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Six types of people are high-risk groups of Alzheimer’s disease, and there are ＂prescriptions＂ for TCM prevention.

　　Recently, an urban emotional drama "Everything is Fine" ended wonderfully. In the end, his father Su Daqiang showed signs of Alzheimer’s disease, but he only remembered to save money to buy a problem set for Xiao Mingyu. This scene drew tears from many viewers.

　　In fact, Alzheimer’s disease is a common disease among the elderly, which has a serious impact on their quality of life. The main symptom is memory loss. So, what should Chinese medicine do to prevent Alzheimer’s disease? Gui Ping, director of the Second Department of Traditional Chinese Medicine Encephalopathy, jiangjin district Hospital of Traditional Chinese Medicine, made a detailed analysis.

　　What is Alzheimer’s disease?

　　Alzheimer disease (AD), which we often talk about, is a degenerative disease of the central nervous system. Its onset is insidious, and the course of disease is chronic and progressive, mainly manifested as neuropsychiatric symptoms such as progressive memory disorder, cognitive dysfunction, personality change and language disorder. This disease can be complicated with depression, anxiety and psychosis. Its pathological changes can involve nervous system, motor system, urinary system, etc., leading to patients’ gradual loss of self-care ability, which has a great impact on their families and seriously affects their social, professional and living abilities.

　　Traditional Chinese medicine believes that the pathogenesis of senile dementia is mostly deficiency of kidney essence. Deficiency of kidney essence, congenital deficiency, decreased qi and blood metaplasia, weak qi and blood transport, and poor blood circulation lead to blood stasis, thus aggravating the aging of human viscera and brain; At the same time, eating too much fat and sweet or invading from external evils will damage the spleen and lungs, which will lead to obstruction of phlegm in the middle, obstruction of brain collaterals in the upper direction, blinding and clearing the orifices, which will lead to the loss of nourishment of the orifices, disorder of the spirit, and the interaction with blood stasis and toxin, which will hinder the movement of qi and blood, thus aggravating the injury of healthy qi. In addition, the injury caused by seven emotions, liver depression and qi stagnation, poor qi movement will lead to blood astringency, qi stagnation and blood stasis, which will blind the resuscitation and obstruction; Excessive worry can damage the heart and spleen, which leads to deficiency of the heart and spleen, loss of nourishment of the brain and loss of use of the mind. Generally speaking, its pathological mechanism involves heart, liver, spleen and kidney, and it is a disease of deficiency in essence and excess in substance, with excess and deficiency mixed.

　　How to prevent Alzheimer’s disease

　　For the elderly, brain aging is an irresistible natural law, such as memory loss, vocational skills decline, clumsy movements, dizziness, insomnia and mild decline in various feelings. There are still no effective and reliable methods to prevent brain aging, but diligent use of brain, smooth mind and skillful exercise can delay brain aging and play a positive role in preventing Alzheimer’s disease.

　　Traditional Chinese medicine believes that although the location of Alzheimer’s disease is in the brain, the root cause is the dysfunction of heart, spleen and kidney, especially the kidney. The brain is the marrow sea, and the kidney stores essence, governs bone and produces marrow. If the essence in the kidney is sufficient, the marrow will be biochemically active and the brain will be strong. With the aging of the human body, the kidney essence is constantly declining, which leads to the weakening of brain power and forgetfulness. "The heart is the official of the monarch, and the gods are out of the way", which means that people’s memory, cognition, emotion and language are dominated by the heart. "Spleen storing meaning" means that thinking and memory are based on qi and blood, so the spleen and stomach are healthy and full of qi and blood, so the memory is strong and the thinking is agile; On the other hand, memory loss and slow thinking. Therefore, Alzheimer’s disease is closely related to heart, spleen and kidney. In the treatment, we should not only treat the brain, but also treat the disease for the root cause, and adopt many therapeutic methods, such as tonifying the kidney and replenishing essence, invigorating the spleen and resolving phlegm, nourishing the heart and calming the nerves, soothing the liver and regulating qi, clearing away heat and purging fire, and promoting blood circulation and dredging collaterals.

　　Long-term research has proved that the factors of this disease have a great relationship with people’s usual lifestyle, so the prevention of Alzheimer’s disease should start from daily life. If you develop good eating habits, rest habits and brain habits, try to avoid suffering from some chronic diseases, including hypertension and diabetes, and you should also control blood lipids and avoid brain trauma. At the same time, we should keep a good mood and avoid excessive pressure.

　　For patients with Alzheimer’s disease, comprehensive preventive and therapeutic measures can generally be adopted, including drug therapy, diet therapy, physical therapy, emotional therapy, entertainment therapy, etc., and the specific methods are very rich, depending on the person and the time. Drug therapy mainly refers to taking anti-aging products, such as Liuwei Dihuang Pill and Bawei Dihuang Pill, and diet therapy can be supplemented by yam, poria cake, walnut, sesame, Polygonum multiflorum Thunb, hawthorn soup, etc., but it should be applied in a proper amount under the guidance of a doctor and must not be abused. Physical therapy refers to insisting on proper exercise, taking part in outdoor activities, such as Qigong, Tai Ji Chuan, ballroom dancing for the elderly or simple and interesting group activities, so as to maintain physical and mental health. Emotional therapy and recreational therapy have a wide range of contents, including listening to radio, music, watching TV, often talking with old friends and colleagues, and rehabilitation training for language and limb dysfunction, all of which are helpful to prevent Alzheimer’s disease.

　　Sticking to three methods of Chinese medicine daily can also prevent Alzheimer’s disease. One is moxibustion on the top of the head. Light one end of the moxa stick and hang it on Baihui point (in the middle of the head) for 5 ~ 8 cm for warm moxibustion, 10 minutes each time, once a day. Moxibustion on Baihui point has the effect of refreshing the brain and inducing resuscitation, enhancing memory and improving brain sensitivity, which can keep away from Alzheimer’s disease. The second is to pinch the instep. Pinch the same Taichong point (the front depression of the first metatarsal joint on the dorsum of the foot) with the thumb of one hand, and it is appropriate to feel slight pain. 3 minutes each time, then switch hands twice a day. Pinching Taichong point can reduce acetylcholinesterase in brain, increase acetylcholine secretion, improve brain spatial position perception, and delay the process of Alzheimer’s disease. The third is to rub the back of your hand. Press and rub Hegu point of the other hand with the thumb of one hand (between the first metacarpal bone and the second metacarpal bone of the back of the hand, about the midpoint of the second metacarpal bone), and the strength is appropriate to feel slight pain, 3 minutes each time, and then switch hands once a day. Pressing and rubbing this point can enhance brain sensitivity.

　　interlinkage

　　Six types of people are high-risk groups.

　　Lonely old people The older they get, the more likely they are to suffer from Alzheimer’s disease. If the elderly themselves don’t like to communicate with the outside world, they will feel lonely and easily depressed, pessimistic and depressed. This kind of lonely elderly people are particularly prone to Alzheimer’s disease.

　　Patients with high blood pressure, hyperlipidemia and hyperglycemia are prone to cardiovascular and cerebrovascular diseases, which make the brain lack of blood supply, affect the normal work of the brain, lead to a large number of nerve cells weakness and severe brain atrophy, and accelerate the emergence of Alzheimer’s disease.

　　Obese people are prone to metabolic syndrome when they are fat, and they are also likely to become "three highs" people, and they are prone to Alzheimer’s disease in the future.

　　People who drink and smoke for a long time are prone to liver failure, and liver damage will also affect the circulation of the brain; Secondly, smoking will accumulate a lot of harmful substances in people’s bodies, which will cause abnormal blood supply to the brain, damage brain tissue, accelerate the aging of the brain and easily lead to Alzheimer’s disease.

　　Hereditary Alzheimer’s disease can be inherited in families. If someone in the family has suffered from Alzheimer’s disease, the chances of future generations suffering from Alzheimer’s disease will increase.

　　People with brain injuries, people who have suffered brain injuries or brain diseases, will suffer brain injuries, leading to an increased risk of Alzheimer’s disease.

Ryan’s ＂In a hurry that year＂ looks retro and plays the infatuated teenager after 80 years.

The film "In a hurry that year" will land in the national cinema on December 12th.

　 　 Directed by Zhang Yibai, the film based on Jiu Yehui’s novel of the same name will hit the national cinema on December 12th. The film, starring Eddie Peng Yuyan, NiNi, Ryan, Vision Wei and other post-80s actors, aims to present the feelings and life course of the post-80s generation. Among them, Zhao Ye, played by Ryan, has the unique rebellion and persistence of the post-80s generation, and is struggling to protect the girl he loves.

Ryan pian modeling

Director’s modeling strives for perfection. Ryan restores the truth in a retro way　

　 　 The film "In a hurry that year" focuses on the youth story of the post-80s generation, so director Zhang Yibai is very strict about restoring the environment at that time, not only making the scene as real as possible, but also making the actors’ modeling more perfect and making great efforts. Among them, Ryan’s modeling is the most classic image of that era. When he walked into the middle school in the play, wearing a baggy school uniform, combing his hair in the middle, and holding a basketball in his hand, even he couldn’t help exclaiming, "This is just what I looked like in high school! At that time, I was also separated, and I really went back! " According to his memory, the boys in high school were very naughty, and even the way to meet and say hello was to lick each other’s pants, and this detail was finally adopted by the director and expressed in the film.

　 　 Another classic retro style of Ryan in the film is that after he graduated from high school and didn’t go to college, he went out to mix the society and set up a stall, with a pinch of yellow hair on his head and a black vest and flowered shirt, just like a street thug. The change of modeling makes Ryan’s role more three-dimensional and his personality more prominent, which also makes this story spanning fifteen years full of real chronological texture.

Ryan’s reenactment of the infatuated teenager was deeply moved by the character.

　 　 Many netizens who have read the original "In a hurry that year" commented that the role of Zhao Ye is a bit like that of Xu Kaiyang in "To Youth". Both of them have gone through all kinds of bitter courtship, but they still can’t get the expected love. As the actor of these two roles, Ryan thinks that the two stories and characters are still very different. "To Youth focuses on the cruelty of youth and the influence of youth on the present, but that year in a hurry is more like a beautiful memory of youth, in which everyone can find himself." When Ryan got the script, he was deeply attracted by the role of Zhao Ye, and several scenes were particularly wonderful and enjoyable, full of tension. He thinks that Zhao Ye’s persistent pursuit of the girl he likes is very touching. Although the process is tortuous, it will make people deeply moved.

Interim ＂report card＂ highlights economic resilience

　　Editor’s note:

　　In 2018, China’s economy will hit the water again.

　　With the release of major economic data in the first half of the year, the market’s attention to the current economic situation continues to heat up. How to grasp the current macroeconomic trend? What changes do the latest data with ups and downs represent? What impact does Sino-US economic and trade friction have on economic trends? Can the main goals of economic development be achieved as scheduled this year? Starting from today, the overseas edition of People’s Daily’s "Rui Caijing" column launched a series of reports on "Mid-year Economic Observation" to analyze the economic situation and respond to economic hotspots.

　　In 2018, the semi-annual economic report of China was released. Mao Shengyong, spokesman of the National Bureau of Statistics, introduced at the press conference on the national economic operation in the first half of the year held by the State Council Office on July 16 that the GDP growth rate in the first half of the year was 6.8%, the economic operation continued to develop steadily, and the economy was moving towards high-quality development. Analysts pointed out that under the background of increasing uncertainty in the external environment and solid progress in domestic structural adjustment, transformation and upgrading, China’s economy has handed over a bright interim "report card", which fully shows that China’s economy has strong resilience in the process of coping with shocks and challenges, and also adds confidence and confidence for China’s economy to face the complicated and severe domestic and international environment in the next stage.

　　Steady growth, stable employment and stable prices.

　　"In the first half of the year, China’s economy continued its overall stable and stable development trend." Mao Shengyong introduced.

　　How to understand "stability"?

　　Mao Shengyong pointed out that from the perspective of growth rate, the GDP growth rate in the first half of the year was 6.8%, and it operated stably in the middle and high speed range of 6.7% to 6.9% for 12 consecutive quarters; From the perspective of employment, the national urban survey unemployment rate has been below 5% for three consecutive months; From the price point of view, consumer price CPI rose by 2% in the first half of the year, showing a moderate upward trend.

　　How to understand "good"?

　　The structure is more reasonable — — According to reports, in the first half of the year, the added value of the tertiary industry accounted for 54.3% of GDP, an increase of 0.3 percentage points over the same period of last year; The contribution of service industry to economic growth was 60.5%, 1.4 percentage points higher than the same period of last year. In terms of demand, the contribution rate of consumption to economic growth reached 78.5% in the first half of the year, an increase of 14.2 percentage points over the same period of last year.

　　Innovation is stronger — — "Since this year ‘ Streamline administration, delegate power, strengthen regulation and improve services ’ Reform continues to deepen, and entrepreneurial innovation continues to develop, ‘ Shuangchuang ’ The upgraded version is constantly being built. " Mao Shengyong said that in the first half of the year, there were 18,100 newly registered market entities per day, representing the rapid growth of related industries and products with technological progress, transformation and upgrading and high technology content, and the accelerated growth of service consumption.

　　Better quality — — In the first half of the year, the proportion of clean energy consumption in the whole energy consumption increased by 1.5 percentage points over the same period of the previous year; Energy consumption per unit of GDP decreased by 3.2% year-on-year. The per capita disposable income of urban and rural residents nationwide actually increased by 6.6%, which was the same as that in the first quarter; General public budget revenue exceeded 10 trillion yuan, an increase of 10.6%.

　　How does the trade war affect us?

　　Zhang Liqun, a researcher in the Macroeconomic Research Department of the State Council Development Research Center, analyzed this reporter’s analysis. The good economic performance of China in the first half of the year fully shows that China’s economy has strong resilience in the process of coping with shocks and challenges. With China vigorously promoting high-quality development, intensifying reform and opening up, innovating and improving macro-control, the resilience of development will be further enhanced, which will add confidence and confidence to China’s economy in the face of complex and severe domestic and international environment.

　　On July 16, when asked by the media about the impact of Sino-US trade friction on economy and prices, Mao Shengyong said, "The main indicators of China’s economic operation in the first half of this year were generally stable. If there is any impact from Sino-US trade friction, I think if there is, it is relatively limited. In the second half of the year, we need to further observe the impact of Sino-US trade friction. But on the whole, the Sino-US trade friction unilaterally provoked by the United States will have an impact on the economies of China and the United States, and because the world economy is generally deeply integrated, the industrial chain is in a global layout, and many related countries will also be affected. Therefore, it will also affect the recovery of the global economy and the sustained growth of world trade. "

　　As for the impact of Sino-US trade friction on prices, Mao Shengyong said that from the current situation, the price operation is still relatively stable. Mainly the price of imported soybeans may rise to some extent, which will bring some changes in the prices of bean products and related products. Generally speaking, first, the weight of soybeans and bean-related products in CPI is relatively small. Secondly, the downstream products of beans, mainly soybean meal feed, may push up the price of pork or eggs, and beans will affect edible oil. However, from the first half of this year, the prices of pork and edible oil in China are still at a relatively low level. The price of pork decreased by 12.5% year-on-year, and the price of edible oil decreased by 1%. Even if the price rises a little, the impact on the whole CPI is very limited. Moreover, from the trend in the second half of the year, consumer prices are expected to continue the trend of moderate increase.

　　The steady and positive trend will not change.

　　"Overall, in the first half of the year, the fundamentals of China’s stable economy were consolidated, and the short-term downward pressure did not cause obvious troubles to China’s economy. In the second half of the year, there are still many variables in the external environment, and the internal economic development is still unbalanced and unstable. However, considering the solid foundation of China’s steady economic growth, the continuous efforts of a series of regulatory measures, the in-depth promotion of supply-side structural reforms and the high growth in the medium and long term, China’s stable and positive economic development trend will continue, and a more beautiful answer sheet should be handed over throughout the year. " Zhang Liqun said.

　　Mao Shengyong said that from the main data in the first half of this year, in the pattern of economic growth, domestic demand is the decisive force, and consumption in domestic demand is the pillar. From the second half of the year, consumption itself has the basis and conditions for rigid growth, residents’ income has maintained rapid growth, the pace of upgrading the consumption structure has accelerated, and increasing imports has promoted the activity and supply of market sales, so consumption still has the conditions to continue the steady and rapid growth trend.

　　From the perspective of investment, the Bureau of Statistics introduced that first, the growth rate of manufacturing investment has accelerated for three consecutive months, and this momentum is expected to continue in the second half of the year; Second, real estate investment increased by 9.7% in the first half of the year, and leading indicators show that real estate investment is still expected to maintain rapid growth in the second half of the year; Third, infrastructure investment declined in the first half of the year. In the second half of the year, with the completion of project cleaning, compliance projects accelerated, and infrastructure investment is expected to remain basically stable in the second half of the year. So investment in the second half of the year should be a basically stable trend.

　　"To say that domestic demand is the decisive factor does not mean that external demand is not important, but external demand is still a very important variable. In the first half of this year, foreign trade generally continued a good development trend. Foreign trade does face some challenges in the second half of the year, but there are also many favorable factors, and overall it is expected to maintain steady and rapid growth. " Mao Shengyong said that considering several factors, the stable and positive economic situation in the second half of the year will not change.

How to collect JD.COM 618 red envelopes this year？ What festival is Taobao 618？ When will Tmall 618 start？

　　The breath of summer is getting stronger and stronger, and the JD.COM 618 Shopping Carnival will be grandly opened in 2025. JD.COM has made all-out preparations, carefully laid out and comprehensively upgraded the goods, games and subsidies, and is committed to creating a large-scale shopping feast with rich discounts and full of fun for consumers, so that consumers can enjoy the happiness and benefits of shopping this summer.

　　At the beginning of the event, the attractive red envelope benefits came strongly. From May 13th, the JD.COM 618 red envelope was officially opened! Open the mobile phone JD.COM APP and search for "Shopping Red Packet 999", and you can get red packets three times a day. This benefit lasts until June 18th. In more than a month’s time, consumers can easily harvest surprise red envelopes, which can be directly deducted from cash at the time of shopping settlement, saving money whether it is daily necessities purchase or large-scale goods purchase.

　　The JD.COM 618 event was promoted in stages and orderly, bringing continuous shopping surprises to consumers. At 8 o’clock on the evening of May 13th, the "Heart Shopping Season" kicked off first. As a warm-up stage of the activity, it will last until May 28th. During this period, consumers can choose their favorite products in advance, feel the atmosphere of the shopping festival and lock in the offers in advance. At 8: 00 pm on May 31, JD.COM 618 officially kicked off. At that time, a large number of super-value goods will be unveiled, and various preferential activities will be launched simultaneously. A wonderful shopping spree will soon be presented to consumers.

　　At the same time, JD.COM also has state subsidies: search for "mobile phone 500" or "Apple mobile phone 886" in JD.COM APP to buy mobile phone tablet digital products, and the highest subsidy is 500 yuan; Search for "home appliances special 818" to buy home appliances, and the maximum subsidy can reach 2000 yuan, so that consumers can buy high-quality goods at more affordable prices.

　　This time, JD.COM 618 made a comprehensive innovation in gameplay and built a diversified marketing system. In the basic gameplay, classic activities such as "over 200 MINUS 20 coupons" and "cross-store full reduction" have returned strongly, and the incentives are even stronger. Consumers can easily enjoy direct reduction and exemption as long as they meet the conditions, regardless of whether they buy a single item or a cross-store combination. Moreover, these offers can also be superimposed and used to truly save money for consumers to shop.

　　In addition, JD.COM has carefully created seven theme promotion days, namely surprise day, super spike day, 10 billion subsidy day, super provincial special price day, super live broadcast day, PLUS member day and ten thousand stores spike day. These theme days span the heart shopping season and the official activity period of 618, and each theme day has unique preferential highlights. There are random benefits on surprise day; Super spike day popular goods low-cost spike; 10 billion subsidies for daily commodity subsidies; Super-provincial special day focuses on high cost performance; Super live broadcast day anchor brings exclusive benefits; PLUS membership day members enjoy privileges; Many stores offer simultaneous discounts on the 10,000-store spike. During the event, stars and popular IP will also participate in it, bringing interesting interactions and rich prizes, making shopping more interesting.

　　The whole 618 activity is divided into four stages. At the beginning stage, the explosive goods are launched at a low price, and consumers can snap up popular new products at the first time; During the special period, promotional activities were carried out in turn according to categories to meet the needs of different consumers; During the climax, all categories of goods participated in the preferential treatment, and the preferential intensity reached the maximum, and the benefits such as red envelopes, full reductions and discounts were fully covered; The return period provides consumers who missed the previous activities with the last chance to pick up the missing items. Hot goods are replenished, affordable and well stocked.

　　Taobao 618 Hongbao

　　You can get 618 red envelopes by searching for [Happy 2266] on mobile phone Taobao.

　　Taobao also has a red envelope to collect, which can be collected every day during the activity, with a maximum of 25,888. It can be operated in a few seconds without any cost. It is recommended to get it every day.

　　In terms of characteristic play, JD.COM highlights frequently. The "Seconds Kill" channel launched activities such as Super Seconds Kill Day and Big-name Seconds Kill Day, which provided businesses with more exposure opportunities and gave consumers more opportunities to snap up big-name good things at low prices. The newly launched "State Subsidy× 10 Billion Subsidy" channel combines policy concessions with platform concessions to create the most favorable shopping experience of the year. Consumers can enjoy double subsidies when purchasing a variety of goods and realize low-cost shopping. The "Special Price" channel brings activities such as "50% off special weekend", "2 yuan postage" and "factory direct sale", so that consumers can enjoy value-added shopping. JD.COM app searches for [Shopping Red Packet 999] to get 618 red packets. The "Trial" channel has been upgraded, and JD.COM has invested a lot of resources to implement the model of trying big-name explosive products before buying, which not only ensures the safety of consumers’ shopping, but also helps brands to pull new promotions and achieve a win-win situation.

　　In 2025, JD.COM 618 invited consumers to participate in this summer shopping spree with rich welfare and innovative gameplay. No matter you are a consumer who pursues quality or a shopper who pays attention to cost performance, you can find your favorite goods and great discounts in JD.COM 618, start a pleasant shopping trip and enjoy the infinite fun brought by shopping!

Health declaration and inquiry system for migrant workers in our province goes online.


On February 16th, the reporter learned from the Provincial Big Data Center that the health declaration and inquiry system for migrant workers in Sichuan has been officially launched. The platform, jointly developed by Sichuan Big Data Center and Provincial Health and Wellness Committee, can provide health certificates for migrant workers in the province and facilitate their return to work. The platform can fill in personal information anytime and anywhere, inquire about health status, and obtain and use the QR code of health certificate. Online reporting can not only reduce the time spent outside, but also reduce close contact and reduce the risk of cross-infection.

It is understood that the health declaration and inquiry system for migrant workers in Sichuan is an online service platform tailored for the convenience of migrant workers. The health certificate can be declared and checked through the provincial government website, Sichuan government service network, Tianfu Tongban APP, Sichuan Group Defense Express, WeChat applet, WeChat, Alipay and other channels. With the launch of the system, the reporter interviewed relevant R&D personnel to reveal the features and highlights of the system for you.

Why launch this online service system? "One is for the convenience of the masses. Basically, everyone has a mobile phone, through which you can fill in personal information, check health status and use health certificates anytime and anywhere. " The R&D staff told the reporter that migrant workers can fill it out on their mobile phones in advance, and only need to carry out necessary epidemiological history investigation and temperature measurement at hospitals or community health service centers. After passing the examination, they can automatically generate health certificates online, which is very convenient. "At the same time, using this system can ensure safety. Online reporting can reduce the stay time in hospitals or community health service centers, reduce close contact between personnel, and minimize the risk of cross-infection. "

"This system mainly introduces three service functions for migrant workers, inspection doctors, employers, etc." The R&D personnel introduced that the first is the declaration function. Migrant workers can fill in personal basic information, health status and contact history online through the system, and complete the declaration of health certificates independently. The second is the confirmation function. The doctor knows the applicant’s information in advance through the system, measures the body temperature on the spot, asks about the contact history and health status, and confirms the results online and offline. The third is the inquiry function. Employers and destination villages (communities) can scan the health QR code of migrant workers and conduct health check at any time.

It is reported that the system was developed under the authorization of emergency headquarters in Sichuan Province to deal with the novel coronavirus epidemic, and the generated electronic health certificate has the same effect as the paper health certificate. Electronic health certificate can be confirmed with one click, generated immediately, valid within 3 days, and can be used directly online. "Therefore, this system is authoritative, extensive and timely."(Reporter   Chen Song   Liu Wenzao)

Fundus screening of premature infants

Original songlei Shanghai children’s medical center ophthalmology

Why do you want to do fundus screening?

Premature babies are prone to retinopathy of prematurity (ROP), which will develop into serious blinding eye diseases if not treated in time. Premature infants leave their mothers when their organs are not fully developed. At this time, the development of retinal blood vessels is not mature. After birth, due to the change of blood oxygen concentration, abnormal vascular proliferation is prone to occur. Abnormal vascular rupture will lead to retinal hemorrhage, fibrous proliferation and contraction, retinal detachment, etc., and even blindness and eyeball atrophy in severe cases. ROP must be found and treated early. If treated in time, the effect is quite good.

Which children need screening and when?

For premature infants and low birth weight infants with birth weight less than 2000g, the first screening should be conducted at 4-6 weeks after birth or at 32 weeks after gestational age correction. The screening scope of premature infants with serious diseases can be appropriately expanded. The frequency of follow-up is generally determined according to the fundus lesions: once every 2 weeks without ROP, once every 1~2 weeks when ROP is diagnosed, and the interval of ROP follow-up before the threshold should be less than 1 week. Complete vascularization of retina, static lesion, scarring, or having received treatment are the termination time of screening and follow-up for retinopathy of prematurity.

What do you think of ROP inspection results?

Diagnostic criteria divide the retina into three areas:

Zone ⅰ: the central area of the retina in the circle with the optic disc as the center and the radius of twice the distance from the optic disc to the fovea maculata.

Zone II: that annular area of retina with the optic disc as the cent and the distance from the optic disc to the serrated edge of nose as the radiu.

Zone ⅲ: the temporal semilunar retinal region.

The zoning indicates the location of the lesion,

The lesion in area ⅰ is the most serious, and the lesion in area ⅲ is mild.

According to the severity of ROP lesions, it is divided into five stages, and the general lesions develop from stage 1 to stage 5 (as shown below). When the disease reaches stage 4, there is little hope of recovery through surgery.

There is a dividing line between the vascular area and the avascular area around the temporal side of ROP in stage 1.

Stage 3 ROP PLUS(+) not only has crista-like protuberance, but also has additional pathological changes: tortuous dilatation of blood vessels, which is more serious than that in Figure 3.

The boundary of ROP in Phase 2 is widened and uplifted.

Normal fundus

Partial retinal detachment caused by contraction and traction of ROP fibroproliferative membrane in stage 4

Stage 3 ROP cristae, accompanied by hyperplasia and hemorrhage.

Stage 5 ROP total retinal detachment

According to the above classification criteria, the baby with ROP will be recorded in the medical record: ROP in several districts and periods, PLUS(+or-). (Note: PLUS is an additional lesion, showing tortuous dilation of retinal vessels, which is a manifestation of rapid progress of ROP)

Screening process

During hospitalization, the baby’s fundus examination will be arranged by the ward; You can go to the outpatient clinic for examination after discharge.

Outpatient service process:

1. After the attending doctor determines the need for fundus screening, he will prescribe medicine for examination.

2. After the parents pay for the medicine, they start to give the baby some mydriatic liquid medicine. Generally, it takes one hour from the beginning of the medicine to the examination of mydriasis.

3. 1~2 drops of surface anesthetic water will be given before the examination, so that the baby can be examined in a painless state.

4. During the examination, the baby was lying on the bed, and the doctor opened the eyelids with a special eyelid opener for the baby. The retina was examined with binocular indirect ophthalmoscope and wide-angle children’s fundus photography system, and recorded according to the lesion area and lesion degree.

5. The doctor will inform whether treatment is needed and/or the time for the next review according to the examination results.

6. After the baby receives the examination, it needs to use anti-inflammatory eye drops for 3 days.

friendly reminder

Please try to arrive at 13: 00 ~ 14: 00 because you need some eye drops and wait for mydriasis before the examination, otherwise your waiting time will be affected.

In order to avoid aspiration pneumonia or even suffocation caused by excessive milk during examination, parents are requested to estimate the time and stop feeding after starting to order medicine.

You need to hold your baby’s head tightly and fix it during the examination. Please ask parents to understand and cooperate. Generally, the examination time only takes 5~10 minutes. Don’t interrupt or give up the examination because of the crying of children and the distress of adults. If the blindness caused by this happens, you will regret it for life.

ROP emphasizes early detection and early treatment. Early intervention and treatment can achieve normal children’s vision. If found late, it may lead to irreversible blindness. Since 2009, our team has carried out fundus screening for premature babies, with more than 2,500 screenings every year, which has accumulated rich experience, and we will give timely and standardized treatment according to the screening results.

The ophthalmology department of Children’s Center has opened a specialized clinic for newborns and children with basic diseases. Please rest assured that our team will take care of your baby’s bright eyes with you.

Read the original text

Deep reading ｜ Trade in the old for the new, looking forward to changing the ＂new world＂ of consumption

Not long ago, the State Council issued the Action Plan for Promoting Large-scale Equipment Renewal and Consumer Goods Trade-in (hereinafter referred to as the "Plan"), proposing key tasks such as carrying out trade-in of automobiles and household appliances and promoting trade-in of home-improvement consumer goods. According to the National Development and Reform Commission, this measure can not only promote technological upgrading of enterprises, improve production efficiency, but also guide residents to upgrade their consumption, realize energy saving and carbon reduction, and reduce potential safety hazards.

To implement a new round of trade-in of consumer goods, major manufacturers and platform enterprises have responded to this trillion-dollar huge market and launched promotional subsidies. What is the feedback from this wave of "more fashionable" markets? Where is the "new" in this round of trade-in? How can production and marketing enterprises and consumers seize the opportunity to achieve a win-win situation of high-quality development and high-quality life?

The home appliance market is moving from "is there" to "is it good"

On March 20th, in the store of Xinjiekou store in Suning.cn, Gao Rongping, a promoter, introduced in detail to Uncle Sun who was interested in buying air conditioners: "The first-class energy efficiency ratio of this Hisense bright air conditioner is as high as 5.28, which is fresh and silent, with a thickness of only 13.4 cm. The paint panel will not turn yellow and discolor after being used for a long time." Gao Rongping said that this air conditioner is currently heavily discounted. She calculated an account. "The market price of air conditioners is 5,099 yuan, which will go straight to 800 yuan during the event. The replacement of old machines at home can subsidize 600 yuan at the highest level, and the actual payment may be as low as 3,699 yuan."

"At present, upgraded products with large size, large capacity and multifunction are particularly popular. Since the launch of the trade-in activity, the sales growth rate of new energy-efficient air conditioners, large-capacity refrigerators and large-screen color TVs over 80 inches has exceeded 120%; Dishwasher sales increased by 103% year-on-year, and dryer sales doubled. " Wang Yisheng, the general manager of Suning.cn Xinjiekou Store, said that the 10 billion-yuan subsidy for trade-in will provide users with a large subsidy of up to 30%, which can be participated online and offline, and also provide services such as free door-to-door, disassembly and handling.

In Wuxi, the ongoing "Revitalization of Quality Life" activity of the 2024 Taihu Shopping Festival has launched a number of preferential policies to boost the release of large-scale consumer demand for household appliances. The maximum subsidy for replacing household appliances is 15%, and the maximum subsidy for a single household is 4,500 yuan. Consumers who purchase new green and energy-saving home appliances and new smart home appliances (the unit price is more than 500 yuan) in the event merchants can use China Unionpay Quick Pass APP payment code to reduce the turnover by 10%, and the maximum single subsidy is 1000 yuan. If the household appliances are trade-in, and the paid-in amount of each piece reaches 4,000 yuan, 6,000 yuan and 10,000 yuan, Wuxi Municipal Bureau of Commerce will give consumers 200 yuan, 300 yuan and 500 yuan extra incentives for trade-in.

The promotion of car companies is also in full swing. BYD launched the activity of "Old Friends Rejuvenating the New Season". During the activity, car owners can get a replacement subsidy of up to 8,000 yuan when they replace BYD’s new energy vehicles in the store, and a new car gift package worth 3,888 yuan. Dongfeng Motor’s trade-in action covers more than 50 models, and the replacement subsidy is expected to exceed 10 billion yuan; FAW-Volkswagen introduced the old car replacement down payment policy …

"In fact," trade-in "is nothing new. As early as 2009, the state launched a combination of" home appliances going to the countryside "and" trade-in ",and enterprises cooperated with the government to implement subsidy policies to recycle and sell services, initially forming an operation mode of trade-in; Since 2016, home appliance sales companies have joined hands with manufacturers to organize their own trade-in activities, subsidize consumers, and develop their own trade-in sales system. " Qian Zhengming, secretary of the Party branch of the Provincial Household Electrical Appliances Association, said.

With the comprehensive popularization of durable consumer goods in China, the demand for upgrading the stock of consumer goods is constantly increasing, and the consumer market is changing from "whether there is" to "whether it is good". According to reports, the home appliance market in Jiangsu Province has accounted for about 10% of the national market over the years, among which it is estimated that there are more than 30 million home appliances in extended service, which has great demand and potential for upgrading. Qian Zhengming believes that the trade-in action will not only enable consumers to enjoy more convenient services and more favorable prices, but also promote the high-end, intelligent and green development of the manufacturing industry. For the society, it will also help to eliminate old household appliances and eliminate security risks.

Let "unwilling to change" and "afraid to change" become "comfortable to change"

I don’t know who to look for to disassemble the toilet, and I want to buy a dishwasher, but there is no reserved position in the kitchen, and the discarded old mattress waste station is not needed … As the real estate industry enters the era of stock, the renovation of old houses has gradually become the main force in the home industry. However, as a kind of low-frequency consumer goods, consumers will not only think twice when buying furniture, but also the disposal of waste furniture often makes people feel quite tricky.

"The biggest problem in this industry is the long consumption decision-making cycle and low conversion efficiency." Bai Yang, the head of Shilin Home Furnishing Division, said that unlike home appliances, automobiles and other industries, the replacement of furniture faces the problems of "difficult handling, difficult handling and low added value of recycling", which makes it difficult for customers to make choices and make decisions.

How to shorten the consumer decision-making cycle? "In addition to providing sufficient discounts in shopping malls, providing convenience services in residential quarters has become an important means to capture service information and increase user stickiness. For example, free recycling of used mattresses, provision of toilet disassembly services, design and local reform of cabinets and balconies … The core is to let consumers see how the service is done and feel the changes in consumption concepts, thus solving the pain points that customers are afraid to change, unwilling to change, and do not know how to change. " Bai Yang said that by integrating merchants to build solutions, the company has now settled in 25 communities and served nearly 1,000 families.

From 2021 to 2023, about 220,000 pieces of household appliances were recycled in Suning.cn, and a total of 19.9 million yuan of old machine residual value subsidies and new machine subsidies were distributed. The proportion of old-for-new appliances was about 3.1%, and there was still much room. In the same period, JD.COM Wuxing recycled 8573 old household appliances, showing a trend of small total and high growth rate. According to statistics, from 2021 to 2023, the household appliance recycling enterprises in Nanjing recycled 3.164 million sets of "four machines and one brain" (TV sets, refrigerators, washing machines, air conditioners and microcomputers).

"At present, the trade-in of home appliances is independently carried out by manufacturers, and the government’s blessing is needed in terms of subsidies and credibility. At the same time, it is necessary to increase publicity, change consumers’ awareness of "home appliances are not broken and not replaced", and help consumers realize the harm of home appliances that are over-aged. In addition, the original definition of trade-in commodities is less, and there are not many participating enterprises. It is necessary to expand the categories and expand the scope of trade-in participating enterprises. " Qian Zhengming suggested.

At present, the automobile consumption demand in the whole province and even the whole country has entered a period of steady development, and the activities of car subsidies are carried out separately in various places, which are more to attract the consumption power of cities with low policy activities and cannot drive new demand.

In this regard, Zhao Qiang, director of the Wuxi Municipal Bureau of Commerce, said that in addition to subsidizing individual consumers who scrap or transfer non-operating passenger cars under their personal names and buy new cars, they will also explore ways to promote the upgrading and expansion of the automobile aftermarket and promote the integrated development of automobile maintenance, cultural experience, professional competitions, vehicle modification and consumer finance. In addition, encourage the transformation from "brokerage" to "distribution", improve the comprehensive management and supporting service functions of the used car market, and encourage qualified enterprises to make full use of various trade promotion platforms to broaden overseas market channels.

Recycle and make good use of misplaced resources.

The "Program" requires the implementation of recycling actions. Improve the recycling network of waste products and equipment, support the circulation and trading of second-hand goods, promote remanufacturing and step-by-step utilization in an orderly manner, and promote the high-level recycling of resources.

On the disassembly assembly line of Nanjing Kaiyan Electronics Co., Ltd., an average ordinary refrigerator produces about 0.4 kg of copper, 0.8 kg of aluminum, 17 kg of iron and 7 kg of plastic after disassembly procedures. Song Guoping, the company’s administrative director, said that the company’s refrigerator line disassembly processing capacity can reach 1,000 units per day, and the annual processing capacity of "four machines and one brain" reaches 1.93 million units. "These renewable resources after resource and harmless treatment have greatly reduced the mining of copper mines and iron mines, reducing carbon emissions and turning waste into treasure."

"Scrapped motor vehicles are a collection of steel, aluminum, rubber, plastics, glass and various non-ferrous metals. If they are dismantled by themselves or by illegal and irregular enterprises, a large number of rubber, plastics and glass will be abandoned and burned, which will seriously pollute the ecological environment. In addition, illegal dismantling of scrapped motor vehicles, vehicle transactions and cross-regional transfer will pose great security risks to road traffic. " Li Zheng, general manager of Nanjing Coson Ning Environmental Protection Technology Co., Ltd. said that scrapped motor vehicles must be disposed of in accordance with the Law on the Prevention and Control of Environmental Pollution by Solid Wastes, and it is suggested that they be scrapped in the vehicle registration area and managed locally.

"At present, China is at the peak of household appliances scrapping. However, at present, enterprises are carrying out the" trade-in "activity, and most of the recycled waste household appliances, except air conditioners, have nowhere to be accepted and piled up in the open air, causing environmental pollution. Some of them flow to the second-hand market and illegal dismantling channels. Even if they enter the formal dismantling enterprises, they have gone through many links, and the expenses are high, so the enterprises lack enthusiasm for operating at a loss. In addition, the’ illegal dismantling’ of used household appliances has no environmental protection disposal facilities, and there is no actual tax payment at the recycling end and the sales end, and the operating cost is low, which directly leads to the lack of competitive advantage in the price of formal dismantling enterprises, resulting in bad money expelling good money. " Qian Zhengming said.

Sun Bo, Secretary-General of Nanjing Renewable Resources Association, said that the recycled waste materials should not just be scrapped, but must enter the formal recycling and dismantling enterprises, and then enter the remanufacturing process, so as to realize the goal of turning old materials into new ones and turning waste into treasure.

The reporter learned from the Nanjing Municipal Bureau of Commerce that this year, we will speed up the cultivation of home appliance recycling and dismantling industries, standardize and rectify the circulation order of second-hand home appliances, and strictly prohibit the illegal renovation and disassembly of three-no products from entering the consumer market. Accelerate the development of "replacement+recycling" logistics system and new model, support household appliance production and sales enterprises to build reverse logistics system through distribution, installation, maintenance and other channels, or cooperate with professional recycling enterprises to recycle waste household appliances at home. Explore the formulation of local standards or industry standards for the service life and scrapping conditions of different types of household appliances, and relax the qualification control of household appliance production and sales enterprises applying for electronic and electrical products processing. At the same time, encourage capable dismantling enterprises to expand home appliance recycling business to the front end, and encourage the construction of recycling network system.

Xinhua Daily Meeting Point reporter Lin Shantian Mochi/Wen Hua Su Jie/photo

Chronic obstructive pulmonary disease, the prevalence rate of men over 70 years old is nearly 50%

Recent studies have found that chronic obstructive pulmonary disease (COPD) is one of the significant factors that affect the death of patients in COVID-19. Among the dead people in COVID-19, the proportion of patients with chronic obstructive pulmonary disease is 6%, but only 1% among the surviving people. In addition, although patients with chronic obstructive pulmonary disease may not be more likely to be infected with Covid-19, they are more likely to die when they are infected.

What is chronic obstructive pulmonary disease? Chronic obstructive pulmonary disease (COPD) is a chronic bronchitis and/or emphysema characterized by airflow obstruction, which can further develop into chronic diseases of cor pulmonale and respiratory failure. Different from common chronic diseases such as hypertension and diabetes, chronic obstructive pulmonary disease is often not well known.

1. The prevalence rate of COPD in men over 70 years old is nearly 50%, and the difference between male and female is nearly 1 time.

According to the latest China Lung Health Survey (CPH2018), among 50,991 people surveyed from June 2012 to May 2015, the prevalence rate of COPD was 8.6%. Based on this, it is estimated that about 99,900 million people in Chinese suffer from COPD. The prevalence rate of COPD increases with age. The prevalence rate of people over 40 years old is significantly higher than that of people aged 20-39. The prevalence rate of COPD in men over 70 years old is nearly 50%. At the same time, the prevalence rate of men in all age groups is higher than that of women, and the prevalence rate of men over 30 years old is more than twice that of women.

　

　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 Figure 1: Prevalence of COPD in different gender and age groups.

2. Smoking is the main risk factor, and air pollution is the main risk factor for non-smokers to get sick.

CPH2018 also made a statistical analysis of possible risk factors of COPD, including smoking, air quality, BMI, family history, education, etc. The results showed that smoking, air pollution, low BMI and parents’ history of respiratory diseases were all risk factors of COPD, among which smoking and air pollution were the main risk factors.

　

　 　 　 　 　 　 　 　 　 　 　 　 　Figure 2: odds ratio (OR) of 2：COPD risk factors

Note: odds ratio (OR, Odds ratio) is the ratio of the exposed and unexposed people in the case group divided by the ratio of the exposed and unexposed people in the control group. Greater than 1 indicates that this factor is a risk factor, less than 1 indicates that this factor is a protective factor, and equal to 1 indicates that this factor does not work.

The analysis also shows that smoking history has a significant impact on the overall prevalence of COPD, and the prevalence of COPD increases with the increase of smoking years. Air pollution has no significant effect on the prevalence of COPD in the whole population, but it has a significant effect on non-smoking groups. The more serious air pollution is, the higher the prevalence of COPD is.

　 　 　 　 　 　 Figure 3: Smoking history and COPD prevalence Figure 4: Smoking years and COPD prevalence.

　

　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　Figure 5: Air quality and COPD prevalence rate

The Prospective Research Project of Chronic Diseases in China also published a survey of 280,000 non-smoking adults in China in 2019. The results show that using solid fuel is an important risk factor for major respiratory diseases, and switching to clean fuel such as natural gas can reduce the risk. Because chronic obstructive pulmonary disease is related to the concentration of sulfur dioxide and carbon monoxide, people who are engaged in jobs with dust environment, such as teachers and coal miners, are also prone to COPD.

3. The prevalence rate of people over 40 years old is different in different regions, with the highest in southwest China (20.2%) and the lowest in central China (10.2%).

The research conducted by China Center for Disease Control and Prevention on 66,752 people in 2014-2015 found that the prevalence rate of COPD over 40 years old also showed obvious differences in different regions, with the highest prevalence rate in southwest China (20.2%) and the lowest in central China (10.2%).

　

　 　 　 　 　 　 　 　 　 　 　 　 Figure 6: Prevalence rate of COPD among people over 40 years old in different regions.

4. Up to 56% of COPD patients may have cognitive impairment.

A large number of neuropsychological tests suggest that up to 56% patients may have cognitive impairment. The Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD)2021 also pointed out that cognitive impairment is common in COPD patients, and the prevalence and severity vary according to the evaluation type, with an average prevalence of about 32%. Moreover, cognitive impairment will aggravate the health problems of COPD patients. Compared with patients with single disease, patients with cognitive impairment and COPD have a higher respiratory-related hospitalization rate of 48% and a higher mortality rate of 3 times. Therefore, it is particularly necessary to help patients with complications to carry out effective self-management.

In addition, cardiovascular disease, osteoporosis, depression/anxiety are also common and important complications of COPD.

5. The mortality rate of COPD has decreased obviously year by year, but it is still high compared with other developed countries.

The mortality rate of COPD in China decreased from 99/100,000 in 1990 to 68/100,000 in 2017, and the mortality rate of standardized age decreased by 68.6%. Although the mortality rate in China is decreasing year by year, it is still at a high level compared with other developed countries (see the figure below).

　 　 　 　 　 　 　 　 　 　 　 　Figure 7: Mortality rate of male COPD patients aged 50-74 in countries around the world.

　

6. The diagnosis rate is lower than 30%, and the proportion of hospitalization is lower than that of outpatient treatment.

The diagnostic rate of COPD in China is between 23.61% and 30.00%, which shows that the diagnostic rate of COPD in China is low and the missed diagnosis and misdiagnosis are serious. On the one hand, COPD is asymptomatic in the early stage. In epidemiological screening, more than 70% of patients (I~II stage) have little or no symptoms, and even if they have symptoms, they just cough and expectoration, which has not attracted the attention of patients. On the other hand, due to the cost of examination and technical operation, lung function examination, as a gold standard for the diagnosis of COPD, has not been popularized in many hospitals (especially in primary hospitals), resulting in many patients not being diagnosed with COPD in time and delaying treatment.

　 　 　 　 　 　 　Table 1: COPD pulmonary function staging (GOLD staging) [After inhaling bronchodilator]

In addition, the diagnosis and treatment of COPD in China is also more severe. The conventional treatment rate of COPD patients is only 7.9%, and 84% of patients with stage ⅱ and above have not received treatment. The proportion of COPD patients receiving outpatient treatment is about 50%, while the proportion receiving hospitalization is only between 8.78% and 35.60%.

7. The average medical expenses of COPD ranged from 5,000 yuan to 16,000 yuan.

At present, no scholars have studied the medical expenses of COPD patients nationwide, and most of the research on COPD expenses is limited to local or regional areas.

A study on the medical expenses of COPD patients in Ningbo, Zhejiang Province found that from October 2012 to October 2013, the hospitalization expenses of male patients and female patients are shown in the following table. Among them, the average total hospitalization expense for men is 16,000 yuan, while that for women is 14,500 yuan, and only about 30% is borne by individuals.

　

　

　 　 　 　 　 　 　 　 　 　 　 　 　 　 Table 2: Hospitalization expenses of COPD patients in Ningbo, Zhejiang Province

In recent years, because the prevalence rate in southwest China is higher than that in other regions, many scholars have begun to choose southwest China to study the treatment cost of COPD patients. The following table is part of the research results, from which we can find that the overall cost of the western region is low, and the average hospitalization cost does not exceed 10 thousand yuan. In addition, according to the survey data of Sichuan province, the cost of western medicine accounts for the highest proportion, accounting for 38.32%, followed by the cost of diagnosis, accounting for 24.41%.

　

　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　Table 3: Hospitalization expenses of COPD patients in western China　

8. About 58% of commonly used drugs for COPD have been included in the medical insurance catalogue.

COPD can be divided into stable stage and acute exacerbation stage according to the progress of the disease course. In the stable stage, the symptoms such as cough and shortness of breath are stable or mild, while in the acute exacerbation stage, the respiratory symptoms that lead to additional treatment are seriously aggravated, and the patients’ cough and wheezing are aggravated, or may be accompanied by fever and other inflammatory manifestations. Drug therapy is a common treatment for COPD. GOLD2021 edition points out that drug therapy can alleviate COPD symptoms and reduce the frequency and severity of acute exacerbation. At present, there are data showing that drug therapy can reduce mortality. It is worth noting that COPD patients need to take drugs for a long time, mainly inhaled drugs, supplemented by oral drugs. With the progress of COPD, the therapeutic drugs and management methods used have been adjusted.

References:

　[1] China Pulmonary Health Study Group. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study. Lancet. 2018 Apr 28; 391(10131):1706-1717. doi: 10.1016/S0140-6736(18)30841-9. Epub 2018 Apr 9. PMID: 29650248.

[2] Li G, Liu Y, Jing X, et al. Mortality risk of COVID-19 in elderly males with comorbidities: a multi-country study. Aging (Albany NY). 2020 Dec 31; 13(1):27-60. doi: 10.18632/aging.202456. Epub 2020 Dec 31. PMID: 33472167.

[3] Zhu B, Wang Y, Ming J, et al. Disease burden of COPD in China: a systematic review. Int J Chron Obstruct Pulmon Dis. 2018 Apr 27;13:1353-1364. doi: 10.2147/COPD.S161555. PMID: 29731623; PMCID: PMC5927339.

[4] GBD 2016 Causes of Death Collaborators Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1151–1210.

[5] Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019 Sep 28; 394(10204):1145-1158. doi: 10.1016/S0140-6736(19)30427-1. Epub 2019 Jun 24. Erratum in: Lancet. 2020 Jul 4; 396(10243):26. PMID: 31248666; PMCID: PMC6891889.

[6] Chan K H , Kurmi O P , Bennett D A , et al. Solid Fuel Use and Risks of Respiratory Diseases: A Cohort Study of 280, 000 Chinese Never-Smokers[J]. American Journal of Respiratory and Critical Care Medicine, 2019, 199.

[7] Lowe KE, Regan EA, Crapo JD, et al. COPDGene? 2019: Redefining the Diagnosis of Chronic Obstructive Pulmonary Disease. Chronic Obstr Pulm Dis. 2019 Nov; 6(5):384-399. doi: 10.15326/jcopdf.6.5.2019.0149. PMID: 31710793; PMCID: PMC7020846.

Shi Bijun, Zhang Tao, Cui Jun, Wang Yong, AARON Li. Analysis of direct economic burden of 803 patients with chronic obstructive pulmonary disease in Ningbo community, Zhejiang province [J]. Disease surveillance, 2015,30(4):300-304.

Zhao Hanqing, Li Xinyi, Tank Tan, et al. Analysis of hospitalization expenses of patients with chronic obstructive pneumonia in Sichuan Province [J]. Health Soft Science, 2020, v.34; No.292(05):57-62.

[10] Wang Lianhong, Luo Qian, Zhang Li. Analysis of disease cost of patients with chronic obstructive pulmonary disease in Zunyi area in 2014 [J]. Guizhou Medicine, 2015, 000(011):1048-1049.

[11] Yu Juan. Analysis of hospitalization expenses and influencing factors of patients with chronic obstructive pulmonary disease in Lanzhou urban hospital [D]. Lanzhou: Lanzhou University, 2018.

[12] Zhong Nanshan. Research progress on prevention and treatment of chronic airway diseases in 2017 [J]. West China Medicine, 2018,33(01):1-7.

After 13 years of control, cigarettes are sold more and more. Has the tobacco control bonus been ＂eaten up＂？

　　"Healthy China 2030" Planning Outline clearly points out that by 2030, the smoking rate of people over the age of 15 will be reduced to 20%, so a series of smoking ban measures have been introduced in various places. However, according to the reporter’s investigation, since 2017, China’s cigarette sales have stopped falling and rose. According to industry insiders, the situation of adolescent smoking and second-hand smoke is still serious, and new types of tobacco, such as e-cigarettes, are "cultivating" young smokers. At the same time, the tobacco control bonus brought by the tax increase on tobacco products has been "eaten up" and the "tug-of-war" of tobacco control continues.

　　After thirteen years of smoking control, cigarettes are sold more and more.

　　It is understood that the WHO Framework Convention on Tobacco Control came into effect in China in January 2006. In order to fulfill the Convention on Tobacco Control, in 2015, China raised the tobacco consumption tax, which led to the decline of cigarette sales in 2015 and 2016, and achieved the effect of controlling tobacco consumption. However, according to the official data of Tobacco Monopoly Bureau, in 2017, the sales volume of cigarettes in China stopped falling and rose, with 47.378 million boxes sold in the whole year, up by 0.8% compared with 2016.

　　The reporter’s investigation found that under the general trend of national tobacco control, the tobacco authorities are still actively seeking how to expand sales and increase tobacco consumers. For example, an insider of Jinan Tobacco Monopoly System published a paper "Analysis on the Factors of Cigarette Sales Growth in Jinan Market", suggesting that "for ordinary wage earners, activities such as buying a certain number of cigarettes to give away other necessities of life, such as giving away laundry soap, towels, etc., can be carried out, and the consumer can use the original expenditure on daily necessities to buy cigarettes, thus increasing cigarette consumption expenditure and giving him the opportunity to cultivate new consumption habits."

　　Tobacco companies are actively exploring new rural markets. Among the outstanding papers of Guangxi Tobacco in 2016-2017, there is a paper saying that "the current tobacco control regulations have not had a great impact on the rural market, and the smoking environment in rural areas has not been greatly restricted, and the consumer groups and smoking habits are relatively stable, which provides a favorable environment for improving sales volume and structure", "Guangxi Baise Company & HELIP; … Deeply tap the potential of rural market, and achieved certain results. In 2015, the sales volume and structure of the rural market maintained growth. When the total sales volume of the whole city was basically the same as that of the same period of last year, the rural market sold a total of 37,235 boxes of cigarettes, an increase of 645 boxes year-on-year, an increase of 1.8%. "

　　Teenagers’ "first cigarette" is easier to get.

　　According to the statistics of the State Tobacco Monopoly Bureau, the sales volume of Double Happiness in the first half of 2017 was as high as 1,935,000 boxes, followed by Yunyan, Liqun and Hongtashan, and the prices of their main varieties were all around 10 yuan. According to CDC statistics, 50% of smokers spend no more than 9.9 yuan on a box of cigarettes, and there is no difference compared with 2015. The proportion of the cost of purchasing 100 boxes of cigarettes to the per capita GDP in the same year decreased from 2.0% in 2015 to 1.5%.

　　According to the reporter’s investigation, low-priced cigarettes "occupy" the vast market, and many young students have also become consumers of low-priced cigarettes. At present, China only counts smokers over the age of 15, and the relevant anti-smoking propaganda is mainly aimed at this group of people over the age of 15. However, teenagers under the age of 15 have been able to contact and buy cigarettes, especially many left-behind children can control their living expenses independently, and their parents’ supervision is insufficient. At the same time, some tobacco companies have also introduced "low tar content" cigarettes to promote their little harm and lure teenagers to try.

　　Wan Xia, an associate researcher at the Institute of Basic Medicine, China Academy of Medical Sciences, said that it is "convenient" and "cheaper" for teenagers to buy cigarettes. Some cigarette shops even unpack cigarettes and sell them individually, and each cigarette costs only a few cents, so teenagers can buy the "first cigarette" in their lives and may become addicted from now on.

　　Some new tobacco products are becoming popular, such as e-cigarettes, heated non-combustible cigarettes, and so on. These products are playing advertisements that are harmless to health. These new tobacco products are used in the same way as traditional cigarettes. Some researchers have found that a large proportion of new tobacco users will gradually take up traditional cigarettes, and "e-cigarettes" are cultivating new smokers.

　　Tobacco control urgently needs "strong medicine"

　　On the one hand, it is public health, on the other hand, it is rich profits, and the "tug-of-war" between the two sides of tobacco control interests is becoming more and more fierce. According to the Survey Results of Adult Tobacco in China in 2018 released by CDC, the smoking rate of people aged 15 and above in China was 26.6% in 2018, including 50.5% for men, 2.1% for women, 28.9% for rural areas and 25.1% for cities. Compared with the previous survey results, the smoking rate shows a downward trend, but it is not the same as achieving the tobacco control goal of "Healthy China 2030" — — There is still a big gap between "the smoking rate of people over 15 years old will drop to 20% in 2030".

　　According to industry insiders, while China’s economy is developing rapidly and residents’ income is increasing, tobacco prices are relatively "stable", which leads to the "tobacco control dividend" brought by the tax increase on tobacco products in 2015 being "eaten up".

　　A team study by Professor university of international business and economics and Zheng Rong, director of the WHO Center for Tobacco Control and Economic Policy Cooperation, found that during 2001-2016, China’s ability to pay for cigarettes continued to increase because the income of China residents increased more than the price of cigarettes. The reporter also learned from the investigation that the consumption level of students has improved, and many of them have smoked more than a dozen or twenty cigarettes.

　　Experts believe that the most powerful tobacco control weapon that the government can use is taxation. It is suggested that China’s tobacco tax should be changed from ad valorem to specific quantity, and the price of low-priced cigarettes should be raised, which is more obvious for low-income people and teenagers. These two groups of people are more sensitive to price because of their limited income. This is also the most important target group for tobacco tax increase to achieve the effect of tobacco control, which can not only reduce the "first smoke" of teenagers, thus reducing the number of new smokers, but also reduce the smoking volume of low-and middle-income smokers.

　　In addition to the lag in tax adjustment, experts believe that China’s tobacco control efforts and policies are not enough. For example, the World Health Organization’s Framework Convention on Tobacco Control stipulates that China should adopt legislative measures to achieve 100% smoke-free indoor public places, workplaces and public transport within five years of its entry into force. The Convention came into effect in 2006, and the Regulations on the Control of Smoking in Public Places (Draft for Comment) just issued in Wuhan in May even suggested setting a three-year "buffer period" for smoking bans in entertainment, restaurants and other places. This also means that smoking in these places will be restricted within three years, and smoking will be completely banned after three years, which not only runs counter to the spirit of the Convention, but also indoor smoking areas have become the source of second-hand smoke.

　　Experts believe that the law must impose heavy penalties for violating the smoking ban, especially indoor smoking ban. Zhou Ning, an associate professor of cardiovascular medicine in tongji hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, said that setting up smoking areas can’t eliminate the harm of second-hand smoke. The results of the technical feasibility study of the smoking room in Hong Kong University of Science and Technology show that any engineering technology, such as exhaust, ventilation and designated smoking areas, can not avoid exposure to tobacco smoke, effectively protecting public health.

　　The role of health education also needs to be strengthened. Cui Xiaobo, vice president of Beijing Smoking Control Association and a professor at Capital Medical University, said that while reminding health risks and reducing the willingness to smoke, warning pictures of cigarette cases will effectively curb the current trend that many high-end cigarettes are given as gifts. There are 118 countries/jurisdictions in the world that have finally determined that tobacco packaging must adopt the requirement of picture warning, covering 58% of the world population, which is an achievement of global public health.

　　"In the Internet and self-media era, tobacco advertisements have spread to new media such as WeChat and Tik Tok. Therefore, banning tobacco advertisements in new media and carrying out health education on tobacco hazards are likely to affect a large number of young people and prevent them from becoming new smokers." Ma Jun, director of Peking University Children and Adolescent Health Research Institute, said.

The attack can reach ten levels of pain, and over 90% of adults carry the virus for life.

Original Dr. Zeqiao, Dr. Zeqiao

Imagine that there is a virus lurking in your body, which quietly ambushes and waits for an opportunity to make you "miserable". More than 90% of adults will carry this virus, which is ready to attack at any time, but we often don’t know it …

This virus is the varicella-zoster virus that causes herpes zoster.

Once infected, carry it for life!

After the first infection, about 70% people will have symptoms of chickenpox, while 30% people will not get sick and become recessive infection. The virus is quietly lurking in the "neurons of the spinal dorsal root ganglion". Terrible is, regardless of symptoms, this virus will be carried for life, and may be activated at any time due to decreased immunity, thus causing herpes zoster.

The pain during the attack is unimaginable.

The pain of herpes zoster can reach ten levels, which has reached the highest level among the most commonly used pain levels at present! At the time of attack, there are various forms of neuralgia, including knife-like, acupuncture-like and burning-like pain, which usually intensifies at night, making it difficult for people to sleep. What’s more, even if the herpes is cured, there may be a long-term neuralgia. According to statistics, about 9%~34% patients with herpes zoster will suffer from this kind of torture, and the pain may last for more than one year, or even as long as 10 years or more.

Treatment within 72 hours is crucial.

Although herpes zoster is a self-limiting disease, most people will heal themselves in about two or three weeks. However, the golden period of herpes zoster treatment is 72 hours! Receiving antiviral treatment in time within 24~72 hours after the appearance of rash can not only effectively control pain, accelerate the healing of rash, but also reduce the risk of post-traumatic neuralgia. Especially when the lesions occur in the head and face, immediate treatment is needed to avoid serious complications.

Who is more likely to be the "target" of herpes zoster?

Epidemiological data show that about one third of adults will suffer from herpes zoster once or more in their lifetime.

Especially the following five high-risk groups, we should be more vigilant:

1. Middle-aged and elderly people over 50 years old: With the increase of age, human immunity gradually declines, and the resistance to varicella-zoster virus weakens. In addition, the risk of herpes zoster in women is relatively higher.

2. Patients with immune system diseases: such as cancer patients, patients with lupus erythematosus, AIDS-infected people, etc., are more prone to herpes zoster due to low immune function.

3. Patients with chronic diseases: such as diabetes, chronic obstructive pulmonary disease, cardiovascular disease, chronic kidney disease, asthma and other chronic diseases, their risk of herpes zoster is also significantly increased.

4. Sub-healthy people: Long-term staying up late, improper diet, sedentary and other bad habits lead to decreased immunity, making this group of people more susceptible to infection.

5. People who regularly take hormones: Hormones will inhibit immune function, and excessive dependence on hormones may even lead to the disappearance of immunity, thus increasing the risk of herpes zoster.

How to prevent herpes zoster?

1. Vaccination: the most effective protection

The data show that within 3 years after vaccination with herpes zoster vaccine, the protective effect on adults aged 50-59 is as high as 96.6%. Therefore, people over 50 years old and people who have suffered from herpes zoster twice or more should be actively vaccinated.

2. Improve immunity

Regular work and rest: It is recommended to fall asleep before 23 o’clock every night, ensure 7-9 hours of sleep, and improve immune cell activity.

Balanced diet: eat more than 12 different kinds of food every day, not less than 25 kinds every week to ensure adequate nutrition; It is recommended to eat more fresh vegetables and fruits, whole grains and potatoes, and supplement probiotics.

Appropriate exercise: It is recommended to carry out moderate-intensity aerobic exercise for 30~45 minutes five times a week, such as jogging, cycling, yoga, etc., to enhance physical fitness.

Step 3 avoid contact

Although herpes zoster is not contagious, close contact with patients should be avoided, especially touching herpes fluid. When there are patients with herpes zoster at home, isolation measures should be taken. At the same time, pay attention to daily disinfection and indoor ventilation to reduce the chance of virus transmission.

To sum up, varicella-zoster virus is hidden in more than 90% adults, and once infected, it will be carried for life. Herpes zoster has a strong pain and may be accompanied by postherpetic neuralgia, so it should be treated with antiviral therapy in time. High-risk groups need to be vigilant, and herpes zoster can be prevented by vaccination, improving immunity and avoiding contact with patients.

That’s the headline of Dr. Zeqiao’s health. See you tomorrow!

References:

[1] Expert Group on the Compilation of the Consensus of Diagnosis and Treatment of Postherpetic Neuralgia. China Expert Consensus on Diagnosis and Treatment of Postherpetic Neuralgia. China Journal of Pain Medicine. 2016; 22(3):161-167.

[2] Johnson ＲW，Alvarez-Pasquin MJ，Bijl M， et al． Herpes zosterepidemiology，management， and disease and economic burden in Europe: a multidisciplinary perspective［J］． Ther AdvVaccines， 2015，3( 4) : 109 － 120．

Quan Yaru, Li Changgui. Chickenpox and herpes zoster and their vaccines. China Food and Drug Administration, 2019, 183(04):87-91.

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