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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.

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.

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.

Why Are More People Developing Arthritis, and How Can It Be Treated?

Arthritis is one of the most common chronic diseases and the number one disabling disease in the world. It affects 50% of people over the age of 50 and 90% of people over the age of 65. In severe cases, it can cause difficulty in walking, affect normal life and even cause disability.

Don't think it's just for old people. More and more young people are suffering from it. Arthritis affects 355 million people worldwide and 1 in 6 people in Asia! As of 2015, there were more than 100 million patients in mainland China, and the number is still increasing. So why is arthritis on the rise? How to treat arthritis?

Why are more and more people getting arthritis?

  1. Knee degeneration with age

In young men, there are reasonable gaps between the kneecaps, and there is synovial fluid, which acts as lubrication. But with the increase of age and some other factors, joint synovial fluid degeneration, knee cartilage and tissue wear degree is gradually aggravated, knee degeneration is almost inevitable. In other words, people of a certain age can get arthritis of the knee, either mildly or severely.

  1. Obesity aggravates knee degeneration

In addition to age, obesity is also a key factor in the development of osteoarthritis. He believes that weight gain increases the load on the knee cartilage, accelerating wear and tear. But now people's life is irregular, the diet is too greasy, weight only gain, accelerate knee degeneration.

  1. Incorrect way of exercise

It is generally accepted that exercise is helpful in the prevention and treatment of most diseases. However, many forms of exercise are not very protective against arthritis. Mountaineering and long-distance running are the last things knee patients should do. Due to the non-standard running posture, improper shoes and other reasons, it is easy to cause injury to the knee joint. And when climbing the knee force is 2-3 times of ordinary sports, more not suitable for knee patients.

How to treat arthritis?

  1. Drug therapy

First of all, if the patient's knee arthritis is in stage 1, the main symptom is slight swelling and pain of the knee joint, but the X-ray is normal with the help of medical instruments, then this situation is mainly treated by reducing activity, physical diagnosis and treatment, and drug means. Drugs, also mainly with some anti-inflammatory analgesic drugs, the effect is better.

  1. Arthroscopic cleaning

Secondly, if the patient's knee joint has active swelling and pain, and the range of motion has been significantly reduced, and the joint space has begun to narrow with the help of medical instruments, early degeneration of the joint, and articular cartilage fibrosis, then the patient has stage 2 knee arthritis.

The condition can also be treated without surgery, but if inflammation is frequent, an arthroscope can be used to clean it up. In addition, if patients have patellar subluxation, patellar tilt, varus deformity and other conditions, doctors will also recommend surgery to correct, because this can delay the degeneration of articular cartilage.

  1. Surgical treatment

If patients with knee joint often twisted the lock and the bow-legged, or appear larger crack, peeling, articular cartilage of knee has been deformed, so at this time of patients with knee osteoarthritis have developed to phase 3, 4, at that time we can adopt the way of cleaning under arthroscopy to treat, even for artificial knee joint replacement surgery.

Antibiotics and Anti-Inflammatory Drugs: Understanding the Difference

"Anti-inflammatory drugs = antibiotics?"

In daily life, people are used to thinking that anti-inflammatory drugs are antibiotics. This statement is not accurate and should not be confused.

Antibiotics and anti-inflammatory drugs are not the same thing at all

Anti-inflammatory drugs, as the name suggests, are drugs that inhibit inflammation, which can relieve inflammation and the pain it brings.

Antibiotics can inhibit or kill all kinds of microorganisms, such as bacteria, fungi, atypical pathogens, etc., so as to achieve the effect of controlling or eliminating infections.

All in all, the main role of antibiotics is to destroy bacteria and control infections, so they are only effective for inflammation caused by infections, while anti-inflammatory drugs can only control the inflammatory response, but cannot eliminate bacteria and control infections.

Abusing antibiotics is simply pitting yourself

Inflammation is not always caused by infection, such as rheumatoid arthritis, allergic rhinitis, etc. If under these circumstances, the wrong use of antibiotics will not only cause a certain economic loss, but also delay the condition and increase the suffering.

More importantly, antibiotics must not be abused! Don't abuse antibiotics! Don't abuse antibiotics!

While antibiotics control and destroy bacteria, they can also induce drug resistance. Whenever we really need to use antibiotics, we will most likely face the embarrassing situation of no medicines available.

How to use anti-inflammatory drugs and antibiotics?

Find out the reason and get twice the result with half the effort:

This requires understanding the causes of inflammation: including bacterial infections, viral infections, fungal infections, allergies, trauma, etc.

Antibiotics are only effective against inflammation caused by bacteria, but are powerless against inflammation caused by viruses, fungi, allergies, and trauma. In other words, if the disease is not caused by bacteria, but by viruses, fungi, allergies, etc., then no amount of antibiotics will help.

It can be seen that antibiotics are different from anti-inflammatory drugs, except that antibiotics have an anti-inflammatory effect under certain circumstances. The real anti-inflammatory drugs are anti-inflammatory drugs, which refer to steroids and non-steroidal anti-inflammatory drugs in medicine.

● Steroids

It is a class of substances that the body can synthesize naturally, that is, hormones that people often say, such as cortisone, hydrocortisone, dexamethasone, etc.;

● Non-steroidal anti-inflammatory drugs

Refers to non-steroidal anti-inflammatory drugs, common ones are aspirin, analgin, acetaminophen, indomethacin and so on.

These are the drugs that can directly reduce inflammation such as redness, swelling, heat, and pain. Even people can produce some hormone anti-inflammatory drugs by themselves, such as throat inflammation caused by colds and other diseases. 90% of them are caused by viruses. They are self-limiting. Even if you don’t use any medicine, you will heal yourself after a few days of rest. This is the function of the body's own secretion of anti-inflammatory drugs, and there is no need for antibacterial drugs such as amoxicillin.

The advent of penicillin in the 1920s saved countless lives of infected patients. Because people use antibiotics as a routine life-saving straw, they must be used regardless of disease.

The abuse of antibiotics not only delays the treatment of physical illnesses, but more importantly, because antibiotics are abused, it breaks the balance between the human body and microorganisms, kills the symbiotic bacteria that have been with us for a long time and is beneficial to us, leading to super bacteria The emergence of super bacteria, and this super bacteria is resistant, invulnerable, difficult to kill, and eventually will make some infections incurable.

Teach you a trick to easily distinguish between antibiotics and anti-inflammatory drugs

The names of antibiotics are quite regular. When I see the names of these 5 drugs in the future, the antibiotics are basically not gone:

  • * Mycin: such as penicillin, erythromycin, azithromycin
  • * Xilin: such as amoxicillin, methicillin

Cephalosporin * *: such as cefuroxime, ceftriaxone, ceftazidime

  • * Floxacin: such as Moxifloxacin, Levofloxacin
  • * Nidazole: such as metronidazole, ornidazole

Can't remember too much? It doesn't matter, there is an easier way-just look at the instructions. If the instructions say "applicable to * * infections caused by bacteria", it is antibiotics.

In short, medication should be used with caution, abuse is harmful, and anti-inflammatory drugs and antibiotics should be used rationally to protect health!

What Should Be Done if a Woman’s Immunity Decreases After Menopause?

Introduction: As women age, the function of the ovaries will gradually decline, which will lead to the emergence of permanent amenorrhoea. This is actually a normal physiological phenomenon for women. Don't feel too panic and anxious. Take it right. This matter, because there are many benefits after menopause, is also unsolicited. For example, for women with dysmenorrhea, they will never endure this kind of pain again after confirming it.

But many people don't know that after a woman's menopause, the body's immune function will decline, which will lead to a decrease in immunity and may cause women to be attacked by some diseases. Therefore, women must pay more attention to this stage of menopause and make some preparations in advance to improve immunity.

What is the manifestation of reduced immunity?

  1. Frequent colds

If the human body's immunity is reduced, as long as the weather changes slightly and the clothes are not added or removed in time, the symptoms of a cold may appear, and this symptom usually takes a long time to heal. And it will happen repeatedly, so you should keep cold medicine at home, so when you find that your body has such an abnormal condition, you have to consider whether it is caused by a weakened immune system.

  1. Easy to fatigue

People with low immunity usually have poor mental status. They tend to lose their energy at work, and feel very tired after working for a while. After going to the hospital for examination, there is no organic disease, as long as they rest for a period of time. , The spirit will be relieved, but after a few days, this fatigue and weakness will reappear. So if you feel that your mental state has deteriorated, it may also be caused by a decline in immunity.

  1. Weak intestines and stomach

Decreased immunity may also be reflected in gastrointestinal health. If everyone eats out together, no one else is abnormal, but they have symptoms of vomiting and diarrhea. This indicates that the self-protection function of the gastrointestinal system is abnormal. This is also the case. A manifestation of low immunity.

  1. The wound is susceptible to infection

If a family member or colleague has a cold, he is always easy to be infected, and the cold symptoms will be more obvious, this may be a problem with the resistance. On the other hand, if a certain part of the body is accidentally scratched and it is always red and swollen and pus is found, it will take a long time to get better, which also shows that the body's resistance is declining.

What should I do if a woman's immunity decreases after menopause? Suggestion: Do these 5 things well, or can help you

  1. Avoid being sedentary

If you want to stay healthy after 50 years old now, you must avoid being sedentary, because prolonged sitting will affect the speed of blood circulation and is not conducive to the metabolism of the body. Over time, it will make the body healthy. The basal metabolic rate continues to decrease, which will affect immunity to a certain extent.

  1. Exercise properly

At this stage of menopause, women will experience a series of uncomfortable symptoms, such as hot flashes and sweating, insomnia and dreaminess, and even their emotions will be greatly affected. If a woman is in a state of emotional instability for a long time, it will lead to exuberant anger, which will allow certain diseases to take advantage of it.

Therefore, women should do more exercises, such as dancing, yoga and other exercises, which can not only help women maintain their shape, but also relieve stress, but also increase the speed of metabolism, thereby helping to improve the body's resistance.

  1. Appropriate supplementation of estrogen

When the menopause comes, the estrogen in the female body will drop sharply. Under the influence of estrogen, the female body will have some abnormal conditions, and it will lead to the advent of aging. At this stage, women should eat some foods rich in estrogen, such as soybeans, peanuts, etc., which can not only slow down the decline of ovarian function, but also help improve the body's immunity.

  1. Properly bask in the sun

After women enter the menopause, a large amount of calcium in the body will be lost. If calcium cannot be supplemented at this time, bone health will be affected, which will cause some joint diseases or osteoporosis. In addition to supplementing calcium-rich foods, women must also properly bask in the sun, because they can help the absorption of calcium and improve the body’s immunity.

  1. Eat more fruits and vegetables

After entering the menopause, due to hormone problems in the body, the female body has symptoms of discomfort. At this time, a lot of nutrients need to be supplemented. These drugs can only be obtained from fresh vegetables and fruits, such as broccoli, strawberries, kiwi, etc., these vegetables Fruits are rich in vitamin C, dietary fiber and other nutrients, which can help improve human immunity.

Conclusion: In daily life, if you want to improve immunity, you must improve your eating habits reasonably, eat more foods containing high-quality protein and vitamins, maintain a balanced diet, avoid eating spicy foods, and take less food eat. In addition, you must maintain a regular schedule, do not stay up late, and maintain eight hours of sleep a day; you must also perform long-term exercise based on your physical condition to control your weight and improve your immunity.

New Anti-Inflammatory Drug: Phase 1b Study of Oral Tyk2 Inhibitor GLPG3667 for Psoriasis Treatment

Galapagos NV recently released the positive top line results of a phase 1b study of tyrosine kinase 2 (Tyk2) inhibitor glpg3667 in the treatment of psoriasis. Glpg3667 was discovered by Galapagos company and is a special selective Tyk2 compound. In a randomized, placebo-controlled, double-blind phase 1b study, 31 patients with moderate to severe plaque psoriasis were treated. In the study, patients were randomly assigned to oral glpg3667 (low or high dose) or placebo in a ratio of 1:1:1 for 4 weeks. The main purpose of this study was to evaluate the safety, tolerance and clinical activity of glpg3667 at week 4.
The results showed that glpg3667 was well tolerated in phase 1b trial. One patient in the low-dose group was interrupted for one day due to deterioration of psoriasis. Most of the treatment-related adverse events (AE) were mild and transient. There were no deaths or serious adverse events in the four week study.
At week 4, 4 of 10 patients in the glpg3667 high-dose group achieved pasi50 response (psoriasis area and severity index [PASI] improved by at least 50% from baseline), and 1 of 10 patients in the placebo group achieved pasi50 response. However, there was no pasi50 response in glpg3667 low-dose group. The PASI scores of four responding patients in the glpg3667 high-dose group were improved by 52%, 65%, 74% and 81% respectively compared with the baseline, while one responding patient in the placebo group was improved by 52% compared with the baseline. At week 4, compared with placebo, high-dose glpg3667 also observed positive response signals for other endpoints (including affected body surface area, overall evaluation by doctors and patients).
Dr Walid ABI Saab, chief medical officer of Galapagos, said: "we are satisfied with the efficacy and safety of glpg3667 in patients with psoriasis after 4 weeks of treatment. Based on these results, we plan to launch the psoriasis global phase 2B project next year as part of our project to develop our selective oral Tyk2 inhibitor glpg3667, which aims to assess gplg3667 for a wide range of inflammatory indications. "
Dr Diamant Thaci, Professor of medicine at the comprehensive inflammatory medicine center of Lubeck University in Germany, said: "the pasi50 response score and other efficacy data after 4 weeks of treatment, combined with the observed safety, are very helpful to promote the compound to a larger scale psoriasis trial. The psoriasis population still needs more treatment options, especially oral therapy. "
Jyseleca filgotinib chemical formula (photo source: Wikipedia)
Galapagos is committed to the discovery and development of small molecule drugs with new mechanisms of action, some of which have shown good efficacy. Currently, the company is working with Gilead sciences to develop an oral anti-inflammatory drug, jyseleca (filgotinib).
Filgotinib is a highly selective Jak1 inhibitor, which was discovered and developed by Galapagos. Gilead and Galapagos reached an agreement with a total amount of US $2 billion at the end of December 2015 to jointly develop and commercialize filgotinib around the world. Due to the major setback in US regulation, the two sides revised the commercial and development agreement of filgotinib in December 2020. Galapagos will be responsible for the commercialization of filgotinib in Europe (the transition period is expected to be completed by the end of 2021), while Gilead will continue to be responsible for the distribution of filgotinib outside Europe, including Japan (where Gilead co sells filgotinib with Sinoma).
Filgotinib is being developed to treat a variety of inflammatory diseases, including rheumatoid arthritis, Crohn's disease and ulcerative colitis.
Jyseleca has been approved for marketing in the European Union, the United Kingdom and Japan for the treatment of adult patients with moderate to severe rheumatoid arthritis (RA) who do not respond to or tolerate one or more disease modifying antirheumatic drugs (DMARD). In terms of medication, jyseleca can be used as monotherapy or in combination with methotrexate (MTX).
At present, jyseleca's application for new indications for the treatment of ulcerative colitis (UC) is also under the regulatory review of the European Union, the United Kingdom and Japan. The specific application is for the treatment of adult patients with moderate to severe active ulcerative colitis (UC) who lack response to conventional therapy or biological agents, lose response, or intolerance. It is worth noting that due to safety considerations, the US FDA has not approved any indications for jyseleca.

Myth: Taking Painkillers Will Surely Lead to Addiction

This is a myth. When it comes to drug addiction, the key is to pay attention to the type of drug and to control the dosage. Follow your doctor's instructions and take the drug in moderation.

Analgesics are generally divided into two categories. One is anti-inflammatory and analgesic drugs that act on the peripheral system and can be purchased in pharmacies with a doctor's prescription. The commonly used analgesics include aspirin, ibuprofen and paracetamol, etc., which are not addictive in themselves. The other is the effect on the central nervous system, with morphine, tramadol hydrochloride and other drugs as the representative, although have addictive, but under the guidance of doctors will not appear addictive phenomenon.

Clinically, drug addiction refers to people's dependence on a certain drug. When they stop taking it, it will cause special symptoms, forming a state of discomfort or even extreme pain when they stop taking it. With painkillers, especially oral administration, there is very little risk of addiction. Since drug tolerance (physical dependence) is a state of reduced responsiveness of the human body to the drug, it often occurs after repeated use of the drug, and it is necessary to increase the dose or the number of times of administration to maintain the efficacy, but after a period of withdrawal, its tolerance will gradually disappear and return to the original level of response to the drug.

It should be noted that the public's fear and concern about "addiction" to painkillers is the root cause of pain that can not be effectively controlled. If the pain person refuses to use morphine and other painkillers, and allows the pain to develop, it can also bring a series of side effects. In fact, the scientific and regulated use of painkillers is not addictive. Doctors and pharmacists will carefully choose drugs according to the patient's pain situation, and develop individualized analgesic treatment plan, so as to alleviate the patient's pain to the greatest extent and reduce adverse reactions.

Increase in Orthopedic Patients with Knee Arthritis

Recently, the reporter learned from the first hospital of Baoding orthopedic department, now, orthopedic outpatient department encountered the most patients is knee joint osteoarthritis patients. "In the process of communicating with patients, I found that many patients have insufficient understanding of this disease, there are some misunderstandings, which have a great impact on the protection and treatment of the knee joint." This hospital bone 3 branch deputy director An Ming introduction. So what should we do in the face of knee osteoarthritis?

Young people can also develop osteoarthritis of the knee

Knee osteoarthritis is also known as knee degenerative disease, senile arthritis and so on. The aging of the knee joint caused by the growth of age is the main cause, obesity, heavy physical labor will also increase the aging speed. Osteoarthritis of the knee may involve any of the three compartments of the knee or a combination of them. What we often call "bowleg" is severe involvement of the medial compartment. In contrast, when the lateral compartment is most heavily involved, the leg is X-shaped.

However, it is important to note that this disease is not exclusive to the elderly. Some of the younger patients' knees have receded to look like those in their 70s and 80s.

The main early symptoms are the following

When you have one or more of the following symptoms, you may have early osteoarthritis of the knee.

Arthritis pain: knee pain after going up and down stairs, squatting, walking for a long time and climbing mountains, and knee pain gradually aggravates, and the frequency of pain attacks is also increasing.

Joint stiffness: sedentary, tightness of the knees after getting up in the morning, gradually feeling normal after a few minutes of activity.

Beat soft: feel the knee joint is weak, when walking feebly.

The back of the knee joint is tense, cramping and stretching.

Swelling and fever of the knee after movement or cold.

Avoid strenuous exercise and keep your knees warm

Here are some things you need to know when you are diagnosed with osteoarthritis:

Osteoarthritis is an aging disease that cannot be cured or reversed. Frayed cartilage and meniscus cannot regenerate. Therefore, do not blindly listen to folk remedies or medical advertisements, which will only increase the physical and economic burden.

Avoid long-distance fatigue running, climbing, up and down the high stairs; Obese people should lose weight; Avoid high heels and wear soft, springy sneakers.

Keep warm. Due to the lack of protection of muscle and adipose tissue in the knee joint, there is not enough heat supply, so don't sit and lie in the cold and wet place at ordinary times, and pay attention to the knee joint to strengthen warmth.

Exercise should choose the knee load is small, can maintain the knee range of motion and can increase muscle strength exercise. Such as walking, swimming, cycling and so on.

This disease requires individualized treatment according to different levels and stages of the disease. The ultimate goal of treatment is to relieve or eliminate pain, improve joint function, and improve the patient's quality of life. Traditional Chinese medicine treatments such as massage, hyperthermia, hydrotherapy, acupuncture and massage can relieve pain symptoms and stiffness of joints. Medical treatment or knee replacement can be performed on the advice of a professional.

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