Xinhua News Agency, Changchun, January 29th Since the winter vacation, many places in Changchun and Shenyang have opened ice and snow custodians. Schools have built ice rinks and snow fields on campus, hired professional coaches, and provided all kinds of ice and snow sports courses for primary and secondary school students, so that students can enjoy ice and snow on campus during the winter vacation and welcome the Winter Olympics.

　　In the cold winter, in the 2,400-square-meter ice rink of Pingquan Primary School in Nanguan District, Changchun City, the students learned from the skating coach in full swing.

　　Students in the primary school of Changchun No.104 Middle School are learning to skate. Xinhua News Agency reporter dorri photo

　　Song Haoxuan, a student in Class Two, Grade Five, Changchun No.104 Middle School, is learning skating for the first time. After three days, he has mastered the basic movements and can stand and walk on the ice. "Before the holiday, the class teacher said that there was ice and snow custody during the holiday, so I signed up. In the past, I could only do my homework at home during the holidays. It is so interesting to learn skating this time. " Song Yuxuan said.

　　At the scene, the reporter saw that a shoe changing room was built around the skating rink, in which all the skating equipment was prepared for students, and each school was accompanied by leading teachers to ensure the safety of students.

　　Sun Jingru, director of the Department of Physical Education, Sports, Arts and Health, Nanguan District Education Bureau, Changchun City, said that in order to create conditions for students to participate in ice and snow sports, Nanguan District Education Bureau poured an ice rink in Pingquan Primary School. Students in grades 4-8 of primary and secondary schools in the whole district took advantage of the winter vacation to participate in ice and snow custody for a total of 30 days, with about 600 participants every day. The total number of participants in the winter vacation is expected to be 18,000. The Education Bureau also hired seven professional coaches to guide students’ ice skills, so that students can master the basic skating movements and experience the fun of skating in a short period of time.

　　Shoe changing room of Pingquan Primary School in Nanguan District, Changchun City. Xinhua News Agency reporter dorri photo

　　In addition, other counties and cities in Changchun also provide various forms of ice and snow amusement activities for primary and secondary schools. Yushu city City, Jilin Province has poured 26 outdoor ice rinks in primary and secondary schools in towns and villages, and equipped students with PE teachers and skating equipment. Up to now, more than 10,000 people have participated in ice and snow custody.

　　In the ninth primary school in Hunnan District, Shenyang City, Liaoning Province, ice and snow activities are another lively scene. The school’s snow machine makes snowflakes fly, and it is fun to have snowball fights, make snowmen and snowball. Two large indoor ski machines allow students to ski at zero distance, and more than 700 students who participate in the trusteeship can enjoy the fun of flying in the snow.

　　Hou Mingfei, principal of the Ninth Primary School in Hunnan District, Shenyang, said that compared with summer classes, the school’s winter vacation trusteeship has increased the single and double snowboarding projects, and students can take skiing classes on campus.

　　On the 120-square-meter indoor simulated ice rink of Heping Street No.1 Primary School in Heping District, Shenyang, the children were dressed in ice hockey equipment, and the teacher explained the technical points and basic sliding movements for the students. The slightly childish movements of the students added vitality and vitality to the winter campus.

　　The school organized a winter vacation hosting service with the theme of "Harmony, Colorful Winter Holidays", and 80 students from different grades signed up to participate. The trusteeship classes were named "Bingdundun" class and "Snow Rongrong" class, and activities such as learning to sing winter Olympic songs and ice hockey experience were also carried out to cultivate students’ interest and skills in ice and snow sports.

　　Students in the primary school of Changchun No.104 Middle School learn skating. Xinhua News Agency reporter dorri photo

　　This school is a characteristic school of ice and snow sports on the national youth campus. Lin Yuheng, the director of teaching, said that ice hockey training in schools usually involves members of the school team, and not all students can master skills such as ice hockey and speed skating. There is plenty of hosting time in winter vacation, and for more than 80 students who participate, they can do no less than two hours of sports every day.

　　In recent years, Shenyang has incorporated ice and snow projects into the teaching content of primary and secondary schools, and carried out ice and snow sports through physical education courses and comprehensive practical activities courses, and achieved remarkable results. Twenty-seven schools in the city were rated as "National Youth Campus Ice and Snow Sports Characteristic Schools" by the Ministry of Education, and 55 schools were named as municipal ice and snow characteristic schools. At present, more than 30% primary and middle school students in the city have mastered the basic skills of ice and snow. (Reporter: Li Shuangxi, dorri, Wang Ying, Wu Jiangmin)

Renal artery denervation (RDN) is a hot topic in the field of hypertension in recent years. Although it has not been widely used in clinic, with the release of various clinical data, more and more industries focus on RDN.

RDN targets the sympathetic nervous system, which does play a role in raising blood pressure. Therefore, RDN selectively reverses a mechanism of hypertension. But hypertension is a multifactorial disease. Is it really enough to target a single pathogenic mechanism to produce effective and sustained blood pressure reduction in a large number of hypertensive patients? Yixin specially interviewed the vice president of Hebei Provincial People’s Hospital.Professor Guo Yifang, shared his views on the future prospects of RDN.

　 One more proof of RDN’s long-term effect 　

Recently, the three-year research results of RADIANCE-HTN SOLO test were published, which confirmed that the safety and effectiveness of ultrasonic RDN lasted for 36 months.

Patients with ambulatory blood pressure ≥135/85 mmHg and < 170/105 mmHg after 4 weeks of stopping antihypertensive drugs were randomly divided into ultrasound RDN group or sham operation group. The results of 36-month follow-up showed that the systolic blood pressure and diastolic blood pressure in RDN group decreased by 17.7 mmHg and 11.3 mmHg respectively compared with baseline. In terms of safety, there were no adverse events related to equipment or operation during the follow-up period.

In response to this research result, Professor Guo Yifang pointed out that in recent years, the effectiveness and safety of RDN has been an important topic in the field of hypertension treatment, which has attracted extensive attention from scholars at home and abroad.Radiation-HTN solo research provides valuable new evidence for the instrument treatment of hypertension. However, Professor Guo is cautiously optimistic about the results of this study, considering the differences in the conclusions of several RDN studies published in recent years and the limitations of this study itself..

　 The evidence-based road of RDN 　

The basic principle of RDN is to block the afferent and efferent activities of sympathetic nerve around renal artery by radio frequency energy, ultrasonic energy or injecting heat into perivascular space, and reduce the influence of sympathetic nervous system on renal vascular resistance, renin release and sodium reabsorption. RDN blocks the signal conduction between the brain and sympathetic nerve to a certain extent, thus reducing the sympathetic nerve excitability of patients with hypertension. Theoretically, it can achieve long-term antihypertensive effect through a minimally invasive operation.

As early as 2009 and 2010, RDN completed two early clinical trials in Europe and Australia, namely Symplicity HTN-1 and HTN-2. The results of 3-year follow-up showed that the average systolic blood pressure and diastolic blood pressure of refractory hypertensive patients receiving RDN decreased by about 30 mmHg and 14 mmHg respectively, and there were no obvious adverse reactions and complications. More importantly, after three years of follow-up, these patients found no obvious signs of blood pressure rebound.

Because this is the first minimally invasive surgical technique that has been proved in history and can definitely lower patients’ blood pressure, RDN shines brilliantly after the above exploratory experiment, but the well-known sham-operated control experiment-Symplicity HTN-3 did not get positive results, which weakened people’s enthusiasm for RDN: although the research proved its safety, it did not significantly lower blood pressure compared with the control group.

On the basis of summarizing the research experience and lessons of SYMPLICITY HTN-3, the researchers subsequently carried out a new generation of randomized controlled trials, such as SPYRAL HTN-OFF MED, SPYRAL HTN-ON MED, SPYRAL HTN-OFF, etc. These studies used different techniques and methods to ablate the renal artery sympathetic nerve. The results showed that the ambulatory blood pressure and clinic blood pressure in RDN group decreased clinically regardless of whether antihypertensive drugs were used or not.

Clinical research course of RDN

(Source: Nat Rev Cardiol. 2020 Oct; 17(10):614-628. ）

In different studies, compared with sham operation group, systolic blood pressure in RDN group decreased.

The REQUIRE study aims to evaluate the effectiveness and safety of ultrasound renal artery ablation system in controlling blood pressure in patients with refractory hypertension. 143 patients with refractory hypertension (office blood pressure ≥150/90 mmHg and 24-hour SBP≥140 mmHg) were randomly assigned to RDN or sham operation group. Three months after operation, there was no significant difference in the 24-hour ambulatory systolic blood pressure between the RDN group (-6.6 mmHg) and the sham operation group (-6.5 mmHg) (P=0.971). The difference of SBP between family self-measured blood pressure and clinic blood pressure was -1.8 mmHg(P=0.488) and -2.0 mmHg(P=0.511) respectively, and there was no difference. There was no significant difference in drug load between the two groups. No major adverse events related to the operation were found.

At the EuroPCR annual meeting in 2022, a number of research data of RDN were published: Global Symplicity Registry, SPYRAL HTN-ON MED, Radiation HTN Solo & Trio, which further confirmed the potential of RDN as an adjuvant therapy for hypertension, supplemented the existing first-line therapy, and thus changed the lifestyle and drug treatment.

　 Professor Guo Yifang: RDN can be expected in the future 　

The occurrence of hypertension is a complex process, involving many mechanisms, and it is not expected to solve all patients’ problems through one drug or technology. RDN only blocks renal sympathetic innervation, and may have no therapeutic effect on other mechanisms that cause and maintain hypertension. Moreover, the antihypertensive effect of RDN is moderate, which is only equivalent to taking an antihypertensive drug.

Professor Guo Yifang talked about the future prospect of RDN. He pointed out that RDN is still in the stage of research and exploration, and it can not be used as a mature treatment technology in clinical practice. From the pathophysiological mechanism, the sympathetic nervous system plays an important role in the occurrence and maintenance of hypertension, so in theory, RDN will definitely have an ideal effect on some hypertensive patients. butThe pathophysiological mechanism of hypertension in different patients is inconsistent, the renal artery structure in different patients is obviously inconsistent, the principle of different types of RDN technology and equipment is inconsistent, and the experience and technical level of different operators are inconsistent. These four "inconsistencies" will inevitably affect the effectiveness and safety of RDN treatment and its application value and clinical status in antihypertensive treatment..

On the whole,For patients whose blood pressure can’t be satisfactorily controlled after lifestyle intervention and adequate treatment with various antihypertensive drugs, patients with obvious sympathetic hyperactivity, or patients who can’t tolerate antihypertensive drugs, it is reasonable to carry out RDN treatment in mature medical centers.. It is believed that RDN will play a more important role in the field of hypertension treatment in the future with the progress of related technologies and the continuous improvement of treatment equipment.

Expert introduction

　

Guo yifang

People’s Hospital of Hebei Province

Chief physician/professor, doctoral tutor, currently vice president of Hebei Provincial People’s Hospital. He is also the vice chairman of the Hypertension Committee of Chinese Medical Doctor Association, the vice chairman of China Society Hypertension Branch, the executive director of China Hypertension Alliance, the chairman of the Geriatrics Branch of Hebei Medical Association, the chairman of the Hypertension Professional Physician Branch of Hebei Medical Association, and the chairman of the Medical Engineering Branch of Hebei Medical Association. And the editorial boards of Chinese Journal of Internal Medicine, Chinese Journal of Geriatrics, chinese journal of cardiology and Chinese Journal of General Practitioners, and the standing editorial boards of Chinese Journal of Hypertension and chinese journal of cardiovascular medicine. Enjoy the special allowance of the State Council.

references

1. David E. Kandzari, Raymond R. Townsend, George Bakris, et al. Renal denervation in hypertension patients: Proceedings from an expert consensus roundtable cosponsored by SCAI and NKF. Catheter Cardiovasc Interv. 03 August 2021.　

2 "China cardiovascular medical device industry innovation white paper 2021"

3. Nat Rev Cardiol. 2020 Oct; 17(10):614-628.

4. C. Venkata S. Ram. Renal Denervation Therapy for Hypertension: All That Glitters Is Not Gold. Medscape. https://www.medscape.com/viewarticle/976670_1

5. Ultrasound renal denervation meets primary efficacy endpoint in RADIANCE II study. Cardiovascularnews. 26th July 2022.

6. Florian Rader, Ajay J. Kirtane, Yale Wang, et al. Durability of blood pressure reduction after ultrasound renal denervation: three-year follow-up of the treatment arm of the randomised RADIANCE-HTN SOLO trial. DOI: 10.4244/EIJ-D-22-00305

Typesetting: Yixin Editorial Department

Guangdong, a place easy to get angry.

For Cantonese people,

If you have a nosebleed

Nine times out of ten, it is getting angry.

Especially now when the weather is dry and things are dry.

Cantonese will remind you to drink herbal tea at once.

If there is a long-term nosebleed,

And it’s when there’s blood in the tears

We are about to start to be vigilant.

This could beGuangdong cancer!

nasal pharyngeal cancerIt is a malignant tumor located in the nasopharynx, also known asGuangdong cancerAccording to the statistics of the World Health Organization, there are80%Nasopharyngeal carcinoma (NPC) occurred in China, especially in Guangdong. The cancer detection data of our province released by Guangdong Provincial Center for Disease Control and Prevention in 2019 shows that at present, nasopharyngeal carcinoma ranks eighth among residents in Guangdong Province, with an incidence rate of 14.84/100,000.Far higher than the national average.

Speaking of nasopharyngeal carcinoma,

I have to mention

Epstein-Barr virus closely related to nasopharyngeal carcinoma

"Reasonable Inspection" Series No.twenty-eightperiod

Let’s have a chat.

Nasopharyngeal carcinoma and EB virus

epstein barr virus

"Good friend" of nasopharyngeal carcinoma, EB virus

Epstein-Barr virus is considered to be the strongest pathogenic factor of nasopharyngeal carcinoma at present. Epstein-Barr virus (EB virus) is one of the most widely infected herpes viruses. It is highly contagious and can be spread through droplets, kissing, sharing tableware and other behaviors, as well as through blood and semen during sexual contact, blood transfusion and organ transplantation. Epstein-Barr virus infection is very common in normal people. It is reported that more than 90% people have been infected with Epstein-Barr virus, and once infected, the antibody of Epstein-Barr virus will be carried for life.

Note: Autumn is the high incidence period of EB virus infection, so try to avoid going to crowded places to avoid cross-infection. Wear a mask when going out and take protective measures.

Then the problem is coming.

EB virus positive = nasopharyngeal carcinoma?

Epstein-Barr virus detection usually includes early antigen IgA antibody detection of Epstein-Barr virus, Rta-IgG detection of Epstein-Barr virus, and qualitative detection of Epstein-Barr virus DNA.

When EB virus antibody is positive, nasopharyngeal carcinoma can not be diagnosed. More than 90% of adults have been infected with EB virus, and only about 3%-10% of people with EB virus antibody positive will turn into nasopharyngeal carcinoma patients, indicating that the occurrence of tumors is not caused by EB virus alone, but by genetic and environmental factors.

(Source: Healthy Guangdong)

Don’t panic when you find EB virus positive in physical examination. Consult your doctor as soon as possible. The doctor can judge whether you are a high-risk patient by asking about your place of origin, family history, living habits and whether you have symptoms. According to the doctor’s advice, you may have an imaging examination for further confirmation. The 5-year survival rate of early nasopharyngeal carcinoma can reach 97%, so early detection is very important!

Epstein-Barr virus is indeed closely related to nasopharyngeal carcinoma. Accurately speaking, Epstein-Barr virus is a related substance of nasopharyngeal carcinoma, not a marker of nasopharyngeal carcinoma.

epstein barr virus

If you have the following symptoms, you should be alert to nasopharyngeal carcinoma.

VCA-lgA titer ≥ 1: 80;

All the EB virus indexes were positive;

Check the EB virus index, any one continues to rise.

When EB virus is positive, nasal congestion occurs; Reflux nasal discharge with blood; Vision loss and ghosting; Cervical lymph node enlargement; Ear buzzing and hearing loss; Headache; Facial numbness, etc., need more attention.

(Source: Healthy Guangdong)

epstein barr virus

What are the high risk factors for nasopharyngeal carcinoma?

At present, the pathogenic factors of nasopharyngeal carcinoma are not clear, except EB virus infection, which may be related to genetic factors, environmental factors, dietary factors and other factors.

01

Gender:

Nasopharyngeal carcinoma is more common in male population, which is 2~3 times higher than that in female.

02

Race:

Nasopharyngeal carcinoma is common in China, Southeast Asia and parts of North Africa. Inuit people also have a higher risk of nasopharyngeal carcinoma than other ethnic groups.

03

Region:

Guangdong, Guangxi, Fujian, Hunan, Jiangxi and other places in South China and East China belong to areas with high incidence of nasopharyngeal carcinoma, among whichPearl River DeltaThe area is particularly obvious.

04

Age:

May occur in any age group, butMostly in 30~50 years old..

(Source: Healthy Guangdong)

05

Diet:

Love foodPreserved foodSome people will also increase the incidence of nasopharyngeal carcinoma. Pickled food contains a lot ofAmmonium nitrite compoundLong-term intake can increase the incidence of nasopharyngeal carcinoma by 2~7 times.

06

Alcohol and tobacco:

manysmokeanddrink wine/alcoholIt will also increase the risk.

07

History of sinusitis and family history:

If someone in the family suffers from nasopharyngeal carcinoma, especiallydirect relativeThe risk of illness will also increase.

People who meet one or more of the above conditions are at high risk of nasopharyngeal carcinoma, so it is necessary to screen nasopharyngeal carcinoma.

epstein barr virus

Prevention: early detection+self-discipline is the key!

How to prevent nasopharyngeal carcinoma?

● Quit smoking and drinking, eat less pickled food;

● Epstein-Barr virus is mainly transmitted through saliva, and infants should not be fed mouth to mouth;

● Maintain good hygiene habits: wash your hands before meals, do not spit everywhere, and advocate the use of public chopsticks;

● If you get up every day and find that you often have a runny nose and are accompanied by bloodshot or bleeding symptoms, you must be vigilant;

(Source: Healthy Guangdong)

● In areas with high incidence of nasopharyngeal carcinoma, people with family history of nasopharyngeal carcinoma, and middle-aged and elderly people, EB virus detection should be taken as a necessary item for physical examination.

reference data

What the hell is EB virus?

https://mp.weixin.qq.com/s/I3I9u_1fsRufBIszp8OoEw

EB virus positive = nasopharyngeal carcinoma?

https://mp.weixin.qq.com/s/Z7iweJudIY9U_35Wla2Rkg

Health Science | Did you "catch" nasopharyngeal carcinoma when the physical examination found that "EB virus" was positive?

https://mp.weixin.qq.com/s/ygn4166PoefdHYrVFwHyrQ

Epstein-Barr virus positive means "Guangdong cancer"? Pay more attention to these daily situations!

https://mp.weixin.qq.com/s/6GB99I0DGXc1eX6YOEvl2A

Nosebleeds, tinnitus, neck mass, beware of "Guangdong cancer"

https://mp.weixin.qq.com/s/_YAKZlbGjfLyxNSHpfRH5w

Source | First Health Group

Editing | First Health Group

Please contact First Health Group for reprinting.

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2, 34 years old, advanced colorectal cancer! I had blood in my stool and thought it was hemorrhoids.

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