terapéutico como es el caso de sus presentaciones en piel. Describiremos a continuación un caso de un paciente género masculino con diagnostico LES con lesiones cutáneas extensas severas con diagnóstico clínico yhistopatológico sugestivo de lupus ampolloso refractarias a tratamiento estándar con corticoterapia e inmunomoduladores con evolución tórpida en su curso, que requiere posteriormente inicio de terapia biológica con Belimumab observándose una remisión clínica significativa de las lesiones y contribuyendo además a disminuir las dosis de corticoides utilizadas desde su ingreso . Se revisaránaspectos en relación del LES en hombres en lo que refiere a epidemiologia, manifestaciones cutáneas, hallazgos histopatológicos, diagnóstico diferencial y opciones terapéuticas actuales.

Systemic lupus erythematosus (SLE) is an autoimmune disease in which multiple factors induce an uncontrolled immune response in an individual who is genetically predisposed, presenting a variety of clinical manifestations that often become a real diagnostic challenge and Therapeutic as in the case of their skin presentations. We will now describe a case of a malepatient with a SLE diagnosis with severe extensive skin lesions with clinical and histopathological diagnosis suggestive of blistering lupus refractory to standard treatment with corticosteroid therapy and immunomodulators with a morphologic evolution in their course, which then requires the initiation of biological therapy with Belimumab observed a significant clinical remission of the lesions and also contributing to decrease the doses of corticosteroids used since their entry. We will review aspects related to SLE in men in terms of epidemiology, cutaneous manifestations, histopathological findings, differential diagnosis and current therapeutic options

Study on the Role of Dendritic Cells in Immune Regulation in Blistering Moxibustion / 上海针灸杂志

As a classical external treatment of traditional Chinese medicine, blistering moxibustion has significant curative effect on asthma, rheumatoid arthritis and other immune disorders, which suggests that it has certain immunoregulation effect. When stimulated, skin immune system evokes innate immune or acquired immune systems, including dendritic cells (DC), a type of crucial cell related to acquired immunity. From the classification and function of DC, especially the differentiation, migration and maturation of DC in local skin after blistering moxibustion. This article was to discuss the possible ways of immunoregulation of DC in local skin after blistering moxibustion, so as to provide reference for the study on immunoregulatory mechanism of blistering moxibustion.

Experience ofpreventing bronchial asthma by blistering therapy of dog-day moxibustion / 中国针灸

Professorowns unique experience of preventing bronchial asthma by the blistering therapy of dog-day moxibustion. He believes that the method has the action of festering moxibustion without its adverse reaction, the pathogenesis of asthma is the impairment of the dispersing and descending of the lung. When the lung,the spleen and the kidney are deficient,pathogenic factors,such as phlegm,damp and the cold,twist in the lung and the air passage is blocked, then asthma happens. Blistering therapy with little but fierce medicines acquires the features of specific but overall acupoints and more big blister. Meanwhile,with the emphasis on communication and nursing service,the therapy is apparently effective and worth widely using.

Application of blistering cupping / 中国针灸

Blistering cupping is special as eliminating wind and dampness as well as removing phlegm and blood stasis, and it achieves effects through suction. In this paper we reviewed relevant literature combined with clinical experience so as to summarize its operation attention through exploring the origin, mechanism and application. We divide the progress into the blistering period, the phlegm-stasis-eliminating period, and the escharosis period according to the changes of bubble and the things pulled out. Blistering cupping creates ways to eliminate concrete unhealthy influences through smoothing meridians and collaterals, such as phlegm and retained fluid, dampness and blood stasis. Thus chronic diseases are relieved. Also,we propose the rules of "blistering acupoints being related to disease location as well as the nature of acupoints and diseases". The therapy has been used to treat diseases of respiratory system, osteoarticular, skin and subcutaneous tissue, mental and behavioral disorders, and tumor, among which the effects of intractable diseases of respiratory and osteoarticular systems are definite. It deserves to be further explored and promoted.

Características clínicas, genéticas y epidemiológicas de la epidermólisis bullosa y su repercusión en la cavidad bucal / Clinical, genetical and epidemiological characteristics of the epidermolysis bullosa and its influence in the oral cavity

La epidermólisis bullosa es una afección poco frecuente, con una prevalencia de 0,5- 1 por millón de habitantes, que comprende un grupo de alteraciones genéticas caracterizadas por lesiones ampollares en la piel y las mucosas, cuyo diagnóstico requiere del empleo de técnicas de biología molecular e inmunohistoquímicas. A tales efectos, se efectuó una revisión exhaustiva con vistas a profundizar en las características clínicas, genéticas y epidemiológicas de esta enfermedad y su repercusión en la cavidad bucal, así como también en algunos aspectos puntuales relacionados con el tema.

The epidermolysis bullosa is an infrequent disorder, with a prevalence of 0,5 - 1 per million of inhabitants comprising a group of genetic changes characterized by bullous lesions in the skin and mucosa, which diagnosis requires of the use of molecular biology and inmunohistochemical techniques. For such effects, an exhaustive review was carried out with the aim of deepening in the clinical, genetic and epidemiological characteristics of this disease and its influence on the oral cavity, as well as in some punctual aspects related to the topic.

Tuberculin skin testing: Spectrum of adverse reactions.

Tuberculin skin testing (TST) is one of the primary diagnostic modalities recommended by the World Health Organization (WHO) and the National Institute for Health and Care Excellence (NICE) study conducted in the United Kingdom (UK) for diagnosing tuberculosis (TB). Even after acceptance as a diagnostic modality and stern standardization, TST has its own flaws that include a spectrum of adverse reactions. We report a series of cases with a spectrum of adverse reactions occurring with a higher frequency than present in the available evidence. The study has some demerits such as being a retrospective one with interobserver variation and lack of histopathological confirmation. The observation is presented to accentuate the fact that adverse reactions are not a rarity and that further studies are required to establish the cause and exact incidence of the same.