For more patient communication help, please pay attention to the WeChat public account [Nephropathy Association] Renal function is an important indicator for assessing the health of a person’s kidneys. Clinically, there are two types of specimens for detecting renal function: blood specimens and urine specimens. For different specimens We have a set of different testing systems and testing indicators. Today I will introduce to you “what are the most commonly used indicators in renal function testing”. The main indicators for clinical examination of renal function are: blood creatinine, urea nitrogen, and ECT. It is currently recognized by the medical community that serum creatinine (basically not affected by extrarenal factors such as diet and high metabolism) combined with the patient’s age and weight are the most accurate indicators for evaluating glomerular function. Urea nitrogen is often affected by many factors, so it cannot be used to evaluate renal function. Such as eating high-protein foods-meat, fish, eggs, etc., high fever, sepsis, gastrointestinal bleeding, etc. can increase urea nitrogen. It is worth noting that the normal value of blood creatinine is 43~106μmol/l, and blood creatinine will increase rapidly when the injury exceeds 70%~75%. ECT (measurement of endogenous creatinine clearance) can be used to further understand glomerular function. The normal value is 80~120ml/min. If the measured value is 70~50ml/min, it means a slight decrease in renal function, 50~30ml/min means a moderate decrease, less than 30ml/min means a severe decrease, 10~5ml/min means advanced renal failure, 5~0ml/min min is end-stage renal failure. In addition, routine urine examination is a common indicator for determining kidney disease. A negative urine routine does not mean that the kidney function is not damaged. For example, advanced renal failure and end-stage renal failure can have a negative urine routine. Because the renal function is extremely impaired, the urine is difficult to filter. Tips: For a healthy person, you may not pay too much attention to physical examination work daily, and renal insufficiency is relatively insidious, and the symptoms are easy to be ignored. If you have frequent back pain, fatigue, It is recommended to go to the hospital to check kidney function if the urine is turbid.
As we all know, rheumatoid arthritis is a chronic rheumatism that requires long-term treatment. Then, in the course of treatment, it is necessary to combine the changes of the disease at any time, review the relevant indicators regularly, and adjust to the best treatment effect and drug dosage by judging whether the disease is in the active phase, the degree of activity, and whether the joint damage is progressing. Therefore, regular review and follow-up of patients with rheumatism is very important. Early detection, early treatment, timely control of the disease, and effective prevention of disease deterioration. However, many classmates are not clear about what items need to be checked in the recheck, and how often should they be rechecked? Today, let’s talk about them one by one. 01Diagnostic indicators Diagnostic indicators are mainly to determine whether you have “rheumatoid arthritis”, the main indicators include rheumatoid factor (RF), anti-cyclic citrulline antibody (anti-CCP), anti-vimentin antibody (anti-MCV) , And anti-keratin antibody (AKA) four kinds. Once one or more of these four antibodies are positive, you need to suspect or be vigilant about whether you have rheumatoid arthritis (of course, it needs to be combined with clinical symptoms and other test items). These items only indicate whether you are suffering from rheumatoid arthritis, but have little to do with the progression of the disease, whether it is aggravated or lessened, so there is no need to review these items frequently. After systematic and standardized treatment, the titer of these antibodies may decrease. , But it does not necessarily turn negative. Review tips: This type of indicator is generally reviewed once every six months to a year. 02 After the diagnosis of “rheumatoid arthritis” by activity indicators, systematic and standardized treatment is needed. The goal of treatment is to reduce disease activity, reduce inflammation, and thereby reduce joint destruction. After the diagnosis is made, more attention should be paid to the two indicators of “ESR” and “C-reactive protein”, which are also commonly known as “inflammation indicators”, which can reflect disease activity, so as to guide doctors to better treat and add or subtract medication. Recheck tips: In the acute phase (when the inflammatory indicators are abnormal or when the pain is very severe), try to keep the need for recheck every 1 month. In the remission period (inflammation indicators are normal, no obvious joint swelling and pain), it is recommended to review once every 3-4 months. 03 Safety indicators Safety indicators mainly refer to blood routine (white blood cells, platelets, hemoglobin, etc.), urine routine (urine protein, urine occult blood, etc.), and liver and kidney function (alanine aminotransferase, aspartate aminotransferase, creatinine, etc.). As the so-called “medicine is three-point poison”, drugs used to treat rheumatoid arthritis may cause blood system damage, or liver and kidney function damage. Generally speaking, doctors will choose safer treatments for patients, but it is unavoidable that a small number of patients may have obvious adverse reactions. Therefore, these safety indicators must be tested regularly. Recheck tips: We recommend rechecking after 1 month of starting the medication. After taking the medication for a long time, you can recheck it every 3 months, half a year or 1 year. 04 Concomitant disease index The concomitant disease index says that rheumatoid arthritis may sometimes have concomitant diseases, such as Sjogren’s syndrome, lupus erythematosus, etc. At this time, it is necessary to screen for autoimmune antibodies (ANA antibody profile, ANA quantitative, anti- Nuclear antibodies, etc.) with a view to early detection. In addition, if you consider using biological agents for treatment, you need to check for infectious diseases such as hepatitis and tuberculosis. Re-check tips: If there are no obvious symptoms, check it every 1 year. The picture comes from the Internet, please contact to delete the infringement, thank you!
Since multiple myeloma became ill, in addition to regular checkups during the treatment phase, it also includes regular rechecks after discharge from the hospital. Many family members of patients wonder what test indicators they should pay attention to? The relevant analysis is carried out below. After illness, these test indicators are “inseparable” from myeloma patients: immunoglobulin, M protein quantity, blood routine, serum urea nitrogen, creatinine, blood calcium… The above test indicators are multiple bone marrow. Tumor patients should be tested every month after the initial treatment. For patients who still have bone damage problems, they also need to undergo skeletal examinations regularly or based on symptoms. In addition, each patient also needs to undergo bone marrow aspiration according to the clinical situation, or undergo MRI (magnetic resonance), PET/CT examination. If there are some other complications, such as diabetes, uremia, etc., you need to do related supplementary testing items based on this aspect. There is an intermittent period after each course of treatment. At this stage, as long as the patient can be discharged from the hospital for recuperation, as long as all indicators are available. After 4-6 courses of treatment for multiple myeloma, it is generally necessary to require the patient to be rechecked in the hospital every two to three months. If the patient’s condition is relatively stable, a recheck every six months is fine. please remember! During this follow-up period, patients with myeloma need to keep in touch with the attending doctor, and see a doctor at any time if their condition changes! Learn more about “disease knowledge” or “myeloma patient group communication” and other WeChat search public number: jjgs120
What should acne muscles least eat? Answer in one word: sugar. Because we consume too much, we secrete too much insulin. When secreting insulin, insulin growth factor 1 has the same effect as androgens. He can promote the synthesis of androgens from the adrenal glands and gonads, affecting the signal transduction of androgen receptors. Therefore, the proliferation of epidermis and dermis is stimulated, and at the same time, our sebaceous gland cells will secrete more oil. At this time, inflammatory factors will be generated due to the reaction of high androgens, thus inducing the occurrence of acne. It should also be emphasized here that sugar, not just refers to sweets, it includes all foods that are likely to cause blood sugar to rise. Then each food makes the blood sugar increase at a different rate. We use the glycemic index to define these foods. It is divided into three levels, namely low blood sugar production index, medium blood sugar production index and high blood sugar production index. The higher the Glycemic Index, the faster the blood sugar rises. In addition, it is also related to how much we eat. The more we eat, the higher the blood sugar. In addition to foods that can raise blood sugar, we also need to pay attention to one food, which is milk. Although milk is not a food with a high glycemic index, it can directly stimulate the secretion of insulin growth factors. Therefore, acne-prone friends, you can refer to the food with low and medium glycemic index to help your acne recover quickly and reduce recurrence.
I have written a lot of science about the diet of gestational diabetes, but “sugar moms” still have many questions: fruits are so sweet, can I really eat them? Can sweet corn be eaten? Sweet potatoes are also very sweet, can they really be eaten? Therefore, it is necessary to specifically popularize this question: whether food is sweet or not is not a criterion for judging whether a diabetic person can eat it. Have diabetes, quit all sweet food? With diabetes, many people consciously quit sweet foods, such as cakes, snacks, drinks, fruits, sweet corn, sweet potatoes, do not put sugar in cooking, and even dare not take sugary medicines. Of course, we encourage this kind of behavior, indicating that patients are beginning to attach importance to diabetes. But in fact, in addition to cakes, snacks and other foods made of artificially added sugar, natural sweet foods such as fruits, corn, and sweet potatoes do not need to be quit. First: Sweetness does not mean that the effect on blood sugar is greater. Many diabetics will think that sweet food will have a greater impact on blood sugar, so they will not eat any sweet food. But in fact, the effect of food on blood sugar is not measured by sweetness or not. Sweetness does not necessarily have a big effect on blood sugar, and unsweetened food may not have a small effect on blood sugar. For example, rice is not sweet, but its effect on blood sugar is greater than that of fruit. To measure the effect of food on blood sugar, it is medically described by the glycemic index (abbreviated as glycemic index). The larger the value, the greater the effect on blood glucose. Usually, the glycemic index of glucose is set to 100, the glycemic index >. 70 is a high glycemic index food, and the glycemic index <. 55 is a low glycemic index food. A word I often say to people with diabetes is: You dare to eat rice, why not dare to eat fruit? The essence behind this is: the glycemic index of fruits is much lower than rice. Although the fruit is sweet, the glycemic index of most common fresh fruits is not high, such as 22 for cherries, 36 for apples, and 43 for grapes. The glycemic index of watermelon, cantaloupe, and pineapple is relatively high, above 55, but also lower than the staple food made of rice or flour (see table below). Sweet corn is also very sweet, but the glycemic index is 55, which is also significantly lower than the staple food made of rice noodles; and the glycemic index of boiled sweet potatoes is 77, although it is also high but lower than rice and buns. If you eat it cool, then blood sugar The index will be lower. Comparison of the glycemic index of fruits and common staple foods. In addition, fruits, potatoes and grains are important components of the diet. There are nearly 50 kinds of essential nutrients in the human body, which are indispensable. No natural food can meet all the nutrients required by the human body. Therefore, the diet must be composed of multiple foods. In the case of fruits, fruits contain minerals essential for the body but not self-synthesized, vitamins that have strong antioxidant effects to prevent cell aging, and soluble fiber pectin that can significantly reduce the concentration of cholesterol in the blood. Potatoes and cereals including corn are even more important. This is the basis of our diet, mainly providing carbohydrates, protein and B vitamins. In summary, if you have diabetes, sweet fruits, corn and potatoes can still be eaten: fruits are not too much at a time (about 150g), and corn and potatoes are used as staple foods. You can enjoy delicious food and increase nutrient intake without raising blood sugar. There are no bad foods, only bad collocations~ Welcome to leave a message in the comment area, I will also check back in time! Author| . Ding Bingjie Weibo丨Ding Ding Nutrition Class
The health status of cardiovascular and cerebrovascular is closely related, in fact, the connection between heart and brain is more than that. According to a report by the American Health Day website on August 2, the latest research found that people with high cardiac index have larger brain volume, and those with the lowest cardiac output have two years of premature aging compared with those with the highest cardiac output. In other words, the heart and brain are healthier. In medicine, the heart index refers to the number of liters of blood pumped by the heart per square meter of body surface area, which is calculated by dividing the cardiac output by the body surface area of the human body. The cardiac output here refers to the volume of blood output by the heart per minute. Cardiac index and cardiac output are commonly used by doctors to judge the blood circulation of the whole body. They can reflect the heart’s ability to supply blood to organs and tissues. Brain volume and structural integrity play a key role in advanced cognitive function. Some studies have pointed out that the decline in the brain volume of the elderly is an important factor in the development of dementia. In this report, the researchers divided the subjects into high, medium and low groups according to the cardiac index. “The heart index belongs to people with low and medium levels, and their brain volume is smaller than those with high levels of heart index.” The study leader, Angela Professor of Neurology, Alzheimer’s Disease Center, Boston University School of Medicine, USA Jefferson introduced. A total of more than 1,500 volunteers participated in the study, the average age was 61 years old, 54% were female, and all participants were free of heart disease. The research report also made statistics on the participants’ disease history and bad living habits. 10% were smokers, 9% had diabetes, and 28% had hypertension. The researchers evaluated the cardiac index and brain volume of all participants by MRI. In recent years, more and more studies have suggested that the health of the heart and circulatory system is closely linked to the health of the brain. For example, studies have shown that people with poor heart function have an increased risk of neuropsychological disorders and Alzheimer’s disease, but few people know that the heart is also closely related to the brain in a healthy state. The survey found that the brain volume of people with a low or medium heart index was significantly lower than those with high heart index. This result surprised the researchers. They also found that the relationship between heart index and brain volume was the closest among participants under 60 years of age. Jefferson speculated that one of the reasons may be that with age, dementia and other factors that affect brain health have also become more numerous. “We may have discovered another mechanism for abnormal changes in the brain, but we need more research to see what is the relationship between heart index and brain changes over time.” Jefferson said to Alzheimer Heart disease is a risk factor for Burden’s disease and other brain diseases. “It’s very interesting. The two are closely related, just like we measure a person’s heart disease risk by measuring their weight, blood pressure, and cholesterol. Now, there are two more indicators of heart index and brain volume. But we still have I don’t know what’s the cause of the two.” Dr. Ralph Sacco, chairman of the American Heart Association and director of neurology at Miami Miller School of Medicine, believes that the key message for the public is to emphasize the relationship between cardiovascular and cerebrovascular Connection, the state of the heart can affect brain health. He said that controlling heart disease risk factors, regular exercise, reasonable diet, maintaining a healthy weight, not smoking, controlling blood pressure, cholesterol and diabetes, etc., are still the fundamental task of maintaining heart, blood vessels, and brain health. For coronary heart disease or stroke Patients with cardiovascular and cerebrovascular diseases, in addition to the above health adjustment plan, also need to use drugs that can protect vascular endothelial cells, improve coronary artery and cerebral artery blood flow, and stabilize atherosclerotic plaque under the guidance of doctors. The Chinese medicine Naoxintong capsule developed under the guidance of “Brain-heart treatment” is an innovative Chinese patent medicine based on ancient medical prescriptions using modern high-tech. It is suitable for cardiovascular and cerebrovascular diseases such as ischemic cerebrovascular disease and coronary heart disease Disease treatment.
Some relatives and friends often ask biochemical results after physical examination, why are my liver and kidney functions, blood lipids and other indicators normal, but C-reactive protein will increase? In addition, some parents often hear doctors after a blood test when they go to the hospital clinic for a child with a fever: “C-reactive protein is elevated, there is inflammation in the body, and anti-inflammatory treatment is required.” What is the sacredness of this C-reactive protein? What is going on? What is C-reactive protein? C-reactive protein was first discovered by American scientists in 1930 and is one of the acute phase-reactive proteins in the body. C-reactive protein has a variety of biological effects. It can increase when the body is in an infection, inflammation, stress state, and tissue damage. Because of its high sensitivity, it is often used as an indicator for the diagnosis of infectious diseases or rheumatic immunity and connective tissue diseases. One, its level can also reflect the severity of the disease. Under physiological conditions, factors such as race, gender, age, obesity, and pregnancy may also affect its level. What is the rise of C-reactive protein? The normal value of C-reactive protein in children and adults is generally ≤10mg / L, and higher than this value can be regarded as an increase. Although C-reactive protein has high sensitivity, its specificity is poor. Many diseases such as infectious diseases, rheumatic immune diseases, cardiovascular and cerebrovascular diseases, metabolic syndrome, surgery and trauma can increase their levels. Therefore, it is difficult to clearly explain what is going on with C-reactive protein alone. Combine clinical symptoms and other indicators for analysis. For example, children often go to the hospital due to fever, cough and sore throat. If the blood leukocytes, neutrophils and C-reactive protein are all increased after examination, the diagnosis is acute tonsillitis. At this time, the increase in C-reactive protein is caused by Caused by bacterial infections. Another example is an elderly patient who suffered from joint pain due to sudden changes in the weather. A blood test revealed an increase in rheumatoid factor, erythrocyte sedimentation rate, and C-reactive protein, indicating that the patient is rheumatoid arthritis. At this time, the increase in C-reactive protein is caused by inflammation. Caused. How to reduce C-reactive protein? Simply put, in a word, the factors that cause the increase of C-reactive protein levels can be reduced. For example, the bacterial infection and rheumatoid arthritis mentioned above, after using antibacterial drugs to kill the pathogenic bacteria, or using anti-inflammatory drugs to suppress the inflammatory response, the level of C-reactive protein will naturally decrease. But in fact, not all C-reactive protein elevations require intervention. Due to their sensitivity, there are sometimes unexplained mild elevations, but the examiner does not experience any discomfort. High, everything else is normal. In fact, there is no need to intervene or worry too much. Even if you ca n’t worry, you can consult a laboratory physician or a specialist medical staff. References:  Zhang Xiaohui, Li Guangtao, Zhang Zhuoli. Detection and clinical significance of C-reactive protein and high-sensitivity C-reactive protein [J]. Chinese Journal of Clinical Immunology and Allergy, 2011, 5 (1): 74-79 [ 2] Ma Aihua, Liu Pan, Zhi Honglei, He Yingying, et al. Clinical study of C-reactive protein and procalcitonin indicators in emergency fever patients to guide the selection of antibacterial drugs [J], 2017, 27 (4): 774-780 (part of the picture in the text The source network, the copyright belongs to the original author, thank you for the picture author, if you find any violation of your copyright, please contact me, I will delete it.)
As an endocrinologist, a value I often use is the BMI index. Many people do n’t understand what the BMI index is. In fact, BMI is just an abbreviation of the English alphabet. Its full name is BodyMassIndex, which is also called body mass index in Chinese, and many people also call it. Is the body mass index. The BMI index is a commonly used international standard to measure the body’s fatness and thinness and whether it is healthy. Because this standard is very scientific, it is widely used in clinical practice. In reality, few people come to calculate their own BMI index. They It is often measured directly on the weight machine, and many people believe that weight is more than 150 pounds to be obese, and it is normal to be within 150 pounds. One important factor that is overlooked here is height. The BMI index is a perfect combination of weight and height. The data obtained by dividing your own weight (kg) by the square of your height (m) is the BMI index, so if you want to know your BMI index, you must not only measure Weight, but also measure height. The normal value of adult BMI is between 18.5-23.9, if the BMI is lower than 18.5, consider the underweight, BMI reaches 24-27 is overweight, BMI is between 28-32 is obese, if BMI exceeds 32, it is Very obese situation. For example, yesterday I saw a male patient in the outpatient clinic with a weight of 65kg and a height of 1.7 meters. According to the formula, his BMI index is about 20.76, which is a standard weight. There is also a male with a weight of 75kg and a height of 1.83 meters. According to the formula, his BMI index is about 19.46, which is also the standard weight. For example, a woman with a weight of 75kg and a height of 1.6 meters. According to the formula, his BMI index is about 29.29. Then according to the standard, she belongs to Obese. So, if the BMI index is abnormal, what harm will it cause? First, if the BMI index exceeds 28, the risk of suffering from cardiovascular and cerebrovascular diseases will be greatly increased, because the fatter, the higher the risk of hypertension, diabetes, coronary heart disease, and high blood fat. Second, the BMI index is less than 18.5, or even lower. Be alert to possible malnutrition, tuberculosis, or cancer. Although it is not too heavy, it is not good if it is too light.
Some people and patients with early stage kidney disease think that if the renal function index is normal in blood biochemical examination, they will think that there is no big problem. Blood creatinine = kidney function, in fact, this is wrong. The kidney has a powerful compensatory function. If both kidneys are normal, as long as one kidney functions, blood creatinine can be maintained at normal levels. That is to say, when blood creatinine is found to be elevated, nearly half of the kidneys have “broken”. How to detect early kidney damage? In addition to blood creatinine, what other indicators are more reliable? 01 Creatinine Clinically, blood creatinine is an important indicator for understanding kidney function. There is no fixed value for the normal value of blood creatinine, only a general range: the normal value of male blood creatinine is 54-106umol / L, the normal value of female blood creatinine is 44-97umol / L, and the normal value of pediatric blood creatinine is 24.9-69.7umol / L. In addition, the standards for measuring blood creatinine in different hospitals are also different. Generally speaking, the blood creatinine standard is: 44-133umol / L. When the blood creatinine exceeds 133umol / L, it means that the kidney has different degrees of damage, including renal insufficiency and renal failure. 02 Glomerular filtration rate is not perfect, and blood creatinine also has congenital deficiencies. Creatinine is a metabolic product of muscles. The more developed the muscles, the higher the creatinine will cause errors. And only when kidney function decreases by more than 2/3, creatinine will increase significantly. In view of the shortcomings of the creatinine index, medical workers based on the blood creatinine index, combined with the patient’s gender, age, weight and other factors, estimate the patient’s renal filtration rate, which can objectively reflect the true situation of the patient’s renal function. Clinically, the relationship between the progression of kidney disease and glomerular filtration rate is as follows: 03 urea nitrogen Before blood creatinine index application, urea nitrogen has been used to judge renal function, but urea nitrogen after glomerular filtration , It will still be reabsorbed by the renal tubules, and it will also be affected by external factors (such as infection, diet, heart failure, etc.), so it gradually faded out of people’s vision. However, among dialysis patients, urea nitrogen is widely used. The higher the index, the more serious the disease. 04 Cystatin C creatinine and urea nitrogen have their own shortcomings, and the factors involved in glomerular filtration rate are more complicated. Therefore, the measurement of renal function urgently needs a more reliable and direct stable index, cystatin Prime C undoubtedly assumed such a role. Cystatin C can only be excreted by the kidney, will not be reabsorbed by the renal tubule, and is not affected by factors such as gender, inflammation, muscle, etc. The index itself is sensitive, accurate, and relatively stable, which is suitable for measuring the size of renal function . At present, the clinical application of cystatin C is relatively short, and it is difficult to replace creatinine. 05 Renal function imaging is often referred to as renal ECT. The excretion process of radionuclides (technetium) in the kidney is used to comprehensively measure the patient’s renal function. The detection process is convenient and non-invasive, but the price is relatively high. At present, the reference to the creatinine index is still too much to judge renal function, and doctors rely more on glomerular filtration rate to assess patients’ renal function. It can also determine the patient’s renal function. If you have any related problems such as kidney disease, you can directly [Private Message] Professor Mo Feifan
【Case】 Male, 31 years old, married for 4 years, has been unfertile. A month ago, the hospital examined and found that the sperm motility was low, with a concentration of 21M / ml, Class A 15%, B13%, C20%, D52%. After taking medication, the semen was reviewed again recently, and it was found that the indicators were worse than before the medication: sperm concentration, 15M / ml, type A 5%, B10%, C25%, D60%. [Patient question] Can I still have children? How much hope is there for natural birth? [Doctor answer] Various indicators in the semen examination, such as the aforementioned concentration and sperm motility, only represent the probability of pregnancy. Indicators are normal, it can only show that the probability of pregnancy is relatively large, and it is not necessarily pregnant. Similarly, if the index does not meet the standard, it can only indicate that the probability of pregnancy is relatively small, and it may not necessarily be missed. From the patient’s index alone, if the child is within 1 year, the natural pregnancy probability per month is 20% to 30%, the probability of pregnancy in half a year should be 75%, and the probability of pregnancy in one year is 85% . If you do not have children for more than 1 year, the natural pregnancy probability will be greatly reduced. If you have not been pregnant for 4 consecutive years, the probability of natural birth every month can be less than 1%, and you need to pay attention to treatment.