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Food Control: Research Progress Of Aptamer Sensor Technology In The Detection Of Foodborne Pathogenic Bacteria

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Professor Wang Zhouping's team from the School of Food Science and Technology of Jiangnan University published a review paper titled "of in the of" (Research Progress of Aptamer Sensor Technology in the Detection of Foodborne Pathogenic Bacteria) in Food.

Summary:

In recent years, foodborne pathogenic bacteria have attracted increasing public concern. Therefore, constructing a simple, fast, effective, and low-cost rapid detection method has become an important issue in the field of food safety. Among them, aptasensors are emerging biosensors in the fields of food safety, detection and control. Nucleic acid aptamers (Nucleic acid aptamers) are single-stranded DNA or RNA sequences that specifically bind to proteins or other small molecules through systematic evolution of exponentially enriched ligands (SELEX) and other derivative technologies. Nucleic acid aptamers are widely used in food safety testing due to their wide range of target molecules, high sensitivity, strong specificity, and good stability. This article will review the latest research on aptamers of foodborne pathogenic bacteria, potential applications and optimization methods of aptasensors in foodborne pathogenic bacteria. Finally, we hope that this review can provide new ideas and approaches for the development and application of aptamer sensors for foodborne pathogenic bacteria.

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Fig. 1. of paper.

2.Adapter

Fig. 2. , and of the . (A) of the . (B) . (C) the of the L3 by a , with from Ref (Ma et al., 2022). (D) of the by a 2′- O-RNA base, from Ref (Maio et al., 2017).

4. Combination of aptamers and biosensors

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4.1 Application of aptamers in colorimetric sensors

Fig. 3. The -based . (A) based on label-free AuNPs (a), (b). (B) of for S., with from Ref (Wei et al., 2022). (C) n of the for of S. , from Ref (Yu et al., 2020).

4.2. Application of aptamers in fluorescence sensors

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Fig. 4. The -based . (A) of the S. , with from Ref (Ren et al., 2019). (B) for V. , from Ref (Wu, 2019). (C) for E. , with from Ref (Yao et al., 2021).

4.3. Application of aptamers in electrochemical sensors

Fig. 5. The -based . (A) for of C. , with from Ref (Peng et al., 2019). (B) for B. , from Ref ( et al., 2019). (C) the of E. coli, with from Ref (Hua et al., 2018).

4.6 Zoom in

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Fig. 6. The of the -based , and -based .(A) of V. , from Ref (Wu et al., 2015). (B) of P. , with from Ref (Xie etal., 2022). (C) for the of E. coli, from Ref (Yang et al., 2020).

5. Conclusion Future Prospects and Challenges

Foodborne pathogenic bacteria are an important threat to food safety. In summary, this article reviews the research progress of aptamers in food-borne pathogenic bacteria in recent years, as well as the application of aptamer sensors in the detection of food-borne pathogenic bacteria. These aptamer-based biosensors exhibit good detection sensitivity, selectivity, and accuracy by introducing new signal transduction systems and multiple amplification strategies. We can find that colorimetric and fluorescent sensors have similar detection limits. But fluorescent sensors tend to have a larger detection range, while electrochemical sensors have the highest sensitivity and the lowest detection limit. However, during the application process, there are still some challenges that need to be solved in the application of these biosensors.

With the development of SELEX technology, the selection of faster and more accurate nucleic acid aptamers and a series of nucleic acid aptamer optimization methods are also conducive to obtaining more stable, better performance, higher affinity, and lower costs. of nucleic acid aptamers. Currently, in terms of aptamers, obtaining more stable and higher affinity aptamers is the direction of development. To achieve this goal, analyzing the specific binding sites of bacterial aptamers and the specific components of bacterial whole cells has become a key issue. However, due to the complexity of bacteria, there are few studies on the analysis of aptamer-bacterial binding sites and the molecular resolution of bacterial-aptamer binding. In order to solve the above problems, the application of computational prediction tools has become particularly important. In addition to using computers for primary sequence analysis, two-dimensional and three-dimensional structure prediction, how to complete the docking of complex targets such as food-borne pathogenic bacteria and aptamers and conduct corresponding molecular dynamics simulations to more accurately evaluate aptamers The stability of the body-target complex and determining its binding energy are also future considerations. Continuing developments along this direction could enhance the practical significance of aptamers.

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In terms of sensors, aptamer sensors targeting the detection of foodborne pathogenic bacteria have been a hot research topic in recent years. Optical aptamer sensors can detect changes in color or absorbance by direct observation. The electrochemical aptasensor has high sensitivity. A large number of papers have been published in this field, but most of them are verification of conceptual models and lack the potential for clinical practice. Therefore, it is necessary to improve aptasensor technology and sensor practicality. On the one hand, due to the complex composition of actual samples and the influence of environmental factors, the structure and properties of aptamers will change. Such as protein, lipid carbohydrates, pH and temperature, etc.

Nonspecific binding of aptamers may also lead to false-positive results, a phenomenon known as matrix effect. For example, target substances in milk can easily combine with other proteins to form polymers, thus affecting the detection results. This problem is often solved by diluting the sample before analysis or by protein precipitation. However, both processes are time-consuming. Therefore, it is necessary to study the effects of environmental factors, actual sample compositions of proteins and lipids on aptamer-target binding to guide the application of aptamers in detection systems. On the other hand, detected foodborne pathogens can present false positives due to mutations. Selecting aptamers that target specific components of bacteria can help avoid mutations. For example, bacteria can be identified through targeted screening of aptamers targeting specific proteins or polysaccharide components.

Sensors with high sensitivity are usually achieved by using one or more signal amplification methods. However, different amplification methods also have their limitations. Magnetic enrichment of magnetic species may affect signal intensity, and combination with enzymatic reactions may hinder the sensor's ability to function optimally in real-world and complex samples. The main challenge with nanomaterials is ensuring sensor stability and fabrication reproducibility. The solution to these problems is also the future development direction of fitness sensors.

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Every Part Of The Fish Is A "treasure", But Chinese People Generally Don't Eat Fish Enough To Make Up For The "fish" In Every Mouthful Of Fish.

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Recently, a study conducted by the University of Bordeaux in France on 1,623 people over the age of 65 showed that people who regularly eat fish have fewer cerebrovascular diseases and a lower risk of dementia and stroke than those who do not eat fish. The association was strongest among people aged 65-69.

Although we all know that eating fish is good, the amount of fish eaten by Chinese people is still far from enough. How to eat fish? Chen Shunsheng, a professor at the School of Food Science at Shanghai Ocean University, and Fan Zhihong, an associate professor at the School of Food Science and Nutritional Engineering at China Agricultural University, list the nutrition of each part of a fish and teach you how to make up for the "fish".

Chinese people generally have insufficient “fish” quota

The "State of World Fisheries and Aquaculture" report released by the Food and Agriculture Organization of the United Nations in 2020 stated that global per capita fish consumption has set a new record of 20.5 kilograms (approximately 55 grams/day) per year, and is expected to further increase in the next decade. Increase.

The latest survey data from the Nutrition and Health Institute of the Chinese Center for Disease Control and Prevention shows that the average fish and shrimp intake of Chinese residents is only 23.7 grams per day per person, which is not only lower than the world level, but also far lower than the "Dietary Guidelines for Chinese Residents" ( 2016)" recommended 40-75 grams, 73.7% of Chinese residents do not meet the minimum limit of reasonable intake of aquatic products.

Fan Zhihong, associate professor at the School of Food Science and Nutritional Engineering at China Agricultural University, believes that on the one hand, because the supply of fish is not as convenient as meat, eggs, and milk, and it is relatively difficult to raise and preserve, live fish and frozen fish are sold in inland areas. There are fewer stalls than those selling meat; on the other hand, the handling and cooking of fish is relatively troublesome, and it is more likely to carry pathogenic bacteria from a food safety perspective, so many families generally eat less fish.

Chen Shunsheng, a professor at the School of Food Science and Technology at Shanghai Ocean University, said that my country’s sea area is limited, and coupled with the different food culture and habits caused by the regional differences between the north and the south, Chinese people have always eaten more fish in the south and less in the north, and more in the east and less in the west.

However, my country's freshwater aquaculture industry is relatively developed. Using rivers and lakes to raise fish not only takes up precious land resources, but also supplements sources of high-quality animal protein, which can effectively solve the problem of insufficient fish consumption. Since the reform and opening up, the average fish consumption of Chinese people has increased two or three times, but there is still room for continued growth.

my country has also become the largest country in marine aquaculture. It has developed rapidly in the past thirty years and formed large-scale production of economic species, mainly including grouper, seabass, large yellow croaker, turbot, etc. Although it is limited by economic, environmental and other objective conditions , the amount of fish, shrimp and crab culture is relatively small, but the development momentum is good and prices are constantly falling, which is good news for residents.

Every part of the fish is a “treasure”

Fish are divided into seawater fish and freshwater fish according to the difference in living waters, which is what we often call sea fish and river fish. Commonly eaten sea fish include hairtail, croaker, salmon, mackerel, horse mackerel, perch, tuna, etc.; commonly eaten river fish include grass carp, crucian carp, silver carp, carp, catfish, tilapia, etc.

So, which one is more nutritious, sea fish or river fish?

From a nutritional point of view, there is not much difference between sea fish and river fish. They are both rich in high-quality protein, unsaturated fatty acids (including DHA and EPA that are beneficial to brain development), vitamins, minerals and other nutrients. In particular, everyone is generally concerned about the content of DHA (docosahexaenoic acid). Its level does not entirely depend on whether it is a river fish or a deep-sea fish, but mainly on the species of fish. Generally speaking, deep-sea fish and carnivorous freshwater fish, such as bass, mandarin fish, and catfish, contain more DHA in their bodies.

DHA is usually concentrated in the fat of fish. For example, eel has a high fat content, and its body naturally contains more DHA. The nutritional content of the same fish will change with the seasons. Before the winter and breeding season, the fat content is higher, which is not only more nutritious, but also more delicious. After spawning, the meat texture and taste decrease significantly.

Looking at each part, there are "treasures" everywhere on the fish (pictured). For example, fish bones can be used as a natural source of calcium. Add vinegar to the soup and simmer over low heat for 2-4 hours until the bone spurs become soft.

Eating fish should not only be enough

Still want to do it

When eating fish healthily, adequate quantity and choosing the right cooking method are the top priorities. Although we are encouraged to eat as much fish as possible, we should also be aware that going too far is never enough.

It is recommended to eat fish 2-3 times a week, with 100-200 grams of pure fish meat at a time. Just eat each part in such a way that the advantages and disadvantages are avoided. There is no need to deliberately eat certain parts. In addition, you can also eat some shrimp, shellfish and other aquatic products appropriately. Generally speaking, salmon, anchovies, herrings, sardines, hairtail, pomfret, mackerel, large and small yellow croakers, saury, etc. are more suitable for daily consumption. They can not only contribute DHA and EPA, but the price is relatively reasonable.

People with underlying diseases should pay attention to some taboos when eating fish: patients with gout attacks are best not to eat fish for the time being; people with gallbladder disease or who need to lose weight should eat less fried fish; pregnant women, wet nurses, children and other special groups Fish with high mercury content, such as marlin, swordfish, and bluefin tuna, should be avoided as much as possible; the elderly and children should give priority to boneless fish, such as tilapia, whitebait, cod, herring, flounder, etc.

When it comes to cooking fish, from a cooking perspective, you must first pay attention to choosing fresh fish. Secondly, you can refer to the method of eating fish in the "Mediterranean Diet". If you want to rank the various cooking methods, the first recommendation is pressure cooker frying. And the steaming method can retain the DHA in the fish to the greatest extent.

Pressure cooker frying: Apply a little oil on the bottom of the pot, put the fish on it, and cover it. This can isolate the outside oxygen, reduce oxidation reaction, and retain nutrients.

Steaming: The temperature does not exceed 100°C. The wrapping of water vapor can ensure that the umami flavor of the fish is firmly locked in without excessive oil, which is very healthy.

Charcoal grilling: It will produce carcinogens on the surface. It is safer to choose an oven, which can not only control the temperature, but also ensure the taste and reduce the loss of DHA.

Braised in soy sauce: It needs to be fried first. Failure to control the heat will lead to loss of nutrients. You can shorten the frying time as much as possible.

Frying: Best avoided as high temperatures destroy nutrients.

Eating more fish will not only keep you healthy, but also from a macro perspective, increasing protein intake can enhance the physical fitness of the entire nation, thereby improving the health quality of the entire nation. I hope that Chinese people can eat more and better quality fish in the future.

Comprehensive Life Times report

In The Era Of Pet Raising 3.0, Insights Into The New Category Trends Of Global Pet Food

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As a necessity for pets' daily life, pet food has become an important track in global development. As pet owners gradually increase their requirements for the quality of life of their pets, the pet food market is undergoing some new changes. For example, more and more pet owners are beginning to pay attention to the health and nutritional needs of their pets. Therefore, when purchasing pet food, they will pay more attention to its ingredient list and nutritional content.

Over the years, the pet food track has maintained steady growth, attracting more and more companies and investors. From the current point of view, under the concept of scientific pet raising, pet food consumption demand will continue to grow and will develop in the direction of refinement, diversification and specialization. These trends will also have a positive impact on the development of the entire pet industry.

Current status of global pet food market

1.1 Pet food types/raw materials

According to pet type, pet food can be divided into dog food, cat food, other pet staple food, snacks and other nutritional and health pet food. At present, dogs and cats are the main pets in the world, so the proportion of dog food and cat food far exceeds that of other pet foods. According to data from the "2022 China Pet Industry White Paper", dog food will account for 60% of the global pet food retail market in 2022, and cat food will account for 36%.

By functional type, pet food mainly includes three categories: pet staple food, pet snacks and pet nutrition products.

Divided by raw materials, they are mainly derived from animals, plants, grains, and other ingredient types.

1.2 Pet food consumption trends

Pet food consumption varies among pet owners in different countries and regions.

Purchasing preferences: There is a common trend that pet owners are paying more and more attention to the health and nutrition of their pets, and high-quality, natural and organic pet foods have become their first choice. Not only that, pet owners also like to feed their pets snacks and supplements to keep their pets healthy and energetic.

Pet owners prefer functional treats over other treats because they provide additional health benefits to their pets. Due to this trend, major players in the market are developing new functional treats to meet the needs of pet owners. For example, in 2019, Hill's, a subsidiary of Colgate-Palmolive, launched a new line of functional dog foods specifically designed to help dogs manage weight, mobility, and address food allergies and dental problems.

Expenditure: A survey shows that despite rising inflation, pet consumption continues to rise. More than 40% of people spend between US$100 and US$299 on pets per month, and 22% spend at least US$299 per month. Spend $300, with food and medical expenses at the top of the list.

Price trends: Research by Consumer Insights and Analysis found that due to inflation, pet food prices have increased by more than 24% as of the fourth quarter of 2022, which has changed the way pet owners purchase pet food. Four in 10 pet owners say they will seek deals and plan to buy more food and pet care supplies online in 2023, which may force some brands to make significant investments in direct-to-pet owner and other new sales channels.

1.3 Pet food distribution channels

The development history of pet food in different countries is different, and the distribution channel structure is also significantly different. For example, the main sales channel of China's pet food industry is online, while European and American pet food distribution channels are more diversified. The following are some of the major distribution channels for global pet food:

Stores/Supermarkets: Distribution through common retail stores and supermarkets, such as pet stores, pet food specialty stores, pet supply stores, large supermarket chains, etc. This channel often provides great presentation and sales support.

Online retailers: With the development of e-commerce, more and more people choose to buy pet food online. Online retailers offer a convenient shopping experience, such as a large product selection, the ability to view and compare different brands and models of pet food, and complete purchases quickly.

Professional channels: In addition to traditional retail channels, some pet food companies choose to distribute through professional channels, such as veterinary clinics, wholesalers, farmers' markets, etc. These channels can effectively increase product visibility and reliability.

Direct sales: Some pet food companies choose to sell their products through direct sales, which means they can better control the quality of their products, provide more personalized service, and build long-term relationships with their customers.

Three insights into new categories in the pet food industry

2.1 Market Insight Perspective

Market insight mainly refers to discovering potential needs or blank markets in the market. It mainly combines observations of new trends, the development history of high-level markets, changes in consumers and changes in channel costs to discover opportunities for innovation.

Take the “focus on the development history of high-level markets” approach as an example. When we look at the development of the pet food market in Europe and the United States, we will find that they have also experienced the evolution from being full to eating well, and finally entering the healthy and natural era.

For example, Lanjue has created a new category of "natural food", and the value it brings is to promote the pursuit of healthy pet food in the US market. Under this trend, the “natural food” category is rapidly emerging in the US pet food market. Lanjue quickly opened up the market after its launch in 2012, became the market leader around 2015, and continues to be ahead of the second brand.

One enlightenment this brings us is that for pet food, natural, health and science are the three directions of innovation.

2.2 Technical Insight Perspective

New technology often solves some problems of old categories, so it is a very good entry point for category innovation. The combination of new technologies and old categories often creates many new categories.

For example, the combination of ordinary pure meat and freeze-drying technology creates freeze-dried pet food, which is more nutritious, healthier, more palatable, and contains fewer additives. In addition, ordinary pure meat is combined with freshness-locking technology to create a new category of fresh pet food. Its value is that it can be stored at room temperature for a longer time without preservatives, which is also more beneficial to the health of pets.

With nutrition and freshness, we can create categories such as fresh grains. This is to discover new category opportunities through technological innovation.

2.3 Mental Insight Perspective

Mental insight mainly refers to discovering vacant opportunities in consumers’ minds and seizing them to create new categories. In the pet industry, it is important to understand the mind of pet owners before seizing their minds. What pet owners pay attention to will benefit their pets.

What is the consumption pattern of current pet owners? Driven by the current rise in both volume and price, it is first judged that the cat economy will be stronger than the dog economy.

First of all, from a data perspective, the market size of pet cats has now exceeded that of dogs, and the growth rate is much higher than that of pet dogs.

Secondly, from the perspective of demand adaptation, the improvement of cat economy mainly comes from the different needs of cats and dogs for their owners. The growing environment that cats need is actually more suitable for today's young people, because today's young people have small living spaces and high work pressure, so they are not suitable for raising dogs.

In addition, compared to dogs, there is more room for high-end diets in cats. For example, cats require higher levels of protein and fat than dogs due to differences in diet. Cat wet food, which is higher-end than ordinary dry food, has become the choice of more people because it contains more meat and can solve the problem of cats not liking to drink water. This trend has been verified by the high-end American market. Health and cat economy have given rise to category innovation opportunities such as cat wet food. This is to discover new category opportunities through the perspective of mental insight.

Category opportunities in China’s pet food industry

Based on the above three major insights into new categories, we can determine where the opportunities are for categories with greater growth and explosive potential.

3.1 Baking staple food

With the popularization of concepts such as pure nature and staple food technology, it is inevitable to upgrade the awareness of high-quality food. Specifically, baking staple foods are in line with this trend.

First of all, from a market perspective, baking staple foods are growing very fast, and the number of new products is also increasing day by day. On the other hand, from a technical point of view, it is produced through low-temperature cold pressing technology and does not need to be processed in a high-temperature environment, so it can retain more nutrients. From a mental point of view, although this is not a new thing in the industry, its industry standard has not been formed, and no leading brand has been born in the minds of consumers, so this is an important category innovation. Chance.

3.2 Raw cuts of meat

With the popularization of the concept of fresher and higher meat content, the cognitive upgrade of fresh food has become inevitable. A new category opportunity born here is raw meat.

From a market perspective, scientific feeding is sought after, and cats’ dietary structure requires higher meat content and sufficient moisture. On the other hand, from a technical perspective, freshness locking technology is constantly being upgraded. From a mental perspective, cats are more in line with the preferences of young pet owners than dogs.

Therefore, based on these three perspectives, raw cut meat has great market development prospects and is also an important category innovation opportunity.

3.3 Alternative protein foods

With the changes in pet owners' cognition, concepts such as low-carbon, environmental protection, and vegetarianism are deeply rooted in the hearts of the people, and the cognitive upgrade of protein food has become inevitable, and some important categories will also be born. Opportunities for innovation first arise from insecticide proteins.

From a market perspective, alternative protein foods in the pet market are heating up, which is a manifestation of the trend.

From a technical point of view, the protein content in many insects is between 40% and 70%, which is much higher than fish protein and rich in trace elements. It can also enhance the immunity of pets.

From a mental standpoint, pet owners are also increasingly concerned about their impact on the planet, and are increasingly enthusiastic about flexitarian vegetarianism. Based on this trend, insecticide proteins will also have more development prospects.

In addition, another category innovation opportunity comes from plant protein.

From a market perspective, these plant-based ingredients are starting to be used more frequently in pet foods. From a technical point of view, the appropriate introduction of plant proportions can reduce allergic reactions in animals. Plant protein also supplements dietary fiber, aids your dog’s digestion, and strengthens the immune system and intestinal health. From a mental point of view, plant-based foods are now constantly educating consumers, so they have also left a healthier and more advanced mental imprint in the minds of pet owners.

Breast Health | Women Should Take Good Care Of Their Breasts. These 3 Taboos Must Not Be Touched!

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Breasts are one of the sexy parts of the female body, but here comes the problem. They are also one of the parts of the body that ages the fastest. For example, sagging and bulging are all manifestations of breast aging.

So is there any good way to prevent breast aging? How should we pay attention to breast care in daily life?

01

5-level measures for breast care

Level 1 Action: Choose a bra that fits well

After the growth period, the breasts generally do not change much, but they will still change due to diet and physical conditions (such as menstruation, pregnancy, etc.).

Girls should always pay attention to changes in their breast size and choose a bra that fits them well. Frequently wearing underwear that is too tight for more than 18 hours will also affect the detoxification function of the armpit lymph nodes and block blood vessels, which will have adverse effects on health and breast shape.

Tips:

You can prepare some underwear of different sizes so that you can wear a suitable bra when your breasts change. In addition, you can loosen your bust and massage the lymph nodes under your arms when you get home.

Level 2 measures: chest strengthening exercises

Moderately exercise the chest muscles, so that part of the chest fat tissue can be converted into muscles through reasonable exercise, so that the chest line will become more straight.

Tips:

The simplest chest-building exercise is – put your hands together, slowly lift it up, hold it for 10 seconds, and then slowly lower it to your chest. Repeat this 5-10 times and move up and down to lift the chest muscles.

Level 3 measures: Develop good standing and sitting postures

Sucking the breast causes the greatest damage to the breasts, because it compresses the growth of breast tissue and encroaches on its living space, which can easily lead to sagging of the breasts.

Tips:

Maintain an upright sitting and standing posture at all times, and be sure to hold your chest and head high. Friends who are interested can try to practice yoga for correction, which also has obvious effects.

Level 4 measures: Eat more high-protein foods

Eat more foods with high protein content, preferably combined with chest massage, and if you insist on it for a long time, your chest will become stronger and stronger. But don't eat high-calorie foods, which will only accumulate fat.

Tips:

Fish, meat, fresh milk and other foods are rich in protein and are good for strengthening breasts. Eat more foods with high protein content, preferably combined with chest massage, and stick to it for a long time.

Level 5 measures: normal routine

Some experts pointed out that in addition to the natural aging of the human body, staying up late and living an irregular life will also affect the body's metabolism and blood circulation. Improper work and rest can also lead to hormonal chaos and affect breast health.

Tips:

When to go to bed and when to wake up, form a habit and stick to it for a long time.

02

Chest care taboos

One taboo: Deliberately squeezing the breasts

Underwear that is too tight is like "squeezing toothpaste", which will squeeze the breasts and affect local blood circulation and the normal flow of lymph fluid;

During activities, underwear that is too tight will also frequently rub against the skin, which may be detrimental to breast health.

There is no need to pay for other people's aesthetics with your own health.

Two taboos: Gluttony on high-calorie junk food

Maybe many girls like to eat: milk tea, yogurt, juice, chicken feet, spicy strips, egg yolk crisps and other delicacies. However, after enjoying the pleasure of taste buds, if they do not exercise, it will further aggravate the accumulation of calories and cause obesity.

Obesity also reduces our body's sensitivity to insulin, known as "insulin resistance," ultimately making us more susceptible to breast cancer.

A meta-study in the British Medical Journal (BMJ) revealed that for every 5 kilograms of weight gain, the risk of breast cancer increases by 11%.

Three taboos: Ignoring inspections

Among cancer patients worldwide in 2020, the number of breast cancer patients surpassed lung cancer for the first time, becoming the most common cancer in the world. For tumors, early detection and early treatment will greatly increase the cure rate.

Don't take it for granted that "if your chest doesn't hurt usually, it means there's nothing wrong with it." In fact, 90% of breast cancers are painless.

In particular, women with the following characteristics must have regular check-ups:

Generally speaking, the more natural the better for breast care. Maintaining a normal daily routine, choosing the right bra, and eating some breast-building foods are all good ways to maintain breasts.

Also, don’t leave anything to chance. The safest thing to do is to have regular breast health check-ups to prevent problems before they happen. I wish everyone can have a proud figure and a healthy body.

END

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Jaundice (yellow Bile)

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(2) Pathogenesis

1. Normal bilirubin metabolism

(1) Source and formation of bilirubin: 80% to 85% of bilirubin comes from hemoglobin of mature red blood cells. The average life span of normal red blood cells is 120 days. Hemoglobin released from aging and damaged red blood cells is swallowed, destroyed and decomposed by the monocyte-macrophage system (spleen, liver, bone marrow), and becomes heme, Iron and globin (iron is reused by the body and globin enters the protein metabolism pool), heme is converted into biliverdin by the action of heme oxygenase, and biliverdin is reduced to bilirubin by the action of biliverdin reductase. white. Normal people produce about 60-80g/L of hemoglobin every day from the destruction of red blood cells, and the total amount of bilirubin produced is about 340-510μmol/L, with an average of 425μmol/L; in addition, there are 15% to 20% of bilirubin sources. Hemoglobin in immature red blood cells in the bone marrow (ineffective hematopoiesis), free heme in the liver, and heme-containing proteins (including myoglobin, catalase, peroxidase, cytochrome P450, etc.). These substances The bilirubin produced is called bypass bilirubin; the bilirubin decomposed from hemoglobin (also including bypass bilirubin) is called unconjugated bilirubin ( ); unconjugated bilirubin rapidly It combines with serum albumin to form an unconjugated bilirubin-albumin complex, which is then transported to the liver through the blood circulation. Unconjugated bilirubin is insoluble in water and cannot be filtered out from the glomerulus, so urine does not contain unconjugated bilirubin. However, unconjugated bilirubin is fat-soluble and has a good affinity with adipose tissue.

(2) The liver’s uptake, conjugation and excretion functions of unconjugated bilirubin:

① Uptake of unconjugated bilirubin by the liver: The liver is an important place for bilirubin metabolism. When the unconjugated bilirubin-albumin complex is transported to the hepatocytes through the blood, according to ultrastructural observation, after the unconjugated bilirubin is separated from the albumin, it is taken up by the microprocesses of the hepatocytes through the Disse's space of the liver sinusoids. After entering the liver cells, unconjugated bilirubin is carried by the special proteins y and Z in the liver cytoplasm (the y and Z proteins serve as carriers) and transported to the microsomes of the smooth endoplasmic reticulum of the liver cells.

②Conjugation of unconjugated bilirubin (that is, the formation of conjugated bilirubin): There is glucuronosyltransferase in the microsomes of the smooth endoplasmic reticulum, and unconjugated bilirubin is combined with glucuronic acid under the action of this enzyme Formation of glucuronide, also known as conjugated bilirubin ( ). Conjugated bilirubin combined with one molecule of glucuronic acid is called bilirubin I (monoester), and conjugated bilirubin combined with two molecules of glucuronic acid is called bilirubin II (diester). Most of the conjugated bilirubin excreted from bile is the diester bilirubin. Because conjugated bilirubin is water-soluble and can be excreted in the urine through glomerular filtration, the qualitative test for bilirubin in urine is positive.

③Excretion of conjugated bilirubin: The exact mechanism of how conjugated bilirubin is excreted from liver cells after formation has not yet been fully elucidated. It is mostly thought to be completed through an energy-consuming process of active excretion. Conjugated bilirubin is transported through the Golgi apparatus to the bile capillary microprocesses, microbiliary ducts, thin bile ducts, small bile ducts, common hepatic duct, and common bile duct, and is discharged into the duodenum through the duodenal papilla.

④Enterohepatic circulation of bilirubin: Conjugated bilirubin cannot be absorbed by the intestinal mucosa after being discharged into the intestine through the biliary tract, but is reduced to urobilinogen in the terminal ileum and colon after the action of anaerobic bacterial reductase (Daily intestinal The total amount of urobilinogen formed in the tract is approximately 68 to 473 μmol). Most of the urobilinogen is oxidized into urobilin and excreted in the feces, also called urobilin; a small part of the urobilinogen (10% to 20%) is absorbed by the ileum and colon mucosa, and returns to the liver through the portal blood flow. , most of the urobilinogen returned to the liver is converted into conjugated bilirubin after the action of liver cells, and is excreted into the intestine with bile. This process is called "enterohepatic circulation of bilirubin" ". A small part cannot be converted into conjugated bilirubin, but passes through the systemic circulation (i.e. a small part of urobilinogen→hepatic vein→inferior vena cava→heart→systemic circulation) and is excreted by the kidneys. Normal people excrete the amount of urine in urine every day. Biligen generally does not exceed 6.8 μmol. The qualitative test for urobilinogen in urine is weakly positive or positive (normal bilirubin metabolism).

2. In hemolytic jaundice, after a large amount of red blood cells are destroyed (hemolysis), the formation of unconjugated bilirubin increases. A large amount of unconjugated bilirubin is transported to the liver, which will inevitably increase the burden on the liver (hepatocytes). When the burden on the liver exceeds the requirement for unconjugated bilirubin, When the uptake and binding ability of red pigment are impaired, the concentration of unconjugated bilirubin in the blood increases. In addition, anemia caused by massive hemolysis puts liver cells in a state of hypoxia and ischemia, and their ability to absorb and bind unconjugated bilirubin will inevitably be further reduced, resulting in a higher concentration of unconjugated bilirubin in the blood. Jaundice occurs due to increased height.

3. Hepatocellular jaundice: Due to the extensive damage (degeneration, necrosis) of liver cells, the uptake and conjugation of unconjugated bilirubin by liver cells is impaired, so the concentration of unconjugated bilirubin in the serum increases, and some unconjugated bilirubin increases. Damaged liver cells can still continue to take up and combine unconjugated bilirubin, converting it into conjugated bilirubin, but part of the conjugated bilirubin is not excreted in the capillary bile ducts, but passes through the spaces between necrotic hepatocytes. Reflux into hepatic lymph and blood, or due to liver cell degeneration, swelling, inflammatory lesions in the portal area, and the formation of bile plugs in capillary bile ducts and small bile ducts, the excretion of conjugated bilirubin is blocked, resulting in the formation of conjugated bilirubin through the small intestine. Bile duct overflow (the pressure in the small bile duct increases and ruptures) and flows back into the liver lymphatic flow and blood, eventually leading to an increase in the concentration of conjugated bilirubin in the serum and jaundice.

4. Obstructive jaundice (cholestatic jaundice) is caused by obstruction in any part of the intrahepatic capillary bile ducts, micro bile ducts, small bile ducts, extrahepatic bile ducts, common hepatic duct, common bile duct, ampulla of Vute, etc. or In cholestasis, the pressure in the upper bile duct above the obstruction or stagnation continues to increase, and the bile duct continues to expand, which will eventually lead to the rupture of small or micro bile ducts or capillary bile ducts in the liver, causing conjugated bilirubin to overflow from the ruptured bile duct and flow back into the blood. And jaundice occurs. In addition, some intrahepatic cholestasis is not entirely caused by mechanical factors such as bile duct rupture (such as drug-induced cholestasis). It can also be caused by reduced bile secretion (secretory dysfunction), increased permeability of bile capillaries, bile Concentration and stasis lead to reduced flow, ultimately leading to the deposition of bile salts in the bile duct and the formation of bile plugs.

Clinical classification of jaundice

Jaundice mainly due to increased unconjugated bilirubin

1) Excessive bilirubin production such as congenital hemolytic jaundice, acquired hemolytic jaundice, bypass hyperbilirubinemia caused by ineffective hematopoiesis, etc.

2) Bilirubin uptake disorders such as post-hepatitis hyperbilirubinemia, syndrome, jaundice caused by certain drugs and examination reagents (such as cholecystography contrast agents).

3) Bilirubin conjugation disorder is jaundice caused by reduced or lack of glucuronosyltransferase activity, such as syndrome, – syndrome (type 1 and type Ⅱ), neonatal physiological jaundice, etc.

Jaundice mainly due to increased conjugated bilirubin

It can be caused by disorders of bilirubin transport and excretion within hepatocytes or by simultaneous disorders of bilirubin uptake, conjugation, and excretion.

1) Extrahepatic bile duct obstruction such as gallstones, pancreatic head cancer, bile duct or common bile duct cancer, ampullary cancer, bile duct atresia, etc.

2) Intrahepatic bile duct obstruction such as intrahepatic bile duct stones, clonorchiasis, etc.

3) Intrahepatic cholestasis such as hepatitis, drug-induced liver disease, recurrent jaundice during pregnancy, Dubin-syndrome, etc.

clinical diagnosis

Jaundice refers to hyperbilirubinemia. The clinical manifestation is that the bilirubin in the blood increases and causes yellow staining of the sclera, skin, mucous membranes, and other tissues and body fluids. It is easy to diagnose based on liver function and other items. When the serum bilirubin concentration is 17.1~34.2umol/L (1~2mg/dl), but jaundice is not visible to the naked eye, it is called latent jaundice. If the serum bilirubin concentration is higher than 34.2umol/L (2mg/dl), it is overt jaundice.

How to identify neonatal jaundice

It is very important for treatment to carefully observe the changes in the child's jaundice and distinguish whether the child has physiological jaundice or pathological jaundice. Parents can be identified based on the following characteristics:

Physiological jaundice in newborns is generally not deep and has the following characteristics:

① Jaundice usually begins to appear 2 to 3 days after birth.

②Jaundice gradually deepens, reaching a peak on the 4th to 6th day, and then gradually reduces.

③ In full-term newborns, jaundice usually subsides in 2 weeks after birth, and in premature babies, jaundice usually subsides in 3 weeks after birth.

④The degree of jaundice is generally not deep, and the skin color is light yellow. Jaundice is often limited to the face and upper body. The child's general condition is good with jaundice, with normal body temperature, normal appetite, normal color of urine and feces, and normal growth and development.

⑤The serum bilirubin in the laboratory test exceeds the normal 2 mg/dl (34.2 μmol/L), but is less than 12.9 mg/dl (221 μmol/L). If this is the case with your child's jaundice, parents don't need to worry.

Pathological jaundice has the following characteristics

① Jaundice appears too early, within 24 hours after birth.

② The jaundice subsides too late and lasts too long, exceeding the normal subsidence time, or the jaundice has subsided and then reappears, or the jaundice gradually subsides and then worsens after the peak time.

③ The degree of jaundice is too severe, often spreading to the whole body, and the skin and mucous membranes are obviously yellow.

④ When checking serum bilirubin, the bilirubin exceeds 12.9mg/dl, or rises too fast, rising by more than 5mg/dl every day.

⑤ In addition to jaundice, it is accompanied by other abnormal conditions, such as mental fatigue, less crying, less movement, less eating or unstable body temperature, etc.

When pathological jaundice is severe, it can be complicated by bilirubin encephalopathy, often called "kernicterus", causing damage to the nervous system, leading to serious sequelae such as mental retardation in children, and even death. Therefore, when a child develops jaundice, parents should pay close attention to any of the above five aspects, so that pathological jaundice can be detected early for timely treatment.

Take good care of babies with jaundice

When jaundice is found in a newborn, parents should pay attention to:

(1) To judge the degree of jaundice, parents can observe the degree of jaundice on the newborn's skin under natural light. If only the face is jaundiced, it is mild jaundice; if the skin of the trunk is jaundiced, it is moderate jaundice; if the limbs, hands and feet are jaundice The heart also appears yellowish, indicating severe jaundice.

(2) Observe the color of the stool. If the stool is clay-colored, pathological jaundice should be considered, which is mostly caused by congenital biliary malformations.

If the degree of jaundice is severe, accompanied by symptoms or the color of the stool is abnormal, you should go to the hospital in time to avoid delaying treatment.

(3) Excrete meconium as soon as possible. Because meconium contains a lot of bilirubin, if the meconium is not cleared, the bilirubin will be reabsorbed into the blood through the newborn's special enterohepatic circulation, causing jaundice to increase.

(4) Give newborns plenty of water. Too little urine is not conducive to the excretion of bilirubin.

Differential diagnosis

The identification of jaundice should be carried out under sufficient natural light, and it should first be distinguished from pseudojaundice. Pseudojaundice is seen in excessive consumption of carotene-containing foods such as carrots, pumpkins, tomatoes, and citrus. Carotene only causes jaundice on the skin, but the sclera is normal; in the elderly, the bulbar conjunctiva has yellowish fat accumulation, the sclera is unevenly jaundiced, and the inner canthus is more obvious, but the skin has no jaundice. Blood bilirubin concentration is normal in pseudojaundice.

Laboratory examination

When jaundice occurs, serum total bilirubin and direct bilirubin should be checked to distinguish the type of elevated bilirubin. It is also essential to check urinary bilirubin, urobilinogen and liver function.

1. Jaundice mainly caused by elevated indirect bilirubin. Mainly seen in various types of hemolytic diseases, neonatal jaundice and other diseases. The ratio of direct bilirubin to total bilirubin is less than 35%.

In addition to the above examinations, some auxiliary examinations related to hemolytic diseases should also be carried out, such as red blood cell fragility test, acid hemolysis test, autohemolysis test, anti-globulin test, blood routine, urine occult blood, serum free hemoglobin, and urine hemosiderin. hormone, serum lactate dehydrogenase, glucose-6-phosphate dehydrogenase, etc.

2. Jaundice mainly caused by elevated direct bilirubin. It is seen in all kinds of intrahepatic and extrahepatic obstructions that prevent bile excretion, and the ratio of direct bilirubin to total is greater than 55%.

In addition to some routine examinations, further examinations of alkaline phosphatase, γ-glutamyl transpeptidase, leucine aminopeptidase, 5-nucleotidase, total cholesterol, lipoprotein-X, etc. are required.

3. Mixed jaundice due to liver cell damage. Seen in various types of liver diseases, both direct bilirubin and indirect bilirubin are elevated. The ratio of direct bilirubin to total bilirubin is 35% to 55%. Abnormal results can be obtained when checking liver function.

Auxiliary inspection

Auxiliary check items

1. Blood routine and urine routine.

2. Quantitative test of jaundice index and serum bilirubin.

3. Examination of bilirubin, urobilinogen, and urobilin in urine.

4. Serum enzymology test.

5. Measurement of blood cholesterol and cholesterol esters.

6. Immunological examination.

7. X-ray examination.

8. B-type ultrasonic examination.

9. Radionuclide inspection.

10. Liver biopsy.

11. Laparoscopy.

Examination of neonatal jaundice

Normal newborn cord blood bilirubin has a maximum of about 51.3 μmol/L (3 mg/dl), reaching a peak around 4 days after birth, generally not exceeding 171-205 μmol/L (10-12 mg/dl), and premature infants not exceeding 256.5 μmol/L (15mg/dl), and then gradually recovered. The Vendenbein test showed an indirect reaction. Bilirubin in urine was negative and bile pigment increased in feces.

Cord blood ~24h ~28h 3~7d

Full-term baby

premature baby

Can jaundice and hepatitis be treated?

Icteric hepatitis is caused by the hepatitis virus destroying liver cells, destroying and remodeling liver tissue, and blocking bile canaliculi, resulting in an increase in both conjugated and unconjugated bilirubin in the blood, resulting in skin, mucous membranes, and sclera of the eye. Symptoms of yellowing.

Acute icteric hepatitis is a type of acute viral hepatitis, and it is also the longest symptom of icteric hepatitis. It is an acute digestive tract infectious disease caused by hepatitis virus. Clinical manifestations include acute onset, loss of appetite, aversion to oil, fatigue, upper abdominal discomfort, dull pain in the liver area, nausea, and vomiting. Some patients experience chills and fever, followed by deepening of urine, and jaundice on the sclera and skin.

So can jaundice hepatitis be cured? Professor Wang clearly pointed out that jaundice hepatitis can be cured. The treatment process of jaundice hepatitis mainly includes four components: basic treatment, antiviral treatment, immune regulation, and active microcirculation regulation. Whether jaundice hepatitis can be cured is directly related to whether the hepatitis virus can be completely eliminated. As long as hepatitis If the virus can be completely eliminated, it is very promising to cure jaundice hepatitis.

TCM syndrome differentiation

(1)Yanghuang

Intrinsic symptoms of dampness and heat: yellow eyes, yellow body, bright color, or fever, thirst, worry in the heart, body fatigue and weakness, abdominal distension, poor appetite, aversion to greasy food, nausea and vomiting, dark yellow or short red urine, large Constipation, yellow and greasy tongue coating, slippery and rapid pulse.

Excessive heat poison: dark yellow eyes and bright color, sudden onset, rapid deepening of jaundice, strong fever, restlessness, or coma and delirium, epistaxis and bloody stools, skin rashes, thirst and preference for cold drinks, abdominal distension and hypochondriac pain, tongue texture Red crimson fur, yellow and dry coating, pulse stringy or stringy and thin.

Biliary tract blockage: yellowing of the body and eyes, rapid onset, alternation of cold and heat, colic in the right hypochondrium extending to the shoulder and back, nausea and vomiting, bitter mouth and dry throat, aversion to greasy food, dark yellow urine, gray-white stools, red tongue with yellow and greasy coating, pulse Number of strings.

Cold-dampness internal obstruction: yellow body and eyes, dark color like smoke, fear of cold and cold limbs, mental fatigue, epigastric tightness or abdominal distension, indigestion, loose stools, light mouth and no thirst, unfavorable urination. The tongue is pale, fat and has white greasy coating, and the pulse is moist and slow.

Stagnation of blood stasis: the body and eyes are yellow and dark, swelling and pain under the hypochondriac, refusal to press, or ascites, exposed abdominal wall veins, red streaks of blood on the neck and chest, black stool, blue tongue or pale tongue with blood stasis Spots, stringy and astringent pulse.

Spleen deficiency and blood deficiency: yellowish and dull skin, fatigue, palpitations, insomnia, dizziness, dull claws and nails, pale tongue, soft and thready pulse.

(2) Yin yellow

Cold-dampness obstruction: yellowish color of the body and eyes, yellowish dullness, abdominal distention, loss of appetite, loose stools, fatigue and fear of cold, white and greasy coating, light body weight and fat body, and a heavy, thready and slow pulse.

Liver stagnation and blood stasis: the body and eyes are yellow and dull, the complexion is dark, there are swelling and pain under the flanks, red streaks can be seen on the skin, the tongue is purple or has ecchymosis, and the pulse is stringy or thin.

Spleen deficiency and blood deficiency: Syndrome: yellow face and skin, lighter yellow, yellow urine, soft and weak limbs, palpitations and shortness of breath, indigestion and loose stools, pale tongue with thin coating, and weak and thready pulse.

(3) Rapid yellowing

Excessive heat poison: jaundice starts suddenly and deepens quickly, high fever, polydipsia, frequent vomiting, fullness and distension of the epigastrium, pain and refusal to press, constipation, yellow and red urine, irritability, yellow and rough coating, red tip of tongue, palpable Qian, the pulse may be rapid or stringy.

Heat poison invagination: sudden onset, rapid change, body as yellow as gold, high fever, anuria, bloody epistaxis, subcutaneous rash, or restlessness, or even madness, convulsions, or trance, or even coma, delirium, dirty tongue coating , reddish-purple in texture, stringy, thin and rapid pulse.

treat

basic treatment

[Drug name] Common name: Bifidobacterium and Lactobacillus triple live bacteria

Product name: Jinshuangqi

English name: Live and

[Ingredients] Bifidobacterium longum, Lactobacillus bulgaricus, Streptococcus thermophilus, probiotic factors, oligosaccharides, skim milk powder

[Character] Acidic, milky white or light yellow tablets

[Pharmacological effects] This product can directly supplement normal physiological bacteria, regulate the balance of intestinal flora, and inhibit and remove bacteria in the intestine that are potentially harmful to humans.

[Absorption, Distribution] The three bacteria in this product are all members of the normal flora in the healthy human intestine and can grow and reproduce in the human intestine.

[Indications] It is mainly used to treat acute and chronic diarrhea, habitual constipation, colitis, anorexia in children, and indigestion caused by intestinal flora imbalance. It can also treat gastrointestinal discomfort caused by antibiotics, radiotherapy, chemotherapy, surgery, etc., and improve liver function. , improve immunity.

[Usage and Dosage] Take 4 tablets orally, 2-3 times a day. Take with warm water or milk.

[Medicine for children] Take orally, infants under 6 months old take 1 tablet at a time, 2-3 times a day; children from 6 months to 3 years old take 2 tablets at a time, 2-3 times a day; children from 3 to 12 years old take 3 tablets at a time. 2-3 times a day. Take it with warm water or warm milk. Infants and young children can crush the tablets and dissolve them in milk.

[Adverse Reactions] No adverse reactions were seen.

[Notes] This product is vacuum sealed and should be taken as soon as possible after opening the bag. If antibiotics are necessary due to illness, please stagger the administration of antibiotics by 2 hours.

[Specification] Bifidobacterium longum live bacteria 050 million/piece, 0.5g/piece,

[Packaging] PVP-PTP blister, vacuum aluminum plastic bag packaging, 12 pieces/box, 24 pieces/box, 36 pieces/box.

[Storage] Store in a cool, dark, and sealed place.

[Validity period] 24 months

[Approval No.] National Drug Approval Number

[Manufacturer] Inner Mongolia Shuangqi Pharmaceutical Co., Ltd.

special purpose

If you have leftover golden bifidum at home, it can be used as a strain for fermenting yogurt. Personal experience suggests that the appropriate ratio is to add 3 tablets to 500ml of whole milk (constant temperature airtight fermentation time is 8.5 hours)

TCM syndrome differentiation and treatment

Yanghuang

1. Heat is more important than moisture

Treatment method: clear away dampness and heat and reduce yellowing

Modifications and subtractions of the prescription Yinchenhao Decoction

2. Moisture is more important than heat

Treatment method: diuresis and turbidity, combined with clearing away heat

Addition and subtraction of prescription Yinchen Wuling Decoction and Lianpu Yin

3. Rapid yellowing

The treatment method is to clear away heat and detoxify, cool blood and resuscitate one's ideas.

Addition and subtraction of the prescription Qianjin Rhinoceros Powder

Yin yellow

1. Cold-dampness trapping the spleen

The treatment method is to warm yang and strengthen the spleen, remove dampness and reduce jaundice.

Recipe Yinchenshu decoction with added flavor

2. Spleen deficiency and dampness stagnation

The treatment method is to strengthen the spleen and nourish blood, remove dampness and reduce jaundice

Modification and subtraction of prescription Huangqi Jianzhong Decoction

Introduction to ten types

1. Yin yellow: The yellow color is not obvious, the lower body is yellow but the upper body is not yellow; urination is uncomfortable at night but easy to urinate during the day. The cause is mild dampness. For treatment, 6 to 15 grams of "Quhuang Powder" plus Poria, Alisma, Barley, or Wuling Powder should be used. It will stop after taking a few doses.

2. Yang Huang: Yellow as gold, the upper body and eyes are all yellow, but the lower body is not yellow; urination is not smooth during the day, and may be painful or not painful, but normal at night; the cause is slight dampness, and the treatment is appropriate to use 15 to 18 grams of "Quhuang Powder" added Cimicifuga, orange stem, poria, pollen, ephedra, etc. can be cured after a few doses.

3. Hot yellow: severe thirst, unpleasant feeling after drinking too much, yellowish color all over the body; yellowish eyes, urgent and painful urination, urine color like yellow juice. Cause: Heat knot in the bladder. For treatment, 15 grams of "Quhuang Powder" plus gentian, gardenia, white peony root, poria, Alisma, etc. can also be used to eliminate jaundice caused by severe heat.

4. Cold yellow: Aversion to cold, abdominal pain, relieved on time; jaundice all over, white eyes, long and clear urine, especially at night. The cause is cold bladder. For treatment, 3 to 6 grams of "Quhuang Powder" plus Atractylodes, Poria, yam, Gorgon, barley, aconite, etc. can be used to warm the Mingmen, and the disease will be cured after 10 to 15 doses.

5. Damp yellow: The whole body is completely yellow, and the eyes are yellow; the body is swollen and feels like mud when pressed; the cause is water-damp disease. For treatment, it is advisable to use 12 to 15 grams of "Quhuang Powder" plus cohosh, morning glory seed, plantain seed, Alisma, etc., and the condition will be cured after slowly regulating it.

6. Dry yellowing: The cause of yellowing of the chest is extreme dryness of lung metal, which occurs in the chest. For treatment, 3 grams of "Quhuang Powder" plus Ophiopogon japonicus, gardenia, white peony root, tangerine peel, Asparagus asparagus, Yuanshen, pollen, white mustard seeds, etc. can be cured after several doses.

7. Yellow blood: upper and lower body, yellow eyes, fever, boredom, and abdominal pain. The cause is blood stasis. For treatment, 3 to 6 grams of "Quhuang Powder" plus paeonol bark, achyranthes root, angelica root, gardenia, Chuanxiong, rhubarb, etc. will be cured after long-term use.

8. Yellow Qi: Yellow head and face, no fever, slight weakness in activity, incontinent urination, and dry stools. The cause is deficiency of qi and inability to move and transform. For treatment, 12 grams of "Quhuang Powder" plus ginseng, Atractylodes macrocephala, Poria cocos, Plantago seeds, etc. should be used. If the Qi is strong, the symptoms will be cured.

9. Neonatal jaundice: Jaundice can appear 2 to 3 days after birth and reaches its peak around 10 days. The cause is that the fetus senses the mother's damp and hot air. For treatment, 10 grams of "Quhuang Powder" plus 7 doses of gardenia, turmeric, Atractylodes, Gallus gallus gallus, etc. can cure most cases.

10. Yellow hands and feet: The body is not yellow but the hands and feet are yellow. The cause is damp-heat obstruction and middle burn. For treatment, 15 grams of "Quhuang Powder" plus Atractylodes macrocephala, Poria cocos, tangerine peel, licorice, etc. can be cured by slowly adjusting.

Other treatments for jaundice

1.External treatment

(1) 10 grams of muskmelon pedicles, grind into powder for twitching the nose, several times a day, and the symptoms will heal when the yellow water is gone.

(2) 1 handful of Artemisia wormwood and 1 piece of ginger, mash them and rub them on the chest and limbs.

2. Acupuncture therapy

Acupuncture Zhangmen, Taichong, Pishu, Ganshu, Laogong, and Chizhong points. If you are prone to sleeping and have tired limbs, you can moxibustion the hands for three miles.

3. Diet therapy

(1) Chicken bone grass and red dates in pot: 60 grams of chicken bone grass, 8 red dates, decoct in water instead of tea. Suitable for Yang yellow and acute yellow.

(2) Pork liver stewed with Xihuangcao: 60 grams of Xihuangcao, 50 grams of pork liver, decoct in water and take. Suitable for Yang yellow and acute yellow.

(3) Salvia miltiorrhiza and Ganoderma lucidum stewed frog: 30 grams of Salvia miltiorrhiza, 15 grams of Ganoderma lucidum, and 250 grams of frog (frog). Peel and wash the frogs and cook the soup with salt. Season the soup with salt and eat the meat. Suitable for Yin Huang.

4. Preventive care

Eat in moderation, do not be addicted to alcohol, do not eat unclean food, and eat hot, spicy, fatty and sweet things. Patients with jaundice should pay attention to rest, keep their mood comfortable, and eat a light diet. Once the disease is discovered, isolate and treat them immediately, detoxify their tableware and utensils, bury their excreta deeply or disinfect them with bleach. After jaundice subsides after treatment, it is not advisable to stop the drug immediately. Treatment should be continued according to the condition to avoid recurrence.

Melon stems can cure stubborn jaundice

When people eat melons, they often throw away the melon stems, but a certain expert grinds the melon stems into powder and treats stubborn jaundice through nasal inhalation, 1 to 2 times a week, and it can be cured in 2 to 4 weeks. Obvious effect.

This method has good curative effect on hepatocellular jaundice. In patients with various types of acute and chronic hepatitis and liver cirrhosis, jaundice did not subside significantly after 3 weeks of conventional treatment. This method can also be used for patients whose total bilirubin is greater than /L, but who do not have severe heart disease or primary nasopharyngeal disease.

This treatment method is relatively simple to operate. First, grind the drug into fine powder, inhale it into the nasal mucosa through one side of the nasal cavity, and observe it for 24 hours. During the medication, pay attention to gargling with salt water to reduce the irritation of the drug to the patient's pharynx. The therapeutic effect can be achieved by taking 20mg each time, and a large amount of yellow secretion will be discharged from the nose. People with more severe jaundice have more secretions and higher bilirubin content in their excretions. Generally, 1 to 2 times a week for 2 to 4 weeks can make jaundice close to normal. However, melon pedicles have certain toxicity and irritation, so the dosage must be strictly controlled every time you use it.

According to the theory of traditional Chinese medicine, the nose clears the orifice, and its qi passes up to the brain and down to the lungs. The medicine enters the nose and travels to the twelve meridians. The medicine is absorbed through the nasal mucosa, acts on the meridians, blood vessels and internal organs, and enters the meridians directly to the lesions. It has the purpose of curing diseases. Therefore, nasal therapy has the effect of clearing the orifices, dispelling blockages, and relieving the flow of qi. The "powder" of traditional Chinese medicine acts on the nasal mucosa with rich blood flow, allowing the medicine to take effect quickly, which is similar to intravenous administration.

Mucosal administration has the advantages of small dose, quick onset of effect, and is conducive to the drug's effect. Moreover, it does not undergo metabolism, which can reduce the burden on the liver and avoid further aggravation of liver damage. Jia Jianwei said that from clinical observation, for patients with true cholestasis, the effect of using melon pedicel powder for nasal inhalation is no less than that of Simetai and hormones. Patients with more nasal secretions after taking the drug will excrete bilirubin faster. It is especially effective for patients with refractory jaundice caused by alcohol.

Chinese medicine prescriptions for neonatal jaundice

[Syndrome differentiation] Damp-heat fumigation, bile overflow.

[Treatment] Clear away heat and resolve stagnation, strengthen the spleen and liver.

[Prescription Name] Hegan Powder.

[Composition] 60 grams of whole Trichosanthes trichosanthes, 15 grams of Guangyujin, 15 grams of sliced ​​turmeric, 15 grams of Shenqu, and 15 grams of raw licorice.

[Usage] Grind into fine powder, take 2 grams each time for 3 years old (can increase or decrease according to age), 3-4 times a day, drink with sugar water.

【Source】Ma Yindufang

Neonatal jaundice prevention and health care

During pregnancy, pay attention to dietary hygiene, avoid alcohol and spicy products, and do not abuse drugs. If the pregnant mother has a history of jaundice, she can take Jaundice Yin Zhen Granules orally. The time from the time of diagnosis to delivery is preferably more than two months. The baby's skin should be closely observed after birth. In order to timely diagnose and treat jaundice, pay attention to premature appearance or late subsidence or jaundice gradually deepening or retreating and reappearing in order to timely damage and infection.

Notes on blue light care:

Blue light therapy uses blue fluorescent tubes with a wavelength of 420 to 470 nm to irradiate the skin of newborns, which can convert indirect bilirubin in the serum and skin of the irradiated area into photo-oxybilirubin, and excrete it through bile and urine to reduce indirect bilirubin. Bilirubin content.

Inject distilled water into the water basin of the blue light bed, adjust the temperature to 30 to 32 degrees for premature infants/newborn infants to 32 to 36 degrees, the humidity to 55% to 65%, the distance between the upper lamp tubes is 30~50CM, and the distance between the lower lamp tubes is 20~30CM, before phototherapy Measure vital signs, record the degree of jaundice, wear eye masks and diapers, measure vital signs every 2 to 4 hours, ensure the supply of water, and give sugar water between feedings.

Index normal value

normal jaundice index in adults

Jaundice index (serum bilirubin value)﹤17.1umol is the normal range

normal value of jaundice index in children

Children's jaundice index (serum bilirubin value) generally does not exceed 15mg/dL, which is within the normal range.

In medicine, the concentration of bilirubin in the blood is used to represent the degree of bilirubin accumulation. For example, if the bilirubin concentration is 12 mg/dl, it means that there are 12 mg of bilirubin in 100 pounds of blood. When medical staff explain the condition, they will use the "jaundice index" to refer to the bilirubin concentration. For example, a jaundice index of 12 means that the bilirubin concentration is 12mg/dl. Neonatal jaundice includes "physiological jaundice" and "pathological jaundice".

There are several types of pathological jaundice in newborns

hemolytic jaundice

It is more commonly caused by blood type incompatibility between mother and child, neonatal sepsis, and postpartum use of certain drugs, such as large doses of vitamin K3, sulfonamides, salicylic acid, novobiocin, and rifampin.

hepatocellular jaundice

Due to the immaturity of the liver, the activity of enzymes in liver cells is low, or the activity of liver enzymes is inhibited due to hypoxia, asphyxia, infection, etc., inborn metabolic diseases or hypothyroidism, etc. can all affect the absorption of bilirubin by liver cells. Metabolism causes jaundice in children.

obstructive jaundice

Due to malformation of the bile duct or inflammation and obstruction, bile is stagnated in the bile duct and refluxes into the liver, causing the capillary bile ducts to rupture and the bile to enter the blood and cause jaundice.

What diseases can jaundice be easily confused with?

In patients with viral hepatitis, jaundice usually appears slowly. In hepatitis A, jaundice usually appears when the fever subsides. In patients with cholelithiasis, jaundice often occurs intermittently. In patients with liver cancer, jaundice usually occurs slowly and gradually, leading to fulminant liver failure. In patients with pancreatic cancer, the jaundice often deepens suddenly; in pancreatic head cancer, the jaundice often deepens progressively.

Causes and mechanisms of jaundice

(1) Hemolytic jaundice

Due to the destruction of a large number of red blood cells, the production of unconjugated bilirubin in the blood increases, which exceeds the processing capacity of the liver. At the same time, hemolytic diseases weaken the metabolic function of liver cells in bilirubin, resulting in the retention of unconjugated bilirubin in the blood. And jaundice occurs.

Hemolytic jaundice is caused by various hemolytic diseases, including: 1. Congenital hemolytic anemia, such as thalassemia; 2. Acquired hemolytic anemia, such as autoimmune hemolytic anemia, neonatal hemolysis, Broad bean disease, etc.

(2) Hepatocellular jaundice

Due to damage to liver cells, the liver's ability to process bilirubin metabolism decreases, and unconjugated bilirubin increases in the blood; on the other hand, due to necrosis of liver cells or obstruction of bile excretion, conjugated bilirubin is converted into reflux into the blood, and the amount of unconjugated bilirubin in the blood increases. Conjugated bilirubin also increases resulting in jaundice.

Common causes include viral hepatitis, toxic hepatitis, cirrhosis, infectious mononucleosis, leptospirosis, sepsis, etc.

(3) Cholestatic jaundice

Due to the obstruction of the bile duct, the pressure above the obstruction increases, the bile ducts dilate, and finally the small bile ducts and capillaries rupture, and the bilirubin in the bile flows back into the bloodstream.

Bile stasis is divided into intrahepatic and extrahepatic types. The former is common in intrahepatic sludge-like stones, cancer emboli, parasites, primary cholestatic cirrhosis, drug-induced cholestasis, etc.; the latter is common in common bile duct stones, stenosis, edema, tumors, roundworms, etc.

(4)Congenital non-hemolytic jaundice

Jaundice is caused by defects in the uptake, conjugation and excretion of bilirubin by liver cells.

20 Ways To Make Your Mind More Flexible The More You Use It

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1. Read a good book. Reading stimulates the imagination. When you read a book, your brain cannot continue to reflect the images. Reading gets your mind working.

2. Play games appropriately. Some online games will help you enhance your thinking and test your mental activity. You must know how to select games that are helpful to your brain.

3. Practice meditation. There are many ways to meditate. In its simplest form, meditation is a way of spending some time alone to relax and concentrate. It's miraculous healing.

4. Get plenty of rest. Lack of sleep can affect your ability to absorb new information. This means that pulling all-nighters in college to cram is a lot less efficient than you might think. Your brain needs rest to work at its peak performance. This may be why things always seem clearer after a good night's sleep.

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5. Exercise regularly. One study found that physical exercise actually helps expand the size of the brain. So, if you want a bigger, better brain, exercise!

6. A good breakfast. A good breakfast really gets you off to a better start. You should eat a breakfast that is high in protein and high-quality carbohydrates. Two slices of whole wheat toast sandwiched with peanut butter fit this criteria. Eggs are also a good source of protein. Nuts, milk and fresh fruit all provide good nutrition for the brain.

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7. Think positively. Positive thinking will provide brain efficiency and help avoid disappointment. Find positivity, encourage people to hang out, read material that makes you happy, and do anything that makes you feel good. These things will help you become more mentally productive.

8. Keep learning. Never stop doubting your world, seek out new experiences, skills and knowledge, always want to learn to do things and start doing them. A now-famous study shows that certain areas of the brains of London taxi drivers are developed to a greater extent than the average citizen. This is because they need to learn how to navigate the maze of city streets. We can use this technology to challenge our brains and improve our capabilities.

9. Stop relying on GPS to walk. Using your brain to figure out how to get from point A to point B is good mental gymnastics. You must use your brain's ability to determine spatial relationships to improve the efficiency of map reading and travel through the city. Traveling to an unfamiliar place is even better!

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10. Quit drinking. Alcohol is a cause of depression, it reduces mental function, and there is ample evidence that alcohol can cause sexual problems. It also reduces sleep and hinders your ability to think clearly. If you want peak mental performance, stop drinking.

11. Expand your vocabulary. Decide to learn a new word every day, and you'll not only expand your mind but also impress your friends and colleagues when you introduce a new vocabulary word into conversation.

12. Break up your routine. Choose a new road to drive to work. Try taking a walk along a different path, writing, typing on the keyboard, etc. with your other hand. Mixing a little bit of different things together. This will perk up your brain because it requires you to think more. You can't just be on autopilot. Challenge your brain by getting out of your rut and it will respond. This is a great way to get your brain flowing.

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13. Don’t watch too much TV. Researchers have found that watching too much television between the ages of 1 and 3 can cause attention problems in children. Television numbs the mind. Of course, there are some good educational programs for kids and adults, so just turn off the TV if you want a productive mental performance.

14. Deal with numbers. Do mental math instead of using a calculator. Processing and memorizing numbers is a great way to get your brain back into shape. Being able to repay substantial dividends along the way.

15. Arouse long-lasting memories. Find old photos and start looking through them. This will go into the memory bank of your mind. Images will help you remember things you have forgotten. Digging deeper is all you can remember. There are also old letters and home movies, so use them as much as possible.

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16. Create beautiful music. Learning to play an instrument is a super way to change your brain. It requires several different parts of your brain working in harmony to create the melody you want. Of course, if you're already a musician, you're learning something new. Force yourself to learn new techniques. Music is a great exercise for the mind.

17. Speak a new language. Many people agree that learning a new language is a powerful way to stretch your mind. If you've ever tried to learn even a few new words, it's going to be hard, but the harder you give your brain, the better! You have a lot more thinking power than you think.

18. Memorize a song. Many of us have a lot of old songs stored in our heads, but why not expand our memory by learning some new tunes? If you keep doing it, you'll find it gets easier and easier. This is your brain's recovery state.

19. Cover your eyes and walk around your house. Your brain can handle it, and once you try it a few times, you'll probably find it fun and challenging. Plus, this will use your memory, motor skills, and reasoning abilities. What a great workout!

20. Appropriate romance (especially women) Everyone should have romantic cells, but some people may not know how to express them, because when you are racking your brains to think of romantic things, your brain is actually running, killing two birds with one stone. !