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The Patient’s Sudden Stiffness Highlights the Importance of Not Rushing Anesthesia

On Sunday, an appendicitis was in the operating room. Suddenly, another notice of appendicitis. The small li that is anaesthesia, in the heart this complain: what day ah, so much appendicitis?

Complaining is complaining, but the work must be done.

Xiao Li thought Sunday was a very good class, but this one let her down.

If I have surgery on Sunday, I can't take the rest of the week off. Add in the week before, and she'll have been under anesthesia for half a month.

In order to buy herself a little more time over the weekend, she quickly adjusted the anesthesia plan and set out to wake up quickly: the inhalant, which had already been prescribed at 2, was turned down. Worried that the depth of anesthesia was insufficient, she was given an IV anesthetic through an IV pump.

Speaking of this I.V. drug, it's something special. In the anesthesia industry, it is affectionately known as "milk". Because its metabolic half-life is very short, a small amount of use without accumulation, popular. But for major surgery, many doctors opt for a different inhalation anesthetic. The inhaled anesthetic li uses is more controllable than "milk" during major surgery. Because this appendicitis is a small operation, xiao Li also did not hesitate to replace it.

Time to the surgeon to close the abdominal stage, Xiao Li quickly inhaled anesthetics all stopped. Normally, it's only 10 minutes away.

However, the surgeon was slow to close the abdomen when it was said to be closed. As if I had never seen such a beautiful abdominal cavity, turned over and over to see.

Because of this delay, ten minutes passed.

Right now small Li, faint feeling anaesthesia may be shallow. Looking at the cut, which was only a few centimeters wide, she manually pushed some pain pills that were still being pumped. Then, fearing that anesthesia was not enough, the pump was speeded up.

The surgeon was about to close the stomach, and Xiao Li's anxious heart calmed down a little.

No sooner had the doctor stitched up the patient's abdomen than he gave a movement. Xiao Li comfort surgeon way: have no matter, the patient breathes quickly to come back, the patient does not ache, suture. So I pushed some more painkillers.

In the past, breathing back and getting a few stitches during exercise were common enough that surgeons did not care. However, afterlight feel Xiao Li's poisonous eyes, they also dare not much delay. After all, if they don't close the abdomen soon after surgery, it affects their anesthesia control.

Ten minutes later, the surgeon finally finished the last stitch.

Seeing the surgical sutures finished, Xiao Li quickly turned off the analgesics.

They said the painkillers were good, and they didn't disappoint her. In theory, it takes no more than 6 minutes to metabolize, and it takes only 3 minutes for the patient to open their eyes.

The patient also blinked in response to Xiao Li's command.

Seeing this situation, Xiao Li thought that there was no problem and pulled out the tracheal tube.

But when she pulled out the tube, she found it impossible to squeeze air in. For a moment, she thought she had a blocked airway.

When she returned with the suction tube, it was impossible to pull the patient apart. The patient at this time, let alone how to call is not open eyes. Look at the patient again, two upper arms tightly clamped on both sides of the trunk, pectoralis major muscle edge stretched obviously, teeth clenched, even the head can not move. Shake the victim's head slightly and the whole body follows. This tells us that the patient's whole body is in a state of muscular rigidity.

The moment she saw it, she knew what was going on. What she didn't expect, however, was that most of the muscle rigidity caused by opioids occurred in the early stages of anaesthesia, rather than during the waking phase.

Too late to regret it, she quickly pushed in a few sedatives and a few muscle relaxants.

Great. Because of the muscle relaxations, we won't be able to get out in half an hour.

After the patient was sent out of the operating room, she was depressed all day. Deep in my heart, I realized that anesthesia could not be too urgent.

Opioid-induced muscle rigidity occurs when the patient begins to lose consciousness or immediately after the loss of consciousness. Mild muscle rigidity may also occur when the patient is awake, such as hoarseness. In severe cases, sudden closure of the glottis resulted in ventilation disorders of the respiratory sac, mask and laryngeal mask, ETCO2 waveform in the absence of ventilation, muscle rigidity of the thoracic and abdominal wall when palpation of the chest and abdomen, and rapid decline of SpO2.

Is the Omicron Virus Highly Transmissible but Less Pathogenic?

The following information was released at a recent press conference on COVID-19:

Previous tracing results of Putuo cases showed that

Gene sequencing analysis was performed in the laboratory of Municipal Center for Disease Control and Prevention

The Novel coronavirus infection of the cases in this outbreak is

Omicron mutant

The citizens found that

The number of asymptomatic cases in Shanghai has increased recently

Is omicron weak?

· The characteristics of the Omicron variant cause many infected people to show "asymptomatic" symptoms.

National COVID - 19 medical treatment expert group members, zhongshan hospital affiliated to fudan university professor bi-jie hu director infection diseases and infection management section, told reporters that the mutation strains pathogens has its own change, in general, people infected with lower respiratory tract infection rate decreased significantly, some people have a headache, fever percentage drops hot symptoms also have no, morbidity.

Experts further analyzed that the characteristics of the pathogen were closely related to the clinical manifestations of the infected. At the beginning of the COVID-19 epidemic, the mutant pathogen was prone to lower respiratory tract infection, which showed imaging changes and was accompanied by fever and cough. Asymptomatic infections were rare. Back in 2003, the SARS virus was also a coronavirus, a pathogen that causes severe illness. The omicron variant in the current epidemic has mild or no symptoms, which is one reason why many infected people are asymptomatic.

· Related to immunization

Professor Wu Fan, a member of the Shanghai Public health expert group on epidemic prevention and control and vice president of Shanghai Medical College of Fudan University, previously mentioned that in addition to the mutation, the proportion of asymptomatic infections will also increase due to mass immunization and enhanced immunity of the population.

Bi-jie hu said, after the vaccination built a "immune wall" in the crowd, the crowd resistance increased, this means that the virus will not thrive, once the virus concentration increases, vaccine, antibody response, although viral load will test (positive), but I can't play out virulence (no symptoms).

· It is also possible that the disease is at an early stage and has not yet shown symptoms

In the interview, experts also mentioned that asymptomatic infected persons do not exclude a situation: that is, they are in the early stage of the disease and have not yet shown symptoms, but may show symptoms after a period of time. At present, Shanghai is under the double pressure of "preventing imported cases from abroad and rebounding from within", and the investigation and screening of cases are very meticulous.

Asymptomatic infected persons in Shanghai are being quarantined for 14 days in strict accordance with national standards. After the 14-day quarantine, asymptomatic infected persons can be released from quarantine only after two consecutive nucleic acid tests are negative.

The omicron variant faced with "off the charts" transmission power

Are regular masks still effective?

Will it be reinfected?

Dr. Shi Qingfeng of infection management department of Zhongshan Hospital affiliated to Fudan University gave answers to several questions of public concern.

· Are regular masks still effective?

According to experts, the novel Coronavirus mutation has enhanced transmission mainly because it can infect more respiratory cells in a short period of time, leading to the early onset of clinical symptoms. However, the mode of transmission is still mainly based on respiratory droplets, so the standard wearing of qualified masks is still one of the most effective prevention and control measures. Before wearing a mask, we need to confirm the inside and outside of the mask, and then wrap the rubber band behind the ear, and open the mask. Remember to press the nose clip along the bridge of the nose. Wash hands thoroughly after removing the mask.

· There is no need to worry if the pathogenicity is weak?

Although omicron is highly contagious, it mainly infects the nasopharynx, the upper respiratory tract, and can become severe once the virus reaches the lungs. Recently, tens of thousands of people in Hong Kong are infected every day, and more than 100 new deaths occur every day. Low pathogenicity does not mean no pathogenicity. Therefore, the public should not take Omicron lightly.

· If you have been infected with other COVID-19 strains, will you be re-infected with Omicron?

Although some immunity can be acquired after COVID-19 infection, Omicron is a relatively new mutant, and antibodies previously obtained may not fully neutralize omicron. Of the 3,582 new positive cases tested in the UK in January, two thirds had been infected with the Novel Coronavirus in the past. Therefore, people who have been infected with COVID-19 in the past should not think that they can rest easy, let alone take personal protection lightly in daily life.

· "Omicron" is the flu?

Shi Qingfeng is clear: this comparison is not appropriate. Although it has mild symptoms, it is much more contagious than influenza. In terms of sequelae, foreign data show that COVID-19 has far more sequelae than influenza. In addition, the infection rate among family members was 15.8 percent, higher than delta's 10.3 percent and much higher than influenza. Therefore, the public should not treat Omicron with the mentality of dealing with flu.

During repeated outbreaks in China

How can people strengthen self-protection?

Shanghai Health Promotion Center today also issued a reminder:

When people come back from going out,

Wash your hands after touching public objects, sneezing or coughing.

In particular, the municipal Health Promotion Center points out that wearing gloves daily is not a substitute for hand hygiene; If people do not have running water outside, they can use hand sanitizer to clean their hands. However, hand sanitizer cannot replace hand washing. The best method is "running water + hand sanitizer/soap".

Adhere to the "epidemic prevention of three sets", keep in mind the "five protection", which is the most effective, the most convenient, the most economical way to prevent infectious diseases.

How Significant Is the Public Health Threat of the New Rabies Virus?

The new rabies virus is basically a bat host. Since the outbreak of the novel Coronavirus pandemic, the study of pathogens in bats around the world has entered a new stage, and further advances the study of rabies virus in bats. This paper is a summary of the research results in this field, introduces the potential threat to public health posed by the new lysa virus, and puts forward some suggestions for future research.
This blog will introduce the main content of this article in succession.
Contents of this article:
Abstract

  1. Introduction
  2. The growing diversity of Lisha virus
  3. Are Miniopterus bats the source of genetically diverse Lissa viruses?
  4. Batlysa virus found in Lleida, France
  5. West Caucasus bat virus found in Italy
  6. Matlo Batlysa virus, Republic of South Africa
  7. Bat host association analysis
  8. Availability of a bat-lysa virus vaccine
  9. Newly emerging Lisha virus
    Conclusion 10.
    reference
  10. Increasing Diversity of Lisha virus (1)
    Lysha virus is classified in the family Rhabdoviridae, order Mononegavirales. Within The Genus Lyssavirus, The International Committee on Taxonomy of Viruses (ICTV) has identified 17 distinct species of Lyssavirus. Based on genome sequences, they are classified as separate species, including: Aravan Lyssavirus (ARAV); Australian bat Lyssavirus (ABLV); Bokeloh bat Lyssavirus (BBLV); Duvenhage Lyssavirus (DUVV); European Bat 1 Lyssavirus (EBLV-1); European Bat 1 Lyssavirus (EBLV-2); Gannoruwa bat Lyssavirus (GBLV); Ikoma Lyssavirus (IKOV); Irkut Lyssavirus (IRKV); Khujand Lyssavirus (KHUV); Lagos bat Lyssavirus (LBV); Lleida bat Lyssavirus (LLEBV); Mokola Lyssavirus (MOKV); Rabies Lyssavirus (RABV, the most common classic Rabies virus); Shimoni bat Lyssavirus (SHIBV); Taiwan bat Lyssavirus (TWBLV); West Caucasian bat Lyssavirus (WCBV).
    Another novel lyssavirus virus, Kotalahti bat Lyssavirus (KBLV), was detected in a Species of Brandt's mouse-eared bat (Myotis Brandtii) from Finland. There is also a potential novel Lyssavirus virus, tentatively named Matlo bat Lyssavirus (MBLV), two sequences of which have been reported but remain tentative until fully identified. In addition to classification by species, these viruses can be classified into distinct genetic lineages (phylogroups) based on genetics, using nucleoprotein genes, phylogenetic and antigenic data.
    At least two genetic lineages can be identified by phylogenetic topological analysis (Figure 1). The phylogenetic tree of genetic lineage I is divided into two main branches (branche), One clade includes species from the Palearctic and Indo-Malay regions (ARAV, BBLV, EBLV-2, KBLV, ABLV, GBLV and KHUV); The other branch is composed of EBLV-1, DUVV, IRKV and TWBLV. Genetic lineage II consists of African Lisha viruses: LBV, MOKVm and SHIBV. The most genetically differentiated Lysa viruses were provisionally classified into genetic lineage III and subdivided into two clades, which were collected from Europe to Africa, including WCBV-MBLV and Ikov-LleBV respectively.
    In terms of sequence similarity, the mean nucleotide sequence similarity of viral glycoprotein genes in genetic lineage II was the highest (71.5%), and that of viruses in genetic lineage I was 70.3%. The average nucleotide sequence similarity of the viruses preliminarily classified as genetic lineage III was 58.2%, indicating that these viruses were quite different. The mean nucleotide sequence similarity of viruses in genetic lineage III was lower than that of viruses in genetic lineage I and GENETIC lineage II (54.1% and 54.5%, respectively).
    Similar to evolutionary and genetic data, antigenic analysis has identified several antigenic groupings comparable to genetic lineages (Figure 1). The degree of differentiation in these genetic lineages can be used to predict the degree of cross-protection that existing rabies vaccines based on RABV, the most common classic rabies virus, may provide. Although different individuals have different immune responses to vaccines, it is generally believed that conserving viral neutralizing antibody (VNA) levels equal to or greater than 0.5 international units (IU/mL) are positively associated with serum transformation after RABV vaccination. With the exception of RABV, approved rabies vaccines appear to offer largely protective immunity against lyssa virus of genetic lineage I, with the least protection against IRKV. In conclusion, the level of VNA required for protection against non-RABV Lyssa viruses is unclear.

Can Nootropics Transform Anyone into a Genius Like Einstein?

The continuous development of science and technology in Fusu has provided a broader space for people to develop their imagination. Some of these ideas have become reality with the support of scientific theory and practice, including 3D bio-printing technology. In the future, it is expected to provide more guarantee for human organ transplantation.

Developing 'nootropics' that could boost human Intelligence

On this basis, some suggest that we might be able to create a nootropics that would help humans develop their intelligence as much as possible, thereby boosting overall development. However, there is also a view that such a drug, even if produced, would be an "intelligence tax" and would not be able to radically change people's physiology, especially their intelligence.

In fact, in many science fiction works, drugs of wisdom, regret and so on can exist, and can promote the development of some plots. But it's hard for them to come true. On the one hand, human technology is not up to it. On the other hand, our society doesn't allow such drugs to exist.

Nootropics are supposed to enhance learning by improving attention and memory, in addition to intelligence.

Throughout our long evolutionary history, we have been able to do everything we can to get closer to the goals we set for ourselves, and our habits have often accumulated over time to help us achieve qualitative change, so the idea is that nootropics are entirely possible.

The human body cannot withstand intelligence imposed from outside

However, other studies have shown that human development requires us to follow a gradual path, that "evolution" by external forces is not natural, and that humans will inevitably be punished for it.

As it is said, technology is a double-edged sword, nootropics bring more impact than people think. For example, in the movie Superbody, the injection of special drugs enables the protagonist to acquire superpowers. She can not only change the physical form at will, but also understand the past of human beings, and has the skills equivalent to four-dimensional creatures.

In the real world, the emergence of nootropics will make more and more people fall into the fierce competition, because the drug support means greater opportunities for development, so the society will become extremely chaotic, and the conflict will deepen at the same time, and the human race may be pushed to extinction.

Nootropics could doom the human race

According to scientists, our brain is like a complex computer that integrates resources to help us do other activities better, and nootropics are like "plugins" that not only speed up the processing of information, but also consume more resources. This means that our bodies may not be able to withstand a lot of stress and eventually collapse.

At present, there are some nootropics drugs in the world, but they are not so advanced. They can only improve the working efficiency of the brain and some organs for a short time, although there are no serious side effects, and they are not widely used.

Today, nootropics are still regarded as stimulants by many people, and natural development is still the principle followed by many people, especially in the recent controversy over gene editing technology, and people even reject the practice of changing the ethical order with the help of advanced technology.

As a result, real nootropics will not only be hard to come by, but will also pose a new challenge to humanity, if not an IQ tax.

Experts: Delivery Outsourcing Can Still Detect Nucleic Acid Fragments After Disinfection, but the Virus Is No Longer Contagious

The mechanism of package disinfection is to destroy the protein of the virus, denaturate it and lose its ability to spread, rather than decompose the nucleic acid -- so the package can still detect the nucleic acid virus after disinfection, but the virus has no infectious ability at this time. In March 6, zhejiang province epidemic prevention and control work press conference, provincial center for Disease Control and Prevention and environmental health deputy director Lu Ye said. To express the disinfection, he said, according to the existing scientific evidence that conform to the level of medical health disinfector, of which will be coronavirus variants are inactivated effect, will be coronavirus is composed of protein, nucleic acid, chemical disinfection way is mainly to virus inactivated, mechanism is destroy the virus protein, make its degeneration loses its ability to spread, It doesn't break down nucleic acids. "So that's why sometimes we can sterilize the package and still detect nucleic acid fragments, but the virus is no longer infectious." He expresses, to the public, choose to disinfect a product to basically see outer package whether to mark "sanitization license of disinfect product" these a few words. Secondly, choose the product instruction label for environmental object surface disinfection, you can pile up express and express and its place for environmental object surface disinfection. Lu Ye reminds, everybody don't forget to unpacking, transport tools, such as a cart and to use in the process of sign after receiving STH of pen and phone also need disinfected, "charge express a look is a little thing, but there are a lot of details in relation to the prevention of each of us, hope you fine point, everyone to do a good job of epidemic prevention, guard against all kinds of possible risk factors."

Two Foods People with Osteoporosis Should Avoid

Osteoporosis is known as a disease of the elderly. According to the definition of osteoporosis by the World Health Organization, it mainly refers to the reduction, degradation and brittleness increase of bone mass, resulting in fracture, or even a systemic bone disease. To the naked eye, it looks like a body with porous bones.

However, with the change of modern people's life, as well as the development of bad habits, not paying attention to calcium supplement, crazy eating high salt, oil and fat food, will increase calcium loss to a certain extent, and the probability of osteoporosis.

At the same time, to correct everyone is that these kinds of food is not suitable for the population of osteoporosis to eat, to avoid the deterioration of the condition.

High salt food: say in daily life too much salty food, eat less snacks, pickles, meat, and people in the process of daily cooking, don't pay attention to salt, even in a large number of light soy sauce, soy sauce, MSG, chicken essence, etc., a large amount of salt to accumulate in the body, can discharge more sodium, into 100 mg sodium, almost every will discharge about 10 mg of calcium.

Carbonated drinks: These drinks produce gas because of their carbonated content. In addition, carbonated drinks also contain more calcium phosphate, which will affect the absorption and utilization of calcium to a certain extent, so it is advisable to touch less.

There are four other things you need to do to help you get your calcium:

Eat calcium-rich food - a lot of people think that eating shrimp skin and sesame paste can supplement calcium, although in calcium content, shrimp skin and sesame paste can not lose to milk, but in terms of overall health index, milk ranked first, there is a great advantage is easy to be digested and absorbed by the body.

In addition to milk, you can also choose fresh leafy greens, nuts, soy products, are good choices.

Moderate Exercise: Is more exercise better? Not necessarily, moderate exercise has greater advantages, through moderate exercise, bones can play the maximum effect, that is, the new dietary Guidelines for Chinese residents recommends doing moderate intensity exercise at least 5 days a week, the total time should be more than 150 minutes.

You can choose to walk fast, run, jump rope, swimming, etc., are strong bones.

Often go outdoors in the sun: of course, this also can yet be regarded as is a good choice, because now ultraviolet ray also is not very severe, you can choose after 10 o 'clock in the morning, around 3 PM, bare legs, still can let the skin absorb vitamin D, and vitamin D and calcium can have the effect of synergy, help the body absorb calcium better.

Ensure sleep quality: sleep is also one of the measures to maintain the normal operation of the body, of course, to reduce the loss of calcium is also very helpful, adults should be based on 7 to 9 hours.

Can a Child Still Be Desired if the Mother Underwent Antiviral Treatment During Pregnancy?

As a clinician in the department of hepatology, this is one of the questions I often hear when I communicate with patients with hepatitis B: Dr. Fang, I am taking antiviral drugs, but I accidentally got pregnant. Can I still have this child?

Before we answer that question, let's take a look at some common sense about drug safety in pregnancy.

Before 2015, the United States Food and Drug Administration (FDA) divided drugs into five grades according to their safety during pregnancy, namely: Class A, no harm to embryos was found in animal experiments and clinical application before the drug was put on the market; Grade B: no harm to embryos has been observed in animal experiments, but the safety for fetuses has not been proved clinically; Grade C: it has been proved to have teratogenic or injurious effects on embryos only in animal experiments, but lacks corresponding data for human beings; Grade D: It has been confirmed clinically that it is unsafe for human embryos, but the drug has certain clinical efficacy for pregnant women and no safe drug can replace it, so it should be used after weighing the advantages and disadvantages; X level: clearly prove to have harm to embryo, gestation period is forbidden. In fact, only 0.7 percent of class A drugs are classed as CLASS B, and most drugs are classed as CLASS C.

Because preclinical drug doses used in animal trials are often dozens or even hundreds of times higher than those used in post-clinical trials, the results of animal trials do not prove the same for humans. Class C pregnancy drugs do not mean that they cannot be used during pregnancy, the FDA notes. Doctors, pregnant women and their families often overestimate the risks of drugs to fetal development during pregnancy. The drug may be used if the assessed benefits outweigh the risks to the pregnant woman.

In recent years, the classification of pregnancy safety of drugs has aroused a lot of controversy, and it is believed that such classification is not reasonable and may cause misunderstanding of drugs by doctors, pregnant women and their families. Therefore, since 2016, THE US FDA has no longer made equal classification of pregnancy safety of newly marketed drugs. The results or data on the use of drugs in animals or humans during pregnancy are simply written in instructions for doctors to use.

Clinical anti-hepatitis B virus drugs have two types: oral antiviral drugs and interferon injection. With the passage of time, some oral antiviral drugs with large clinical side effects, poor antiviral effect and easy drug resistance are gradually replaced by drugs with small side effects, good efficacy and low incidence of drug resistance. At present, there are three kinds of first-line oral antiviral drugs recommended by domestic and foreign guidelines: entecavir, tenofovir fumarate, and propofol tenofovir fumarate, as well as polyethylene glycol interferon injections.

Below, I will introduce the pregnancy safety of these antiviral drugs for hepatitis B mothers one by one in combination with the latest version of hepatitis B prevention and treatment guidelines in our country:

  1. Entecavir (ETV)

It was the first first-line oral anti-hepatitis B drug to hit the market (2015), and was classified as a class C drug for pregnancy by THE US FDA at the time of marketing, which is not recommended for use during pregnancy. The reason why entecavir is listed as C and drug is that in pre-market animal experiments, when the large dose (tens of times higher than the human dose), entecavir is observed to have certain harm to the embryo development of some animals. At doses ranging from three to 40 times the human dose, the incidence of lung tumors increased in mice. At present, entecavir has been clinically used for more than 10 years, and it is the most widely used anti-hepatitis B drug in clinic. No adverse pregnancy reaction cases have been found clinically, nor has there been a clear literature report of harm to fetal development. According to the latest guidelines for the Prevention and Treatment of Chronic Hepatitis B released in 2019, pregnant women who become pregnant unexpectedly during antiviral treatment are not required to terminate their pregnancy if they are being treated with entecavir, and it is recommended to change to Tenofovir fumarate and continue treatment.

  1. Tenofovir fumarate (TDF)

It was listed in 2008 and has been in clinical application for more than 10 years. In animal experiments before TDF was marketed, it was found that the effects on animal embryo development could also be found when the dose was tens of times larger than human body. Due to the lack of data on the safety of human pregnancy, TDF was classified as a class B pregnancy drug by THE US FDA when it was marketed. Because TDF was first used for the treatment of AIDS, there have been a large number of data on the safety of AIDS pregnant women in clinical practice, and it is found to be safe for pregnancy. Existing large amounts of data also confirmed in pregnant women who applied to hepatitis b is safe for fetal development, and for taking TDF, is rare in the breast milk (only about 0.03% of the therapeutic dose), and the low bioavailability of TDF in breast milk, so such traces of TDF content in milk for newborn almost negligible influence growth and development. At present, TDF is recommended by domestic and foreign guidelines as the preferred anti-hepatitis B drug during pregnancy. It can be used before, during and after pregnancy, and hepatitis B mothers can breastfeed while taking the drug.

  1. Propofol Tenofovir dipivoxil (TAF)

TAF was introduced into the market in 2016. Compared with entecavir and Tenofovir fumarate, TAF was put on the market later, because both TDF and TAF were decomposed into tenofovir (TFV) in vivo to play a role. Therefore, TDF was used for reproductive toxicity in animal experiments before marketing. TAF is safer because the dose is much smaller than TDF. At the end of 2021, researchers from the First Affiliated Hospital of Zhengzhou University conducted a multicenter prospective study to evaluate the efficacy and safety of TAF in the treatment of 103 pregnant women with chronic hepatitis B and the prevention of mother-to-child transmission of HBV. The results showed that: For pregnant women with active chronic hepatitis B and their infants, TAF is safe and effective to be administered throughout pregnancy or early in pregnancy. Therefore, TAF will also become a drug with good safety during pregnancy.

  1. Polyethylene glycol interferon (PEG-IFN)

Peginterferon has been on the market since 2005 and has been contraindicated in pregnant women because of reproductive toxicity found in pre-marketing animal tests. "Peg-ifn can be used before pregnancy to complete treatment within the first six months of pregnancy, and reliable contraceptive measures should be taken during the treatment for patients with antiviral therapy indications," the 2019 version of China's Guidelines for the Prevention and Treatment of Chronic Hepatitis B states. According to limited literature reports, interferon pregnancy harms are mainly abortion, fetal growth retardation, low weight children, etc., but there are no reports of teratogenicity, so, China's guidelines also point out: "If a pregnant woman has an unintended pregnancy during peG-IFN antiviral therapy, it is recommended that she and her family be fully informed of the risks, and that she decide whether to continue the pregnancy or switch to TDF treatment if she continues the pregnancy." Guidelines in the United States and Europe are similar, suggesting changing medications and not terminating a pregnancy. Therefore, for older pregnant women, in this case, it is necessary to fully consider the patient's reproductive age, the risk of abortion and the impact of abortion on future fertility, and then decide whether to terminate pregnancy after weighing the advantages and disadvantages.

  1. Other antiviral drugs

These included prior use of lamivudine, adefovir dipivoxil, tibivudine, and common interferon. Lamivudine and tibivudine have been classified as pregnancy B drugs by FDA in the past, and their use during pregnancy has been found to be safe in clinical practice. There are few data on the safety of adefovir dipivoxil in pregnancy, and there are reports that there is no effect on fetal growth and development when adefovir dipivoxil is used in pregnancy. The pregnancy safety of common interferon is the same as peg-interferon. These drugs are not recommended as first-line antiviral drugs at present because of their efficacy, side effects and drug resistance.

As mentioned above, the effect of anti-hepatitis B drugs on hepatitis B mothers is not as serious as people think, and the effect on hepatitis B fathers is even less. Therefore, hepatitis B mothers and hepatitis B fathers, do not worry too much about the safety of antiviral drugs for the fetus, the most important thing is to find a specialist before pregnancy to check and evaluate, timely safe and effective intervention when needed, in order to block the occurrence of vertical transmission of hepatitis B virus from mother to child, to avoid the transmission of hepatitis B virus to the next generation.

How Does the Novel Coronavirus Compare with Historical Super-Plagues?

The COVID-19 outbreak in early 2020 has changed too many lives. The COVID-19 pandemic has been raging worldwide for a year, but it is still going strong, infecting more than 91 million people worldwide and killing nearly 2 million as of January.

The economic losses were even greater and incalculable. The continuing pandemic triggered a widespread economic recession and dealt a blow to the already booming wave of globalization. The United States, the only superpower, has fallen in front of the Novel Coronavirus pandemic, which further aggravates the domestic political turmoil and division and exposes its economic, social and institutional vulnerability.

Historically speaking, the Black Death, smallpox and cholera were the deadliest and most terrifying super plagues in human history, killing hundreds of millions of people. These devastating infectious diseases can change the fate of a nation or even the course of human history. To date, only smallpox has been completely eradicated by humans, with only partial samples of the smallpox strain remaining in the laboratory for scientific research. Plague has occasionally spread in small scale around the world, while cholera remains a risk in areas with poor sanitation and a lack of safe water.

Of the three pandemics, the Black Death had a huge impact on Europe. The Black Death, mainly from 1348 to 1451, killed tens of millions of people and nearly halved Europe's population. It was the worst plague pandemic in human history. At that time, it was found that those who were infected with the plague would have many black spots on their skin, and then the whole body would become black, delirium, high fever, and finally painful death, so this particular plague was called "black Death" by the Europeans.

Plague is a natural epidemic disease widely prevalent in wild rodents. Ancient China had already called it "plague" and had already carried out anti-rodent measures to effectively prevent it. In the middle Ages, Europeans were completely ignorant of the disease caused by plague bacteria, and Europe at that time could be said to be the paradise of rats. At that time, Europe had extremely poor public health conditions and people did not pay attention to hygiene. They defecated, urinated and littering everywhere in cities, providing a good living environment for rats. In addition, at that time, the Catholic Church in Europe thought absurdly extreme, that the cat is the angel of the devil, the servant of the witch, so the cat was killed. Lacking natural predators and good living conditions, rats in Europe thrived in cities. Contamination of the environment by rats and their fleas caused the spread of plague.

Later, Europe implemented the strictest quarantine system, isolating patients, villages, people and goods, and eventually, European countries have emerged from the shadow of the Black Death. People learned to control the epidemic of plague effectively through deratization, disinfection and strict isolation measures.

Europe in the Middle Ages was decimated by the Black Death. However, the black Death also completely shook the traditional social structure of Europe, weakened the power of feudal and ecclesiastical aristocrats, led to the revival of humanism and indirectly contributed to the later Renaissance and religious Reform. In the following two or three hundred years, Europe led the world trend, taking a leading position in science and technology, military affairs and economy, thus ushering in the era of global colonial expansion in the 19th century.

The infectious disease that had a profound impact on Chinese history was smallpox. Smallpox was a deadly virus, and it struck quickly. As early as the Jin Dynasty (220-2jin dynasty), the philosopher Ge Hong described the symptoms of smallpox in detail for the first time in his work "Urgent Prescription of Elbow Reserve". Later, with the deepening of medical understanding, song and Yuan dynasties, there have been many doctors began to prevent and treat smallpox through the kind of "human pox", "human pox" is used to blow the scab powder of the patients with pox self-healing into the nasal cavity of the inoculated, which is the most effective smallpox prevention method before the invention of "vaccinia". By the Ming Dynasty, most adults in the Central Plains had certain immunity to tianhua, and only children had a higher incidence. Therefore, in each dynasty before Ming Dynasty, although smallpox always existed, the epidemic scale was not large, and it did not have a significant impact on the whole society and political situation.

Smallpox, however, had a major impact on the fate of the last authoritarian dynasty, the Qing. Smallpox played a decisive role in the succession and power game of the Qing Dynasty.

The Jurchen nationality lived in the northeast area outside Serbia, where the climate was cold and dry. Their lifestyle was mainly nomadic and hunting, and they had little contact with the Han people in the south, so smallpox virus was rarely spread in these areas. At the beginning of the qing army's entry into the pass, the number of smallpox patients in the eight Banners increased with each passing day because of the increased contact with han people due to accultation with the soil and water.

Three of the twelve Emperors of the Qing dynasty died of smallpox. They were Huangtaiji and Shunzhi in the early Qing Dynasty and Tongzhi in the late Qing Dynasty. Another one that could not be ignored was the powerful "Auxiliary Prince Shu Deyu" in the early years of Shunzhi in the early Qing Dynasty.

Dodor, the brother of dourgun, the regent of the emperor's father, also died of smallpox.

The sudden death of these three emperors and an auxiliary prince had a great impact on the political situation of the Qing Court at that time.

Huang Taiji died of smallpox a year before the Qing army entered the Pass. At that time, The disease developed rapidly and he died suddenly before he could stand up. As a result, fu Lin's succession to the throne was an unexpected result of the power struggle. Although Fu Lin, Huangtaiji's ninth son, succeeded to the throne, the highest power was in the hands of duergun, the regent.

In the eighth year of shunzhi, fu Lin, the fourteen-year-old Shunzhi emperor, was in power. Although he only reigned for ten years, he died of smallpox at the age of twenty-four. But it was also because of smallpox that Shunzhi came to power. Shunzhi six years, the Second person in the Qing Court, power second only to the regent Duergun "assistant Prince Shudeyu" Duduo died suddenly of smallpox. The following year, Duoergun died suddenly, opening the way for Shunzhi.

On the seventh day of the first lunar month in the 18th year of Shunzhi, emperor Shunzhi died of smallpox in the Hall of Mental Cultivation. Although he had eight sons, four of them died young (thought to have been caused by smallpox), and the eldest was the second son, who was only nine years old. Finally, eight-year-old Xuanye, the third son of the emperor, was chosen by Shunzhi as his successor, the later Kangxi Emperor. The reason for choosing him was simple: Xuanye had smallpox and was immune for life, so he did not have to worry about premature death.

In the late Qing Dynasty, emperor Tongzhi also died of smallpox at the age of 19. Tongzhi's sudden death, although there was no power struggle, caused political turmoil, but his mother Cixi continued to hold the power of the Qing dynasty, objectively played a role in helping. As a result, smallpox had a profound impact on modern Chinese history.

Cholera, on the other hand, is a disease that is still prevalent in areas with poor sanitation. Cholera is an acute diarrheal infectious disease caused by ingestion of food or water contaminated with vibrio cholerae. Cholera peaks in summer and can cause diarrhea, dehydration and death within hours. The World Health Organization estimates there are 3 million to 5 million cholera cases worldwide each year, with 100,000 to 120,000 deaths, and Africa accounts for more than 90 percent of the world's cholera cases.

There have been seven recorded cholera pandemics. In the century-plus years from 1817 to 1923, when the first cholera epidemic began, six pandemics took an incalculable toll, killing more than 38m people in India alone. The seventh cholera pandemic began in 1961. This time it started in Indonesia, then spread to other Asian countries and Europe, and in 1970 it arrived in Africa, where it has been a scourge ever since.

In the 1990s, cholera cases began to rise again. The resurgence of cholera after many years is mainly related to environmental deterioration, poor sanitation facilities, lack of clean drinking water, malnutrition and other factors in poor areas. Cholera hit Latin America in 1991, sickened 400,000 people and killed 4,000 in a single year.

As we have now begun to vaccinate against COVID-19, the spread of the Novel coronavirus virus will be brought under control, just as we have conquered other plagues. Thanks to modern medicine, the novel Coronavirus mortality rate seems to be much lower than those of these three infectious diseases, especially compared with plague and smallpox. But the Novel Coronavirus will undoubtedly go down in history as highly effective, stealthily infectious, with its wide spread and far-reaching impact on the global economy.

How is Viral Hepatitis Commonly Treated?

Treatment of viral hepatitis includes acute treatment and general treatment.

① Treatment of acute phase.

Patients with clinical symptoms of gastrointestinal bleeding should take emergency management.

Vasoactive medications such as vasopressin, octreotide, somatostatin, and terisopressin should be given as soon as possible when bleeding due to gastroesophageal varices occurs. If drugs are ineffective after these treatments, patients should be treated with sclerosing agent injection and ligation under endoscope. Intrahepatic portal vein shunt surgery, such as jugular intrahepatic portal vein stent shunt, balloon compression to stop bleeding or reduce vascular pressure, can also be selected.

② General treatment.

Generally treated patients can choose adequate rest to achieve the purpose of treatment. Viral hepatitis patient should choose to rest in bed when the symptom is apparent or the condition is serious, because the posture of bed can increase the amount of blood flowing through the liver, have certain help to the body to restore health, and the patient with lighter viral hepatitis can choose to have a few lighter activities. At the same time, in daily diet to achieve reasonable collocation, avoid drinking, eat more high-protein, high-vitamin, digestible and high-calorie food, it should be noted that patients do not deliberately eat some high-nutritional food is necessary, because to avoid the occurrence of fatty liver caused by excess nutrition.

In terms of drug therapy, there is no absolute best, best or most effective medication due to the great individual difference of each patient. In addition to commonly used over-the-counter drugs, other drugs should be selected according to individual conditions under the guidance of doctors.

For the antiviral treatment of viral hepatitis, the drugs selected are drugs that can inhibit the replication of the virus, can reduce the infectivity of the virus and improve the liver function of patients, reduce the liver lesions, delay or reduce liver hardening, failure. It should be noted that antiviral therapy should be determined by the doctor based on the patient's comprehensive situation.

Interferon is commonly used for the treatment of chronic hepatitis B and C, but is not recommended for women with serum bilirubin levels more than twice normal, with autoimmune disease, decompensated cirrhosis, with vital organ disease, and women of childbearing age. After using interferon soy platelets and granulocyte bone marrow suppression phenomenon appears the possibility, also can have the possibility of abnormal mental nerve, because this kind of interferon medicine needs to fall in the doctor's guidance, let the doctor decide to reduce medicine or stop medicine through the patient's situation observation.

Nucleoside analogues are a class of drugs that can be used for the treatment of hepatitis B. Biochemical indexes of patients need to be checked before and during treatment, as well as viral load and virological markers. Patients need to be followed up for at least 12 months after stopping the drug to determine the status of their condition.

HIV Discoverer Dies After Controversial Comments

Luc Montagnier, the French virologist who won the Nobel Prize in medicine and Physiology in 2008 and was known for his discovery of the human immunodeficiency virus, died on February 8 at the age of 89.

Montagnier is a man of great achievement and great controversy. Although he made remarkable achievements in medical science, he was criticized for his unscientific opinions in his later years, including artificial theories on the origin of COVID-19.

In 2009, he claimed that DNA emits electromagnetic radiation, and that some bacterial DNA continues to emit signals long after an infection has been cleared; In 2012, he spoke at a conference on autism in Paris, France, claiming that long-term use of antibiotics can successfully treat autism; Last May, he claimed in a video that the vaccine programme was "unacceptably wrong" because it could cause the virus to mutate; In January, he criticized U.S. President Joe Biden's vaccine policy in a Wall Street Journal op-ed with a Yale Law professor.

An accomplished scientist can be "incredibly" amateurish, confusing and incomprehensible. Fortunately, just because he is an "authority" does not automatically give his nonsense the property of truth.

Today, we send Off Montagnier in the 2020 edition, hoping to remember and thank him for his remarkable discoveries. Hopefully, one day AIDS, a hitherto intractable epidemic, will come to an end.

Article | Wang Chengzhi li Runhong
Director | Di Li Hui Tang Peilan

Low low low

Figure 1 2008 Nobel Prize in physiology or medicine for HIV and the discoverer of the HPV virus | photo source: nobelprize.org

On June 5, 1981, the Centers for Disease Control and Prevention (CDC) reported that five los Angeles-area gay men had developed pneumocystis carinii pneumonia.

The disease is very rare and usually occurs only in people with extremely low immunity. Soon, the CDC found more patients with similar symptoms, including Kaposi's sarcoma and giant cell infections.

At the time it was called "gay man's disease". But it soon became clear that all groups of people caught the disease, mostly through sex or blood transfusions. As a kind of infectious disease, it is urgent to find its pathogenic factor to control the disease.

In the race to discover the cause of the disease, Luc Montagnier, a Frenchman, found and proved that HIV was the killer. His discovery, along with a dispute between him and another American scientist, has led to high-level government involvement and even court battles in France and the United States.

01

Montagnier, the refugee

Montagnier was born in 1932 in Chabris, a town in central France known for its goat cheese and white asparagus, among other produce. As an only child, Montagnier was naturally doted on by his parents and could have had a carefree childhood. But life's accidents and the currents of The Times came one after another to disrupt Montagnier's peaceful life.

At the age of five, Montagnier was hit by a speeding car on a main road. Montagnier spent two days in a coma before being revived. Although he escaped death, the accident left him badly injured and scarred.

Figure 2 5 montagnier is | photo source: Nobel Prize's official website
Two years later, in 1939, seven-year-old Montagnier was picking grapes with his family in his uncle's vineyard when France declared war on Germany. The next year, with the full invasion of Germany, the Montagnier family fled as refugees. Since then they have not enough to eat and often suffer from hunger. During the four years of the war, Montagnier, who was still in his teenage years, did not gain any weight.

To add insult to injury, Montagnier's grandfather was diagnosed with colon cancer and died after enduring great pain. Seeing how his grandfather suffered inspired Montagnier to study medicine and cancer.

In high school, Montagnier kept his grades at the top, and his interest in science grew. He set up a simple chemistry lab in the cellar of his home and made his own hydrogen and scented aldehydes, even starting to make his own nitro compounds. At the same time, he also read a lot of books on physics, especially in frontier fields such as atomic physics.

After attending university, he decided to pursue medical research because of his strong interest in it. But there was no medical profession in his town at that time, so he went to the hospital in the morning and attended botany, zoology, and geology at school in the afternoon.

Fortunately, Professor Pierre Gavaudan, who teaches Montagnier's botany, is not constrained by textbooks. His lectures on the latest advances in biology, including the DNA double helix, protein synthesis using ribosomes in vitro systems, and the structure of viruses, opened new doors for Montagnier.

Montagnier received two gifts from his father: a time-lapse camera and a microscope. He used them to study how algae cells adjust chloroplast arrangement in response to light intensity. Using different colour filters, time-lapse photography and microscopy, he showed that instead of using chlorophyll to absorb red light, the algae cells indirectly regulate the direction of the chloroplasts by using yellow pigments to absorb blue light. Montagnier, who was only 21, completed his Faculty of Sciences of Poitiers defense with this result.

02

First foray into the world of viruses

At 23, Montagnier became a research assistant at the Sorbonne Universite in Paris, where he learned cell culture techniques. In 1957, Heinz Fraenkel-Conrat and other scientists discovered that tobacco Mosaic virus uses RNA as genetic material and can infect plants through RNA. Montagnier was impressed and decided to study viruses through the then nascent field of molecular biology.

He then went to Kingsley Sanders' laboratory in Castleton, England, to study the foot-and-mouth disease virus, where he showed that RNA could be copied by base pairing just like DNA.

Soon after, Michael Stocker, a renowned biologist, set up a new virus institute in Glasgow. Montagnier also came to study polyomavirus, a virus that causes tumors. Montagnier and his collaborators showed that the virus's DNA itself has the ability to cause tumors. While this may not seem unusual to modern eyes, at the time it broke the conventional wisdom that all life depended on protein.

After his research studies in the UK, Montagnier returned to France to continue his research on oncogenic viruses at the Curie Institute. At the time, one of the great mysteries of virology was waiting to be solved: How did RNA viruses replicate? Using Rous sarcoma virus (RSV) as a model, Montagnier tried to identify the double-stranded RNA produced by viruses. He did find it in cells infected with the Rous sarcoma virus (RSV), but the sequence was not of viral origin. He also found double-stranded RNA in cells free of viral infection, proving that this double-stranded RNA was not related to the virus. Montagnier later recalled that the discovery was actually a partial approximation of the small interfering Rnas that were later discovered.

In 1970, across the ocean in the United States, two laboratories (Howard Temin and David Baltimore) independently discovered reverse transcriptase in RSV. This enzyme can use viral RNA as a template to make the corresponding DNA. This not only explained the replication of RNA viruses, but also broke the central dogma of biology that RNA can be made from DNA templates, and led to the realization that transcription can also be done in reverse.

Based on this, Montagnier discovered that the DNA retroscribed by the virus can be integrated into the genomic DNA of the host cell. Since then, retroviruses have become the focus of Montagnier's lifelong scientific research.

In 1972, Jacques Monod, director of the Pasteur Institute in France, approached Montagnier to establish a center for virus research at the Institute. At the time, a heavily funded virus cancer program in the United States had made tumor-associated viruses a hot topic, and Montagnier had created the Viral Oncology Unit at the Pasteur Institute.

In 1973, J. C. Chermann and his collaborator Franoise Barre-Sinoussi joined Montagnier's research center. Barre-sinoussi is experienced in detecting reverse transcriptase activity. Montagnier persuaded them to work together on retroviruses that cause cancer in humans. In 1977, they began testing blood and tissue collected from patients in Paris hospitals to see if they could detect retroviruses.

At this point, montagnier's experiments were greatly aided by research in two other LABS.

Because virus replication in the body is blocked by interferon, Montani speculates that blocking interferon would make it easier to detect the virus. Just then Ion Gresser's laboratory in Villejuif, France, produced an antiserum that neutralised interferon. In tests, Montagnier and Barre-Sinoussi et al. found that treating cells with this interferon antiserum increased the expression of endogenous retroviruses by a factor of 50. This greatly increased the sensitivity of their experiments.

At the same time, The Laboratory of Robert Gallo, an American virologist, invented T cell culture technology. By adding a growth factor (TCGF, then called interleukin-2) to the culture, human T cells that would otherwise be difficult to grow in vitro could be expanded.

With the help of these two approaches, Montagnier et al. began studying retroviruses in T cells taken from breast cancer patients.

However, just as Montagnier's lab was preparing various techniques for studying retroviruses, a new retrovirus, HIV, began to spread among humans, with serious consequences.

03

Between the square inch, the sky is very different

After June 1981, the United States Centers for Disease Control and Prevention reported increasing cases of AIDS. What is the cause of this terrible disease? This became an urgent problem at the time.

Gallo speculates that the new disease may be caused by a retrovirus. Gallo, a pioneer in retrovirus research, has good reason to suspect so.

His lab not only invented T-cell culture, but also isolated the first human retrovirus, human T-cell leukemia virus-1 (HTLV-1). The symptoms of htLV-1 infection in animal models are similar to those of the new disease, and htLV-1 can be transmitted through blood transfusion, sex, or mother-to-child transmission. These clues led Gallo to believe that the new disease was caused by a retrovirus similar to HTLV-1.

In 1982, Gallo's lab detected DNA sequences similar to HTLV-1 in blood samples from patients with the new disease. In early 1983, they found HTLV-associated DNA in two of 33 samples. It turned out that this was because both patients were infected with HTLV at the same time, but the experiments misled Gallo into thinking that the pathogen of the new disease was a new member of the HTLV family.

As it turned out, Gallo was right that the new virus was a retrovirus, but not a new member of the HTLV family.

Gallo's conjecture spread through the field, with some clinicians and immunologists. Montagnier learned of these suspicions, too, and in 1982, he teamed up with his student Franoise Brun-Vezinet to study new pathogens.

On 3 January 1983 brun-Vezinet obtained a lymph node sample from a patient numbered BRU. Montagnier himself grinded the sample and grew the T cells in it. Fifteen days later, Franoise Sinoussi detected reverse transcriptional activity in the supernatant of the culture medium, confirming that the new pathogen was indeed a retrovirus. They called the strain lymphadenopathy associated virus (LAV).

At the time, THE HTLV-1 and HTLV-2 discovered in Gallo's lab were the only known human retroviruses. Using Gallo's HTLV antibody, Montagnier's lab tested their samples and found that the HTLV antibody did not bind to their newly discovered virus. This suggests that the new virus is not HTLV, as Gallo had speculated.

Luckily for Montagnier, the first sample led him in the right direction. Later, he recalled, they received a sample of a patient named MOI infected with both the new virus and HTLV. If this is the first sample they test, they are likely to be as misguided as Gallo.

Meanwhile, Montagnier's collaborator, electron microscopist Charles Dauguet, also found that the new virus looked different from HTLV under electron microscopy. Virologist Edwald Edlinger suggested that Montagnier compare the new virus with lentiviruses found in animals. Using electron microscopy, they found that the new virus and lentiviruses looked almost identical.

Figure 4 HIV | photo source: pixabay.com

Montagnier and Gallo shared their findings, and Gallo suggested a joint publication. In May 1983, Montagnier and Gallo simultaneously published their own isolates of the new virus. However, Gallo did not know at this time that the virus he had isolated was actually a mixture of the new virus and HTLV, and that Montagnier's LAV was a pure strain. This is probably the main reason gallo was later unable to share the Prize with Montagnier.

Between late 1983 and early 1984, Gallo lab technician Betsy Reed-Connole and collaborator Mika Popovic isolated several new strains (RF, IIIB, and MN). During this time, they published a series of papers detailing their isolation methods, in vitro amplification methods, and evidence that the virus was the cause of a new disease. These strains also became the standard for subsequent blood tests.

At this point, Montagnier's experiment ran into problems. The virus (LAV) they isolated from BRU patients could not amplify in T cells. Gallo visited Montagnier's lab in Paris and brought him samples of the IIIB strain, which can proliferate continuously in T cells. Gallo wanted Montagnier to compare the IIIB and LAV strains, and they agreed to hold a joint press conference if the virus they isolated was the same.

04

The controversy has rattled the French and American top brass

Somehow, however, the news leaked out. A reporter contacted Margaret Heckler, then the secretary of health and Human Services, prompting her to urgently recall Gallo and hold an early unilateral press conference in the United States.

In May 1985, the U.S. Patent and Trademark Office granted gallo's research institute a patent for a blood test for the new virus. In fact, France had already filed an almost identical patent application before Gallo.

Between 1985 and 1986, French representatives launched four lawsuits and two years of wrangling between the two governments. Then, in 1987, President Ronald Reagan and French Prime Minister Francois Mitterrand signed a settlement that offered shared benefits. The deal, however, gave the United States more rights until it was renegotiated in 1994 and the two sides agreed on a 50-50 split.

The hastily called press conference in the United States not only caused a political storm, but also generated a lot of debate in the scientific community. Coincidences since then have intensified the debate.

Montagnier isolated a proliferative strain called LAI after LAV. Possibly because this strain of virus is highly proliferative, it contaminated montagnier's previous LAV samples. Montagnier had sent this sample to Gallo, which led to the contamination of gallo's lab strain. Gallo later found that IIIB isolated in his laboratory was also contaminated with LAI, and the contaminated strain spread to many laboratories. Although the contamination between these strains was gradually recognized in the 1990s, it did not affect scientists' understanding of their cause of immunodeficiency disease in humans.

Figure 5 December 10, 2008 montagnier won the Nobel Prize in the Stockholm concert hall | photo source: nobelprize.org

After academic discussion, the new virus was finally named as human immunodeficiency virus (HIV), and the diseases it causes are collectively known as immune deficiency syndrome (AIDS), so HIV is also referred to as HIV.

Despite many twists and turns, Montagnier's contribution to the first isolation of HIV has been recognized by the academic community. Gallo's commentary, published in Science in 2002, also explicitly acknowledged that Montagnier's team was indisputably the first to isolate true HIV, since his team had failed to exclude HTLV from the strain published in 1983.

In 2008, Montagny and his collaborator Franoise Barre-Sinoussi shared the Nobel Prize in Physiology or Medicine for their discovery of HIV. He later became one of the co-founders of the World Foundation for AIDS Research, contributing greatly to the understanding of HIV and AIDS.

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