The main symptoms and signs of vascular aortic dissection?

&nbsp.&nbsp.1. pain. &nbsp.&nbsp. Pain is the most common chief complaint of AD patients. The pain caused by AD is often described as a “tear-like” or “knife-like” sharp, persistent and unbearable pain. Some patients may also have no pain symptoms. &nbsp.&nbsp. The location and nature of the pain can indicate the location and progress of the AD break. Stanford type A dissection often presents with front chest pain or back pain, and Stanford type B dissection often presents with back pain or abdominal pain, but the two painful parts may overlap. The presence of migratory pain may indicate the progression of dissection. If the patient has pain in the lower limbs, it may indicate that the dissection may involve the iliac artery or femoral artery. &nbsp.&nbsp.2. Heart complications. &nbsp.&nbsp.The heart is the most commonly affected organ in Stanford A type AD. AD can lead to the destruction of the normal anatomical structure of the heart or the restriction of heart activity and cause related symptoms:&nbsp.&nbsp. (1) Dissection leads to dilation of the aortic root, poor aortic valve alignment, etc., which can cause aortic valve insufficiency. Obvious clinical manifestations, heart failure or even cardiogenic shock may occur in severe cases. &nbsp.&nbsp.(2) Dissection involving coronary artery openings can lead to acute myocardial infarction, heart failure or malignant arrhythmia. Patients can present with typical coronary syndromes such as chest pain, chest tightness and dyspnea, and ST segment elevation of ECG And T wave changes. &nbsp.&nbsp. (3) The leakage of the dissection false cavity or the dissection breaking into the pericardium can cause pericardial effusion or pericardial tamponade, and the incidence is about 17.7%. &nbsp.&nbsp.(4) Acute aortic insufficiency, acute ischemia or infarction and pericardial tamponade are often manifested as heart failure. &nbsp.&nbsp.3. Other manifestations of poor perfusion of organs&nbsp.&nbsp. Involving other important branch vessels of the aorta can lead to clinical manifestations of organ ischemia or poor perfusion:&nbsp.&nbsp. (1) Dissection involving the innominate artery or left common carotid artery can lead to the central nervous system Nervous system symptoms, 3% to 6% of patients have cerebrovascular accidents, and the patients show syncope or disturbance of consciousness; when the dissection affects the perfusion of the spinal artery, spinal cord ischemia or necrosis can lead to paresis or paraplegia of the lower limbs. &nbsp.&nbsp. (2) Dissection involving one or both renal arteries may have hematuria, anuria, severe hypertension and even renal failure. &nbsp.&nbsp. (3) Dissections involving the abdominal trunk, superior mesenteric and inferior mesenteric arteries can cause gastrointestinal ischemic manifestations, such as acute abdomen and intestinal necrosis, and some patients have black stools or bloody stools; sometimes celiac artery involvement Liver or spleen infarction. &nbsp.&nbsp. (4) Acute lower limb ischemia symptoms such as pain, pulselessness and even lower limb ischemic necrosis may occur when the dissection involves the lower limb arteries. &nbsp.&nbsp.&nbsp.Clinical patients have the following signs:&nbsp.&nbsp.(1) Abnormal blood pressure: AD can often cause a decrease in blood flow in the distal limbs, leading to greater differences in blood pressure in the limbs. If the measured limb is the affected side of the dissection, it will be misdiagnosed as hypotension, leading to misdiagnosis and wrong treatment. Therefore, for AD patients, blood pressure of the extremities should be measured routinely. 50.1% to 75.9% of AD patients have hypertension, but some patients have low blood pressure when they see a doctor. At this time, the possibility of cardiac tamponade should be considered. &nbsp.&nbsp. (2) Diastolic murmurs in the aortic valve area and the patient has no history of heart disease, suggesting the possibility of acute aortic regurgitation caused by dissection. &nbsp.&nbsp. (3) Chest signs: When AD has a large amount of exudation or rupture and bleeding, the trachea may shift to the right, the left chest percussion is dull, and the left breath sounds weakened; the wet rales in both lungs indicate acute left heart failure . &nbsp.&nbsp. (4) Abdominal signs: AD causes intestinal paralysis or even necrosis when the blood supply to the abdominal organs is impaired. It is manifested as abdominal bulging, drum sounds on percussion, extensive tenderness, rebound pain and muscle tension. &nbsp.&nbsp. (5) Nervous system signs: apathy, lethargy, coma, or hemiplegia when the blood supply to the brain is impaired; when the blood supply to the spinal cord is impaired, the muscle strength of the lower limbs may be weakened or even paraplegia.

[Disease Science] Diagnosis and treatment of Major syndrome

&nbsp.Meige Syndrome is a group of extrapyramidal diseases first described by the French neurologist Henry Meige in 1910. It is also an idiopathic dystonia involving the head and face. It can occasionally involve the neck and upper limbs. ,trunk. Treatment is more difficult, often leading to patients with inferiority complex, obstructing walking and reading, and obstructing normal communication with others, which seriously affects patients’ normal life and work. Major syndrome is more common in middle-aged and elderly women. Most of the first symptoms are bilateral blepharospasm, which can gradually involve the mouth, face, jaw and other parts. The patient showed frequent involuntary blinking of the eyes, difficulty in opening the eyes, involuntary movement of the muscles of the mouth, face and jaw, showing a “eyebrow winking” shape. A small number of patients may have unilateral onset and gradually involve the contralateral side. Symptoms of patients are often induced and aggravated by tension, fatigue, bright light, staring, etc., and improved during sleep, speech, singing, and mouth opening. Major syndrome needs to be distinguished from hemifacial spasm. Facial spasm is often only unilaterally affected. Bilateral involvement is rare. The main manifestations are unilateral eyelid involuntary beating and twitching, which can affect the ipsilateral cheek, but not There is involuntary movement of the jaw on both sides of the mouth and face. Non-surgical treatment of Major’s syndrome Non-surgical treatment of Major’s syndrome mainly includes botulinum toxin injection and drug treatment. Botulinum toxin injection can improve the symptoms of some patients, but it usually recurs within 3-6 months, and the effect is further reduced after repeated injections. The overall effect of drug treatment is not satisfactory. Commonly used drugs are Antan, clonazepam, baclofen, haloperidol, and chlorazide. Drugs are ineffective for many patients and can only partially improve the symptoms of some patients, and the side effects caused by drugs are often difficult for patients to tolerate. Levodopa can aggravate the condition. Carbamazepine and sodium valproate are ineffective. Surgical treatment of Major’s syndrome Surgical treatment is currently the best method for treating Major’s syndrome. In recent years, we have used deep brain stimulation to treat Major syndrome and achieved good results. Deep brain stimulation is also called “brain pacemaker therapy”, and the postoperative symptoms improve better.

What are the clinical manifestations of gout

1. Acute gouty arthritis    most patients have no obvious signs before the onset, or only fatigue, general malaise and joint tingling. The typical attack is often awakened by joint pain in the middle of the night, and the pain is progressively intensified, reaching a peak around 12 hours, showing tearing, knife cutting or biting, which is unbearable. The affected joints and surrounding tissues are red, swollen, hot, painful, and functional. More than a few days or 2 weeks to relieve itself. The first attack often invades a single joint, and some of it occurs in the first metatarsophalangeal joint. In the later course of the disease, some patients involve this part. Followed by joints such as the back of the foot, heel, ankle, knee, wrist, and elbow. Joints such as shoulder, hip, spine and temporomandibular joints are less affected, and multiple joints may be involved at the same time, showing polyarthritis. Some patients may have systemic symptoms such as fever, chills, headache, palpitations and nausea, which may be accompanied by increased white blood cell count, increased red blood cell sedimentation rate, and increased C-reactive protein. 2. During the intermittent period, the gout attack lasts for several days to several weeks and can be relieved by itself. Generally, there are no obvious sequelae symptoms, or local skin pigmentation, scaling and irritation, etc., will enter the asymptomatic intermittent period, which lasts several months and several months. Recurrence after a year or more than ten years, most patients relapse within one year, more and more frequently, more and more joints are involved, and symptoms last longer and longer. The affected joints generally develop from the lower limbs to the upper limbs, from the distal small joints to the large joints. Joints such as fingers, wrists, and elbows are involved. A few patients may affect the shoulder, hip, sacroiliac, sternoclavicular or spinal joints, or joints. Symptoms tend to be atypical in surrounding bursae, tendons and tendon sheaths. A small number of patients have no intermittent periods and show chronic arthritis after the first onset. 3. Subcutaneous tophi and chronic tophus arthritis during chronic tophi disease are the results of long-term significant hyperuricemia, and a large number of monosodium urate crystals are deposited under the skin, joint synovium, cartilage, bone and soft tissue around the joint . The typical location of subcutaneous tophi is the ears, and it is also common around the joints, olecranon, Achilles tendon, and patella bursa. The appearance is yellow-white growths of various sizes raised under the skin. The skin surface is thin, and white powder or paste is discharged after rupture, which does not heal for a long time. Subcutaneous tophi often coexists with chronic tophitic arthritis. A large amount of tophi deposited in the joints can cause joint bone destruction, fibrosis of the tissues around the joints, and secondary degenerative changes. The clinical manifestations are persistent joint swelling and pain, tenderness, deformity and dysfunction. Symptoms in the chronic phase are relatively mild, but acute attacks may also occur.  4. Kidney disease   (1) Chronic urate nephropathy Uric acid crystals are deposited in the renal interstitium, resulting in chronic tubular-interstitial nephritis. The clinical manifestations include decreased urine concentration, increased nocturia, low specific gravity urine, small molecule proteinuria, leukocyte urine, mild hematuria, and tubular urine. The late stage can cause glomerular filtration function to decline and renal insufficiency.  (2) Uric acid urinary tract stones The concentration of uric acid in the urine increases and becomes supersaturated, which deposits and forms stones in the urinary system. The incidence in gout patients is more than 20%, and it may occur before the occurrence of gout arthritis. Smaller stones are excreted in the urine in a gritty shape, and may be asymptomatic. Larger ones can block the urinary tract, causing renal colic, hematuria, dysuria, urinary tract infection, renal pelvic dilation, and water accumulation.   (3) Acute uric acid nephropathy blood and urine levels of uric acid rise sharply, a large number of uric acid crystals are deposited in the renal tubules, collecting ducts, etc., causing acute urinary tract obstruction. The clinical manifestations are oliguria, anuria, and acute renal failure. A large number of uric acid crystals can be seen in the urine. Mostly caused by secondary causes such as malignant tumors and their radiotherapy and chemotherapy (ie tumor lysis syndrome).

Focus on children’s allergic purpura, and support children for a whole day

   Many parents think that small purpura is not harmful, it is just a skin disease. It is wrong to have this kind of thinking. It seems that it is a skin problem, but it can actually damage the kidneys! Clinically, there are frequent recurring attacks. The incidence of renal involvement can reach 20%-100%. Repeated attacks further increase the incidence of renal involvement. Kidney involvement and its degree directly determine the prognosis of the disease. Therefore, the doctor advises you to: First of all, change your lifestyle!  1. Skin care  Because most of the patients are young and have low self-control ability, the nurses need to work with their families to supervise the skin of the children, and avoid the children from touching and scratching the skin of the purpura to avoid skin damage. During the nursing period, strengthen the cleaning of parts of purpura to keep the skin dry and clean. For existing wounds, timely disinfection is required, and the ulcerated parts should be disinfected and cleaned in time to prevent infection. In addition, it is necessary to regularly replace clothing that directly touches the skin of children, such as bed sheets and hospital clothes, and carefully disinfect the changed clothing to avoid skin irritation and infection.  2. Diet Nursing   Most children with allergic constitutions need to cut off allergens from the food first, and strictly prohibit the consumption of high-protein foods such as fish, shrimp, crab, eggs, milk, and allergenic plants. At the same time, the child is in the growth period and needs a balanced and reasonable diet. According to the communication with the family and the situation of the child, a nutritional menu that meets the dietary requirements and can be accepted by the child is developed. Appropriate vitamin C-rich vegetables and fruits can be added to the menu to protect blood vessels, increase blood vessel toughness, and reduce bleeding points.  Because most children have gastrointestinal pain and even bleeding, they need to pay special attention to fasting spicy, rough, and difficult to digest foods to avoid re-irritating the mucous membranes and causing bleeding. Children with nephrotic syndrome such as edema need to pay special attention to salt intake and implement a low-salt diet to reduce the burden on the kidneys. During the hospitalization period, it is necessary to prepare three meals for the child in strict accordance with the dishes in the nutrition menu, and it is forbidden to eat food outside the menu. 3. Environmental care first, keep the ward sanitary and clean, change sheets regularly, disinfect and clean fixed medical equipment regularly, open windows regularly for ventilation, and use wet cleaning during cleaning to avoid dust and cause dust allergy. . Second, toys and entertainment facilities in children’s wards must be safe and clean. The integrity of the toys and the safety of the facilities must be checked regularly, and disinfection should be done regularly. Third, you can make some decorations in a suitable position in the ward to adjust the atmosphere of the ward.

Patient questions | What are the symptoms of syringomyelia?

Syringomyelia refers to the formation of a cavity in the spinal cord. It is a slowly progressive degenerative disease of the spinal cord caused by a variety of reasons. These cavities can be the enlargement of the central canal of the spinal cord (some people call it hydrocephalus) or it can be Independent cavity. The number of new cases of the disease each year is about 8.4 people per 100,000. It is common in the cervical segment and can involve multiple spinal cord segments. In some cases, it can extend up to the medulla oblongata and pons, called medulla bulbar cavity. Symptoms of syringomyelia 1. Sensory disturbances are most often caused by cavities from the base of the posterior horn of one side of the neck. Therefore, the early prominent symptoms are segmental dissociative sensory disturbances, that is, pain, loss of temperature and the presence of touch and deep sensation Most cases start with asymmetric unilateral sensory loss. Sensory loss may be reflected by clinical manifestations such as painless skin ulcers, scars, edema, Charcot joints, and end finger (toe) bone resorption. Children have multiple causes. There is no pain in the fingers, and the local skin is burned. When the cavity expands to the front of the gray matter, bilateral “vest” type dissociative sensory disturbance appears. Sometimes children complain of spontaneous indescribable burning in the sensory loss area The pain is continuous and is called &quot.central pain&quot.. If the cavity continues to expand and invades the spinothalamic tract, the contralateral pain below the damage plane and loss of temperature perception. The posterior cord of the spinal cord is often finally invaded and the damage plane appears The following deep sensory loss.    2 Dyskinesia syringomyelia mostly occurs in lower motor neuron atrophy and weakness of the upper limbs. The lesions often involve the ends of the upper limbs, with the most claw-shaped hands, rarely affecting the forearms and upper arms, and the muscle atrophy of the corresponding segments. Fasciculation. If the cavity is in the cervical dilatation zone, the small muscles of the hands are the most prominent, and the upper limb tendon reflex is reduced or disappeared. Invasion of the pyramidal tract will damage the upper motor neurons below the plane, and the ipsilateral limb spastic paralysis. Enlargement, due to the proliferation of glial cells in the lateral cord of the spinal cord or compression of the corticospinal tract, there may be sphincter dysfunction. T1 segment involvement often leads to ipsilateral Horner syndrome. Sometimes bleeding in the syringomyelia can quickly worsen the symptoms.   3 The most common nutritional disorders are joint swelling, articular surface wear, cortical atrophy, and bone decalcification, which often invade the upper limb joints, without pain, and make noise when moving. Neurogenic arthropathy is called Charcot joints. In addition. , Skin nutritional disorders, including abnormal sweating, bruising, hyperkeratosis, and thickening of the skin. Because there is no pain, the fingers or toes are often injured and form intractable ulcers, and even painless necrosis and prolapse occur at the ends of the fingers and toes.   4 medullary symptom Bulbala is often accompanied by syringomyelia, which is a continuation of syringomyelia. Symptoms are asymmetrical, involving one side of the medulla oblongata, and may have dysarthria, dysphagia, etc. Lateral signs. Involving the trigeminal nerve spinal tract and spinal tract nucleus, there may be cross sensory disturbances, and there may be fibers that affect the cerebellar pathway.    5 Other diseases may have bladder and rectal dysfunction in the later stages. In addition, this disease often combines multiple congenitals Sexual deformities, such as cervical ribs, high arched palate, kyphosis or scoliosis, spina bifida and Arnold-Chiari deformity, arched feet, etc.

Tell you what are the symptoms of gout

1. Acute gouty arthritis    most patients have no obvious signs before the onset, or only fatigue, general malaise and joint tingling. The typical attack often wakes up late at night due to joint pain, and the pain is progressively intensified, reaching a peak at about 12 hours, showing tearing, knife cutting or biting, which is unbearable. The affected joints and surrounding tissues are red, swollen, hot, painful, and functional. More than a few days or 2 weeks to relieve itself. The first attack often invades a single joint, and some of it occurs in the first metatarsophalangeal joint. In the later course of the disease, some patients involve this part. Followed by joints such as the back of the foot, heel, ankle, knee, wrist and elbow, the shoulder, hip, spine and temporomandibular joints are less affected, and multiple joints may be involved at the same time, showing polyarthritis. Some patients may have systemic symptoms such as fever, chills, headache, palpitations and nausea, which may be accompanied by increased white blood cell count, increased red blood cell sedimentation rate, and increased C-reactive protein. 2. During the intermittent period, the gout attack lasts for several days to several weeks and can be relieved by itself. Generally, there are no obvious sequelae symptoms, or local skin pigmentation, scaling and irritation, etc., will enter the asymptomatic intermittent period, which lasts several months and several months. Recurrence after a year or more than ten years, most patients relapse within one year, more and more frequently, more and more joints are involved, and symptoms last longer and longer. The affected joints generally develop from the lower limbs to the upper limbs, from the distal small joints to the large joints. Joints such as fingers, wrists, and elbows are involved. A few patients may affect the shoulder, hip, sacroiliac, sternoclavicular or spinal joints, or joints. Symptoms tend to be atypical in surrounding bursae, tendons and tendon sheaths. A small number of patients have no intermittent periods and show chronic arthritis after the first onset. 3. Subcutaneous tophi and chronic tophus arthritis during chronic tophi disease are the results of long-term significant hyperuricemia, and a large number of monosodium urate crystals are deposited under the skin, joint synovium, cartilage, bone and soft tissue around the joint . The typical location of subcutaneous tophi is the ears, and it is also common around the joints, olecranon, Achilles tendon, and patella bursa. The appearance is yellow-white growths of various sizes raised under the skin. The skin surface is thin, and white powder or paste is discharged after rupture, which does not heal for a long time. Subcutaneous tophi often coexists with chronic tophitic arthritis. A large amount of tophi deposited in the joints can cause joint bone destruction, fibrosis of the tissues around the joints, and secondary degenerative changes. The clinical manifestations are persistent joint swelling and pain, tenderness, deformity and dysfunction. Symptoms in the chronic phase are relatively mild, but acute attacks may also occur.  4. Kidney disease   (1) Chronic urate nephropathy Uric acid crystals are deposited in the renal interstitium, resulting in chronic tubular-interstitial nephritis. The clinical manifestations include decreased urine concentration, increased nocturia, low specific gravity urine, small molecule proteinuria, leukocyte urine, mild hematuria, and tubular urine. The late stage can cause glomerular filtration function to decline and renal insufficiency.  (2) Uric acid urinary tract stones The concentration of uric acid in the urine increases and becomes supersaturated, which deposits and forms stones in the urinary system. The incidence in gout patients is more than 20%, and it may occur before the occurrence of gout arthritis. Smaller stones are excreted in the urine in a gritty shape, and may be asymptomatic. Larger ones can block the urinary tract, causing renal colic, hematuria, dysuria, urinary tract infection, renal pelvic dilation, and water accumulation.   (3) Acute uric acid nephropathy blood and urine levels of uric acid rise sharply, a large number of uric acid crystals are deposited in the renal tubules, collecting ducts, etc., causing acute urinary tract obstruction. The clinical manifestations are oliguria, anuria, and acute renal failure. A large number of uric acid crystals can be seen in the urine. Mostly caused by secondary causes such as malignant tumors and their radiotherapy and chemotherapy (ie tumor lysis syndrome).

Do you know the symptoms of gout

1. Acute gouty arthritis    most patients have no obvious signs before the onset, or only fatigue, general malaise and joint tingling. The typical attack often wakes up late at night due to joint pain, and the pain is progressively intensified, reaching a peak at about 12 hours, showing tearing, knife cutting or biting, which is unbearable. The affected joints and surrounding tissues are red, swollen, hot, painful, and functional. More than a few days or 2 weeks to relieve itself. The first attack often invades a single joint, and some of it occurs in the first metatarsophalangeal joint. In the later course of the disease, some patients involve this part. Followed by joints such as the back of the foot, heel, ankle, knee, wrist and elbow, the shoulder, hip, spine and temporomandibular joints are less affected, and multiple joints may be involved at the same time, showing polyarthritis. Some patients may have systemic symptoms such as fever, chills, headache, palpitations and nausea, which may be accompanied by increased white blood cell count, increased red blood cell sedimentation rate, and increased C-reactive protein. 2. During the intermittent period, the gout attack lasts for several days to several weeks and can be relieved by itself. Generally, there are no obvious sequelae symptoms, or local skin pigmentation, scaling and irritation, etc., will enter the asymptomatic intermittent period, which lasts several months and several months. Recurrence after a year or more than ten years, most patients relapse within one year, more and more frequently, more and more joints are involved, and symptoms last longer and longer. The affected joints generally develop from the lower limbs to the upper limbs, from the distal small joints to the large joints. Joints such as fingers, wrists, and elbows are involved. A few patients may affect the shoulder, hip, sacroiliac, sternoclavicular or spinal joints, or joints. Symptoms tend to be atypical in surrounding bursae, tendons and tendon sheaths. A small number of patients have no intermittent periods and show chronic arthritis after the first onset. 3. Subcutaneous tophi and chronic tophus arthritis during chronic tophi disease are the results of long-term significant hyperuricemia, and a large number of monosodium urate crystals are deposited under the skin, joint synovium, cartilage, bone and soft tissue around the joint . The typical location of subcutaneous tophi is the ears, and it is also common around the joints, olecranon, Achilles tendon, and patella bursa. The appearance is yellow-white growths of various sizes raised under the skin. The skin surface is thin, and white powder or paste is discharged after rupture, which does not heal for a long time. Subcutaneous tophi often coexists with chronic tophitic arthritis. A large amount of tophi deposited in the joints can cause joint bone destruction, fibrosis of the tissues around the joints, and secondary degenerative changes. The clinical manifestations are persistent joint swelling and pain, tenderness, deformity and dysfunction. Symptoms in the chronic phase are relatively mild, but acute attacks may also occur.  4. Kidney disease   (1) Chronic urate nephropathy Uric acid crystals are deposited in the renal interstitium, resulting in chronic tubular-interstitial nephritis. The clinical manifestations include decreased urine concentration, increased nocturia, low specific gravity urine, small molecule proteinuria, leukocyte urine, mild hematuria, and tubular urine. The late stage can cause glomerular filtration function to decline and renal insufficiency.  (2) Uric acid urinary tract stones The concentration of uric acid in the urine increases and becomes supersaturated, which deposits and forms stones in the urinary system. The incidence in gout patients is more than 20%, and it may occur before the occurrence of gout arthritis. Smaller stones are excreted in the urine in a gritty shape, and may be asymptomatic. Larger ones can block the urinary tract, causing renal colic, hematuria, dysuria, urinary tract infection, renal pelvic dilation, and water accumulation.   (3) Acute uric acid nephropathy blood and urine levels of uric acid rise sharply, a large number of uric acid crystals are deposited in the renal tubules, collecting ducts, etc., causing acute urinary tract obstruction. The clinical manifestations are oliguria, anuria, and acute renal failure. A large number of uric acid crystals can be seen in the urine. Mostly caused by secondary causes such as malignant tumors and their radiotherapy and chemotherapy (ie tumor lysis syndrome).

A small allergic purpura can also develop into kidney failure? The doctor advises you, these lifestyles

Many parents believe that small purpura is not harmful, it is just a skin disease. It is wrong to have this kind of thinking. It seems that it is a skin problem, but it can actually damage the kidneys! Frequent recurring episodes in clinical practice, the incidence of renal involvement can reach 20%-100%. Repeated episodes further increase the incidence of renal involvement. Kidney involvement and its degree directly determine the prognosis of the disease. Therefore, the doctor advises you to: First of all, change your lifestyle!  1. Skin care  Because most of the patients are young and have low self-control ability, the nurses need to work with their families to supervise the skin of the children, to avoid the children touching and scratching the skin of the purpura to avoid skin damage. During the nursing period, strengthen the cleaning of parts of purpura to keep the skin dry and clean. For existing wounds, timely disinfection is required, and the ulcerated parts should be disinfected and cleaned in time to prevent infection. In addition, it is necessary to regularly replace clothing that directly touches the skin of children, such as bed sheets and hospital clothes, and carefully disinfect the changed clothing to avoid skin irritation and infection.  2. Diet Nursing   Most children with allergic constitutions need to cut off allergens from the food first, and strictly prohibit the consumption of high-protein foods such as fish, shrimp, crab, eggs, milk, and allergenic plants. At the same time, the child is in the growth period and needs a balanced and reasonable diet. According to the communication with the family and the situation of the child, a nutritional menu that meets the dietary requirements and can be accepted by the child is developed. Appropriate vitamin C-rich vegetables and fruits can be added to the menu to protect blood vessels, increase blood vessel toughness, and reduce bleeding points. &nbsp.Hu Guisheng Assistant WeChat: dd326751   Because most children have gastrointestinal pain and even bleeding, they need to pay special attention to fasting spicy, rough, and difficult to digest foods to avoid re-irritating the mucous membranes and causing bleeding. Children with nephrotic syndrome such as edema need to pay special attention to salt intake and implement a low-salt diet to reduce the burden on the kidneys. During the hospitalization period, it is necessary to prepare three meals for the child in strict accordance with the dishes in the nutrition menu, and it is forbidden to eat food outside the menu. 3. Environmental care first, keep the ward clean, change bed sheets regularly, disinfect and clean fixed medical equipment regularly, open windows regularly for ventilation, and use wet cleaning during cleaning to avoid dust and cause dust allergy. . Second, toys and entertainment facilities in children’s wards must be safe and clean. The integrity of the toys and the safety of the facilities must be checked regularly, and disinfection should be done regularly. Third, you can make some decorations in a suitable position in the ward to adjust the atmosphere of the ward.

How is scleroderma diagnosed? The latest guide is here

Is skin swelling a scleroderma? Is skin darkening scleroderma? How is scleroderma diagnosed? The latest version of the 2019 guide is here. Systemic sclerosis, commonly known as scleroderma, often starts with Raynaud’s phenomenon. Gastroesophageal reflux may be combined in the early stage of the disease. As the course of the disease progresses, the patient gradually develops skin swelling and hardening, which may be accompanied by skin pigment changes, including hyperpigmentation or depigmentation. In addition to skin involvement, patients with scleroderma are often accompanied by symptoms such as joint pain and myalgia, as well as finger ulcers and telangiectasia. In addition, patients with scleroderma may have multiple internal organ involvement. The respiratory system is more susceptible to involvement, mainly manifested as pulmonary interstitial fibrosis and pulmonary hypertension. The digestive system of patients with scleroderma has various manifestations, including gastroesophageal reflux, antral vasodilation, abdominal pain, diarrhea, constipation, and fecal incontinence. A small number of patients may have renal crisis, which is mainly manifested as acute renal insufficiency, and often complicated by hypertension. Heart involvement can be manifested as pericardial effusion and cardiac conduction system abnormalities, and individual patients may have myocardial involvement. In terms of the nervous system, peripheral nervous system involvement is more common, such as trigeminal neuropathy, peripheral neuropathy, etc., and central nervous system involvement is rare. CREST syndrome is a special subtype of scleroderma. The clinical manifestations include calcium deposits, Raynaud’s phenomenon, esophageal dysfunction, digit (toe) sclerosis, and telangiectasia. Such patients are often accompanied by anticentromere antibodies (ACA) positive. According to the SSc classification criteria issued by ACR/EULAR in 2013, when the total score is greater than or equal to 9 points, it can be classified and diagnosed as systemic sclerosis. The skin lesions of systemic sclerosis can be divided into three stages from the course of the disease: ① Swelling stage: Early skin swelling, shiny, tightness, non-pitting, hard swelling, fingers can be “sausage finger” change. ② Hardening period: The skin gradually thickens and hardens, indicating that it is smooth and leather-like, wrinkles disappear, not easy to pinch, and hairs are reduced. Facial skin is affected, radioactive grooves appear around the mouth, lips become thinner, and the nose tip becomes sharp, showing a “mask face”. ③Atrophy: the superficial dermis becomes thin and brittle, the epidermis is loose, and the subcutaneous soft tissue is calcified. There is less sweat at the lesion and hair loss. In the swelling and sclerosis phases, most patients’ skin lesions can be reversed or improved to avoid entering the atrophy phase.

Diagnostic criteria for rheumatoid arthritis

Early detection to prevent the irreversible lesions of rheumatoid arthritis is the first priority in diagnosis, but the diagnosis may only be confirmed after several examinations by a physician. In view of this, the American College of Rheumatology (ACR) assembled experts in 1987 to re-draw a set of simple and accurate diagnostic criteria. At present, many* have adopted this standard. In addition, domestic diagnostic criteria for this disease have also been proposed. The following is introduced:   (1) The diagnostic criteria for rheumatoid arthritis of the American Academy of Rheumatology  ①Morning stiffness.  ② Pain or tenderness when at least one joint moves (as seen by the doctor).  ③At least one joint is swollen (soft tissue hypertrophy or fluid accumulation instead of bone hyperplasia, as seen by the doctor).  ④At least another joint is swollen (as seen by the doctor, the time between the involvement of the two joints should not exceed 3 months).  ⑤ Symmetrical joint swelling (as seen by the doctor) and invading the same joint on both sides of the body at the same time (if it invades the proximal interphalangeal joint, metacarpophalangeal joint or ?FDA3? toe joint, it does not need to be completely symmetrical). The involvement of the distal interphalangeal joints cannot meet this criterion.  ⑥ The subcutaneous nodules on the extension side near the bone protuberance or joint (as seen by the doctor).  ⑦ Standard X-ray findings (except for bone hyperplasia, there must be osteoporosis near the affected joints).  ⑧ positive for rheumatoid factor.  ⑨Poor coagulation of mucin in synovial fluid. ⑩ There are three or more of the following synovial pathological changes: obvious villous hyperplasia; superficial synovial cell hyperplasia and palisade; obvious chronic inflammatory cell (mainly lymphocytes and plasma cells) infiltration and lymph node formation Trend; dense cellulose deposition in the surface or interstitium; focal necrosis.  ⑾ The histological changes in the subcutaneous nodules should show cell necrosis in the central area, surrounded by palisade hyperplastic macrophages and the outermost chronic inflammatory cell infiltration.  Typical rheumatoid arthritis: The diagnostic criteria require 7 items of the above items. In items 1 to 5, joint symptoms must last at least 6 weeks.   Affirmative rheumatoid arthritis: its diagnosis requires 5 of the above items. In items 1 to 5, joint symptoms must last at least 6 weeks.  Possible rheumatoid arthritis: The diagnosis requires 3 of the above items, and at least 1 of the 1 to 5 items. His joint symptoms must last at least 6 weeks.   Suspected rheumatoid arthritis: The diagnosis requires 2 of the following items, and the duration of joint symptoms should be no less than 3 weeks:   ①Morning stiffness.  ②Tenderness and pain during activity (as seen by the doctor), intermittently or lasting for at least 3 weeks.  ③History or findings of joint swelling.  ⑤ Subcutaneous nodules (as seen by the doctor).  ⑤The erythrocyte sedimentation rate increased, and C-reactive protein was positive.  ⑥ Iritis (except in children with rheumatoid arthritis, the value is questionable). (2) Domestic diagnostic criteria (revised and adopted by the National Conference on Integrated Traditional Chinese and Western Medicine in Rheumatic Diseases in 1988)   ①Symptoms: mainly small joints, mostly multiple joint swelling and pain or small joint symmetrical swelling and pain (single cases must be serious Different from others, joint symptoms last at least 6 weeks), morning stiffness.  ②Physical signs: swelling and tenderness of the involved joints, limited mobility, or deformity, or rigidity, some cases may have subcutaneous nodules.  ③Laboratory examination: RF (rheumatoid factor) is positive, ESR (erythrocyte sedimentation rate) is more rapid.  ④X-ray examination: Key affected joints have typical X-ray findings of rheumatoid arthritis.   It can be diagnosed for patients with the above-mentioned symptoms and signs, either with RF positive or with typical X-ray findings. And there are the following stages.  ①Early: Most of the affected joints have swelling and pain and limited mobility, but X-rays only show swelling of soft tissues and osteoporosis.  ②In the middle stage: some of the affected joints are significantly restricted in functional activities, and X-ray films show narrowing of the joint space and varying degrees of bone corrosion.  ③ Late stage: Most of the affected joints have various deformities or rigidity, and are difficult to move. X-ray films show severe joint damage, dislocation or fusion.

How to treat male urethral orifice condyloma acuminatum

   Urethral condyloma acuminata actually refers to the condyloma acuminata that grows inside the urethra, usually at a depth of 1-1.5cm from the urethral opening. Symptoms usually include frequent urination, urgency, dysuria, and changes in urine flow curve.   If the urethral condyloma acuminata lesions in the urethra, severely involving the bladder may cause bilateral ureteral obstruction, which may cause hydronephrosis, renal infection, renal insufficiency, etc. Those who involve the pelvic cavity can cause intestinal obstruction, lower extremity edema, and secondary infections due to scratching. Try to avoid laser, electrocautery, freezing and other treatments. First, the focus of these methods is to remove warts. HPV virus that cannot act on the skin and mucous membranes is very easy to relapse. Second, the operation process is painful and easily leads to urethral discomfort. It does not disappear for a long time, and even causes scarring of the urethra.  Nanjing Youjia Virus and Wart Medical Research Institute-the national pure Chinese medicine patent formula treats condyloma acuminatum, cures the symptoms and the root cause, achieves a radical cure, and goes with the treatment.  1. Blocking the replication of viral DNA, causing the wart to lose its root and nutritional support.  2. It automatically becomes smaller, withered, and gradually falls off.  3. Improve the body’s microcirculation function, activate the human immune system, produce immunoglobulins, and improve autoimmune function.   4. No pain, no toxic side effects, no scars after healing.   5. For those who are far away, they can be treated remotely.

What are the symptoms of rheumatoid arthritis?

Rheumatoid Arthritis Symptoms&nbsp. Any age-onset   In our*, there are many patients with rheumatoid arthritis, and the common patients are basically women. There is generally no age limit for rheumatoid arthritis. It can occur at any age, but the most common age is still between 20 and 50 years old. The recurrence of this disease is very high, so the possibility of disability is relatively high. For current medicine, there is currently no better way to treat this disease. &nbsp.Rheumatoid Arthritis Symptoms&nbsp. Joint involvement Rheumatoid arthritis is generally manifested in the pain and swelling of the affected joints and restricted movement. At the beginning of the disease, it is only migratory, but then it will appear in certain Parts. At the same time, single or multiple joints are affected, and symmetry appears. In most patients, the small joints of the hands and feet are the first to be affected, and the interphalangeal joints, wrist joints, and metacarpophalangeal joints are more common.

Can the purpura kidney be reversed?

Assistant Hu Guisheng WeChat: dd326751 Purpura is a kind of vasculitis. Due to the combination of antigen and antibody, immune complexes are deposited on the blood vessel wall, causing inflammation in and around the walls of capillaries and small blood vessels. The kidney is the place where the capillaries gather. When the blood vessels of the kidney are damaged, urine protein and occult blood will appear. This is the origin of purpuric nephritis. The long-term treatment and repeated recurrence of Henoch-Schonlein purpura will aggravate the kidney damage and increase the difficulty of treatment. There will be no possibility of affecting life safety in the short term. However, as the course of the disease grows, it cannot be ruled out that the progress of the disease can worsen and may lead to the kidney Aging and uremia.   Kidney involvement is usually impaired, manifested as gross hematuria or microscopic hematuria, which can appear continuously or intermittently, and is more severe during purpura infection or attacks.   Allergic purpura develops to purpura kidney, according to the clinical pathological classification, it can be divided into mild, moderate, and severe. To see whether the purpura kidney can be reversed, it depends on whether it is controlled when the condition has not become serious. The kidney is one of the main organs involved, which directly affects the course and prognosis of the disease. Its incidence is 90%-100% based on renal biopsy, but the clinical incidence is about 30%-600%. This is because the kidney is The organ with the most abundant capillary distribution is extremely vulnerable. The degree of disease varies and the clinical manifestations vary. Therefore, whether there is kidney damage, the diagnosis should be based on pathology.   Severe purpura kidney is irreversible, it will cause continuous damage to the kidney, affect the normal role of renal function, and may enter end-stage renal failure in the short term. In the event of severe renal impairment, patients need to receive renal replacement therapy to promote recovery. In terms of treatment, a comprehensive treatment based on the formal system should be adopted to treat the cause of the kidney. With the aid of Chinese medicine, it can regulate and repair damaged kidney cells from the inside, avoiding kidney failure and preventing the further development of the disease.

What kind of disease is purpuric nephritis?

Purpura nephritis is the abbreviation of Henoch-Schonlein purpura nephritis. It is the manifestation of allergic purpura involving the kidneys. The clinical manifestations are mainly hematuria, proteinuria, hypertension, edema, renal insufficiency, and accompanied by skin rash, joint pain, gastrointestinal bleeding, etc. Extrarenal manifestations are a kidney disease that is common in children and can also affect adults. What kind of disease is purpuric nephritis? Henoch-Schonlein purpura nephritis is actually a type of capillary vasculitis. The tiny blood vessels in the body have allergic reactions to certain special substances, which leads to increased permeability and fragility of blood vessels; blood cells in the blood vessels enter through the blood vessel wall. Skin purpura (peechosis under the skin and mucous membranes) is caused in the tissue. Current studies have found that allergic substances (antibodies) usually activate the gastrointestinal lymphatic system (MALT) to produce a large amount of defective immunoglobulin A (IgA). These IgA molecules enter the blood circulatory system to form complexes, and then further Attacks the tiny blood vessels and kidney tissues throughout the body, leading to corresponding clinical manifestations. Its pathogenesis is similar to that of IgA nephropathy. As there are tiny blood vessels in various parts of the human body, allergic purpura is a systemic and systemic disease. When the gastrointestinal tract is involved, symptoms such as abdominal pain and blood in the stool may occur; when joints are involved, joint swelling and pain may occur; when the kidneys are involved, symptoms such as hematuria and proteinuria may occur. Allergic purpura nephritis is one of the most serious complications of allergic purpura. Many patients will ask, what is the cause and mechanism of purpuric nephritis? Unfortunately, the current cause of purpura nephritis has not been fully explained. Infection, drugs, environment, diet, vaccines, and genetic factors may be related to the disease. ①Infection: Various pathogens can cause the occurrence or recurrence of this disease, including upper respiratory tract infection, intestinal infection, etc. Some studies have shown that parasitic infection is also an important cause of allergic purpura. The most common parasite that causes allergic purpura is roundworms, followed by hookworms, filarials, schistosomiasis, and trichomoniasis. Therefore, it is recommended that patients with Henoch-Schonlein purpura routinely undergo screening for parasitic infections (fecal examination), and can take drugs to treat parasitic infections when necessary. Avoiding infection is an important way for patients with Henoch-Schonlein purpura to manage themselves. ②Drugs: Some drugs that easily cause allergic reactions in the body are also key factors leading to the occurrence and recurrence of this disease. Common drugs include: penicillin, streptomycin, sulfonamides, isoniazid, sodium salicylate, quinine, etc. Patients must be clear about their drug allergy history and strictly avoid taking drugs that can cause allergic reactions. ③Environment and diet: Spring and autumn are the seasons for purpura, which may be related to pollen inhalation, catkins, and insect eggs. Proteins of the opposite sex, such as fish, shrimp, crab, eggs, milk, chicken and seafood, are also important factors in the induction of allergic purpura. Some patients with sensitive physique cannot tolerate the above-mentioned protein, which may cause allergic reactions after taking it. Therefore, for such people, contact with allergens should be avoided as much as possible. Wearing a mask is also helpful to avoid contact with allergens. ④Vaccination: There are a small number of medical record reports suggesting that influenza vaccine, hepatitis B vaccine, rabies vaccine, and meningococcal vaccine may induce allergic purpura. But its probability is relatively very low. Studies abroad only suggest that the MMR (measles, rubella, mumps) combination vaccine may indeed increase the risk of purpura. But other vaccines will not. There is no large-scale research in our country, only some relevant case reports. Therefore, patients with Henoch-Schonlein purpura should be cautious when vaccinating, and must take the initiative to inform the doctor of the condition in order to facilitate the doctor’s comprehensive judgment. ⑤Other factors: Allergic purpura is not completely an allergic disease, and allergens are only an important cause of the disease. It is not sufficient to explain the occurrence and development of purpura simply by allergic reactions. Existing studies have also revealed that cold, trauma, imbalance of intestinal flora, menopause, and mental factors are closely related to the disease. Therefore, Henoch-Schonlein purpura nephritis is a disease caused by multiple factors. In view of the fact that the etiology and pathogenesis of Henoch-Schonlein purpura nephritis are not well understood, preventing infection and avoiding contact with allergens are relatively more important. Patients can learn about their allergies through allergen testing, and pay more attention to avoid them in daily life. This will reduce the possibility of recurrence and aggravation of Henoch-Schonlein purpura nephritis.

What are the diagnosis of rheumatoid arthritis

 &Nbsp. Osteoarthritis   is more common in middle-aged and elderly people, and the onset process is mostly slow. The joints of the hands, knees, hips and spine are easily affected, while the palms, fingers, wrists and other joints are less affected. The condition usually worsens with activities or relieved by rest. Morning stiffness is usually less than half an hour. Heberden and Bouchard nodules can be seen on physical examination when the hands are involved, and the knee joint can be touched with friction. It is not accompanied by extra-articular manifestations such as subcutaneous nodules and vasculitis. Rheumatoid factor is mostly negative, and a small number of elderly patients may have low titer positive.  &Nbsp. Psoriatic arthritis    The polyarthritis type of psoriatic arthritis is very similar to rheumatoid arthritis. However, patients with this disease have characteristic psoriasis or nail lesions, or accompanied by a family history of psoriasis. The distal interphalangeal joints are often involved, and the early stage is mostly asymmetrical. The serum rheumatoid factor and other antibodies are negative. &nbsp. Ankylosing spondylitis is more common in young men, mainly involving axial joints such as sacroiliac and spinal joints. Although there are peripheral joint diseases, it is mostly manifested as large joints of the lower limbs, which are asymmetrical swelling and pain. And often accompanied by spinous process, greater trochanter, Achilles tendon, spinal costal joints and other tendons and ligament attachment points pain. Extra-articular manifestations are mostly iridocyclitis, heart block disorder and aortic valve insufficiency. X-ray film showed sacroiliac joint invasion, destruction or fusion, patients were negative for rheumatoid factor, and most of them were positive for HLA-B27 antigen. The disease has a more obvious tendency of family disease. &nbsp. Patients with systemic lupus erythematosus may have symptoms of arthritis in the hands or wrist joints early in the course of the disease, but patients are often accompanied by fever, fatigue, oral ulcers, skin rash, blood cell reduction, proteinuria, or antinuclear antibody positive and other lupus specific features Sexual, multi-system manifestations, and arthritis is less severe than rheumatoid arthritis patients, no joint deformities. Laboratory tests can find multiple autoantibodies

What are the symptoms of juvenile rheumatoid arthritis

&nbsp. The clinical manifestations of this disease are very different. The main symptoms of infants and young children are flaccid fever and skin rash. Older children may have multiple arthritis or only a few joints are affected. According to the clinical manifestations in the first six months of onset, it can be divided into three types, which have guiding significance for treatment and prognosis.  &Nbsp. Systemic type    is also known as Still disease (it used to be called allergic subsepticemia in the past). About 10% of children with JRA are systemic, characterized by systemic manifestations, with a rapid onset. The fever is relaxing, fluctuating between 36℃~41℃ every day. The high fever may be accompanied by chills at the beginning, and the children are sluggish. After the fever subsides for a few hours, the children move as usual. Relaxation fever can last for several weeks or months and naturally resolve, but it recurs after several weeks or months. Skin rash is also a typical symptom of this type. It often appears during high fever and sometimes disappears with the rise and fall of body temperature. The rash is usually a round congestive maculopapular rash, 0.2 to 1.0 cm in size, and can be fused into a piece, distributed on the chest and proximal limbs. Most children have enlarged liver and spleen, and lymphadenopathy around the body, which may be accompanied by mild liver function abnormalities. Pleurisy and pericarditis occur in about 1/2 patients. There is not much pericardial effusion, and pericardial friction sounds may occur. Pericarditis gradually recovers, and constrictive pericarditis rarely occurs. The myocardium can be affected, but endocarditis is rare. Most children with this type develop multiple arthritis at the onset or several months later, and all joints can be affected. At the onset, due to severe systemic symptoms, arthritis is often ignored. Some patients only have arthralgia, myalgia or transient arthritis. A small number of sick children may develop arthritis after months or years. Children may have mild anemia and may have leukemia-like reactions. About a quarter of children with this type of disease eventually suffer from severe arthritis. Studies have found that patients with hepatosplenomegaly, serositis, low plasma albumin at the onset, and persistent systemic symptoms and platelet elevation ≥600×109/L after the onset of disease are prone to destructive arthritis .  &Nbsp. Polyarthritis type    is characterized by chronic symmetrical polyarthritis, involving more than 5 joints, especially the small joints of the fingers and toes. Girls are more affected than boys. The onset is slow or abrupt, manifested by joint stiffness, swelling and pain, and local fever. Redness is generally rare. It usually starts with large joints, such as knees, ankles, and elbows, and gradually involves small joints, and fusiform fingers appear. Approximately one-half of the sick children’s cervical joints are involved, resulting in restricted neck movement. Involvement of the temporomandibular joint causes difficulty chewing. A few cases develop arthritis of the ring and dipper (cartilage of the larynx), causing dumbness and throat wheezing. In the late stage, hip joint involvement, femoral head destruction, and movement disorders may occur. If joint symptoms occur repeatedly and last for several years, the joints become stiff and deformed, and the muscles near the joints atrophy. This type of systemic symptoms are mild, with only low fever, loss of appetite, fatigue, anemia, and mild liver, spleen and lymph node enlargement, but pericarditis or iridocyclitis are rare. About 1/4 of the children with this type are rheumatoid factor positive, and they develop in late childhood and have severe arthritis. Eventually, more than half of the children suffer from severe arthritis.  &Nbsp. The oligoarthritis type    involves no more than 4 joints, mainly large joints. This type can be divided into two types: (1) Type I girls have more disease than boys, and the age of onset is mostly 1 to 5 years old. The knees, ankles, and elbow joints are the most common sites, and some involve only a single knee joint, and occasionally invade the temporomandibular joint or individual finger and toe joints. If no more than 4 joints are involved within 6 months of onset, it generally does not develop into polyarthritis. Arthritis can recur, but it rarely leaves severe dysfunction. In addition to joint symptoms, this type of disease is mainly chronic iridocyclitis. About half of the patients are affected. It is often asymptomatic in the early stage. It can be detected with a slit lamp. It usually occurs after the symptoms of arthritis appear, even when the arthritis has stopped. Time. Chronic iridocyclitis can cause blindness. Therefore, patients with oligoarthritis should undergo regular slit lamp examinations every 3 to 4 months for early detection and timely treatment. During the onset of arthritis, the patient has no joint pain, low fever, fatigue, mild liver and spleen and lymph node enlargement, and mild anemia. (2) Type Ⅱ boys have a high incidence, usually around 8 years old, and often have a family history. There may be rheumatoid arthritis, ankylosing spondylitis, Reiter’s syndrome (including arthritis, urethritis and conjunctivitis) at home. ) Or patients with psoriasis. The large joints of the lower extremities are often affected, and hip arthritis and sacroiliitis occur early. More heel pain and Achilles tendinitis. Occasionally, transient ankle, wrist

Juvenile rheumatoid arthritis three main types

Juvenile rheumatoid arthritis    1. Whole body type. This type is characterized by rapid onset and flaccid fever, flaccid fever can last for several weeks or months and naturally relieves, high fever can be accompanied by chills at the beginning, and the child’s mental state is poor, and it will not affect after several hours of fever. Until its normal activities, the recurrence rate of the disease is relatively high. Therefore, the initial treatment must be thoroughly treated, or something like this will happen again in a few weeks or months. If polyarthritis reappears later, it will affect the small and small joints, and the systemic symptoms will be severe, some may have mild anemia, and the white blood cells will increase significantly.   2. Multi-joint type. This type of pediatric patients has no more than five joints involved. Chronic symmetric polyarthritis is the main feature, especially the involvement of the small joints of the fingers and toes. The incidence of the disease is greater in girls than in boys. The onset can be rapid or slow, and the symptoms are mainly joint stiffness, swelling and pain, and local fever. Redness is rarely seen. Starting from the large joints, such as the knees, ankles, and elbows, it gradually involves the small joints, and it can also involve the cervical joints and restrict the movement of the neck. Joint symptoms occur repeatedly, and the joints become stiff and deformed for several years, and the muscles near the joints atrophy.   3. Less joint type. There are no more than four involved joints of this type, mainly large joints. Generally, there are two cases. If girls are more affected, they are mostly before 3 years old. The most common areas are knees, ankles, and elbows. Arthritis can be repeated Onset, but rarely leave serious dysfunction. During the onset of arthritis, patients may have no arthralgia, but have low fever, fatigue, mild liver and spleen, etc. Some patients will have symptoms of chronic iridocyclitis; the second type The situation is that boys suffer from many diseases, usually after 8 years old, and often have a family history. The large joints of the lower limbs are mainly affected, and there is ankylosing spondylitis of the lower back.

Why do you have kidney deficiency at a young age? Let you discover TA’s little secrets ​

As we all know, the main site of rigidity is the lumbosacral region. From the perspective of Chinese medicine, the home of the waist and kidney is often treated from the perspective of kidney deficiency. Ankylosing spondylitis is a chronic and progressive inflammatory disease of systemic immunity. It mainly involves the sacroiliac joints, spinal processes and nearby ligaments, as well as peripheral joints. The symptoms are high in young adults aged 15-40 (you should be careful!) The symptoms are: must wake up in the early morning, and can turn over with hand support, hip joint, knee joint, ankle joint, lower back or hip pain, Stiffness may be evident after prolonged lying and sitting, which can be relieved after general activities. The thoracic spine will also be affected, chest expansion is limited, and sometimes coughing and sneezing will cause chest pain. When the lumbar spine is involved, the patient’s waist activity is limited, symptoms such as progressive bending and difficulty turning around, and severe kyphosis. Scoliosis deformity. However, young people should be the most vigorous period of kidney qi. Why is it that strong and easy to occur in young people? So many people wonder, why I have this kind of kidney deficiency-related disease at a young age? Although there are many important theories , But the exact cause of rigidity is still unclear. First, genetic factors play an important role. Secondly, the age of onset of tonicity is concentrated in the age of small fresh meat, which may be related to the lifestyle and eating habits of young people, such as staying up late and living under pressure, and a large amount of kidney qi is dissipated, which leads to the occurrence of rigidity in this age group. In addition to rigidity, gout is also related to kidney deficiency. Gout is a series of clinical symptoms caused by the increase or sharp fluctuation of uric acid in the human body, including the acute phase and the remission phase. Gout is more common in middle-aged men. The symptoms are: the commonly affected joints in patients with acute gouty arthritis are the back of the foot, ankle joints, heels, knee joints, wrist joints, fingers and elbow joints. The first attack of most patients occurs suddenly, and they often wake up with pain after a deep sleep at night. Within hours of the attack, the affected joints will appear red, swollen, hot and extremely tender. Isn’t it said that gout is caused by drinking too much alcohol and eating too much high-protein food? Many people, no matter how they control their diet, no matter how they are not allowed to eat, it still occurs mercilessly when it should happen. And why does the pain start from the big toe, and then there will be joint deformities later? In fact, this is also a manifestation of kidney deficiency, because the filtering function of the kidney is weakened, the “acid” in the blood cannot be discharged, and it flows with the blood circulation. The big toe joint is the most distal joint of the human body, and crystals are most likely to accumulate here. So, is kidney deficiency the root cause of gout and rigidity? How should this be adjusted? From 14:00 to 16:30 on August 1st, the Comprehensive Outpatient Department of Kanghe Shang Medical will invite the Rheumatism and Immunology Research Team of Guangdong Provincial Hospital of Traditional Chinese Medicine to give you detailed science-the relationship between rigidity, gout and kidney deficiency.

alert! Allergic purpura can cause spontaneous perforation

Assistant Hu Guisheng WeChat: dd326751 Allergic purpura is a common blood disease in children. The symptoms include purpura on the skin, accompanied by abdominal pain, joint pain, hematuria, proteinuria and other symptoms. When systemic symptoms such as joint pain and abdominal pain appear before purpura of the skin, it is easy to be misdiagnosed as rheumatoid arthritis or acute abdomen. It needs to be differentiated from these diseases and other types of purpura and vasculitis. The gastrointestinal symptoms are the most common symptoms. Abdominal Henoch-Schonlein purpura can cause spontaneous perforation, and many deaths are caused by this clinically. The pathogenesis is that vasculitis leads to thrombosis and continuous severe ischemia leads to the entire intestinal wall. The thickening necrosis eventually perforates.  The age of onset is often younger than the average age of purpura. The specific reasons are not fully understood. It may be related to the poor physical fitness of young children and the development of the immune system of children with age.   The most common spontaneous perforation is the small intestine, accounting for 64.7% by statistics. There are also reports of perforation of the stomach, duodenum and large intestine. Perforations are generally single, but multiple perforations have also been reported.   Spontaneous intestinal perforation has typical manifestations of chemical peritonitis, but because children often have obvious abdominal distension before perforation, it is difficult to diagnose by clinical signs alone, and auxiliary examination is very important. Both ultrasound and CT examinations can be used to confirm bowel involvement, show the thickening of the bowel wall and hematoma, and the progression of bowel involvement.   series of ultrasound can prove whether the intestinal wall thickening subsides or worsen to show the progress of gastrointestinal involvement, which has become a good clinical auxiliary method. Regarding the progress of intra-abdominal involvement of purpura, B-ultrasound was found to have 100% sensitivity and specificity in two independent large studies, which can early detect the involved bowel edema, and the appearance of gas in the bowel wall, mostly in the form of beads. Gas accumulation, single shot is rare. The upright abdominal radiograph is a classic examination for diagnosing perforation of the digestive tract.   Therefore, in order to prevent spontaneous perforation, it is necessary to develop good bowel habits. Avoid flowers in the living environment, because flowers may cause pollen allergies. It is also necessary to avoid allergies to decoration and other substances, and to avoid contact with chemical substances. When using anti-allergic drugs, pay attention to dizziness, drowsiness and other adverse reactions. Patients in special industries should avoid driving or working at heights during medication. Patients who use hormone therapy should pay attention to the side effects of hormones, regular outpatient visits, and timely treatment.   In short, spontaneous intestinal perforation is a serious complication of Henoch-Schonlein purpura, and delayed diagnosis and treatment often lead to death. Early diagnosis and surgery are necessary.

How to treat rheumatoid arthritis What are the symptoms of childhood

&nbsp. The clinical manifestations of this disease are very different. The main symptoms of infants and young children are flaccid fever and skin rash. Older children may have multiple arthritis or only a few joints are affected. According to the clinical manifestations in the first six months of onset, it can be divided into three types, which have guiding significance for treatment and prognosis.  &Nbsp. Systemic type    is also known as Still disease (it used to be called allergic subsepticemia in the past). About 10% of children with JRA are systemic, characterized by systemic manifestations, with a rapid onset. The fever is relaxing, fluctuating between 36℃~41℃ every day. The high fever may be accompanied by chills at the beginning, and the children are sluggish. After the fever subsides for a few hours, the children move as usual. Relaxation fever can last for several weeks or months and naturally resolve, but it recurs after several weeks or months. Skin rash is also a typical symptom of this type. It often appears during high fever and sometimes disappears with the rise and fall of body temperature. The rash is usually a round congestive maculopapular rash, 0.2 to 1.0 cm in size, and can be fused into a piece, distributed on the chest and proximal limbs. Most children have enlarged liver and spleen, and lymphadenopathy around the body, which may be accompanied by mild liver function abnormalities. Pleurisy and pericarditis occur in about 1/2 patients. There is not much pericardial effusion, and pericardial friction sounds may occur. Pericarditis gradually recovers, and constrictive pericarditis rarely occurs. The myocardium can be affected, but endocarditis is rare. Most children with this type develop multiple arthritis at the onset or several months later, and all joints can be affected. At the onset, due to severe systemic symptoms, arthritis is often ignored. Some patients only have arthralgia, myalgia or transient arthritis. A small number of sick children may develop arthritis after months or years. Children may have mild anemia and may have leukemia-like reactions. About a quarter of children with this type of disease eventually suffer from severe arthritis. Studies have found that patients with hepatosplenomegaly, serositis, low plasma albumin at the onset, and persistent systemic symptoms and platelet elevation ≥600×109/L after the onset of disease are prone to destructive arthritis .  &Nbsp. Polyarthritis type    is characterized by chronic symmetrical polyarthritis, involving more than 5 joints, especially the small joints of the fingers and toes. Girls are more affected than boys. The onset is slow or abrupt, manifested by joint stiffness, swelling and pain, and local fever. Redness is generally rare. It usually starts with large joints, such as knees, ankles, and elbows, and gradually involves small joints, and fusiform fingers appear. Approximately one-half of the sick children’s cervical joints are involved, resulting in restricted neck movement. Involvement of the temporomandibular joint causes difficulty chewing. A few cases develop arthritis of the ring and dipper (cartilage of the larynx), causing dumbness and throat wheezing. In the late stage, hip joint involvement, femoral head destruction, and movement disorders may occur. If joint symptoms occur repeatedly and last for several years, the joints become stiff and deformed, and the muscles near the joints atrophy. This type of systemic symptoms are mild, with only low fever, loss of appetite, fatigue, anemia, and mild liver, spleen and lymph node enlargement, but pericarditis or iridocyclitis are rare. About 1/4 of the children with this type are rheumatoid factor positive, and they develop in late childhood and have severe arthritis. Eventually, more than half of the children suffer from severe arthritis.  &Nbsp. The oligoarthritis type    involves no more than 4 joints, mainly large joints. This type can be divided into two types: (1) Type I girls have more disease than boys, and the age of onset is mostly 1 to 5 years old. The knees, ankles, and elbow joints are the most common sites, and some involve only a single knee joint, and occasionally invade the temporomandibular joint or individual finger and toe joints. If no more than 4 joints are involved within 6 months of onset, it generally does not develop into polyarthritis. Arthritis can recur, but it rarely leaves severe dysfunction. In addition to joint symptoms, this type of disease is mainly chronic iridocyclitis. About half of the patients are affected. It is often asymptomatic in the early stage. It can be detected with a slit lamp. It usually occurs after the symptoms of arthritis appear, even when the arthritis has stopped. Time. Chronic iridocyclitis can cause blindness. Therefore, patients with oligoarthritis should undergo regular slit lamp examinations every 3 to 4 months for early detection and timely treatment. During the onset of arthritis, the patient has no joint pain, low fever, fatigue, mild liver and spleen and lymph node enlargement, and mild anemia. (2) Type Ⅱ boys have a high incidence, usually around 8 years old, and often have a family history. There may be rheumatoid arthritis, ankylosing spondylitis, Reiter’s syndrome (including arthritis, urethritis and conjunctivitis) at home. ) Or patients with psoriasis. The large joints of the lower extremities are often affected, and hip arthritis and sacroiliitis occur early. More heel pain and Achilles tendinitis. Occasionally, transient ankle, wrist