Medical Week Medical Affairs∣The first domestically produced anti-new crown oral drug was approved, how is the efficacy?

Original title: Medical Week Medical Affairs∣The first domestic anti-new crown oral drug was approved, how is the efficacy? For the first time, dietary supplements can prevent hereditary cancers

Medical Policy and Medical Information

Medical Policy and Medical Information

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1.

Azvudine tablets can significantly improve the clinical symptoms of patients and accelerate the clearance of the virus for the treatment of adult patients with common new coronavirus pneumonia; Paxlovid can significantly reduce the risk of hospitalization or all-cause death related to new coronavirus infection

In addition, azvudine tablets have another advantage: cheap

Source: Tencent Medical Code

2.

2.

In clinical practice, optic nerve diseases caused by other causes should be excluded based on the patient's medical history, symptoms, results of routine and special ophthalmic examinations (color vision, brightness, contrast sensitivity, visual field, etc.

The main differential diagnosis of DON includes optic neuritis in diabetic patients, non-arteritic anterior ischemic optic neuropathy caused by buried optic disc drusen, and compressive, toxic and hereditary optic neuropathy

The typical clinical manifestations of optic neuritis are sharply decreased visual acuity, with or without eye pain, positive relative afferent pupillary disturbance, and optic disc edema or normal; typical fascicular visual field damage, such as giant central scotoma, blind central scotoma, and light Diffusely decreased sensitivity; visual evoked potentials showed prolonged P2/P100 latency with normal or decreased amplitudes; orbital or cranial MRI showed enlarged and/or enhanced optic nerves; water channels were detectable in blood and/or cerebrospinal fluid in some patients Protein 4 antibody or myelin oligodendrocyte glycoprotein antibody was positive

Source: China Medical Information Herald

3.

3.

The "Notice" proposes to encourage medical institutions to use information technology to intelligently review and manage the entire process of clinical medication

Source: Cyberblue

4.

4.

Zheng Zhongwei also pointed out that the following situations are recommended as contraindications to vaccination:

First, severe allergic reactions have occurred during previous vaccinations, such as anaphylactic shock and laryngeal edema, which must be contraindicated as new crown vaccinations

Source: Medical Courier

5.

5.
Mysterious childhood hepatitis found important clues! 5.
Mysterious childhood hepatitis found important clues!

Two independent studies of children with unexplained liver damage or hepatitis found that nearly all affected children had a virus called adeno-associated virus 2 (AAV2), which was not found in other children, and Nearly all children with hepatitis have a genetic variant that affects their immune response
.

AAV2 is a common virus that was previously thought not to cause any disease
.
AAV2 can integrate its own DNA into the genome of infected cells, allowing it to remain in the body indefinitely
.
However, AAV2 is rather unusual in that it can only replicate in the presence of other viruses, such as adenovirus or herpesvirus
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Emma Thomson of the University of Glasgow, UK, believes that it is still unclear whether AAV2 is the cause of hepatitis or just an indicator of adenovirus infection
.

These findings suggest that AAV2 or other viruses may trigger liver damage in genetically predisposed children through an unknown immune mechanism
.
"Viral hepatitis may have an immune-mediated cause, and we need more work to test this hypothesis
," Thomson said
.

Source: Chinese Science Journal

6.
The new version of the medical insurance catalogue is implemented, and these Chinese herbal medicines, Chinese patent medicines, and western medicines are restricted!

6.
The new version of the medical insurance catalogue is implemented, and these Chinese herbal medicines, Chinese patent medicines, and western medicines are restricted! 6.
The new version of the medical insurance catalogue is implemented, and these Chinese herbal medicines, Chinese patent medicines, and western medicines are restricted!

The new version of the medical insurance catalogue contains a total of 1486 western medicines and Chinese patent medicines, 1374 Chinese patent medicines, a total of 2860
.
Among them, more than 500 drugs are restricted in medical insurance payment
.

94 limited indications of western medicines (oral preparations), such as febuxostat: limited to gout patients with renal insufficiency or allergy to allopurinol; 37 limited indications of Chinese patent medicines, such as Angongniuhuang Pill: limited to hyperthermia or stroke.
19 kinds of β-lactam antibiotics are limited, such as piperacillin sulbactam injection is limited to patients with clear drug susceptibility test evidence or severe infection; 25 kinds of drugs have limited payment period, such as Chuanxiong Zine (injection): limited to acute ischemic cerebrovascular disease, the payment shall not exceed 14 days; 164 kinds of injection limited indications, such as human albumin (injection): limited to rescue, severe or pleural and ascites caused by liver cirrhosis and cancer patients, and albumin is less than 30g/L; 54 western medicines are limited to second-line drugs, such as sumatriptan (oral normal-release dosage form): limited to second-line drugs for patients with acute migraine attacks; vancomycin, linezolid, tega Cyclin and polymyxin were restricted
.
In addition, 20 drugs are restricted to children, 18 are limited to indications for topical preparations, 34 kinds of proprietary Chinese medicines are restricted to cancer, 40 kinds of traditional Chinese medicine injections are restricted to medical institutions of grade 2 and above, and 7 kinds of acid-suppressing drugs are restricted Indications, 13 insulin analogs were restricted, 4 fluoroquinolones were restricted, and 13 antithrombotics were restricted
.

Source: New Frontiers in Neuroscience

Frontiers of Medicine

Frontiers of Medicine

1.
Harvard study found that 150-600 minutes of exercise per week has the lowest risk of death

1.
Harvard study found that exercise 150-600 minutes per week, the lowest risk of death 1.
Harvard study found that exercise 150-600 minutes per week, the lowest risk of death

Early research suggests that regular physical activity is associated with a lower risk of cardiovascular disease and premature death
.
Physical activity has a large impact on health, but it remains unclear whether engaging in prolonged, vigorous, or moderate-intensity physical activity above recommended levels has any additional benefits for cardiovascular health
.
According to the World Health Organization exercise guidelines, adults should engage in at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week
.

Source: Medical Novi

2.
Stop fooling your kids with "growing pains"!

2.
Stop fooling your kids with "growing pains"! 2.
Stop fooling your kids with "growing pains"!

The term "growing pains" is often used to refer to extremity pain in children, and it is the most common cause of bone or muscle pain in adolescents
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Some studies estimate that growing pains affect more than one-third of children
.
Still, there is still no clear definition of what growing pains are, or what causes them
.
A recent study published in Pediatrics found that 93% of the papers did not mention the relationship between symptoms of bone or muscle pain and growth
.

Children and teens are told that they have growing pains, but this is not accurate
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The study combed through 147 studies that mentioned teenage growth or growing pains and found that the studies were contradictory across multiple areas
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The studies reached a basic consensus on the location of pain: 50% of the studies concluded that pain during growth primarily affects the legs
.
Other studies have found that the arms, back, groin or shoulders are the main pain sites
.
But the contradictions generated by these studies make the associated diagnosis largely meaningless
.

Source: Chinese Science Journal

3.
For the first time, dietary supplements can prevent hereditary cancers

3.
For the first time, dietary supplements have been shown to prevent hereditary cancers 3.
For the first time, dietary supplements have been shown to prevent hereditary cancers

Lynch syndrome is an autosomal dominant familial tumor syndrome caused by mutations in mismatch repair (MMR) genes, resulting in errors during DNA replication that cannot be obtained.
Repairs, which are accumulated and passed on to future generations, thereby increasing the risk of many types of cancer, especially colorectal cancer, as well as endometrial, ovarian, gastric, esophageal, pancreatic, biliary, brain, skin, and more
.

Recently, researchers from the University of Newcastle and the University of Leeds published a research paper in the journal Cancer Prevention Research
.
The double-blind controlled trial of nearly 1,000 Lynch syndrome patients showed that taking resistant starch as a dietary supplement for an average of 2 years reduced the risk of cancers other than colorectal cancer in Lynch syndrome patients by more than half, Especially for cancers of the upper gastrointestinal tract (including cancers of the esophagus, stomach, biliary tract, pancreas, and duodenum), this preventive effect continued for more than 10 years after the supplement was discontinued
.
Another 2020 study published in The Lancet showed that people with Lynch syndrome who took aspirin for 2 years had their colorectal cancer rate cut in half
.
Collectively, these two clinical trials suggest that the risk of developing Lynch syndrome, a heritable cancer, is preventable
.

Source: Bioworld

4.
Babies with stressed parents pay more attention to angry faces

4.
Babies with stressed parents pay more attention to angry faces 4.
Babies with stressed parents pay more attention to angry faces

A new study in the journal Developmental Psychobiology suggests that infants exposed to increased parental stress may exhibit altered threat processing
.
This suggests that the influence of environmental factors, such as parental stress, on children's threat processing emerges earlier than previously assumed
.
The study followed infants and their caregivers between 4 and 12 months of age to understand how attentional preference for threat and associated neural and behavioral correlates arise and change from infancy to early childhood
.

The researchers found that infants whose parents had lower or average intensity of their daily quarrels did not differ in the amount of time they spent staring at threatening faces compared with neutral or happy faces
.
However, when parents reported high-intensity daily arguments, four-month-olds were more likely to stare at angry faces than neutral or happy faces
.
However, as the children reached their first year of age, these children gradually slowed down to focus on threatening facial expressions, an effect that was not mediated by parental anxiety
.

Importantly, this study shows that infants change during the first year of life in response to environmental factors associated with parental stress
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In addition, because attentional preference to threats may be an early predictor of future anxiety, early intervention is warranted for children whose parents experience extreme stress, even in the first four months of life

Source: Thunderbolt and the students

5.
Change your mind! "The Lancet" is heavy: statin reduction does not reduce the effect, so it can also reduce lipids!

5.
Change your mind! "The Lancet" is heavy: statin reduction does not reduce the effect, so it can also reduce lipids! 5.
Change your mind! "The Lancet" is heavy: statin reduction does not reduce the effect, so it can also reduce lipids!

Current clinical practice guidelines recommend the use of high-intensity statins for robust LDL-C reduction in patients with established atherosclerotic cardiovascular disease (ASCVD)
.
However, there is also a lot of evidence that, compared with increasing the dose of a single lipid-lowering drug, the combined use of lipid-lowering drugs can achieve more significant efficacy and further reduce the risk of cardiovascular events
.

Ezetimibe can effectively inhibit the absorption of cholesterol in the intestine, thereby reducing the transport of cholesterol to the liver and lowering the level of cholesterol in the blood
.
The addition of ezetimibe to lower-intensity statins may provide a viable alternative treatment strategy compared to high-intensity statins alone
.
Recently, "The LANCET" (THE LANCET) published blockbuster research results, confirming that moderate-intensity statin combined with ezetimibe lipid-lowering efficacy is not inferior to high-intensity statin monotherapy
.

In the study, patients who received the combination of moderate-intensity statins and ezetimibe not only had a lower 3-year risk of cardiovascular composite events, but also achieved a significantly higher proportion of LDL-C lipid lowering targets
.
Combination therapy may be considered as early as possible in patients with a higher risk of statin side effects, or in patients with intolerance to high-intensity statin therapy
.
The paper emphasizes that based on the results of this research, the blood lipid management model is expected to usher in an important change in concept, and the future combination therapy is expected to become the initial choice of lipid-lowering therapy for patients with high risk of cardiovascular disease!

Source: New Perspectives in Medicine

6.
NEJM heavyweight: find the "liver protection" gene mutation!

6.
NEJM heavyweight: find the "liver protection" gene mutation! 6.
NEJM heavyweight: find the "liver protection" gene mutation!

July 28 is World Hepatitis Day, which was established to raise global public awareness and awareness of viral hepatitis in order to eliminate its pandemic
.
However, in recent years, the prevalence of non-viral hepatitis, including chronic liver diseases such as alcoholic and non-alcoholic fatty liver disease, is not optimistic, and there is a lack of effective treatment drugs.
After progressing to liver fibrosis and liver cirrhosis, the risk of death is greatly increased.

.
According to statistics, in 2017, liver cirrhosis caused 1.
32 million deaths worldwide, accounting for 2.
4% of the total deaths
.

The risk of progression to steatohepatitis and cirrhosis in patients with obesity and nonalcoholic fatty liver disease (NAFLD) is very individual, and genetic factors play a key role in this.
Therefore, starting from genetic differences may be able to provide patients with bring new treatments
.

The Regeneron Genetics Center, in conjunction with Indiana University School of Medicine and Lund University, published the latest research results in the New England Journal of Medicine.
They discovered a group of liver-protective gene mutations - CIDEB's Rare predictable loss-of-function mutations + missense mutations are associated with a 33% lower risk of liver disease! Mutation carriers had a 31-54% lower risk of liver disease of different causes and severity compared to non-carriers, a 50% lower risk of cirrhosis of any cause, and a 49% lower risk of liver cancer
.

Source: Singularity Network

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