Will autologous fat filling shift?

Many beauty seekers worry that they will shift and be absorbed after fat filling. Today, let’s take a brief look at the knowledge about auto fat filling. First of all, a science point: the fat extracted from fat filling is generally a single bubble fat cell. What is a single bubble fat cell? Single bubble fat cells are also called white fat cells. The center of the cell contains a large lipid droplet. The fat is stored in a semi-liquid state, mainly triglyceride and cholesterol ester. It is this fat cell that constitutes a large amount of fat in obese patients. It is worth noting that an average adult has about 30 billion white fat cells and weighs 13.5 kg. White fat cells can increase in volume by a hundredfold, and once the fat cells accumulate and swell and become larger, it is difficult to disappear or return to their original state. So unless the violent squeeze causes the “Berlin Wall” to rupture, there will be no single bubble fat cell “out of duty”. Why do you think fat cells may shift after filling? We must first figure out what is going on under the skin? The main components of subcutaneous tissue are fat cells, fibrous septa and blood vessels. The fat cells exist in the fibrous space in the form of fat lobes, and each fat cell is surrounded by capillaries. For the face, the general fat is directly transplanted into the subcutaneous tissue, first into the fat leaflet, because of the role of the leaflet fiber spacing, it will hinder the movement of fat transplantation. Coupled with the growth and further wrapping of the new blood vessels repaired by ACMETEA, the transplanted fat cells have no chance of moving to other places, so the transplanted fat will not be displaced. Although it does not shift according to normal, why do some people still shift after facial filling? Facial fat filling is also a test of the doctor’s skills than liposuction surgery. It seems simple, but it actually tests the doctor. The waist and thighs are liposuction, and there are not many nerves in the blood vessels, but the nerves and blood vessels on the face are dense and dense. But the doctor can’t see the inside, so the doctor needs to accurately grasp the facial anatomy knowledge and the direction and operation level of the nerve. If the doctor doesn’t know much about these, and doesn’t have much hands-on experience, then imagine the consequences of the wrong injection location? I think the filling shift means overfilling. The amount of filling doesn’t seem to be a big problem. In fact, many doctors don’t know well. Too many people have overfilled, including celebrities and internet celebrities. If the amount of filling is not well controlled, the fat will not achieve the desired effect once it is displaced, which will make the face worse and worse. I wish to fill in a little less and not overfill. If there is less filling, you can do a second filling, but if you meet a person with a high fat survival rate, filling too much fat will cause excessive facial fat. It will not be easy. Therefore, it is very important to say that fat transplantation is suitable for yourself. Don’t blindly follow the trend. Go to the hospital for more consultations and communicate with the doctor. You can get the point you want by talking about your details. Therefore, you must choose a regular hospital doctor for facial filling. You can not fill too much in a single filling, and follow the principle of uniformity for a small number of times. In order to avoid the phenomenon of excessive displacement of the filling, only experienced doctors can accurately change and effect the filling site during the operation, and reduce the postoperative risk.

The disease is in the epidermis, and the source is inside. Vitiligo can not ignore the adjustment of the body

Although vitiligo is a skin disease, it is caused by the epidermis. Some physical problems manifest themselves through the skin. When vitiligo appears, what problems have occurred inside the body? 1. Abnormal liver and kidney function When the liver and kidney are damaged, it will cause the blood circulation of the human body to be blocked, the skin can not be nourished in time, and the production of melanocytes is blocked; coupled with the abnormal liver function, the body is prone to fatigue, loss of appetite, and endocrine disorders. The body will be relatively weak and resistance will decline. These conditions can easily induce vitiligo or lead to aggravation of the vitiligo, and the liver, as the body storing blood and digestive organs, once damaged, nutrients cannot be fully absorbed, affecting the patient’s absorption of drugs. 2. Endocrine disorders When endocrine disorders occur, many hormones related to melanin synthesis in the human body will be secreted abnormally, such as glucocorticoids, epinephrine, thyroxine, etc.; the dynamic balance in the process of human melanocytes will be destroyed, it is easy Cause melanin metabolism disorder, which leads to the occurrence of vitiligo.   3. Microcirculation obstacles    The basic function of microcirculation is to transport oxygen and nutrients to the tissues and take away metabolites. Clinical testing found that the vast majority of patients with vitiligo lack trace elements, and on the same area of ​​skin, the number of capillaries in the leukoplakia area is far less than that in normal skin areas. Nutrients cannot be transported to various parts of the skin of patients with vitiligo, melanocytes cannot be produced normally, and the body’s metabolism has problems. Over time, it will lead to the loss of melanin and vitiligo. 4. Immunity disorders Immunity is the body’s own defense mechanism. It is the body’s ability to recognize and eliminate foreign invading substances (viruses, bacteria, etc.), deal with aging, injury, death, degeneration of its own cells, and recognize and process mutant cells and virus-infected cells in the body. of.  Human immunity disorders can be divided into two situations:    First, the immune system is hyperactive, which causes the body to destroy normal cells while resisting and clearing the mutant cells. The test found that anti-melanocyte antibodies are present in the serum of most patients with vitiligo, resulting in the destruction of melanocytes.  Secondly, the weakened immunity leads to a decrease in the body’s ability to resist disease. Viruses, bacteria, etc. will take advantage of it and affect the health of patients with vitiligo.   Fifth, nerve dysfunction    The human central nervous system controls all activities inside and outside the human body. When there is a problem with the human nerve function, some physiological activities of the human body will be greatly affected. Regarding patients with vitiligo, the performance is as follows: First, when the patient suffers from a major change or a severe emotional change, etc., the patient’s leukoplakia condition will be affected. This is because the production of melanin is formed under the regulation of neurohumoral fluid, so when affected by stressful mental factors such as trauma, overuse of the brain, and nervous thoughts, the patient’s condition will change.   The second is that vitiligo is distributed in bands or strips along the nerve segments or dermis, and it is accompanied by local dullness. This situation has a great relationship with local nerve damage.   Therefore, the treatment of vitiligo should be adjusted from the inside out, and the daily routine and diet should also be paid attention to. Treatment and care must keep up.

More and more young people have rheumatism? 3 reasons to pay attention to

Rheumatoid arthritis is a kind of “senile disease” in the impression of many people, a disease that only the elderly can suffer from. However, clinical data shows that the number of young rheumatoid patients is increasing year by year, and young people are more likely to develop rheumatoid arthritis. Reasons for young people to get rheumatism Diet factors: Daily diet is an important factor leading to the onset of rheumatism. Many people will consume excessive amounts of animal fats in their lives. Animal fats contain many substances that can cause rheumatism. Occurred, for some people who have rheumatism, excessive intake of animal fat foods will aggravate the symptoms of rheumatism. Immune factors: Our body will have some irritation to some exogenous or endogenous antigen substances, so it will activate the corresponding T cells. At this time, T cells will produce a variety of factors that lead to the production of inflammatory cells, causing a certain degree of damage to various tissues and organs, and some T cells will stimulate B-cells, which in turn will cause the body to produce a lot of antibodies and antigens. When combined, an immune complex is formed, which damages both tissues and organs, causing rheumatism. The problem of dressing: Many young people often have the concept of demeanor and no temperature in their lives. Will cause cold air to invade into the body, and over time will lead to rheumatism. Even when the weather is relatively hot in summer, it is necessary to do a good job of keeping warm, especially for people who need to stay in the air-conditioned room for a long time. Failure to pay attention to keeping warm will also lead to cold air intrusion and rheumatism.

Treatment of leukemia focuses on primary disease

[Overview]    Leukemia response is a response response of the hematopoietic system after the body is stimulated, which is manifested by a marked increase in the number of peripheral blood leukocytes, and the appearance of immature cells, similar to leukemia.  【Diagnosis】   1. Medical history and symptoms    (1) Medical history Question: Note: ① Are there bacterial, fungal and parasitic infections.  ②Is there autoimmunity&nbsp. disease&nbsp.(rheumatoid arthritis, sarcoidosis, etc.) and neoplastic disease (kidney tumor, leukemia, etc.).   ③ Whether to use glucocorticoid, epinephrine, lithium chloride and other drugs.   ④ Whether there is severe burn, crush injury, electric shock injury. Poisoning. Acute hemolysis or massive blood loss. Whether it is in the recovery period of bone marrow suppression, etc.  ⑵Clinical symptoms: Depending on the original disease, the corresponding clinical symptoms appear.   Second, physical examination found:    is mainly the corresponding signs of primary disease.   3. Auxiliary blood test: red blood cells and hemoglobin can be normal (except acute hemolysis, massive blood loss and leukemia), and platelet count is normal. The number of white blood cells increased significantly> 25×109/L, up to 200×109/L The proportion of granulocytes increased. Classification shows naive cells, toxic granules and vacuoles often appear in the neutrophil cytoplasm.   2. Bone marrow elephants: hyperplasia is active or obviously active, and there is no obvious increase in primitive cells, and there is no abnormal cell morphology of leukemia. The erythroid and megakaryocyte cell lines are normal.   3. Cytochemical staining: The neutrophil alkaline phosphatase score is significantly increased.   4.&nbsp. Genetic examination: no Ph1 chromosome.   Fourth, differential diagnosis    Leukemia-like reactions often have clear incentives, but when the original disease is more concealed, attention should be paid to differentiate from leukemia.  【Therapeutic measures】  The leukemia reaction itself does not require treatment, and can be quickly recovered after the original cause is removed. Therefore, we should carefully look for the primary disease and actively treat it.

Application prospect of pirfenidone in treating keloids

The treatment of keloids is constantly updated and developed. At the same time, the research on the treatment of keloids is also constantly being carried out. Not long ago, some scholars published a related literature about pirfenidone inhibiting keloids. &nbsp. Keloids are benign proliferative skin lesions that are difficult to treat and are a source of distress for patients. As far as its mechanism is concerned, recent literature shows that the conversion of keloid epidermis to dermis is one of its important pathogenesis. In the past, by studying the effect of the antifibrotic drug pirfenidone on keloid keratinocytes, it was found that pirfenidone has a certain inhibitory effect on keloids. In the experiment, keratinocytes isolated from normal skin tissue and scar tissue were cultured in vitro, and the effects of pirfenidone on cytotoxicity, cell migration, cell proliferation, and EMT-related genes and protein expression were studied. The experiment found that pirfenidone can significantly reduce the levels of vimentin and fibronectin in normal and keloid keratinocytes, and hinder the migration of basal cells. When the concentration of pirfenidone was from 200-1000ug/ml, the proliferation rate of cell basal cells showed a significant dose-dependent decrease. When the concentration of pirfenidone was as high as 1000ug/ml, the experiment did not find any cytotoxic effect . This study suggests that pirfenidone may inhibit the progress and recurrence of keloids. The literature shows that pirfenidone may have the prospect of treating keloids, but it is worth noting that the response of the same cells to the same drugs in vivo and in vitro is usually different. The most important thing is the effect of pirfenidone on cells in the body. The experimental results still need to be supported by clinical application data.

To remove fat, why does the eye bag relapse, liposuction surgery will not?

“It’s also fat. Why is it possible to relapse after puffing the eye bags, but not liposuction?” Some people have doubts about this. The reason for the bags under the eyes first understand the bags under the eyes. The bags under the eyes are the skin of the lower eyelid, the subcutaneous tissue, the muscles and the orbital septum are slack, and the fat behind the orbit is hypertrophy, protruding to form a bag-shaped protrusion called the eye bag. The eye bags are primary, which is caused by the hernia of fat hypertrophy of the natural orbital septum; there are also secondary, that is, due to age, the skin elasticity gradually decreases, and the tension between the orbicularis oculi muscle and the orbital septum decreases, so that the inside of the orbit Fat tissue herniated from the weak part of the orbital septum. To put it simply, the cellulite of the orbital septum can no longer fall out, forming a pouch. The cause of eye bags Since the fat of the orbital septum is the “mastermind” that causes the bags under the eyes, the eye bags are cut off. Later, the doctor changed his mind and used the fat of the orbital septum, and then released it and filled it back into the concave part of the frame, which eliminated the eye bags and filled the tear groove, showing a smooth and full state when he was young. Why is there a possibility of recurrence? Regardless of whether the orbital septal fat was removed or the orbital septal fat was released and backfilled, only a part of the orbital septal fat was taken, and most of them remained honestly in the orbital septum. The location of the orbital septal fat ▼ After the orbital septal fat is released and backfilled ▼ After the eye bags are removed, the skin, orbital septum and soft tissue of the lower eyelid will further relax and weaken with the passage of time. When the “uneasiness” ran out, eye bags were formed again. This is the “recurrence of eye bags” in many populations. Will it rebound after liposuction? After liposuction, most cases will not rebound, because the number of subcutaneous fat cells is reduced. &nbsp. There are two ways to become obese, one is that the fat cells become larger, and the other is that the number of fat cells becomes larger. After liposuction, the number of fat cells becomes smaller, and the remaining fat cells become larger in a limited range. After liposuction surgery, if you take good care and maintain good living habits, it is not easy to have a significant rebound. &nbsp. Liposuction surgery is to suck out excess fat cells, so it is not easy to have rebound problems. Of course, this premise is to maintain good living habits after the operation, do not overeating, because once the situation of eating and drinking is restored, The remaining fat volume will expand again. Excess calorie intake will be converted into fat fluid, which exists in the remaining fat cells. The more fat drops, the larger the fat cells: the fat layer becomes thicker, and the person looks fatter, so it is still necessary to finish liposuction. Be wary. Although removing eye bags cannot be done once and for all, don’t worry too much. After removing eye bags or after orbital septal fat release, it will not be so fast even if it will “relapse”; as long as you maintain a healthy body and a normal diet after liposuction, Generally not fat, at least no longer “fat physique.”

Do not underestimate the destructive power of rheumatic fever

Rheumatic fever is a systemic inflammation of connective tissue. In the early stage, joint and heart involvement are the most common, and heart damage is the most important. According to the pathogenesis of the lesion, it can be divided into the following three stages.   (1) Denaturation and exudation period&nbsp. Collagen fibers in connective tissue split and swell, forming glass-like and cellulose-like degeneration. Inflammatory cells such as lymphocytes, plasma cells, eosinophils, and neutrophils infiltrate around the degeneration lesions. This period may last 1 to 2 months, and recovery or enter the second and third periods. (2) Proliferative period&nbsp. This period is characterized by the presence of rheumatic granuloma or rheumatoid body (Aschoffbody) on the basis of the above lesions. This is a characteristic lesion of rheumatic fever, which is the basis for pathological diagnosis of rheumatic fever and rheumatism. Indicators of activity. There is cellulose-like necrosis in the center of the corpuscle, infiltration of lymphocytes and plasma cells at the edge, and rheumatic cells. Rheumatic cells are round, elliptical or polygonal, the cytoplasm is abundant and basophilic, the nucleus is empty, with obvious nucleoli, and sometimes binuclear or multinuclear form giant cells and enter the sclerosis period. This period lasts about 3 to 4 months.   (3) Sclerosis period&nbsp. The degenerative and necrotic substance in the center of the upper body of rheumatism is gradually absorbed, the exudative inflammatory cells are reduced, the fibrous tissue is proliferated, and the scar tissue is formed in the granuloma.  Because the disease often recurs, the above three stages of development can be staggered, which takes about 4 to 6 months. The first stage and the second stage are often accompanied by the exudation of serous fluid and the infiltration of inflammatory cells. This exudative lesion largely determines the occurrence of clinically significant symptoms. Pathological changes in joints and pericardium are mainly exudative, while scar formation is mainly limited to endocardium and myocardium, especially valves.  Inflammation of rheumatic fever affects the collagen fibers of connective tissues throughout the body. In the early stage, the joints and heart are mostly involved, and then the heart damage is the main cause. Each stage of the disease has a focus on the affected organs. For example, the joints and pericardium are mainly exuded, forming arthritis and pericarditis. Later, the exudate can be completely absorbed, and a small number of pericardial exudates are not completely absorbed, and the mechanism causes partial adhesion. The myocardium and the endocardium are mainly proliferative lesions, and later scars form. Proliferative lesions and adhesions of heart valves often lead to chronic rheumatic heart valve disease.

What happens after the skin is dehydrated

There is a saying in the Dream of the Red Mansion that a woman is made of water. In fact, it is not just a woman. All people’s body water accounts for about 80%, and the highest child is the oldest. Then a normal adult’s body water accounts for 70~75%. So everywhere in our bodies is water. In our normal skin stratum corneum, the water content reaches about 20%, and the higher the water content in the bottom layer. As in other tissues, moisture is the basis of all metabolism and defense in the skin. When you see a skin like dead bark, then its water content must be less than 10%, then our cells will languish, the gap between cells will increase, the skin’s self Reduced repair capacity and slowed metabolism. In addition, the skin is still the source of many skin problems in the absence of water. 1. Dark yellow spots like to find dehydrated skin. The body receives a lot of free radicals and lipofuscin produced by its own metabolism every day. When the skin is dehydrated, our self-healing ability is greatly reduced, so those harmful substances will not be metabolized to the body in time, the metabolism of the entire skin will slow down, and the melanin in the surface layer will not be quickly decomposed, resulting in dullness of the entire skin. Without gloss, after a long time, it will become a stain or color. In addition, when the skin is dehydrated, the ability of self-repair decreases, the aging of cells accelerates, and the new cells also die quickly. 2. It’s easier to get acne, yes, the skin becomes very, and it is easier to get acne when dry. This is because when the skin is very dehydrated, the sebaceous glands will actively secrete a lot of oil, and you can use it as a self-protection mechanism. Because the skin thinks he is very dry, he needs to use too much oil to moisturize, which will cause the entire skin to lose balance in the long-term. In this way, there will be more clogged pores, aging keratin, and skin trash can not be discharged, which will cause vicious circles such as enlarged pores and rough skin. In severe cases, there will be blackheads or whiteheads, or even inflammatory acne. After acne, it will leave acne marks, and even acne pits and other reactions. 3. Skin care products can not be absorbed. When the skin is dehydrated, it is difficult to absorb the nutrients in many skin care products. The state of being unfilled is that too many skin care products remain on the skin surface, which may cause the formation of fat particles. . 3. In the series of processes mentioned above, skin allergies increase. It can be seen that many substances cannot be metabolized, excessive oil secretion, and the imbalance of water and oil will exacerbate the destruction of the skin barrier. Therefore, accidents can cause allergy symptoms. 4. Wrinkled skin The nutrients of the dermis layer are reduced when the skin is dehydrated. The skin does not have the ability to lock in water, so the collagen elastic fibers in the skin are damaged, and it is easy to cause them to run off and make the skin lose its elasticity. At this time, you Skin is more prone to wrinkles, and it is true wrinkles

What laboratory tests are needed to diagnose genital warts?

  The typical condyloma acuminatum is usually diagnosed without laboratory tests. When the patient’s symptoms are not typical, and the site is not typical, especially women, the vaginal opening may have pseudocondyloma similar to condyloma acuminatum, and laboratory tests are required to confirm the diagnosis. Common laboratory tests are as follows:    (1) Acetic acid white test cotton swab dipped in 3-5% medical acetic acid solution is applied to the skin lesion and the surrounding skin mucosa, if the skin lesion becomes White, and normal skin around does not turn white, it is judged as condyloma acuminatum. Due to the high sensitivity of the acetate white test, if it is condyloma acuminatum, it will definitely turn white. However, the whitening is not necessarily condyloma acuminatum. In special cases, false positives will occur.   (2) Histopathological changes are mainly keratinization, hypertrophic spine, and papilloma-like hyperplasia. The cells in the upper part of the granular layer and spinous layer have obvious vacuoles. The basal cells of spinous cells have a considerable number of nuclear divisions, which seem to be cancerous, but the cells divide regularly, and the boundary between hyperplastic epithelium and dermis is clear.   (3) Immunohistological examination commonly used peroxidase anti-peroxidase method (that is, PAP), showing the viral protein in genital warts, to prove the presence of viral antigens in wart damage. When HPV protein is positive, a pale red weak positive reaction may appear in the superficial epithelial cells of condyloma acuminatum. Reprint please indicate: Nanjing Institute of gifted Ka medical wart virus Lixing Chun, otherwise declined to reprint.

Do not underestimate the destructive power of rheumatic fever

Rheumatic fever is a systemic inflammation of connective tissue. In the early stage, joint and heart involvement are the most common, and heart damage is the most important. According to the pathogenesis of the lesion, it can be divided into the following three stages.   (1) Denaturation and exudation period&nbsp. Collagen fibers in connective tissue split and swell, forming glass-like and cellulose-like degeneration. Inflammatory cells such as lymphocytes, plasma cells, eosinophils, and neutrophils infiltrate around the degeneration lesions. This period can last 1 to 2 months, and recovery or enter the second and third periods. (2) Proliferative period&nbsp. This period is characterized by the appearance of rheumatic granuloma or rheumatoid body (Aschoffbody) on the basis of the above lesions. This is a characteristic lesion of rheumatic fever, which is the basis for pathological diagnosis of rheumatic fever and rheumatism. Indicators of activity. There is cellulose-like necrosis in the center of the corpuscle, infiltration of lymphocytes and plasma cells at the edge, and rheumatic cells. Rheumatic cells are round, elliptical or polygonal, the cytoplasm is rich and basophilic, the nucleus is empty, with obvious nucleoli, and sometimes binuclear or multinuclear form giant cells, and enter the sclerosis period. This period lasts about 3 to 4 months.   (three) hardening stage&nbsp. The degenerative and necrotic substance in the center of the upper body of rheumatism is gradually absorbed, the exudative inflammatory cells are reduced, the fibrous tissue is proliferated, and scar tissue is formed at the site of granuloma.  Because the disease often recurs, the above three stages of development can be staggered, which takes about 4 to 6 months. The first stage and the second stage are often accompanied by the exudation of serous fluid and the infiltration of inflammatory cells. This exudative lesion largely determines the occurrence of clinically significant symptoms. Pathological changes in joints and pericardium are mainly exudative, while scar formation is mainly limited to endocardium and myocardium, especially valves.  Inflammation of rheumatic fever affects the collagen fibers of connective tissues throughout the body. In the early stage, the joints and heart are mostly involved, and then the heart damage is the main cause. Each stage of the disease has a focus on the affected organs, such as exudation in the joints and pericardium, forming arthritis and pericarditis. Later, the exudate can be completely absorbed, and a small number of pericardial exudates are not completely absorbed, and the mechanism causes partial adhesion. The myocardium and the endocardium are mainly proliferative lesions, and later scars form. Proliferative lesions and adhesions of heart valves often lead to chronic rheumatic heart valve disease.

Why is leukemia so difficult to treat? Where is the root cause of refractory?

Leukemia is considered a “fatal disease”. People deeply experience its harm and incurability. Many patients have undoubtedly the most profound experience of the difficult treatment of leukemia during the long treatment process. Why is leukemia so difficult to treat? What is the root cause of refractory leukemia? First of all, leukemia patients know that leukemia cells will proliferate and divide indefinitely. It is not difficult to use chemotherapy drugs to kill leukemia cells, but the applied chemotherapy drugs are not good or bad, killing At the same time that the leukemia cells are destroyed, the normal cells are also killed. Therefore, patients often have complications such as infections and bleeding during chemotherapy. For leukemia patients, common infections such as “cold, enteritis&quot.” The patient is fatal. Secondly, after the treatment of leukemia is relieved, some patients relax their vigilance and think that they have been completely cured. In fact, there are some leukemia cells in their bodies, which are extremely small amounts of leukemia cells. These cells are potential risk factors. It will recur at some time in the future, so it is more difficult to treat. Then, leukemia cells can invade the central nervous system, causing a series of symptoms. A large part of the chemotherapy drugs cannot pass through the blood-brain barrier or only a small part of the drugs cannot pass the therapeutic amount. The therapeutic effect for central nervous system leukemia is not very good ideal. Although leukemia is considered to be a “fatal disease”, with the development of modern medical technology, the treatment of leukemia has made a qualitative leap. Clinically, many patients can get a great improvement under comprehensive treatment. Even some patients can be cured, such as acute promyelocytic leukemia, chronic myeloid leukemia, etc. can be cured.

What factors affect the condition of vitiligo in summer?

   Vitiligo is a kind of white spots on the skin. Skin diseases caused by lack of pigment can occur in various parts of the body. Vitiligo damage to the appearance and damage to physical health has caused huge mental stress for patients, and psychological problems will occur over time. Vitiligo has obvious seasonality, it is easy to spread in spring and summer, and the disease will be significantly relieved in autumn and winter. So, what factors affect the condition of vitiligo in summer?    Exposure causes melanin to fall off in advance. The summer weather is hot. Many people wear it very cool and thin. The exposed parts of the human body are more than other seasons. The length and area of ​​exposure to sunlight are also It is more than usual, and after the human body is exposed to the sun, the melanocytes on the surface of the skin become hyperactive and over-secrete melanin, resulting in the lack of melanin-forming intermediates and the melanocytes falling off prematurely. Sultry makes people feel abnormal. Summer weather is sultry, it is easy to make people irritable. Some people will also perform unusual behaviors, such as irritability, thinking disorders, temper tantrums, etc., leading to disorders of the body’s immune system. It affects the synthesis of melanocytes and causes the spread of vitiligo. The high temperature makes the cell activity more active. The high temperature environment in summer makes the human cell activity more active, so the summer metabolism is also more vigorous than in other seasons, and the sebaceous glands secrete more, which will cause greater loss of body fluids and cause instability in the body environment. Factors such as prolonged friction stimulation and sunburn trauma infection may awaken vitiligo. The summer weather is hot, and everyone is more exposed. Many patients with vitiligo will have more or less inferiority complexes, because the white spots on their skin will make them look stranger to outsiders. Such patients with vitiligo must pay attention to adjust themselves Emotions, divert their attention.  

Do meningiomas have a tendency to recur and be aggressive? How to grade and type?

  WHO classifies and types meningiomas according to their recurrence tendency and invasiveness, and divides them into 3 pathological 15 subtypes. WHOI grade is benign meningioma (Benignmeningioma, BM), including meningeal epithelial type, fibrous type, hemangioma type, glioblastic type, transitional type, microcystic type, lymphocyte-rich type, secretory type and metaplastic type;    WHOII grade Between benign and malignant, including atypical, clear cell type and notochord-like type;    WHO III is malignant meningioma (Malignantmeningioma, MM), including anaplastic, striated muscle type and papillary type.   1. WHOI grade meningioma    accounts for about 90% of meningiomas, of which secretory, metaplastic, microcystic, and lymphocyte-rich types are rare. The incidence of secretory meningioma (Secretorymeningi-oma) accounts for about 1.6%.  Microcystic meningioma (Microcysticmeningioma) is also rare, its incidence rate is about 1.6%, its pathological characteristics are: the tumor cell cytoplasm is transparent, separated by extracellular fluid into cystic, fusiform or star-shaped. The incidence of metaplastic meningioma (Metaplasticmeningioma) has not been clearly reported, and its pathological characteristics are: bone, cartilage or adipocyte components can be seen between tumor cells, which are non-specific cytoplasmic lipid-like changes rather than true metaplasia. Lymphocyte-rich meningioma (Lymphoplasmacyte-richmeningioma) is rare, its incidence rate is 1.7%, this type of tumor can be seen infiltration of chronic inflammatory cells mainly lymphocytes, may be accompanied by germinal center structure, such tumors can also be seen notochord-like Histological performance, but mostly in children and young people. 2. WHO II meningiomas account for about 4.7% to 7.2% of meningiomas, and their properties are between benign and malignant meningiomas. Compared with class I meningiomas, they have a higher invasiveness and recurrence rate. Meningioma (Atypicalmeningioma, AM) mainly.  Atypical meningioma can be the atypical changes of the above subtypes, but it has its special pathological characteristics, that is, equal to or more than 4 mitotic phases per 10 high power fields to confirm the diagnosis. When the mitotic rate does not increase, at least three of the following five signs can be diagnosed as atypical meningiomas. These signs include: ① dense cells; ② small cell components with high nuclear/plasma ratio; ③ The nucleolus is obvious and prominent; ④ the typical structure disappears and grows in a diffuse or flaky shape; ⑤ regional or map-like necrosis. Clear cell meningioma (CCM) is relatively rare, and its incidence accounts for 0.2% to 1% of meningiomas. CCM has a higher invasiveness and recurrence than benign meningiomas.   Chordoid meningioma (Chordoidmeningioma) is rare, accounting for 0.5% to 1% of meningiomas, and also has a high invasiveness and recurrence rate. The pathological characteristics of the tumor are similar to chordoma and intertwined with meningioma cells.  3. WHO Ⅲ meningiomas    is rare, accounting for about 1% to 3% of meningiomas, with high invasiveness and recurrence rate.  Anaplastic meningioma (Anaplasticmeningioma) can be evolved from grade I and II meningiomas, or it can be a malignant growth mode at the beginning. It is characterized by marked degeneration of tumor cells, a high rate of mitosis (10 high-power fields of 20 or more mitotic phases), or both. Rhabdoidmeningioma tumor cells have a striated muscle-like structure, often retaining the area of ​​meningiomas. The tumor cells are dense, the nuclei are large and deviated, inclusion bodies like bodies are visible near the nucleus, the nucleoli are obvious, and mitotic figures are more common. See necrosis zone. Papillary meningioma (Papillarymeningioma) is characterized by tumor cells arranged like papillae around the blood vessel, cytoplasm and nucleus extending to the blood vessel wall, showing a pseudo-chrysanthemum-like mass, which seems to float in the tissue section, the preserved meningeal epithelial area and classic Of meningiomas are different, characterized by dense cells, visible nuclear division and necrosis.

Discussion on Treatment of Acute Leukemia with Chinese Medicine

Leukemia is a malignant disease originating from hematopoietic stem cells. The clinical manifestations include fever, anemia, bleeding, hepatosplenomegaly and lymphadenopathy, and bone and joint pain. The study of acute leukemia in Chinese medicine has been carried out for decades, and its understanding is also quite controversial. Nonetheless, clinical and experimental research on the treatment of acute leukemia with traditional Chinese medicine has achieved gratifying results, and integrated traditional Chinese and western medicine has its unique advantages in the treatment of acute leukemia.   At present, clinical and experimental researches on acute leukemia have a curative effect on traditional Chinese medicine. They are divided into three categories from traditional medicines, namely poisons, heat-clearing drugs and tonic medicines. In clinical manifestations, the main cause of acute leukemia is Xie Sheng, and by the end, righteousness gradually declines and exhausts. Modern research also believes that tumor cells proliferate faster in the early stages of the disease. In the later stages, due to the prolonged cell proliferation cycle, the number of cells in the proliferating state decreases, and the number of dead cells increases with the increase in tumor load, as well as the lack of blood supply and deep evil. Chinese medicine called evil poison. Detoxification, that is, heat-clearing and detoxification drugs; attacking detoxification, that is, poisons such as arsenic. Generally speaking, the heat-clearing and detoxifying drugs taste bitter and cold, non-toxic or slightly toxic, and can be used for those with warmer evil poison. Arsenic and other poisons are the products of Daxin and Dahe. They are highly toxic or highly toxic. Tonic drugs mainly control the development of diseases by improving righteousness, that is, improving the immune function of the body. The above three types of drugs can act on tumor cell proliferation, differentiation and apoptosis and take effect. In the specific medication process, multiple methods can also be used in combination.  From the perspective of modern medicine, there is no symptom or sign in the motherland medicine that is comprehensive and can reflect the essence and overall picture of acute leukemia. According to the characteristics of the loss of the common organs, which causes the patient’s systemic failure to death, the syndrome differentiation of traditional Chinese medicine belongs to the category of “labor”; for those with prominent bleeding symptoms, the syndrome can be differentiated as the “blood syndrome”; the liver and splenomegaly can be differentiated as the syndrome. “Accumulation”; those with superficial lymphadenopathy are called “plague”, “sputum nucleus”, “scrofula”; typical symptoms are fever, anemia, bleeding, etc. The heat phenomenon is significant, and the incidence is sharp, the disease is serious, and the development is rapid , In line with the characteristics of TCM Yangre syndrome, often attributed to “emergency labor” and “hot labor”. Acute leukemia has a dangerous condition and many changes that require long-term treatment, especially simple chemotherapy is often difficult to kill potential leukemia cells and cannot achieve the overall treatment effect. The effect of traditional Chinese medicine on acute leukemia is objective. If disease identification and syndrome differentiation are combined, the treatment of symptoms and the root cause are combined, and the relationship between righteousness and evilness is emphasized, a better effect can be expected.   At present, the experimental research of traditional Chinese medicine on acute leukemia is mostly limited to the in vitro study of acute leukemia cell lines, and there is still a lack of systematic and comprehensive analysis. The treatment of acute leukemia by traditional Chinese medicine does not rely on a single role, but from multiple targets, multiple organs play a comprehensive role. Experts believe that the anti-tumor of traditional Chinese medicine must be guided by the theory of traditional Chinese medicine, based on the basic views of traditional Chinese medicine and the basic principles of traditional Chinese medicine treatment of diseases, combined with the extensiveness and integrity of traditional Chinese medicine treatment, and discuss the mechanism of action at multiple levels. In recent years, Chinese medicine has made great progress in the treatment of acute leukemia. On the basis of syndrome differentiation, some prescriptions with anti-cancer effects are selected. The prescription can greatly improve the remission rate of acute leukemia without side effects such as gastrointestinal reactions and bone marrow suppression. , Has great application prospects.  Although many achievements have been made in the treatment of acute leukemia with traditional Chinese medicine, the efficacy of traditional Chinese medicine alone is not good, and combined Chinese and Western medicine treatment can greatly improve the survival rate and reduce the recurrence rate. Chinese medicine can reduce the toxic and side effects of chemotherapeutic drugs and play a role in reducing toxicity and increasing efficacy. The combination of traditional Chinese medicine and western medicine is the only way to treat acute leukemia, and the organic combination of the two is also an urgent research topic.

Who is suitable for immunotherapy, all lung cancer patients can try, but the three types of people are better

In 2018, the research content of “suppressing immune system negative regulation and treatment of tumors” won the Nobel Prize. With the award of immune-related research and the launch of multiple immunotherapy drugs in China, the country has set off a wave of immunotherapy for various types of tumors. The most studied are PD1/PDL1 immune checkpoint inhibitors and antibody drugs targeting CTLA-4 targets. At present, there are many kinds of immunotherapy drugs originally developed in China. Regarding the clinical application of immunotherapy, in addition to malignant melanoma and lymphoma, non-small cell lung cancer is also a cancer species supported by precise clinical treatment guidelines. A swarm of bees researches immunotherapy. A swarm of bees uses immunotherapy drugs to treat a variety of malignant tumors. Many patients and doctors have found that immunotherapy is not as good as imagined, the efficiency is not very high, and patients may also face Some unknown immune-related adverse reactions, and even some adverse reactions are fatal. In view of this situation, we should find a better way to improve the effectiveness of drugs and reduce the occurrence of adverse reactions. How should we choose immunotherapy for lung cancer in the future? 1. Screening suitable patients through more optimized genetic testing indicators. Previous trials have shown that MSI-H and microsatellite highly unstable tumors respond well to immunotherapy. Because of this, the United States has approved PD-1 monoclonal antibody for all solid tumors that are highly unstable in microsatellites. In addition, patients with high tumor mutation load (TMB) have better efficacy. The higher the expression of tumor cell PD-L1 (TPS ≥50%), the more likely the tumor will shrink. There is no unified conclusion. In addition, the number of lymphocytes, the value of lactate dehydrogenase, CD28, etc. all assist in the selection of immunotherapy patients, and hope that more and better “targets” can be studied in the future to guide the selection of suitable patients. 2. Choose patients with good physical condition as far as possible. Those with higher physical condition scores are usually evaluated dynamically during admission and hospitalization. For those with better physical conditions, the number of T cells is higher and the more powerful The greater the number of T cells awakened by immunotherapy drugs, the more effective they are in removing tumor cells. Therefore, patients with advanced lung cancer who are eligible for immunotherapy should choose immunotherapy as far as possible, rather than wait until other treatments are used up before considering immunotherapy. 3. Combination of immunotherapy drugs At the ASCO conference in 2020, a lot of joint immunotherapy programs were mentioned. In the CheckMate227 study, PD-L1 ≥ 1% of patients with advanced non-small cell lung cancer, O drug (Nivolumab) + Y drug (Ipilimumab) first-line treatment of non-small cell lung cancer, 3-year survival rate exceeded 30 %, the risk of death decreased by 21% compared to chemotherapy. At present, O drugs + Y drugs have been approved by the US FDA for the first-line treatment of advanced non-small cell lung cancer with PD-L1 ≥ 1%. In the research process of various new immunotherapy drugs and dual-target monoclonal antibody drugs, in the future, it is likely that they will not be the only immunotherapy drugs for PD1/PDL1.

Immunotherapy is not useful for everyone. There are three reasons for the failure of lung cancer immunotherapy, or genes

In recent years, immunotherapy has been in full swing. In addition to the increase in imported varieties, domestic PD1/PDL1 inhibitors are also increasingly used in clinical practice. The immune checkpoint inhibitor against PD1/PDL1 is actually a drug that releases the molecular brake of the immune response. Since cancer cells often use this “immune brake” to escape the attack of immune T cells, PD1 is a molecular brake. By suppressing this “brake” signal, the immune response of T cells to tumors is reactivated, so that cancer cells can be recognized and killed by T lymphocytes. In some cancer patients, such as malignant melanoma, some non-small cell lung cancer, etc., PD-1 drugs have been proven to be very effective, but in general these drugs only benefit a few patients. Clinical practice has found that the effective rate of PD-1/PD-L1 antibody in treating tumors is only about 20% to 30%. Why does immunotherapy not work for some patients? 1. Gene mutations Scientists at the University of California, Los Angeles (UCLA) have discovered that cancer patients carrying the gene mutation JAK1 or JAK2 will not benefit from the immunotherapy drug pembrolizumab. They found that mutations in the JAK1 or JAK2 genes cause the loss of reactive PD-L1 expression, thereby preventing tumor cells from being recognized by T cells or receiving signals from T cells to stop growth. PD-L1 is a type of immune biomarker expressed by tumor cells. Immune checkpoint inhibitors require PD-L1 overexpression to effectively attack cancer cells. 2. Metabolic imbalance A 2019 Harvard Medical School, Dana-Farber Cancer Institute and MIT research report pointed out that some cancer patients have metabolic imbalances after treatment with immune checkpoint inhibitors, which may cause Immunotherapy is ineffective and the survival time is shortened. This metabolic change is reflected in the conversion of tryptophan to the metabolite kynurenine. 3. There are other immunosuppressive cells in the body. Professor Ye Lilin of the Institute of Immunology, Army Medical University, Professor Li Qijing of Duke University, and Professor Yu Jia of the Institute of Basic Medical Sciences of the Chinese Academy of Medical Sciences and other teams have found a kind of peripheral blood in tumor patients. New immunosuppressive cells. Such immunosuppressive cells will suppress the cell’s immune response by generating reactive oxygen species, resulting in a decline in the antiviral and antitumor immune responses of tumor patients. Studies have shown that there are three ways that checkpoint inhibitor therapy may fail: 1. The drug does not trigger an immune response to resuscitation; 2. The immune response generated is insufficient to respond to the size of the tumor; 3. The drug does not bind to the target, Is off-target. Immunotherapy is currently a highly effective treatment for cancer. PDL1 expression and tumor mutation load TMB are usually detected before use. Others such as CD28 molecule and lactate dehydrogenase LDH are also used to help judge the efficacy of immunotherapy. For patients, it is also a choice full of risks and challenges. Immunotherapy-related adverse reactions are also encountered more and more by doctors in clinical practice. More serious ones such as immunomyocarditis, immunopneumonia, and immunohepatitis, etc., may cause the death of patients. Such adverse reactions are worthy of attention. Nowadays, immunotherapy combined with chemotherapy, radiotherapy or anti-angiogenesis drugs are all being tested in different tumor types, and we look forward to more good news. As for why many people are not effective in immunotherapy, the mechanism is extremely complicated, and there are too many unknown things that require further research by scientists.

What are the components of fat tissue?

Normal adult adipose tissue is composed of adipocytes and matrix components including collagen fibers, blood vessels, fibroblasts and immune cells. 50% of the cell components in fat tissue are fat cells, but the volume accounts for 96%. Therefore, the subcutaneous fat of animals we usually see is mainly yellow fat cells rich in lipid droplets. As the main structural unit of adipose tissue, fat cells mainly store and mobilize lipids. The general number of adults is (25~4.5)×1000, while the number of obese persons can reach 9×1000. Its size depends on the amount of lipids it contains, the diameter is 20-200μm, and the volume can differ by hundreds of times. So to be precise, fat fatness is mainly fat cell fat. The remaining 50% of the adipose tissue is composed of blood vessels, nerves, connective woven cells, and macrophages. These cells are numerous in number, but the volume is relatively small, accounting for only 4% of the volume. However, it is of great significance to the physiological activities of fat cells such as nutrition, migration, transformation and apoptosis. Our clinical suction or transfer is mainly fat cells, that is, yellow granular fat tissue can be seen by the naked eye. During the operation, the fat cells must be protected to avoid damage and destruction in order to maximize the survival rate of the transplant.

Shi Shurong’s medical words: patients with slow-grain have these performances, they should be alert to the possibility of sudden changes!

Chronic myeloid leukemia is a clonal malignant tumor disease of bone marrow hematopoietic stem cells. Although it is classified as chronic leukemia, not all development outcomes will stagnate in the “chronic stage”, and patients are more afraid of the progress of the disease! In particular, the slow-grabbing “rapid change period” is often difficult to reverse! Director Shi Shurong’s WeChat signal zkxk9999 slow-grain blast crisis (CML-BP) diagnostic criteria: (1) Peripheral blood leukocytes or bone marrow nucleated cells account for ≧20% of primitive cells, about 70% of patients are acute myeloid changes, which can be neutrophils, About 20%-30% of the primitive cells of eosinophils, basophils, monocytes, erythrocytes or megakaryocytes are acute gonorrhea. ⑵ Extramedullary infiltration: the common site is skin, lymph nodes, spleen, bones or central nervous system. ⑶ Bone marrow biopsy showed that the primitive cells accumulated or clustered in large numbers. If the blast cells are obviously focally accumulated in the bone marrow, even if the bone marrow biopsy of the remaining parts is shown as chronic, it can still be diagnosed as BP. Chronic myelogenous leukemia patients should be alert to the possibility of acute changes when the following clinical manifestations occur, and they should see a doctor in time: (1) Progressive anemia: Anemia symptoms appear in a short period of time (chronic granulose patients generally do not have anemia in the chronic phase), And continue to increase; (2) fever persists, can not be controlled with general antibiotics; (3) spleen progressive enlargement; (4) bleeding tendency; (5) changes in blood and bone marrow. To this end, I hope that patients with slow-grain must regularly review and monitor the condition and curative effect, and when the condition changes, take the corresponding treatment measures as soon as possible. Finally, it is emphasized that no matter for patients with chronic myeloid leukemia who have not accelerated or have accelerated, they need to actively receive correct treatment, adjust the treatment plan, and strive to achieve remission as soon as possible! For more knowledge about chronic myeloid leukemia disease or patient help, please pay attention to WeChat public account: mbxb120

How does vitiligo “root and sprout” on the skin?

The onset of vitiligo can be broadly explained as: under the combined action of some internal and external factors, the local or generalized skin and mucous membrane pigments of the human body begin to lose, or even completely disappear. Many of these internal and external factors are common in everyone’s daily life. External causes include: strong sun exposure, skin trauma, improper diet, irregular work schedule, etc. Internal causes include: poor body immunity, insufficient liver and kidney function, lack of trace elements, etc., they interact with each other, combined effect, and eventually cause vitiligo Skin diseases.   However, why these complex internal and external factors can cause the loss of skin melanin? 01Strong sun exposure to the sun for a long time will produce a large amount of free radicals in the skin, such as singlet oxygen, hydrogen peroxide and nitrogen. Including lipid, protein, DNA damage, and these damages will cause the normal function of melanocytes to be impaired; in addition, the phototoxic reactions and photoallergic reactions caused by ultra-violet ultraviolet rays in sunlight will also damage melanocytes or impede their transport, Eventually lead to vitiligo. 02 Skin trauma Human skin is traumatized, it is likely to trigger a skin stress response, leading to endocrine disorders, melanin synthesis is hindered, plus the trauma destroys melanocytes in the skin, damaged melanocytes are used as antigens in the immune system The anti-melanocyte antibody is produced under the action of the antibody, and the antibody further damages the melanocytes near the wound, resulting in further damage to the melanocytes and the production of vitiligo.  03 Improper diet    First, eat less irritating food, which is not good for vitiligo. Secondly, children who lack zinc in their bodies will have various symptoms, such as loss of appetite, decreased taste, fatigue, weight loss, and even anorexia, which cause the body to lack nutrition and lead to the onset of vitiligo. Third, irregular diets for adults, or dieting for weight loss, etc., can also lead to the loss of nutrients and damage to the body, causing problems in melanin production and causing vitiligo.  04 Irregular work and rest   Long staying up for a long time will affect the normal endocrine system of the human body, leading to disorder of the endocrine system, and endocrine disorders itself is a factor leading to the occurrence of vitiligo.  05 Poor body immunity    Autoimmune is low, and the body’s elements are also lacking, resulting in reduced tyrosinase activity or insufficient tyrosinase, which will cause the melanocytes to lose their function and fail to produce melanin.  06 Insufficient liver and kidney function   Insufficiency of liver and kidney is one of the clinical symptoms of vitiligo. In the growth and development stage of the human body, the promotion of kidney qi is particularly important. The liver and kidney are damaged, resulting in blocked blood circulation, and the skin can not get nutrition in time, which may cause vitiligo.  07 Endocrine disorders  The synthesis of human melanin is regulated by many hormones in the body to maintain a dynamic balance. Therefore, when a disorder occurs in the human endocrine system, it is easy to cause melanin metabolism disorders, resulting in the occurrence of vitiligo. The known melanocyte stimulating hormone, thyroid hormone, corticosteroid hormone, etc., are the key substances for skin melanocytes to secrete normally. In short, when endocrine disorders occur, the levels of melanin stimulating hormone, corticosteroid hormone and thyroid hormone in the blood cannot maintain a relative balance, which will affect the secretion process of corticosteroid hormone and thyroid hormone, thereby inhibiting the secretion of melanocytes by the pituitary Stimulator.  08 genetic factors    vitiligo has a family genetic tendency, is a polygenic inherited disease, accompanied by different penetrance. However, it is not necessarily hereditary. That is: parents have vitiligo, and children do not necessarily have vitiligo.  Reminder: No matter whether everyone is successful or not, the above mentioned hope to arouse our vigilance, timely protection and reduce the risk of whitening. In addition, you are welcome to share your knowledge and understanding of vitiligo in the message area. If you have any questions, please send me a private letter to answer your questions. Provide everyone with more comprehensive knowledge and experience of leukoplakia, help to eliminate white!

The key to the success of autologous fat breast augmentation

More and more women choose autologous fat injection breast augmentation, because this kind of breast augmentation plastic surgery is very safe and effective, after the operation can not only make the chest full and round, but also shape the body. So, do the majority of beauty seekers know what are the key points for the success of breast augmentation with fat injection? The key to the success of breast augmentation with fat injection are mainly the following: due to the difference in the activity of lipoprotein protease in different parts of the human body, the High activity is conducive to the regeneration of transplanted fat cells. According to the research, it is found that the activity of lipoproteinase is the highest in the thighs and buttocks, which is conducive to the regeneration of transplanted fat cells. According to the study of human fat and the deep fat distribution of these parts, the lower half of the trunk is generally selected as the preferred donor area for autologous fat breast augmentation. Breast augmentation with autologous fat injection directly affects the result of surgery. It is inevitable that some cells will be damaged during the operation. The greater the damage, the fewer viable cells and the lower the survival rate. When injecting fat, the principle is to evenly distribute in the tissues of the recipient area. There are many devices for liposuction, and the effect of breast augmentation is different when the fat extracted by different devices is injected into the chest. Breast augmentation experts advocate liposuction with an empty needle, the negative pressure of which does not exceed 0.05MPa, which can reduce cell damage. In addition, the straws should be thin tubes less than 4mm. The extracted fat should be treated, and the collected fat particles should be washed and filtered with 4 degree normal saline to wash away the damaged fat cells, fat droplets and blood. In the purification process, special attention should be paid to aseptic operation, and the storage time of fat particles in vitro should be minimized to improve the survival rate of fat cells. These require the doctor to have a high degree of responsibility and patience, carefully handle the fat particles, and improve the success rate of the operation.