Yesterday’s Technology WE Conference, Today’s Medical ME Conference, this weekend belongs to Tencent Technology Week.
Compared to the brain-burning WE conference, the ME conference is closer to our lives, because you may not look up to the stars, but you must cherish life.
In addition, the presence of Zhong Nanshan and Zhang Wenhong, two symbolic characters during the epidemic, made the ME conference full of appeal.
In order to ensure that it is as compelling as the WE conference, the ME conference is jointly organized by Tencent and the world’s top medical journal “New England Journal of Medicine” and its exclusive Chinese digital media “NEJM Medical Frontiers”. As the second session of the Science and Technology Week, the Tencent Medical ME Conference that started last year ushered in the second session today.
This year’s theme is “Pain Points”. The 7 speakers focused on cutting-edge medicine such as the new crown epidemic, heart disease, cancer, reproductive medicine, and depression. Tencent stated that it would like to explore the individual, medical, and social issues through this WE conference. Pain points and solutions, reveal the reflection and evolution of life and civilization, and promote the universal benefit of medical science.
The invited speakers are all top domestic medical experts, including Academician Zhong Nanshan, Director of the National Respiratory Diseases Clinical Medical Research Center, Academician Ge Junbo, Director of the Department of Cardiology, Zhongshan Hospital Affiliated to Fudan University, and Academician Huang Hefeng, Director of the Shanghai Key Laboratory of Embryonic Diseases , Academician Lu Lin, Director of the National Research Center for Mental and Mental Diseases, Professor Cai Sanjun, Director of Colorectal Surgery, Fudan University Tumor Hospital, Professor Peng Baogan, Director of Spine Surgery, Third Medical Center of PLA General Hospital, and Professor Zhang Wenhong, Director of Infectious Diseases Department of Huashan Hospital, Fudan University .
Why is it a “pain point”, Li Hang, vice chairman of the Tencent Youth Development Committee, explained yesterday: “Because everyone was in pain during the epidemic this year. The way of pain at the earliest time of the new crown epidemic was the pain of suffocation. Very uncomfortable.”
“Ma Huateng always said that what the Internet solves is the pain points of the product and the pain points of the users, and then can we find it and solve it. In fact, the essence of medicine is the pain point, the most basic pain point of people. Where are you? Pain, not pain is actually the most terrible; or it is the most terrible if you don’t feel it. In fact, the body has been sending us pain signals, the sooner you discover it and solve it, the sooner you You can get a chance of life.” Li Hang added, “So in fact, the essence of the Internet itself and medicine itself are the same. They both solve pain points, but they are just different pain points.”
This afternoon, Tang Daosheng, senior executive vice president of Tencent and president of the cloud and smart industry business group, also said in the opening remarks: “We believe that technology should be good, and medicine should be combined to help eliminateHuman pain points. Using technology to guard the light of life, make everyone’s health measurable, manageable and improveable. “
Professor Zhang Wenhong, the “net celebrity” during the epidemic this year, and the director of the Department of Infectious Diseases of Huashan Hospital affiliated to Fudan University, was the first medical expert to give a speech. He said: “I believe that no pain will prevail on a global scale. After this year’s new crown epidemic, the whole world is in great pain for the disaster brought about by this epidemic. China just took a breath from this epidemic, but the whole world is still in darkness.”
Speaking of the COVID-19 pandemic sweeping the world, why China, which was the first to find a case of COVID-19, achieved staged success? Zhang Wenhong attributed this to two factors: “It depends on the first one is leadership, the second It’s our great Eastern culture. We can sacrifice our very short-lived freedom for the better life of the entire group.”
Academician Huang Hefeng, director of the Shanghai Key Laboratory of Embryonic Diseases, talked about the childbirth problems that every family may encounter. She mainly talked about how to “escort” healthy embryos through assisted reproductive technology. The so-called test tube baby. Because some babies are born with birth defects, such as hare lips, congenital heart disease, genetic diseases, deaf and dumb, and mental retardation. However, through some technical means, we can reduce the birth defects of the Chinese population and improve the quality of birth by intervening in the population with birth defects. For example, the pre-pregnancy diagnosis she talked about at the end point, this technology is based on test-tube babies.
The topic of Dr. Lu Lin’s speech at the National Center for Clinical Research of Mental and Mental Diseases of Peking University Sixth Hospital was a topic of extraordinary concern for contemporary people: depression. He likened depression to “the black dog in our mind.” He said: “If you are sure that you have depression, you must be treated. 70% to 80% of depression can be cured, and some can be cured without recurrence for life. 70% to 80% of the depression can be treated. It has been improved, only a small part of the treatment is not good, and long-term medication is required. The treatment of depression is relatively effective, so we must get formal treatment.”
Cai Sanjun, chief physician of the Colorectal Surgery Department of Fudan University Cancer Hospital and chief expert of colorectal multidisciplinary, believes that colorectal cancer is preventable and curable.
Lung cancer is the first among all malignant tumors, breast cancer is the second, and colorectal cancer is the third, accounting for 10% of all malignant tumors. In terms of the cause of death, lung cancer is the first. Colorectal cancer has become the second leading cause of death.
He said: “As long as we earnestly change our lifestyles, seek medical care in time, actively participate in screening surveys, treat precancerous lesions, treat clinical tumors in a standardized manner, reduce the incidence of colorectal cancer, reduce the death of colorectal cancer, and improve colorectal cancer. Survival is possible.”
Peng Baogan, director of spine surgery at the Third Medical Center of the People’s Liberation Army General Hospital (formerly the Armed Police General Hospital), tried to solve the “common problem” of every workplace-cervical spondylosis. He said: “In our daily life, we must pay attention to improving our lifestyle. Home care includes increasing neck and back muscle exercises, paying attention to sleeping posture, and avoiding pillows or no pillows. Work management is for long-term desk workers. Pay attention to posture and computer. Keep the screen in line with the line of sight or raise it slightly; strengthening exercise and proper dietary conditioning can prevent the aggravation of spondylosis.”
We all know the truth, but we can’t do it.
Ge Junbo, director of the Department of Cardiology, Zhongshan Hospital Affiliated to Fudan University, director of the Shanghai Institute of Cardiovascular Diseases, and academician of the Chinese Academy of Sciences, gave a speech on coronary heart disease and how to prevent and treat it. He is the person who developed the world’s first fully degradable drug-eluting stent.
According to our China Cardiovascular Disease Report, we know that for every two people who die, nearly one person is caused by cardiovascular diseases, including cardiovascular and cerebrovascular diseases. One out of every four people who die is a tumor. At present, the most deadly cardiovascular disease may still be coronary heart disease, the disease dominated by atherosclerosis, and the other is hypertension. For example, Ge Junbo said that Churchill, Roosevelt, and Stalin in the famous photo in 1945 all died of a stroke caused by high blood pressure. He still hopes that everyone will find the answer from the following.
Academician Zhong Nanshan made his final appearance, but what he brought was not a speech, but rather a speech to the ME conference.
In yesterday’s article “Let Ma Huateng crouch on this live broadcast, where are the 7 scientists taking us”, some readers disliked not including the video link, so today I posted the video link of the ME conference here. Copy the link to watch the replay:
The following are the keynote speeches of seven experts. In order to ensure the authenticity, they have not been deleted. As a kind of respect, give priority to Zhong Nanshan’s speech at the beginning.
Zhong Nanshan: Let the scientific light of medicine illuminate the way of life for more people
Dear medical colleagues, friends in the audience, hello everyone. This is Zhong Nanshan.
I am very happy to come to the Tencent Medical ME Conference. Of course this is through video. It is not easy for us to gather here for a meeting. Today, Tencent holds a medical ME conference to bring medical practitioners, the public, and colleagues from enterprises together to discuss life and medicine, and discuss how science can better guard life. This is of great social value and significance.
We know that our President Xi Jinping (proposed) the 20-character anti-epidemic spirit, that is to say, the 20-character guideline of “life is supreme, the whole country is of one heart, giving up life and forgetting death, respecting science, and sharing destiny” China has won the first stage of epidemic prevention and control. However, in general, the current global view of the new crown epidemic is still spreading. Today, more than 40 million people have been diagnosed with the new crown epidemic, and more than 1.1 million lives have been taken away. Therefore, the current global close cooperation and joint fight against the epidemic is the most important task.
We have gained a very important experience in this epidemic, that is, we must further improve the scientific literacy of the public. Through the strategy of joint prevention and control in the community, we quickly contained the epidemic. To a large extent, we benefited from the strong investment in medical science from all walks of life. I think this is better than foreign countries, so that the public can eliminate panic. And understand and comply with various defensive measures, thus effectively responding to the epidemic.
Mr. Ma Huateng said that the task of the Internet is to find and solve the pain points of users. This is very similar to the mission of medicine. Our doctors also have to solve the most fundamental pain points of mankind. Of course, the most fundamental pain point is the pain of life. As felt in this epidemicYes, in the face of the pain of life, human beings are an inseparable community of destiny. Therefore, medical experts around the world need to establish a long-term cooperation and exchange mechanism to share success and failure experience in order to expand the scope of human medical capabilities. The practice of future medical research and development should also actively invest in cutting-edge scientific and technological forces.
We know that in medicine, one of the biggest success points of this epidemic prevention, or one of our pain points this time, is to capture the community prevention and control at the community level, which is It is our biggest achievement to say that we will not let the disease spread in the upstream and not spread to more people.
When it comes to our treatment and other aspects, we do not care about predicting the condition, rapid diagnosis and treatment, predicting the development of the condition, and finding out its rules. We need AI, we need big data, we need 5G, we need a cloud network, which will give us great help in epidemic forecasting, vaccine research and development, and disease diagnosis, and it is now giving us great help. Cutting-edge technology is a transformative force driving the development of future medicine. Tencent put forward the “Technology for Good”, and I resonate well.
Health is related to life and life. I hope that in the future, more industry colleagues and social forces can be together, so that the light of medicine and science can illuminate the way of life for more people. thank you all.
Zhang Wenhong: Out of the darkest moment
I am very glad to be here today to communicate with you about this epidemic, my current feelings, and some ideas or opinions about the future.
A lot of people came to this conference today. Everyone is discussing a topic and pain point. I believe that no pain will be better than this year’s new crown epidemic on a global scale. The whole world is bringing about this epidemic. China’s disaster is extremely painful. China just took a breath from the epidemic, but the whole world is still in darkness.
Today we have been discussing whenLater, we will get out of this related disease caused by this bat-the new crown epidemic. Of course, we are still discussing whether it is a bat or not, but we all know today that this virus from nature brings us a challenge for mankind. , Completely beyond our imagination.
Today we review the development trend of our epidemic since this epidemic. You will find that according to the data on October 16, the number of confirmed cases worldwide has exceeded 39 million, and the cumulative number of deaths has exceeded 1.09 million. , I believe this data in January this year should be unimaginable.
Of course, China has kept its pace of controlling the new crown epidemic at the level of more than 80,000 cases, and the trend of cases in the whole world today does not seem to stop, so how long will this darkness continue? We should discuss this from a scientific point of view.
Many people discussed in March this year whether summer will come, and the entire epidemic will be like the virus brought by the new crown epidemic. Like the previous SARS in 2003, it will naturally go away when summer comes. But today we have been discussing this issue, why the same coronavirus went away in the summer of SARS in 2003, but this time it did not, and this judgment is so late today, I believe today Many people in the world will agree that this epidemic may continue to spread. Many people even think that this virus has become a resident virus in human society. It may stay there and not go. The true situation is in the end. What will happen?
Today we will see from the epidemics in key countries in the world. After the epidemic began to slowly rise in January this year, the number of cases in many countries in the world has exceeded 8 million, 7 million to 8 Millions, or even going upwards, this is the cumulative number of patients in the top 8 countries in the world this year. This number exceeds our earliest prediction of this disease.
In fact, from March of this year, we can see that the epidemic has become fully global in March. At this time, its trend is not a trend that SARS showed that it can be stopped in the summer, but more There are many trends of global spread. This situation was only discovered during the pandemic. So before the coming of summer this year, there are two kinds of thoughts that are arguing. One thought is that we will always be the epidemic caused by the coronavirus. When the summer arrives, the virus may die slowly and will not cause further spread. However, another thought is that the coronavirus, but its characteristics show a spreading situation like a flu virus.
So today we follow one of the most spreading countries in the world, in India, we goTake a look at the characteristics of the new crown epidemic. This is a comprehensive analysis of the Indian epidemic published on Science this year. What characteristics will you find in the spread of the new crown epidemic at this time? This group of mainly young people has caused the spread of the epidemic in this country, that is, the spread of the epidemic brought about by the widespread activities of young people in this country has contributed the most to it.
But more we see that in every age group, its transmission shows a horizontal transmission trend, that is, its epidemic performance among children between 0 and 14 years old is that they are spreading each other. We see 65 years old. The epidemics of the above-mentioned elderly people are also spreading to each other. This is a typical feature during the pandemic period after the epidemic spreads globally. That is to say, it spreads widely among people of all ages and close contacts. In this case, we will How to end this epidemic is what we are going to discuss today.
Today, I am here to show you several strategies for the global epidemic.
The first strategy. Obviously everyone likes to listen to China’s experience. What is China’s experience? In fact, China’s experience did not become experience at the beginning. China’s experience was when our team opened to Wuhan. In fact, we don’t have a very complete final experience in our minds. These experiences are related to the virus. Formed in constant struggle. This photo comes from the back of our teammates when they opened to Wuhan, but here we see many young doctors carrying backpacks and walking forward in a fearless attitude. We can see the younger generation of China. The doctor has demonstrated extraordinary spiritual power and his professional power.
And what kind of war is our war in Wuhan? We in China have implemented a 100% lockdown (sound) to lock down the entire city, and we have also implemented a 100% closure of the city. In today’s China, we have adopted 100% prevention and control of infectious diseases for the outbreak. Spirit, so after about two months, practice has proved that this set of methods is successful.
But successful experience does not mean that you can copy it, because there are many factors behind that make our Chinese experience successful in our land. Here is the leadership of the government, our Eastern culture, and our The cooperation of the people.
Today’s war epidemic has achieved initial victory in China, and has achieved initial success, and it has come to an end, but many people have been asking, is there no new crown in China since then? Obviously not.
In this global epidemic, we know that the world is an anti-epidemic community. When the world’s epidemic is not over, can China aloneStand outside the world? Obviously not.
So in China, there will be some sporadic cases, imported cases, but we are very afraid of the situation in Wuhan again, so the second experience of the Wuhan epidemic is that it has a very large population and medical resources In a situation where per capita resources are relatively poor, if the consequences of the spread of the epidemic are very serious, China must adopt a resolute strategy. This strategy is that when you encircle the virus in a comprehensive way and win, we The next thing to do is to run faster than the virus.
So today we see in China that when a virus outbreak occurs in any place, we will quickly carry out centralized control of this place, and at the same time, we will test the people in contact with it, and even expand it. Testing, large-scale testing, until every case was discovered, many people told me, he said that this measure is too strict, did you pay too much? It is necessary to know very clearly, if you do not do this, what are the consequences? If you do not run faster than the virus, the virus will spread. As soon as the virus spreads, we will ask ourselves whether we have enough medical resources to bring the epidemic under control again. Therefore, China’s experience is faster than the virus. You can control the epidemic within one month in Beijing.
Then you will find in Xinjiang that the epidemic should be controlled within one month when the epidemic occurs, and in Dalian, the epidemic will also be controlled within a month. This situation will also occur in Chinese cities today, but we will follow us today The people and the people have fully communicated, so many people asked me why the Chinese people cooperated so well during this epidemic. In fact, in China, our people have always been regarded as the main body of this epidemic, so Someone will ask me today what exactly is China’s experience?
In China’s experience, the first point is of course the leadership of the government. It has formulated a series of strategies, but the government’s strategy is not enough. We should let the public know clearly why our strategy is In this way, there are many professionals in China during this process, and I am among them.
We will communicate with our people through various channels. Our self-media, our publications, and many of our official accounts have actually had a lot of communication with the public. This is our My team published the first international novel coronavirus disease during the epidemic. It was born in the very early stage of the fight against the epidemic. It was widely published in April and May with zero international copyrights. The popular science books we wrote are internationally 18 countries conduct extensive publications with zero royalties. We hope to tell China’s experience and our experience in communicating with the publicThe whole world, that is to say, an epidemic is truly successful. Only when the whole society is united and everyone understands each other can the fight against the epidemic succeed.
So the success of China’s fight against the epidemic depends on the first one is leadership, and the second one is our oriental culture. We can sacrifice our own very short-term freedom for a better life of the entire group.
So Margaret Chan, the former secretary of the World Health Organization, once said that we must sacrifice a little bit of our own freedom to gain greater freedom in the whole society. I think this sentence is very good, and some of the Chinese people We have fully seen the cooperation in this epidemic. Therefore, when an epidemic can be controlled, it should depend on many factors, and ultimately it can succeed.
Is it true that other countries in the world do not have their own unique secrets for epidemic control? In fact, today we see that the second wave of foreign countries that everyone is very worried about has indeed risen. We will see here that this is the data of France yesterday. We see that the proportion of France’s second wave of new additions seems to exceed it In the first wave, let’s look at the British data. The second wave of new cases in the UK has exceeded the first wave, so many people will be very worried about whether they have exceeded the first wave of this epidemic. Full control?
In fact, I still want to tell you here that other countries have formed their own anti-epidemic strategies in the world, especially countries like Europe. What are their main strategies? When the epidemic recurs and my medical resources cannot effectively cope with it, I will definitely step up my anti-epidemic strategy, such as closing schools, reducing going out, and working from home. There is a very important point among them. I have to ensure my own The beds in the ICU, that is, the beds in the intensive care unit, can be used to treat enough patients with multiple illnesses. Why should we make room for them? Because the death rate of our disease is ultimately caused by whether critically ill patients receive effective care.
So we all know the strategy adopted by China this time, why in China we must resolutely control the disease at an early stage, we just hope that the number of our severe cases will be completely within our control. Only then can you Realize the concept of people first and life first. Therefore, at such a level abroad, after everything is placed there, you will find that it becomes strict when the epidemic situation arises. Recently, both France and the United Kingdom have once again extended their emergency response time and brought the epidemic under control. This is their first thought.
Second thought, when you see his recent increase in the number of cases, his fatality rate, such as the United Kingdom, has now dropped to a level of about 0.5%, which means that these countries have been fighting their own In the epidemic strategyMaintain a dynamic balance.
So when you can’t completely eradicate this virus, you have to learn how to live with this virus. In a sense, we think these two strategies are suitable for our country. China will eliminate the virus in the short term, and European countries cannot eliminate the virus in the short term. I have learned a strategy to coexist with the virus, but I must The fatality rate goes down, so what are everyone waiting for? Could the world never reopen like this?
Now we know that people can’t go abroad or it’s troublesome to go abroad, and it’s troublesome for people from abroad to come in. If the world keeps shutting down like this, our economy, politics, and culture will be greatly challenged. Then everyone is waiting what? Obviously all of us are waiting for this year’s weapon-vaccine. But everyone’s question is here again. Will there be no new coronaviruses in the world once the vaccine comes? So we know today that countless vaccines have been born in the world, measles vaccines have been born, measles still exists, chickenpox vaccines have been born, chickenpox is still there, we still have flu vaccines, do all the flu in the autumn and winter come every year? once? So the birth of the vaccine does not mean that we have completely solved this problem.
Where is the effect of the vaccine?
Today, with the birth of the vaccine, we will know that the world’s strategy for the control of the new crown epidemic will come out with a third strategy. This strategy means that this year before the vaccine is released, that is, at this time today, the vaccine is not released. Even if you said that I did not get vaccinated when I went abroad, this is an emergency vaccination in the country, only a very small number of people are vaccinated, most people have not been vaccinated, at this time we are still in China, our Are schools, hospitals, and communities still facing some challenges? Yes, we are still accepting the challenge, because the epidemic in the world is not over, I hope everyone will always have this vigilant thought.
We are going out on the crowded subways and buses, in gathering theaters, like today, we also need to wear masks. We must wash our hands frequently when we return from outing, and try our best to ensure social distancing when the crowd gathers. China has entered a new normal. It has been several months. On October 1st of this year, China has been so far. Accepted a very powerful challenge. We call this challenge a “stress test”. The first very huge “stress test” after China withstood the new crown epidemic was this year’s National Day. China has as many as I know. Nearly 600 million people have traveled outside, near or far, but today the epidemic in China is still within a controllable range. At the same time, there are some sporadic cases in very local areas of China. Do you think very scary? In fact, no. For the sporadic cases that appeared today, we used our original strategy and adoptedWith powerful medical monitoring and testing methods, we are ahead of the virus, and we can eventually control the epidemic.
So after the vaccine came out, did our epidemic leave us? Is the virus gone? Actually not. When the vaccine comes in, it will not be 100% vaccinated internationally. In some countries, 30% will be vaccinated and some 40% will be vaccinated. What we have to do is even if 30% or 40% of people are vaccinated, the most dangerous group will get it. Protection, so the fatality rate of the entire social group will be greatly reduced. When the fatality rate of this society drops significantly, we begin to welcome the restart of the world, because whether it is flu or other diseases, when the fatality rate drops significantly At this time, the opportunity for the world to restart came. At this time, we have to face a restarted world again in China. We have kept China very clean during this epidemic. Our local cases are basically zero. We How will we face the challenge of restarting the world and the virus that still exists in the world?
Obviously, China must rely on universal vaccination of vaccines, and we still have to maintain an ultra-low level of local cases through higher vaccination rates to welcome the restart and opening of the world.
So this year’s new crown epidemic has come to today. We believe that we have passed the darkest time, and the dawn has appeared in the distance on the ground. We will eventually come out from the darkest hour. Thank you everyone.
Huang Hefeng: Assisted Reproductive Technology “Protects” Healthy Embryos
Hello everyone, I’m Huang Hefeng from Shanghai Jiaotong University. My major is reproductive medicine and reproductive genetics. The topic I bring to you today is “Assisted Reproductive Technology “Protecting Healthy Embryos””, which is what we commonly call For the third generation of test-tube babies, the technical term is preimplantation genetic diagnosis.
First of all, we want everyone to know about birth defects. It refers to the abnormal development of the fetus in the mother’s body before birth. There are three aspects. The first aspect is the structure.Abnormalities, which we are very familiar with, are like hare lips and congenital heart disease. The second type is abnormal metabolic function. There is no structural abnormality in genetic diseases, deaf and dumb people. There is another kind of intelligence, such as severe mental retardation and so on. Then there are some that can be discovered at birth, some may not be discovered until a few years later, and some may even be discovered for decades. For example, many of our polycystic diseases will undergo kidney dialysis at the age of 40 or 50. Functional failure, these diseases actually carry some genetic changes before birth.
Let’s give a lot of examples. There is trisomy 21, which is called Down’s syndrome, and congenital heart disease. These diseases are all called birth defects. Among them, birth defects include one It is called a rare disease, but because the number of rare diseases in our country is very large, there are about 7,000 to 8,000 rare diseases in China. Our population base is large, so rare diseases account for a large part of our birth defects. ingredient.
We are very familiar with American volleyball player Hyman and Chinese volleyball players. They are both Marfan syndrome. They died at the age of 31 and 39. There is also the world’s most advanced Van Gogh, a famous painter. He is Purin’s disease and also a birth defect, a rare disease. He died at the age of less than 40, probably at the age of 38.
Birth defects are very harmful to our entire country and even every family. About 80 to 1 million unhealthy children are born every year. We can describe it intuitively. A defect is born in 30 seconds. The burden on our country’s economy and society is very, very large. Among them, 30% die within a few hours or a few days after birth, but another 40% will have these disabilities for life. This gives every family It brings a huge burden.
To reduce birth defects, our country and even the world focus on prevention. There are four aspects to the prevention measures we are currently taking in China. The first aspect is pre-pregnancy care, and the second aspect is pre-implantation genetics. Learn to diagnose, we now call it pre-pregnancy diagnosis, which means that you are not pregnant yet, and the embryo is not in the mother’s womb, and the birth defect is diagnosed. If another one is pregnant, the fetus in the uterus will be examined before the birth. If the fetus is proved to be malformed, the pregnancy will be terminated. There is another one who still needs to be screened after birth. Many congenital heart diseases need to be operated on. If the thyroid function is low, the thyroid must be supplemented for life, so that these children are not disabled children, but can also be normal. These four One aspect is an important means for our country to prevent birth defects.
What I want to introduce today is the latest method we use in the prevention and treatment of birth defects, also called pre-pregnancy diagnosis. This technology is based on the test tube baby, the first test tube baby so farI was born in the UK in 1978, and later invented it. We called him the first generation. Later, it was discovered that many patients with sperm disease were treated. We can directly inject sperm into the oocyte. This is called the first generation. Second generation. The third generation I want to talk about, when the embryo is in the laboratory, one cell or a small number of cells are taken for disease diagnosis. If the embryo is normal, I will put it in the mother’s womb and give birth to a normal child. , This is the pre-pregnancy examination technology I introduced today to protect healthy embryos, and healthy newborns can be born with healthy embryos.
Assisted reproductive technology has gone through three eras. We do not distinguish by year, mainly based on the popularity of this technology. For example, our first generation was in 1978, and the second generation was in 1992. In fact, the third generation I am talking about today The generation was in 1990, but this technology has only developed rapidly in recent years due to its difficulty and high requirements for molecular biology. This technology is synchronized with China and the world. A new technology is in line with the world. The above is synchronized, which is also a pride of our people. This technology has made a huge contribution to controlling the birth defects of our country’s population.
Let’s take a look first. Our technology is simply called PGD technology, and later changed to PGT technology. The embryo’s genetic diagnosis is before implantation. So at the beginning, it not only solves the problem of infertility, It can also solve the problem of genetic diseases. This technology is what I will focus on today.
What is preimplantation genetic diagnosis technology? We can see in these pictures, for example, these embryos that we developed in the laboratory, we take out one cell or three to five cells for diagnosis, and the diagnosis is to implant normal embryos into the mother. This method is called PGT technology. , This is traditional. We divide this technology into three categories according to its indications. The first category is called PGT-A, the second category is PGT-M, and the third category is called PGT-SR. The following will introduce which people these technologies are suitable for.
Let’s first look at the PGT-A technology. First of all, our PGT-A technology is mainly to screen the chromosome number of the embryo, or it is a mosaic. This person has 46XX and 46XXX. There are two sets of this Kind of, this kind of embryo screening can be passed when giving birth, and repeated test-tube babies are unsuccessful, we also carry out screening, or this person has repeated miscarriages three or more times, this test can also be done, and life We have confirmed that the abortion is a chromosomal abnormality. This technique can be used in the next pregnancy, and this method can also be used in severe males with hypospermia, weak semen, or even semen accumulation to ensure the health of the embryo. . Another is advanced age. China sets this age at 38, especially for women. The older the age the higher the occurrence of chromosome split errors.Therefore, the probability of having a child with chromosomal abnormality is very high. If a woman reaches 45 years old, the probability of giving birth to a child with chromosomal abnormality is as high as one in twentieth, which is very, very high risk.
For Down’s syndrome, there is no separation of chromosome 21. He is in trisomy, and there is also trisomy 18. Newborns like this also have a chromosome 45XO missing. These are all born. He was born. In the future, the growth and development is not good, the intelligence is not good, and there is no fertility, and there are chromosomal inversions below. These are all suitable techniques for PGT-A.
Looking at M below, it is a single gene disease or rare disease. What does he include? Single-gene disease genetic disease, autosomal dominant inheritance, recessive inheritance, can also be sex-linked dominant inheritance and recessive inheritance. The second thing to talk about is that HL-matched siblings treat hematological diseases. We are also called design babies. For example, the first child has a serious immunodeficiency disease. I think the second child will use his umbilical cord stem cells to treat the previous Child, then I have to give birth to a child with exactly the same HL type, so I can choose an HL type exactly the same as the previous child through the PGT-M method.
One more thing, tumor susceptibility syndrome, customized cancer-free babies, what everyone knows best is Angelina Jolie. She had her breasts removed because she had breast cancer genes. In fact, it didn’t take long before she discovered This gene can also cause ovarian cancer. She also removed the ovaries. We can use some methods to make this kind of people with tumor genes remove the tumor gene embryos at the embryonic stage when they give birth. The tumor gene is implanted in the uterus, and a child without the tumor gene is born. Everyone has already understood this technology. One is that the gene that can cause disease in this family can make the child become absent. From then on, the genetic disease of the entire family can be completely blocked, that is, we can use this technology to make families one by one. The eradication of diseases inherited for a lifetime is very beneficial to the evolution of the genetic background of our entire nation. So far, for example, our breast cancer, ovarian cancer, multiple neurofibromas, and familial multiple nodular intestinal polyps have genes, and many tumors such as eye tumors have genes.
For example, long chromosome dominant inheritance, Marfan’s, retinal tumors, recessive albinism, common people are called moon dolls, and SMA, melena, sickle-type anemia, etc., which are dominant. There are also some, such as autosomal inherited diseases, more hemophilia, British Elizabeth family is hemophilia, and Y can also be chained, two hairs on his ears always grow out, which is also inherited. There are color blindness and so on. How can rare diseases and genetic diseases be blocked by our technology?
We use a biopsy to confirm whether the chromosomes or genes of the biopsy cell are normal or not, to determine whether the embryo being biopsy is healthy, and then to decide which embryo to implant into the uterus, so that we have a diagnosis before pregnancy , So we call it pre-pregnancy diagnosis. Our prenatal diagnosis is invasive. If you are pregnant, you can take his villi and amniotic fluid. If an abnormality is found at this time, the pregnancy will be terminated. The termination of pregnancy is invasive to the mental and physical of the pregnant woman. It is also subject to religious ethics and social law. interference. This problem does not exist in the pre-pregnancy diagnosis. She is not pregnant. Don’t move bad embryos in. This technique can avoid ethics and reduce the harm to the mother.
If it is a prenatal diagnosis and an abortion, the ethical controversy is also very big. Our technology has several advantages. One is proactive, he chooses the quality of the embryo himself, and the other is comprehensive. He removes all the chromosomes of the embryo. At the same time, one cell can treat it in addition to all the chromosomes. Diagnosis of disease-causing genes, a cell has a gene and a chromosome, so it is very comprehensive.
How to do it? Let me briefly introduce it. This is very similar to IVF. Let’s get an injection outside of the body to allow follicles to develop, then take out the oocyte through B ultrasound, and fertilize it with the husband’s sperm outside the body. On the third day of fertilization Even on the fifth day, through the biopsy of this embryo, one cell or several cells are examined for chromosomes or genes, and a good embryo is selected. We know that the embryo of monogenic disease can be completely normal, can be carried, and can cause disease. We will discuss with family members. We generally choose to have no pathogenic genes at all. If there is no way, we may discuss the carrier. , Can also be transplanted, because the carrier does not get sick, it is to consider the carrier’s next problem.
This is the genetic diagnosis that our team has carried out so far. Many of the names of the diseases may not be very clear to you. You can check them on our website.
I will give you a few examples here to give you some perceptual understanding. X-linked Duchenne muscular dystrophy occurs relatively high in China. At present, it is mainly due to the deletion of many exons in a section of the X chromosome. This is the most common. It can be a point mutation or a duplication of fragments, butMissing is more common. You see, this muscle is pseudo-hypertrophy. In the end, he can’t walk at all. All the muscles are atrophy, even the diaphragm is atrophy. He is about to die.
Let’s see, there is a family. There is a mother in the middle. She is not sick. She has the X chromosome. She gave birth to a child. There is an arrow pointing there. This is a hemizygous, this child. He was sick, and his mutant gene was exactly the same as his mother, but on this mother, his grandmother and grandfather did not have a disease gene, which proved that this mother was a new mutation, so in our real life, some of the family is very clear, and some come suddenly. A new mutation, if we don’t terminate him, he will become the ancestor of the family inherited. We found out when a newborn was born in this family, and we started to terminate it. This is the whole process. A total of 6 oocytes were taken. Cells, four effective embryos, and finally we diagnosed two embryos, one is normal, we put in the normal embryos, and the bottom four embryos, she became pregnant and gave birth to a normal newborn. This is a tumor case. Circle is a daughter, his father has cancer, and she herself has breast cancer. She is going to have a baby. We finally diagnosed through ovulation induction and egg retrieval. We found that there were three normal embryos in this case, and they were finally transplanted. One, and finally a healthy child was born. The protein expression of this child is exactly the same as that of a normal person. It is a normal child.
So after this gene is eliminated, the descendants of this family have no breast cancer gene since then. This mother’s gene came from his father, and his father is also a tumor. We have a single gene disease called a porcelain doll. , It’s a rickets, how brittle the bones of the porcelain dolls are, and they fractured after giving me a hug. This kind of child often passed away very early. Through this method, the porcelain doll’s mother gave birth to a normal child. Normal boy, this is our more common severe immunodeficiency. We call this child Bubble Boy. He will always live in a sterile transparent plastic cover. Once he gets infected with bacteria, he will die. This child will survive. Now it is completely dependent on medical conditions. Both his parents have this gene, but their parents do not get sick because it is a recessive disease, but they get sick after giving birth to a child. He knows this technology, and the next child will come to us. Through this inspection method, we found that there was a normal embryo, two of which were carried, so we gave him a normal embryo. These two were pathogenic, so after the transplant, we gave birth to one in the last 40 weeks. Girl, this is another X-chain. You see that this family gave birth to 6 children in total. The first two boys died. Later, they miscarried several times and finally gave birth to a girl. It’s normal. This girl passed our PGT-M. The technology was completed. After the child was born, the test did not carry the pathogenic genes related to hematophiles. It is normal for girls to pass on from generation to generation. This is the time of Women’s Day 2017Troubled, he likened depression to a black dog. He said that his body and mind are like purgatory on earth. He can’t find an outlet for his emotions and can only bear the bullying of the black dog silently. Since then, the black dog has become synonymous with depression.
The famous British psychotherapist and author Stoll told us in “Churchill’s Black Dog”: Depression is actually one of the most effective forms for wise men to think inward and return to their hearts. So Churchill, Kafka and Newton Many of the great politicians, philosophers, and scientists in our history have suffered from depression, or have black dogs like depression biting them in their hearts and making them very painful.
“The depression in my heart is like a black dog, biting me at every opportunity.” Historically, painters, writers, and photographers like Matthew Johnstone have suffered from depression. Although he is not a psychiatrist, he has learned many ways to tame depression and tame this black dog during his years of struggle with depression. Together with his wife, he co-created “I Have a Black Dog Called Depression” “Books like this have inspired and helped countless people with depression and their families recover and get out of depression.
The situation of depression in our country. In 2019, Professor Huang Yueqin of Peking University Sixth Hospital published the results of the third survey of mental illness in China in The Lancet-Psychiatry, the lifetime prevalence of depression It reached 6.8%, and the prevalence rate reached 3.6% in December. This means that 6.8% of our adults may be suffering from depression or have had depression. Then this does not include teenagers, so there are six depressions in our country. Between 10 million and 90 million people are very large. Diseases with an incidence of more than 5% are common and frequently-occurring diseases. Therefore, depression is also the most common disease in our lives. It will affect many of us.
The incidence of depression among our women is higher than that of men, about 50% higher, which means that women are more susceptible to depression, and the incidence of depression in the elderly is also high.
Depression is the main factor in the loss of our healthy lifespan, which means that our average life span is prolonging, but because it is depression that makes our lifespan loss, or our lifespan will be shortened, depression is causing us An important factor in the reduction of life expectancy, it exceeds substance use barriers, exceeds our hearing damage, and exceeds the impact of natural disasters on humans.
So the global burden of depression, the World Health Organization has done a survey, we have 300 million people in the world suffering from depression. In the global burden of disease in 2017, depression ranked third among the burden of disease among women and fifth among men. That is to say, the impact of human diseases on our productivity, our society, and our economy.Depression ranks third among women, and men rank fifth. In the past ten years, for example, comparing 2020 with 1990, the loss caused by depression has exceeded 47%, which means an increase of about 50%. Depression has brought more and more effects to our society. .
An important reason for the increased burden of depression is our low rate of consultation and diagnosis. The low rate of medical visits is because many people do not go to see a doctor if they suffer from depression. He does not know that depression can be treated. There is also a situation where I am embarrassed to go to the doctor and fear that others will say that I am not good. This is our misunderstanding of depression. Some people think that depression is not due to illness, but may be related to superstition, ghosts and gods, and become superstition, so the rate of consultation is low. There is also a low diagnosis rate. The low diagnosis rate means that many of our grassroots doctors who can see depression are not many, so there are many depressions in our country that have not been treated, so many depressions in hospitals below prefecture-level cities across the country are not recognized. To 20%. This is the opposite of the global figure. In developed countries, about 80% of depression is diagnosed and treated, and in our country, only 20% to 30% of depression are diagnosed and treated, so depression is missed and misdiagnosed. It also brings a lot of losses to our society and patients.
The most common manifestation of depression is a low mood, that is, a bad mood, gloom, sadness or even serious suicide, or hurting yourself. Its most important core symptoms are depression or not well, decreased interest, or lack of pleasure , Which is a happy thing for many people. When we meet our relatives, we eat delicious things, we encounter happy things, our healthy people will be happy, but people with depression do not express this kind of happiness. Come out, that is, when he should be happy, he has no such cause of happiness, so this is an important manifestation of depression.
There are many clinical manifestations of depression. Some people may have less depression; some people have inattention, such as young people, middle school students, and college students. He can’t keep up with his studies; and he may not be able to sleep, which may be a manifestation of depression. Some people sleep a lot and want to sleep most of the day. This is also a problem. There are also some patients with depression. He is unwilling to communicate with others, and he does not want to go out, which is also a manifestation of depression; some people suffer from insomnia, which means that they do not sleep well, and then dream and wake up all the time; some people eat poorly, do not want to eat, and have no appetite for eating. This is also a manifestation of depression; there are also palpitation, palpitations, and worry caused by people. We are called panic all day long, that is, we are always worried about what will happen. Then these are possible manifestations of depression. Therefore, depression is a kind of complicated etiology, which is not clear at present. We call it a chronic disease with various iatrogenic manifestations. It needs timely diagnosis and treatment.
Depression is not equal to depression. We healthy people may have some low mood or high stress when encountering unhappy things, but they are not depression. The performance of depression is not the same as our bad mood. For example, a patient with depression has a long period of bad mood. Generally speaking, it lasts for more than two weeks. If a person continues to be in a bad mood for more than two weeks, it may It’s depression. If a person is in a bad mood today, he is in a bad mood when he encounters something unhappy, only for one or two days, and it will be better after two days, then this is not depression, this does not need treatment, this is the expression of our healthy people’s emotions .
The patient with depression is that he still has some mental symptoms. He does not sleep well at night or sleeps more at night. He feels uncomfortable when he wakes up in the morning, but may be better in the afternoon. There is also no reason for depression in bad mood. He has no factors and no pressure. He will also feel bad and depressed. Therefore, patients with depression are not the same as healthy people. A healthy person can be relieved when he is in a bad mood, and maybe he will recover in a few days, but the patient with depression is different, he cannot recover by himself. Therefore, the mechanism of depression is still unclear. It may be related to our environment and stress during pregnancy, during adolescence’s upbringing, and also related to bad habits. The mechanism of depression may be related to Our neuroendocrine, immune system, and genetics may all be related.
So when treating depression, we must find a professional doctor for evaluation and treatment. For example, if we want to find a black dog in our heart, we should pay attention to the fact that the doctor may have to pay attention to this person’s original personality, but now he has become very withdrawn. Is it dull now, often unhappy, lack of clear life goals and information, negative view of problems, and obvious external pressure? These factors may all be manifestations of depression.
If we are psychologically stressed at this time, we will have some psychological signals that indicate that we may be at a high risk of depression in the future. For example, we were in good health and concentrated mentally, but now We have become inattentive, our spirits are low, or our interest has faded, or our will is very depressed, meaningless to things, we don’t want to do it, we don’t learnYou have to sit and not learn, or feel tired and not learn, or feel that you might not be able to do this thing well. This may be a symptom of pre-depression. There is also a significant decrease in memory. There is no other disease. The original memory is very good, but now the memory is decreased. This is also a possible early symptom of depression. When stressed, we may be depressed, which may affect our health, such as feeling bloating, stomach pain, loss of appetite, insomnia and dreams, chest tightness, suffocation, palpitation, and palpitations. These may also be the early symptoms of depression. We need to find a professional doctor for evaluation. A professional doctor or psychotherapist can evaluate whether the person’s mood is low through observation. Through conversations, we may see if the patient is different from the past. It turns out that an introverted person A person who doesn’t talk much may be a manifestation of such a personality for a long time, but there is a person who talks a lot before, and suddenly he talks very little. Then we should pay attention to whether he is depressed.
In addition, we can monitor whether our emotions are low through many scales. If our emotions are obviously low and have obvious depression and anxiety, then many psychological measurements can also help us solve problems.
If it is determined that there is depression, it must be treated. 70%-80% of depression can be cured, and some can be cured without recurrence for life, and 70%-80% can be obtained through treatment To improve, only a small part of the treatment is not good, and long-term medication is required. The treatment of depression is relatively effective, so it must be treated regularly. The goal of depression treatment is to increase the clinical cure rate and minimize disability and suicide, because if depression is not treated for a long time, about 50% of people who are serious will think of suicide to hurt themselves. In addition, long-term treatment may be required, and some depressions also relapse, so they still have to undergo professional maintenance treatment by doctors. The other is to improve the quality of life and quality of life through treatment, and restore social functions. Therefore, after treatment for many depressions, he can still do a lot of things in society, contribute to society, and be able to achieve his own ideals and goals in life. Like many politicians, scientists, philosophers, and depression patients mentioned earlier After treatment and recovery, he has made great contributions in his field.
So for a healthy person or for someone who may be depressed, we have to learn some emotional management, such as reducing stress and reducing the impact of negative emotions on us through psychological cues, shifting attention, and self-comfort. We may often encounter various pressures in life and work. We work hard to cope with it, but if we cannot overcome it and cannot cope with it, we must practice self-comfort and find new emotional outlets. Repeated pressure can easily cause us The risk of depression.
In addition, we must correctly handle interpersonal relationsYes, this kind of interpersonal relationship must be good at communicating with others, and truly understanding and helping others is also happy for ourselves. This is some of the principles for us to establish interpersonal relationships. We need and can reduce the occurrence of depression.
In addition, learn to exercise. Exercise can improve the symptoms of depression. Therefore, everyone has at least half an hour to 50 minutes of exercise time a day. For patients and those who are busy at work, the time for exercise should not be less than about 5 times a week, at least 4 to 5 times, and exercise for half each time. Hours, this amount of exercise can relieve our emotions and reduce tension, and it can also prevent depression.
How do we treat depression? Then psychotherapy may be needed. From family psychotherapy, community psychotherapy, and cognitive behavioral therapy, these psychotherapy are all very professional. If depression is not serious, we can live and work normally, and even sleep, if we just feel low in interest, low in mood, and unable to fight, then psychotherapy is effective. If the mood is very low and affects work, life and even sleep, then medications are needed, and even serious ones need to be hospitalized. Many depressions can be helped after treatment. We have to learn some psychological training methods to reduce the risk of depression, or to reduce the harm of depression to us, such as mindfulness meditation. This is a simple treatment. Through sitting meditation, meditation, and conscious attention and awareness of everything in the moment, it is possible to divert our attention from those negative emotions and bad things to a specific place of us, and let go of our negativity. Emotions and stress are also helpful in the treatment of our depression.
There are many medical treatments, and current medical treatments are also very effective. We mentioned earlier that 70%-80% of depression can be relieved by medication. When medication is involved, you must ask a doctor to prescribe it, and never take your own medication. Most of the drug treatments are safe and will not become addictive, so when to receive treatment, when to stop the drug, when to add the drug, and when to reduce the drug, the doctor’s permission must be obtained, because the doctor is relatively The most professional. Some of our personal worries are unnecessary, such as worries about whether drugs have toxic side effects and whether drugs are dependent. These worries are unnecessary, because most antidepressants are safe.
We should pay attention to the treatment of depression in special populations. Children and adolescents are at a high incidence of depression, because children and adolescents are under a lot of pressure during their physical and psychological development during adolescence, they are under great pressure during physical growth, and there are also problems related to their love and emotions, so children and adolescents The incidence of depression is high. There are also pregnant and lying-in women, due to endocrine changes after childbirth, changes in pregnancy and infant hormones and the pressure of childbirth, the risk of depression in pregnant and lying-in women is high. In western countriesOne out of every four postpartum mothers in the family has depression. Our country has no data on this aspect, but the incidence should be very high. There is also a high incidence of depression among the elderly. Due to chronic physical illness, the elderly leave the work unit and social activities after retirement, and their pressure will increase. Especially the death of many elderly spouses causes great psychological stress on them. Trauma, as well as children leaving home, can also cause a lot of stress to the elderly. The elderly are also a high incidence of depression. Therefore, children and adolescents, pregnant women and the elderly are susceptible to depression and need additional help to help them recover.
There are many antidepressant drugs, and of course there are new antidepressant drugs in clinical trials.
In addition to medication, we also have physical therapy, such as transcranial magnetic therapy, electroconvulsive therapy, vagus nerve stimulation therapy, and deep brain stimulation therapy. All of these require hospitalization to help us recover.
There are others, such as people with sleep problems, sleep deprivation, and phototherapy, which are also used in some countries to help patients with depression.
In the context of the current big data, there are many treatment measures to achieve the recovery and prevention of depression. The recovery and prevention of depression have now reached a new level in our country. In fact, the recurrence rate of depression is very high, but through maintenance treatment, many depression patients can fully recover, and nearly 10,000 depression can be completely restored to normal. About 20%-35% of depression patients Some residual symptoms require long-term treatment, so we must seek the doctor’s advice, cooperate with the doctor, cooperate with the family, adhere to the treatment, and restore health.
We should pay attention to the factors that affect the recovery and recurrence of depression. If an adult has depression, we hope that he will not relapse, and we must pay attention to related problems. For example, to reduce stressful events in life, widows of the elderly, widows, unemployed, no job, and remedy, insist on using the prescriptions prescribed by the doctor. You should not refrain from medication because you are worried about the side effects of the medication or feel that the medication is not effective. If you feel that the doctor has problems We must tell the doctor that we must also improve our physical exercises to improve our cognitive function, physical condition, and expand communication with people.
We also need to understand the psychological health education and the rehabilitation of personal life ability, as well as the management of some social disabilities brought to us by depression, as well as some social role adaptation training. Adapting to the role of the new mother can be adapted to the role of the new mother by learning knowledge and consulting with others. It can also reduce the recurrence of depression or reduce the risk of depression.
There are family rehabilitation and vocational rehabilitation in the rehabilitation of depression. The most important thing is to eliminate discrimination. WeThe society of depression should be tolerant. Depression is like a cold, high blood pressure, and diabetes. It is very common, and its treatment effect is also very good for most people. Depression requires attention, care, and companionship, not discrimination. It is not a factor of character, nor is it because of his bad quality, nor is it not because of his pretense of illness, nor is it because of how hypocritical he is. It is a common disease, which is the same as our cancer, diabetes, and high blood pressure. There may be genetic factors, social factors, or without these factors, he may also have depression. Therefore, the onset of depression has many factors. It is not certain that a certain factor will definitely cause depression, and a certain factor will definitely not cause depression. It is a multi-factorial effect.
We must reduce the occurrence of depression through self-mental health training, and reduce social discrimination against depression through the care, help, companionship, and support of patients with social depression, so that more depression patients can receive timely Diagnosis and treatment, so that the whole society has no prejudice against depression. When we get depression in the future, we will be able to get more treatment, more care, more help and company, and we can be better. To promote their own recovery.
To prevent and protect depression, we should emphasize mental health education. The public still does not understand the basic prevention and treatment knowledge of depression, so publicity and popularization, like our conference today, can help us understand depression. In addition, depression must maintain this long-term drug treatment during the recovery period, to understand when it relapses, and to deal with social psychological stress, that is, we must learn some skills, how to deal with the pressure in life, contradictions at work, If family disputes are handled properly, the risk of depression will also be reduced. Therefore, family care and communication between colleagues can also reduce the recurrence of depression.
There are also about 50% of depression patients who hurt themselves, self-harm and commit suicide, so our society needs some measures to reduce the self-harm and suicide behavior of depression patients.
At present, the public in our country still don’t understand depression, and there are many misunderstandings.
Some people think that depression is extreme sadness, not illness. Some people think that strong German power can help overcome depression. This depression has nothing to do with willpower. Anyone can get depression, from politicians, scientists, philosophers, corporate bosses, cadres, workers, and students. Depression is possible, so strong willpower will help you overcome depression. This is wrong. Depression has nothing to do with willpower.
Depression only affects the weak. This is also wrong. Whether it is the strong or the weak, many corporate bosses also suffer from depression.
There is no effective treatment for depression, which is also a misunderstanding. There are many treatments for depression, 70%-80% can be alleviated, many patients can be cured completely, and some people are cured without recurrence for life.
Depression only affects women, and men are not bothered by depression. This is also a mistake. Both men and women get depression, but women get a little more depression, and men also get depression.
There is also a misunderstanding that antidepressant drugs are the only treatment for depression. Antidepressants are one of the ways to treat depression. We have psychotherapy and other physical therapies, which are effective for depression.
There is also a misunderstanding that once you use antidepressants you will take them for life, which is also wrong. Some of us need to take medicine for life, some people do not relapse for a long time after the medicine treatment is good, the medicine can be stopped later, and 1/3 of the people can stop the medicine after the medicine treatment, without taking the medicine.
There is also a misunderstanding that depression has no physical symptoms. Depression has both mental and physical symptoms. Patients with depression have many physical symptoms, from the digestive tract, heart, head, and body to physical symptoms. These physical symptoms are also very painful.
There is also a misunderstanding that if your parents and close relatives suffer from depression, you will also inherit depression. This is not necessarily true. Some parents have depression. Children may have a good environment, cope well and prevent common sense of life with depression. He may not be depressed, so children with parents who have depression may have depression. Symptoms may also be healthy, not depression.
There is also a misunderstanding that children and adolescents do not suffer from depression. Some people say that you are young, why are you worried and why are you depressed? This has nothing to do with young people and teenagers. Anyone can get depression. Therefore, children and adolescents are also high-risk groups of depression, as young as junior high school students and elementary school students are likely to get depression. Therefore, if we adults cannot see that children have depression, we just say why you are so young. You should not worry about it, and you should not be depressed. This is wrong. Yes, children and adolescents are also high-risk groups of depression, especially now that children and adolescents mature earlier, so the incidence of depression is also very high.
So we have to eliminate “stigma” and get rid of “stigma”, so that more depression can be respected, treated, and recovered. Our society is more tolerant of depression. Every depression can be treated and recovered in time, and the number of patients with depression in the society will be reduced. The entire society is a civilized society and a positive society. It is very important for patients with depression to get treatment in time, so societyThe public’s stigmatization of depression, the inability to understand patients, and the belief that patients with depression are hypocritical, this will increase the stigma of patients, and the increase in stigma. Many depressed patients do not admit that they have depression, so they will Can not get timely treatment and rehabilitation.
There are still some patients who have given up treatment because of stigma after being treated. This is also problematic. Therefore, the entire society must form an atmosphere of understanding, respect, care, companionship, and support for patients with depression. The entire society must understand the knowledge of depression, the symptoms of depression, its treatment and rehabilitation programs, and some depression It shows that only in this way can the entire society be a modern and civilized society. The tolerance, acceptance and care for depression is also the tolerance, care and acceptance for ourselves and each of us, so that our society is full of hope.
Cai Sanjun: Colorectal cancer is preventable and curable
Hello friends, I am Dr. Cai Sanjun from Fudan University Cancer Hospital. I am very happy to share with you my topic today: Colorectal cancer is preventable and curable.
A happy and happy life requires physical and mental health, and physical health is the foundation of mental health. Let’s look at such a happy family for three generations, under such lights, in food, and in a beautiful environment. To enjoy a good life, good health is a very important foundation, so we are very concerned about good health. What is the most serious cause of death in China? In the 1950s, respiratory diseases, infectious system diseases and tuberculosis, such infectious and infectious diseases accounted for the first, second and third causes of death; and by the 1970s At that time, cerebrovascular diseases, heart diseases, and malignant tumors became the first to three causes of death; in the 1990s, malignant tumors replaced other diseases and became the first cause of death. Tumor is a very important first cause of death for us at present, and it must arouse our attention.
The 2012 global cancer status report tells us that there were 12.7 million new cases (cancer cases) in 2018 and 14.1 million in 2012, and it is predicted that by 2025, the number of new cases will reach 19.3 million, nearly 20 million New cases, among all malignant tumors, lung cancer is the first, breast cancer is the second, and colorectal cancer is the third, accounting for 10% of all malignant tumors.
New data in 2018 tells us that lung cancer, breast cancer, and colorectal cancer are still the top three malignant tumors, while colorectal cancer has become the second cause of death, and lung cancer is the first. We know that the treatment effect of breast cancer is very good, so its deaths are not as many as those of colorectal cancer.
The latest China National Cancer Center released data on the incidence of tumors, reporting the situation in 2018. There were 3.93 million new-born patients with malignant tumors across the country. This is a very large number, with an average of one person every 7.5 minutes. With cancer, 10,000 people will develop malignant tumors every day, and more than 30% of us Chinese will develop malignant tumors in their lives, so this is a serious situation.
In all malignant tumors in China, lung cancer is the first, gastric cancer is the second, and colorectal cancer is the third. Such a data also tells us that lung cancer, gastric cancer, and breast cancer account for more than 50% of all malignant tumors and are the three most serious tumors.
So why are malignant tumors in China so high? I think there are four reasons.
The first is that our life expectancy has been greatly improved. Just like the longer a car is driven, the possible damage or breakdown will increase. In Shanghai (the 1950s), the life expectancy of the population was 47 years old, and by 2018, the life expectancy has reached 81.3 years, so various diseases will inevitably occur in such a process.
Secondly, our lifestyle has changed. Our diet has undergone great changes. From eating mainly vegetarian dishes to mainly eating meat dishes, we have reduced exercise and increased obesity.
The third is environmental pollution. Our food pollution, water pollution, and air pollution have severely affected our lives and our health.
The fourth point is the perfection of the detection equipment, so that all of our malignant tumors can be diagnosed. In the past, there was not so much money, not so good equipment, and not so many equipment can be diagnosed.
What is the current status of malignant tumor treatment in China? The relative survival rate of malignant tumors in our country is 40.5%. This is the latest national statistics.The period reached 66%, which is 26% higher than ours. This is a huge gap.
So why is the malignant tumor (survival rate) so poor in China? We concluded that there are two reasons.
First, the malignant tumors we have developed are different from those in the United States. We mainly focus on (prognostic) cancers with poor prognosis such as lung cancer, esophageal cancer, liver cancer, and pancreatic cancer, while the higher incidence in Europe and the United States is (prognosis) of prostate cancer, breast cancer, and thyroid cancer. Lord, so this created a gap.
The second reason is that our diagnosis and treatment are not standardized enough. The five-year survival rate of each of our tumors is very far from that of European and American countries.
The third is that the proportion of our early disease is relatively small. Take colorectal cancer as an example. The first-stage bowel cancer in China accounts for only 10%, while the first-stage bowel cancer in the United States accounts for 25% to 30%, so the treatment effect of first-stage bowel cancer is very good. So this is the reason for our gap.
Let’s talk about the Shanghai example again. Its data is very accurate. In 2003, the crude incidence rate of malignant tumors was 312/100,000, but in 2015, 12 years later, its crude incidence rate The rate has increased to four hundred and ninety-seven, so it is a very large increase. The situation in China and Shanghai is similar, and the crude incidence of malignant tumors is also rapidly increasing.
I just talked about the overall situation of malignant tumors. Today, we are focusing on malignant tumors of the large intestine. In malignant tumors of the large intestine, we can see that the incidence rate of the whole world was 12.45/100,000 in the 1970s, but By 2010, the number of developed countries had reached 59.9 per 100,000, and the number of developing countries had reached 20 per 100,000. There was a significant increase, but this chart also tells us that the incidence of colorectal cancer in the United States has increased from 63.5/10 in the 1980s. Ten thousand fell to 39.1 per 100,000 in 2010, a very significant decrease, while China’s increase from 13.48 per 100,000 in the 1980s to 376,000 per 10,000, an increase of nearly three times, a significant decrease in theirs, a significant decrease in our Elevation is worth thinking about, and what we should do.
This slide tells us that it is the incidence of colorectal cancer in Shanghai. We see four lines, including colon, rectum, male and female. We see these colorectal cancers from 1973 to 2011 in the last century The sexes of men and women are increasing rapidly and obviously, this trend can be seen by everyone.
So if we summarize the above situation, we can see that the incidence of malignant tumors in our country continues to rise, and it is very obvious. In addition, the incidence of colorectal cancer that we are focusing on today is alsoIt is obviously continuing to rise. Due to the rising incidence, the treatment effect is not obvious, so our mortality rate continues to be high. At the same time, there is still a significant gap between our survival rates in developed countries in Europe and America.
Our slide shows us many vivid examples. The famous “Black Panther” actor Bosman died of colorectal cancer at the age of 43, our 38-year-old entrepreneur Wang Junyao died of colorectal cancer, and there are many famous People also die of bowel cancer, so it caused some sensation in society and reminded us that it is a malignant tumor that affects our lives when we are very young. The stage of colorectal cancer at the time of diagnosis has a great influence on our treatment effect. The 5-year survival rate for stage I bowel cancer can reach 90%, for stage 2 it can reach 80%, and for stage 3 it is around 60%. Are there many early tumors when we diagnose? As I mentioned earlier, only 10% of the first-stage bowel cancers, the rate of advanced bowel cancer is still very high. Let’s take an example. A famous gastrointestinal oncologist in Shanghai had colon cancer with liver metastasis when he was diagnosed. Although his survival time was only two years after the best treatment in China, he found that At the late stage, the best treatment is the two-year survival of the terminal patient, so if we can find out how important it is early, what a good result will be.
At present, if China compares with the international in terms of bowel cancer, we can see that China’s five-year standardized net survival rate is 54.6%, which is 53.2% for rectal cancer, and 64% for developed countries in Europe and America, which is almost exactly lower. 10%, this 10 is the gap. Of course, our country used to be lower, and we have made progress.
So faced with such a malignant tumor, can we prevent it? It would be great if it could be prevented. Let us give an international example to tell us whether it can be prevented. The occurrence and development of colorectal cancer is a long-term process from normal mucosa to hyperplastic polyps, adenomas, early cancers and advanced cancers. It may take 5 to 10 years or even longer. Such a long period of time has given us an opportunity to be able to diagnose, treat, and even detect early. We should not lose such an opportunity. In the prevention of malignant tumors, there is the concept of three-level prevention. The first level is prevention of the cause, the second level is early diagnosis, early treatment, and early detection, and the third level is standard treatment for clinical patients.
Then the value of primary and secondary prevention is very important. A chart of the incidence and death of colorectal cancer in the United States from 1975 to 2006 in the past 30 years tells us that the mortality rate and the incidence rate are significantly decreasing. , The five-year survival rate is significantly improving, so these three lines are what every doctor of colorectal cancer expects.
Why does its incidence rate decrease? Mainly due to lifeTreatment of changes and precancerous lesions. Why has its mortality rate decreased? The main reason is the increase of early disease and standardized multidisciplinary comprehensive treatment. The increase in its five-year survival rate is mainly due to the increase in early lesions and standardized multidisciplinary treatment.
The United States did a cause analysis of these three lines and found that about 35% of the results of these three lines were caused by primary prevention, and primary prevention was mainly lifestyle changes; secondary prevention of colorectal cancer The screening has played a role of more than 53 points, and more than half of the role is screening; tertiary prevention, which is the best clinical treatment, only improved by nearly 12%, so all cancer patients should consider 35 and 53 How important it is.
The facts in the United States tell us that screening and census can reduce the incidence. Therefore, colorectal cancer can be found early through screening and census during a long 5 to 10 year development process, and even reduce its incidence.
So what can we do in the second part? We see the situation in the United States. First, we can do something in primary prevention. For example, we can change our lifestyle, reduce high-protein, high-fat, refined diet, reduce pickled and smoked foods, and increase vegetables, fruits, Coarse grains, reduce smoking, excessive drinking, strengthen exercise, reduce obesity, and appropriately use drugs such as calcium, selenium, and aspirin. We can also actively promote the clinical manifestations of bowel cancer through two-level prevention, so that they can see a doctor in time. Second, actively carry out early detection of screening census. This is the most important means. Actively treat precancerous lesions to reduce the occurrence of colorectal cancer, while the best treatment at the early stage improves survival.
Foreign countries have carried out colorectal cancer screening in the last century. We have seen that developed countries such as the United States and the United Kingdom have already begun.
So the screening of colorectal cancer in Europe and the United States also chooses different screening methods according to different risks. It is impossible to use the same method for different risks, which will waste a lot of medical resources.
In 2011, in our country, Shanghai launched a colorectal cancer screening for four million target populations. At present, the first round of preliminary screening has been completed, and the screening results are still relatively good. In 2012, Tianjin launched colorectal cancer screening, Guangdong launched colorectal cancer screening in 2015, and Hong Kong launched colorectal cancer screening in 2016. These screenings were only carried out in a few large cities. It is carried out across the country, so we need to do more work.
The preliminary results of the first round of screening in Shanghai in 2013 tell us that screening can find the early incidence of colorectal cancer, which accounts for 49.1% of patients with stage I. The occurrence of precancerous lesions can sometimes find 6 precancerous lesions at the same time. Lesions, and the treatment of precancerous lesions will make us reduce the obvious colorectal cancerOnset.
There are 7 screening methods for colorectal cancer, including fecal occult blood, sigmoidoscopy, fiber colonoscopy, CT simulation colonoscopy, magnetic resonance simulation colonoscopy, stool DNA analysis, and Septin9. The latest research in the United States tells us that no research method is superior to other screening methods, as long as participating in the screening will benefit.
In exploring the strategies and methods of colorectal cancer screening, we must pay attention to its incidence, screening age, regional economic status and service capacity, so as to support us to carry out a colorectal cancer screening and benefit.
If we can prevent it, can we cure the bowel cancer? I can tell you from the slide below.
Each of our patients will undergo such a process after the diagnosis is clear, denying, “How can I get malignant tumors”, then fear and anxiety, what should I do, what should I do with my family, what should I do with my job, What to do in the future? I regret why I didn’t find out earlier, why I didn’t do better work like preventing colorectal cancer and malignant tumors, and then depressed and restless, but through the hospital, through the environment, he will gradually accept such a psychological process, and Such a process requires the help of those around us.
Improving the survival rate is mainly our clinical tertiary prevention. In the tertiary prevention, what we mainly do is to carry out standardized pre-treatment diagnosis, standardized treatment plan design, and standardized multidisciplinary Individualized treatment.
In all treatments, surgical treatment is the most important decisive method for the treatment of colorectal cancer. It can be said that 85% to 90% of the five-year survival rate of the entire colorectal cancer treatment is determined by surgery. There are also many surgical treatments. Development, including laparoscopic surgery, endoscopic surgery, and robotic surgery have played a very important role in the treatment of bowel cancer. There is a lot of help, but surgical treatment is still not enough. Medical treatment of tumors can also help. We are playing a very important role in improving survival rate, improving quality of life, and prolonging survival time, including chemical treatment. Of course, many people are afraid of chemotherapy when they talk about hair loss, nausea, vomiting, and even chemotherapy is not effective. In fact, when the doctor uses chemotherapy, it must be proven to improve your survival and improve your quality of life. In addition to chemotherapy, there are targeted drug therapy and immunotherapy in the entire internal medicine department. These two therapies are still helpful in improving the effective rate of colorectal therapy, but they are currently not doing enough to improve the survival rate.
In addition to medical treatment, there is also radiotherapy for colorectal cancer. Radiotherapy is also one of our three major treatments for malignant tumors. The treatment of advanced rectal cancer can significantly reduce local complications.Incidence rate and increase survival rate. At the same time, it can increase the local control rate in recurrent and metastatic bowel cancer, and prolong the survival and quality of life of patients.
In the entire treatment of malignant tumors, we must emphasize standardized treatment, which is to treat according to the guidelines. In colorectal cancer, there are currently the diagnosis and treatment guidelines of the Health Commission and the CSCO guidelines. Follow these guidelines to do you We can get the median level of the five-year survival rate in the world today. Simply put, we can score about 85 in the exam. Of course, we can reach the goal of 90 points with some experience and comprehensive treatment.
The second is multidisciplinary comprehensive treatment. Today, many disciplines such as surgery, internal medicine, radiotherapy, endoscopy, pathology, imaging, liver surgery, and thoracic surgery involve the treatment of colorectal cancer, so a good treatment plan must be combined Everyone’s wisdom provides the best treatment methods to ensure that patients get the best treatment results and best treatment results.
Precision treatment is a very important part that we have put forward in recent years. Precision treatment has made significant progress in lung cancer and breast cancer, but it has not done enough in bowel cancer. It can help us identify more factors, better statistics tell us what we might do to get better results, this is a dream, and the future will definitely enable us to do better.
Let’s give an example. Such a patient, 52 years old, had liver metastasis in 2002 and had colon cancer at the same time. Then we underwent liver resection and colon resection at the same time. It has been alive for 18 years now. Very good results are obtained, so if advanced tumors are treated properly, they can also achieve good survival.
Shanghai Fudan University Cancer Hospital told us that out of more than 10,000 patients undergoing operations, the total five-year survival rate reached 76%. This is a very good result, comparable to the best tumor treatment centers in the world. At the same time, if Shanghai compares with developed countries in the world, the relative survival rate of colon cancer and rectal cancer in Shanghai exceeds that of the United States. Therefore, the treatment of bowel cancer in Shanghai has approached and reached or even exceeded the level of developed countries.
Today, as long as we earnestly change our lifestyle, go to the doctor in time, actively participate in the screening census, treat precancerous lesions, standardize the treatment of clinical tumors, reduce the incidence of colorectal cancer, reduce the death of colorectal cancer, and improve the survival of colorectal cancer. possible.
Peng Baogan: Prevention and Treatment of Spondylopathy
Hello everyone, the topic of my speech today is “Prevention and Treatment of Spine Disease”.
Neck and low back pain is a disease whose incidence is second only to colds. Low back pain is the most common cause of labor loss among adults. Neck pain ranks fourth, followed by low back pain, depression, and other musculoskeletal diseases, such as bones. Arthritis and neck pain.
At any time, about 18% of people are experiencing low back pain, and about 8% of people are experiencing neck pain. What proportion is this? For example, in the normal population, 26 out of 100 people are suffering from neck and back pain.
In the United States, the medical cost of neck and low back pain costs about 100 billion U.S. dollars each year. Although there are no accurate statistics in China, our population base is much larger than that of the United States. We have 1.4 billion people, so the medical expenses should be also Quite impressive.
Let’s first look at the longitudinal structure of the spine. The human body’s longitudinal axis bones are the pillars of the body, the so-called spine bones, which have the functions of weight bearing, shock absorption, protection and sports. The spine consists of 26 vertebrae, including 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, and 1 sacral and coccyx vertebrae. It is connected by ligaments, joints and intervertebral discs. The inside of the spine forms a longitudinal tube from top to bottom. From the head, inside is the spinal cord, which sends out the sensorimotor and urinary functions of nerve roots innervating the limbs. The length of the spine is about 70-75cm for men and 66-70cm for women.
This is a normal intervertebral disc structure. In a normal intervertebral disc, there is nucleus pulposus tissue in the middle and annulus fibrosis on the outside. It has about 15 to 20 layers of lamellar fibrous structure, which contains the nucleus pulposus in the middle, and this nucleus pulposus It is a structure with glycoprotein and extremely high water content. The water content in the nucleus pulposus of infants and young children is about 90%, about 75% in adults, and only about 50% in the elderly.
The lower left is a normal lumbar intervertebral disc structure. We can see that the nucleus pulposus in the middle has a lot of water content. It is white and bright. The degenerated intervertebral disc on the right side. It is a black disc at lumbar 45. Why is it black? Because it has a low water content, it appears as a black intervertebral disc under MRI. The black intervertebral disc is a degenerated intervertebral disc. We know that a normal intervertebral disc is the largest avascular and nerveless tissue in the body, so it does not hurt. Yes, it’s like human hair. When you have a haircut, it doesn’t hurt. Your nails areIt doesn’t hurt if there are no blood vessels or nerves. A normal intervertebral disc has no blood vessels and no nerves, so it’s not painful. In a degenerated intervertebral disc, nerves and blood vessels will grow into the intervertebral disc, so it’s painful. We see the right side. Lumbago is the degeneration of the intervertebral disc and the growth of nerves and blood vessels, which will cause low back pain.
Why do more and more people feel that the spine is uncomfortable? In the past, spondylosis was considered to be a common disease among middle-aged and elderly people or manual workers. Now that people’s work and lifestyle have undergone tremendous changes, it is said that spondylosis has also begun to appear among young people. Now commuting requires driving, work requires a computer, communication and entertainment require smart phones, daily natural exercise methods have been reduced, and habits such as sedentary and long-term bowing have been developed. This has led to long-term incorrect posture of the spine, causing pathology Sexual change. Like normal spine physiological curvature changes, back muscle function strain, chronic structural damage, degenerative changes in the structure of the cervical and lumbar intervertebral discs and the ligaments connected to it lead to neck and back pain. In severe cases, numbness of hands and feet can occur, restricted movement, severe paralysis, fecal incontinence, etc., so the severity of spondylosis is still very serious.
Why are spondylosis getting younger and younger? It is determined by the following three factors.
Like occupational factors, now like computer operators, drivers, accountants, teachers, doctors, etc., the neck, chest, and back are under high load every day.
In fact, the competition in the field of education has intensified, and the educational philosophy that cannot be lost on the starting line is deeply rooted in the hearts of the people. Starting from kindergarten, educational competition has begun. Various tuition classes, extracurricular classes, and special classes have caused children or young people to experience physical overdrafts. In addition, the renewal of school desks, chairs and benches is inconsistent and unmatched with the rapid growth of young people in recent years. Poor learning posture has led to a significant increase in the incidence of neck and waist pain in students.
In addition, the education cycle has been extended. Now the university enrollment rate has been very high, and now the number of masters and doctors has been expanded, so the study time has been significantly extended, which makes the spondylopathy younger and younger.
What are the types of spondylosis?
The structure of the spine is very complicated. Any structure that is damaged may cause spondylosis, such as vertebral bodies, intervertebral discs, articular joints, tendons and ligaments, muscles, spinal cord and nerve roots. Any structural damage can lead to spondylosis. Divide the cervical spine, thoracic spine, lumbar spine, or sacrococcygeal spine according to the location of the photo. Spondylopathy can occur with any changes in the spine. According to the cause, it is divided into specific spondylosis and non-specific spondylopathy.
The so-called non-specific spondylosis is a spondylopathy of unknown cause. The cause is not clear. Just like 85% of cervical and low back pain, the cause cannot be found. It is often said that the patient suffers from low back pain.The low back pain doctors don’t know about it. Only 15% of low back pain can find the cause, and 85% can’t find the cause, so they call it non-specific spondylosis.
The most common specific spondylopathy mainly includes cervical spondylosis and lumbar spondylopathy. Cervical spondylosis is divided into nerve root type and myelopathy. The pathology and clinical manifestations are different. The nerve root type mainly manifests as numbness and pain in the upper limbs, and spinal cord. The main type is compression of the spinal cord, causing dysfunction of both lower limbs, such as unstable walking and dysfunction of stool. Lumbar spondylosis is the most common two diseases, lumbar disc herniation and lumbar spinal stenosis.
Once cervical spondylosis occurs, its clinical manifestations are diverse. What performance can it have? Such as neck pain, headache, dizziness, tinnitus, hearing loss, nausea and vomiting, numbness of hands, dysfunction of both lower limbs, unsteady walking, etc., feeling like stepping on twists, etc. The clinical manifestations are complex and diverse.
The most common symptom of cervical spondylosis is neck pain, and neck pain is accompanied by dizziness. About half of the patients, that is to say, half of the spondylopathy may have dizziness. Then this neck pain and dizziness are a kind of The reason, or coincidence? Because dizziness can be caused by various reasons, how does cervical spondylosis cause dizziness? Can it cause dizziness? We have done a multi-center prospective cohort study. We injected a small amount of anesthetic in the cervical intervertebral disc that was suspected of degeneration, which is 0.1 to 0.3 ml. The local anesthetic, this local anesthetic, can let the local nerves give it. It is prevented. If the patient’s neck no longer hurts and he is not dizzy in the future, it indicates that this intervertebral disc can not only cause neck pain, but also dizziness. For example, he is a responsible intervertebral disc. For this kind of stubborn patients, we can do an anterior cervical surgery, which removes the degenerated intervertebral disc. If his neck pain and dizziness disappear, we further prove that the intervertebral disc is the disc that caused him dizziness. After the operation, he performed histopathological examination of his intervertebral disc. We saw that there were a large number of Rufini corpuscles and upper and lower receptors growing in the intervertebral disc. The upper and lower receptors are painful nerve endings, and the Rufini corpuscles are a kind of A kind of proprioceptor, it can cause dizziness. After the Rufini body grows into the intervertebral disc, the intervertebral disc and his inflammatory response will cause the Rufini body to emit a large number of nerve impulses, which are transmitted to the vestibular nucleus. , And then cause dizziness. You see, the Rufini body is the kind of structure we see at the bottom right.
Then we know that cervical spondylosis is one of the ten most common diseases in humans, such as high blood pressure and heart disease, which belong to the top ten common diseases.
Its main pathological feature is the degeneration of the intervertebral disc. Previous studies have suggested that how does cervical spondylosis cause vertigo? It is believed that the sympathetic nerves distributed around the cervical spine are stimulated, causing the vertebral artery to contract, leading to insufficient blood supply to the cerebellum. Current research foundIt is not like this. It is because the Rufini corpuscles grow into the degenerated intervertebral disc and send out abnormal signals to cause vertigo. We named this Rufini corpuscles phantom receptor. why? Because this receptor grows into the human intervertebral disc, people will feel dizzy, tinnitus, palpitation, shortness of breath, and unstable walking, just like a ghost possessed, so we call it ghost receptor, which is called ghost receptor.
This is our summary. How does cervical disc degeneration cause vertigo? The degeneration of the intervertebral disc produces an inflammatory response. The Rufini corpuscle grows in and produces a large number of abnormal proprioception, which is transmitted to the vestibular nucleus and mismatched with vision and vestibular sensation, which causes the occurrence of vertigo.
Specific spondylosis mainly includes trauma, tumor, infection and spinal degeneration. Everyone knows that trauma is like a height fall or a car accident, which causes compression fractures, burst fractures, or fractures and dislocations of the spine. Tumors include primary tumors, metastatic tumors, and multiple myeloma. Most of the tumors that occur in the spine are metastatic, so they have metastasized from other organs, so they need to be checked. The most common infections are spinal tuberculosis and brucella infections, and they are not uncommon now, mainly in pastoral areas. People who have contact with cattle and sheep are more common, as well as common purulent infections. Degenerative diseases of the spine are specific diseases of the spine, which include cervical spondylosis, lumbar spondylosis or thoracic spondylosis.
The treatment of cervical spondylosis, regardless of any disease, we must first be conservative treatment. If conservative treatment fails, we will consider surgery. For a patient like this, he is a high-risk cervical 34 disc herniated and compressed her cervical spine. This patient has no conservative treatment. So we performed an anterior cervical surgery and removed the herniated disc. This symptom quickly Disappeared.
Lumbar disc herniation is caused by the rupture of the annulus fibrosus. The nucleus pulposus in the middle protrudes through the rupture of the annulus fibrosus, compressing the nerves and causing pain and numbness in the lower limbs. This is called disc herniation. Most of the lumbar intervertebral discs Protrusion does not require surgical treatment. It can be relieved or cured by conservative treatment. However, a small number of patients whose long-term conservative treatment is ineffective will have a great impact on the quality of life of patients. In this way, we can consider surgical treatment. Including simple discectomy or lumbar fusion surgery, which is an imaging treatment of lumbar fusion surgery.
The treatment of non-specific spondylosis is mainly the treatment of cervical and low back pain, mainly conservative treatment. Like restricting his activities, by wearing a neck brace or waist circumference, restricting the movement of the cervical spine or lumbar spine; drug treatments include anti-inflammatory and painkillers and muscle relaxants; physical therapy includes physical therapy and massage therapy; traditional Chinese medicine treatments are also effective, such as acupuncture and small Acupotomy also has a good effect.
This exercise of back muscle function is very important. Can be added after the pain is relievedThe most common functional exercises for strengthening the back muscles are “five-point support” and “yanfei”, and five-point support is easy for anyone to do.
Let’s briefly introduce the treatment of non-specific low back pain, which also follows three plans, conservative treatment, minimally invasive surgery, and open surgery. It is possible that any patient with low back pain can be cured by conservative treatment, and some minimally invasive treatment can be done for patients whose conservative treatment fails. This is our first application of umbilical cord stem cell transplantation to treat chronic low back pain. This is also the first internationally. After we inject umbilical cord mesenchymal stem cells into the degenerated intervertebral disc, we hope that this method can regenerate the degenerated intervertebral disc and eliminate the symptoms of low back pain. This effect seems to be relatively good and promising.
Methylene blue injection to treat chronic low back pain is a method invented by our team. We saw that this was a patient with chronic low back pain. The lumbar 5D intervertebral disc turned black. After we injected methylene blue into the intervertebral disc, the patient’s low back pain disappeared. So this treatment method is very simple and very effective. What is the principle? Because methylene blue can inactivate nerve endings and inhibit inflammation at the same time, the painful intervertebral disc we introduced earlier is mainly because the nerve endings grow into the intervertebral disc before it can be painful. After we inject it with methylene blue, The nerves that grew into the intervertebral disc were disintegrated and inactivated, and the back pain disappeared.
Patients who have failed conservative treatment will be treated with lumbar spine surgery. Lumbar spine surgery usually has two methods. One is lumbar fusion surgery. This is a typical case. This is a 30-year-old man, an Italian businessman. His lumbar 45 and 5D disc mutations, low back pain for more than 5 years, seriously affected his life and work. After he found me, I gave him an intervertebral discography and performed lumbar fusion surgery for him. This patient has been followed up for 15 years. Over years, the effect is very good, and there is no recurrence to this day.
This is the treatment of chronic low back pain through artificial lumbar disc replacement, because he can’t move after lumbar fusion, and after this artificial disc is replaced, the lumbar spine can be maintained. This scheme is theoretically better. But there is no universal application of this technology in the world, but this technology is still worth using.
How to prevent and cure spondylosis once you have it? In daily life, we must pay attention to improving our lifestyle. Home care includes increasing neck and back muscle exercises, paying attention to sleeping posture, avoiding pillows or no pillows; work management is for long-term desk workers, pay attention to posture, pay attention to the computer screen and sight Keep consistent or slightly elevated; strengthen exercise and proper dietary conditioning can prevent the aggravation of spondylosis.
How to prevent degenerative spinal diseases? Mainly to change bad work and living habits, try to avoid bed restWhen reading books, watching TV, playing with mobile phones, and when using electronic products daily, keep your eyes on the screen or look up at 5-10 degrees, take a break for about an hour, avoid long-term work with your head down, and avoid high or no pillows during sleep to avoid wind and cold It is humid, avoid too cold in summer, avoid direct blowing of electric fans, and pay attention to trauma. Because there are too many people driving now, there are many car accidents, so it is like whiplashing to protect the cervical spine and prevent hyperextension injuries. damage.
Pay attention to the health of the spine of young people to prevent the rejuvenation of spondylopathy.
Ge Junbo: Have a healthy heart and enjoy a good life
Hello, friends at the scene, today I take this opportunity to share with you a topic of common concern, cardiovascular disease. The topic I shared with you today is “Having a healthy heart and enjoying a good life”, let me talk about it The harm caused by coronary heart disease to humans, and how we can prevent it and the treatment we currently take.
I will share with you through three topics, one is the importance of the heart to health. Second, the common diseases of the heart and the current epidemiology, and one more, how do we have a healthy heart.
According to our China Cardiovascular Disease Report, we know that for every two people who die, nearly one person is caused by cardiovascular diseases, including cardiovascular and cerebrovascular diseases. One out of every four people who die is a tumor. Let’s take a look at the current epidemiology of cardiovascular disease. The most deadly cardiovascular disease is currently coronary heart disease, atherosclerosis-based diseases, and hypertension. These three people on the screen are familiar to everyone, especially for the older generation of audiences. One is the British Prime Minister at the time, Churchill, the other is the then U.S. President Roosevelt, and the other is the Soviet Union’s Supreme Commander Stalin. These three people were at the Yalta Conference in 1945. The pictures left show the three giants who reversed the world at the end of World War II. All three died of strokes.
This is the blood pressure of President Roosevelt at the time.In 1941, his systolic blood pressure reached 160 and 170 mmHg, and his diastolic blood pressure exceeded 100 mmHg. At the end of 1944 was their presidential election, when his systolic blood pressure reached 200 and his diastolic blood pressure reached one. hundred. In April 1945, also on April 12, 1945, the diastolic blood pressure reached 200 and the systolic blood pressure reached more than 300. At the beginning, we thought that the blood pressure increased because of your heavy work and heavy workload. The blood pressure may rise more.
On the night of April 12, 1945, his blood pressure reached 300, his systolic blood pressure, and his diastolic blood pressure reached 200. That night he suffered a stroke due to cerebral hemorrhage and died, so in 1945, In the newspaper on the 13th, his doctor said, “The president has seen God.”
In this case, why do we know that high blood pressure is a risk factor these years? After the 1960s, there was a very important observational study in the United States. We called the Franklin Heart Study. After this study was over, it was discovered that hypertension is a very important risk factor for cardiovascular and cerebrovascular diseases. Medicine basically divides a person into systems, respiratory system, digestive system, circulatory system, blood system, and so on. We then divide the system into organs. The respiratory system is divided into bronchus, trachea, and lungs. The organs are divided into tissues and cells. One Point by point to point down, where a person feels uncomfortable, go to the doctor to find related diseases, such as headaches for the head, feet pains for the feet, so there is a problem of headaches and feet.
In the past few years, cardiovascular disease has exploded. We just released the report on cardiovascular disease in China. The number of patients with cardiovascular disease in China reached 330 million. This is a huge number, more than the number released in 2019. Out of 40 million people, what is the reason for the explosive increase in cardiovascular disease? We have not controlled the source of the disease well in the past few years, and we have not done a good job in prevention. You treat one person as a whole. The occurrence of these diseases is the past few years. Unhealthy lifestyle, hypercholesterolemia, obesity, and obesity-induced diabetes, smoking, and hypertension are the four main risk factors. There are other factors such as genetic factors or gender that also play a role.
We treat people as a whole, which is actually a vascular disease. We emphasize the concept of pan-vascular disease in our profession, or pan-vascular disease. It is a disease dominated by atherosclerosis, which occurs in different Organs, occurred in the brain, stroke occurred, occurred in the heart, myocardial infarction occurred, occurred in peripheral blood vessels, vascular occlusion and amputation, etc., this slide shows that vascular diseases occur in different places, some people at the same time There are two diseases, coronary heart disease at the same time as stroke, and peripheral vascular disease at the same time. We should treatPeople are viewed as a whole, rather than a headache and a foot pain.
This slide shows our situation from normal to abnormal. On the far left, when we were just born, there were normal blood vessels, normal blood vessels intima, media, and adventitia. As we were exposed to some external risk factors, some people smoked. Including second-hand smoking, inactivity, increased blood pressure, too much nutrition leads to hyperlipidemia, hyperglycemia, etc., this blood vessel will have plaque, which will lead to narrowing of the lumen and cause the ischemia of all organs. Organ ischemia, once the plaque ruptures, it leads to thrombosis, cerebral infarction, myocardial infarction and so on.
In the process of cardiovascular disease prevention, we have been emphasizing these concepts over the years. I summarized them as ABCDE. These letters, A stands for antiplatelet, representative is the drug aspirin, stands for A. B stands for blood pressure control, Blood Pressure Control, we call Beta Blocker this beta blocker, C stands for Cigarette Quitting and Cholesterol Control, which are smoking cessation and cholesterol control, D has two, which means that Diet is healthy We call diet diet, and Diabetes Control diabetes control, E also represents two words, one is Exercise, and the other is Education, so that ordinary people can grasp the risk factors of cardiovascular disease and the usual preventive measures.
You can leave this slide show. The left side represents the systolic blood pressure of the heart, and the right represents the diastolic blood pressure. This represents different ages, from 50 to 59, 60-69, 70-79, 80-89 Age, as blood pressure rises, whether it is systolic pressure, diastolic blood pressure, blood pressure, the occurrence of stroke increases linearly, in a linear relationship, so lowering blood pressure and preventing and treating stroke play a very important role. It is World Hypertension Day. On Hypertension Day, many doctors may take to the streets to promote and conduct academic exchanges, telling people how to lower blood pressure, how to take medicine, how to measure, and monitor blood pressure.
Today is talking about heart disease. Let’s first get to know the heart.
Everyone feel your own pulse. Our heart beats 80,000 to 120,000 times a day 24 hours a day, an average of 100,000 times. We know that Monkey King has turned a somersault cloud for hundreds of thousands of miles. I have been thinking that writers write novels. How can we get one hundred and eight thousand miles at the time, instead of one hundred and nine thousand miles? If a person’s heart beats 75 times per minute, 24 hours a day, that’s one hundred and eighty thousand times. If the heart beats one hundred and eight thousand times a day, if a person’s age is 80 years old, our heart beats almost 3.2 billion times in our lifetime. Looks like,At this time, too many or too little jumps may cause problems.
This picture is a picture of a heart for everyone. The picture above is viewed from the front, and the lower part is cut. The heart is equivalent to a human pump. This pump pumps blood out of the brain, kidneys, and any The organs of the whole body, this blood is pumped from the left ventricle through the aorta to the whole body, through the venous system, back to the right atrium (atrium), through the right ventricle, and then pumped into the lungs, oxygenated in the lungs, and we breathe in the fresh air The blood oxygen exchange is performed in the lungs, and the fresh blood returns to the left atrium to the left ventricle to circulate again. This is the normal circulatory system of our machine.
If our heart has a problem, there is a problem, where is the problem? Let’s explain in normal words. The heart has a circuit and an oil circuit. What is a circuit? The heart, everyone, as long as this person is still alive, he sends an impulse to the second-level organ atrioventricular through the central organ of the heart called the sinoatrial node. How do we monitor the activity of the heart? A Dutch doctor invented one more than 100 years ago. The examination method is called electrocardiogram. We people go to the hospital and the doctor will see how your heart is. The first one is to do an electrocardiogram. In the upper left corner of the electrocardiogram, we see an image, the first is called P wave, the second is called QS wave, and the second is called QS wave. There is a problem with this circuit. It jumps too fast or too slow or jumps randomly. If there are clinical problems, corresponding treatment should be carried out.
The other is the oil circuit. How do the oil circuits compare? There are three blood vessels in our heart. We are called coronary arteries. Any one of the blood vessels that has a lumen stenosis or a blockage will cause myocardial ischemia. After the oil circuit is broken, the oil can’t get in, and the machine can’t run, so the oil circuit is broken. It means myocardial ischemia and coronary heart disease. And the structure of the heart itself is broken, the valve of the heart is broken, or the myocardium itself, or where it was born, is underdeveloped, that is, some congenital heart diseases, we call it structural heart disease, any place is abnormal Can cause clinical symptoms.
How to check? At the end of the last century, a doctor in Germany invented a technique called X-ray technology. It is still being used clinically and has been improved. This is a chest X-ray image. We can see the shadows of our ribs, lungs, and heart. Through this shadow expert, we can judge the left heart, right heart, pulmonary artery dilation, aortic tortuosity, etc., and get some preliminary images.
According to X-rays, CT, computed tomography, combined with angiography, and angiography have been invented on this basis over the years, all of which are contributions from X-rays. The electrocardiogram itself is a vector diagram of the heart, which projects the electrical activity of the heart, so when we do an electrocardiogram, we need to do a lot of leads, 12-lead electrocardiogram, put the electrodes in different places, we are like a flashlight, shining on The electricity of the heart is on different walls