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“Table Revolution”: An Effective Vaccine Against Diseases

Currently novel Coronavirus is still spreading rapidly around the world and the pressure of preventing imported virus from abroad is increasing.
Some parts of China have clustered, and repeated alarm bells are still ringing from time to time.
Although the cause of the epidemic has yet to be explored by scientists, social consensus has gradually been formed to strictly prevent “disease from entering the mouth”.
Recently, the Capital Civilization Engineering Foundation and Civilization Magazine, together with 100 experts from all over the country, proposed a “dining table revolution”, in the hope that the “dining table revolution” with broad public participation could help prevent and control the epidemic.
“A healthy and civilized lifestyle is the best vaccine for disease eradication,” said a study released by the Earth and Resources Institute of the Chinese Academy of Sciences.
Liu Xiaojie, an associate researcher at the institute, told reporters that establishing a healthy and civilized lifestyle to reduce disease exposure could cut off the spread of the disease.

From table to kitchen waste, what does a healthy and civilized lifestyle include?
How do you form a habit?

Eat every meal healthy and safe

The infection data of hepatitis, gastric cancer and other diseases increasing year by year released by the World Health Organization showed the effect of sharing meals on the transmission of foodborne diseases.
“Unhealthy lifestyle, diet, environmental pollution, food pollution and other key carcinogenic factors have made it imperative to change people’s living habits and diet.”
Liu xiaojie said.

“I hope everyone will eat every meal with care like in a Dream of Red Mansions.”
Zheng Linchang, a professor at the Institute of Regional Economics at Hebei University, hopes that focusing on health will become a dining habit for everyone. “It’s not necessarily about being meticulous about food, but more importantly about safety and health.”

What challenges do we face in promoting a “dining table revolution” and fostering a healthy and civilized lifestyle?
Experts believe that, on the one hand, we need to see a growing demand for separate meals, buffet, table meal and other acceptance is increasingly high, some catering enterprises are committed to the implementation of separate meals, through big data, cloud computing to help residents calculate what to eat.
In the process of epidemic prevention and control, residents have gained a further understanding of food-borne diseases, and the separate meal system has gained initial impetus.
On the other hand, family meals carry the cultural concept of “in the same boat” and “helping each other”, which has been running for thousands of years.
Wu Jian, deputy dean of the School of Environment at Renmin University in Beijing, told reporters that changing habits with cultural characteristics would be a “very slow process”.
“It is very difficult to change customs, and some traditional dishes are not suitable for separate meals.
“In the early days, separate meals meant higher costs for families, making it more difficult to implement separate meals.”
Jasonwoo said.
Wang Jie, a professor at the Philosophy department of the Party School of the CPC Central Committee, said: “Separate meals started a momentum during the SARS outbreak, but people seemed to forget it soon after the outbreak was over.”

But the expert thinks commonly, this “dining table revolution” carry out has a lot of advantage condition.
“In the past, most of them were based on appeals and guidance. With the formulation of a healthy China development strategy by the Central Committee in 2017, the Healthy China Action Plan (2019-2030) was further proposed in July 2019. As one of the healthy lifestyles, dining system has specific targets.
Zheng Linchang told reporters.

Civilized repast cannot flow in a gust of wind

Reporters learned in the interview, Beijing, Shanghai and other places have issued the corresponding meal plan.
On June 24, Shandong province issued a guide to catering and dining system, setting a “local standard” for the system.
In many catering enterprises across the country, the public chopsticks and spoons are placed in a conspicuous position.

How to live a healthy and civilized life?
Liu Xiaojie thinks, should start from key industry, key domain, key crowd.
“First of all, cafeterias at all levels will continue to introduce buffets, encouraging catering enterprises to use buffets in various banquets;
Secondly, encourage small and medium-sized catering enterprises to provide public chopsticks, spoons;
Thirdly, guide enterprises to design, produce and sell tableware and sanitary ware for family meals.
Finally, advocacy for foodborne disease transmission goes to schools, communities and businesses.”
Zheng Linchang further explained.

The reform of cultural customs is the biggest difficulty in the implementation of separate meal system.
Wang Jie analysis, there are material and spiritual reasons for this.
From the material point of view, as far as the catering enterprises are concerned, the implementation of separate meal system will increase the cost of human and material resources, and at the same time increase the amount of washing utensils.
For a private family, there are only a few people in a family and three meals a day. If each dish and soup is eaten separately, it will not only increase the cost but also be more cumbersome and make housework more difficult.
From a spiritual point of view, to change a social custom that has been practiced for thousands of years and to form a new custom requires the joint efforts of all social strata and continuous guidance.

The first step is to “target the symptoms” and “attack them one by one”.
“The government can make some proactive policies in a timely manner.
According to the actual situation, some policies to encourage the implementation of separate meals can be introduced in stages.
Recently, for example, Shanghai business committee, market supervision bureau jointly developed for Shanghai in the food service units dining management norms “, used to separate the tableware, places, people, processes, and so on each link all made the rules, and gives the four separate eating patterns: ‘dispatch type’ ‘on type’ ‘the dining-table centiliter invite type’ and ‘buffet style, to some extent, to satisfy the customer different needs, solve the problem of Chinese food is unfavorable use individual.”
Wangjie said.

And catering enterprises can also carry out some timely and appropriate service innovation.
“For some qualified catering enterprises, we can combine the actual situation of the enterprises and the market to explore the innovation of separate service at a lower cost.
For example, some catering enterprises have introduced the concept of “double chopsticks”, “different prices”, “artificial meal sets”, and even separate dishes for some dishes.
“Wang Jie told reporters.

How to make a healthy and civilized lifestyle a habit

From the kitchen table to kitchen waste, a healthy and civilized lifestyle also includes recycling.
Starting from the root of food, not only can avoid waste, reduce pollution, but also can protect the environment.
Shanghai has taken the lead in garbage classification, and Beijing, Shandong, Jiangsu and Hubei provinces have also introduced corresponding measures.

The reporter learned in the interview that garbage recycling classification and separate meal system in the process of promotion have had “halfway” experience.
How to make a healthy and civilized lifestyle a habit, According to Zheng, besides guidance and encouragement, coercion and restraint are also important.
“In some countries, different garbage bags need to be purchased, filled up and put in a special place, or they will be punished.
Some people will secretly throw away old TVS and other appliances, but the cost of recycling is too high.
At present, there are still no mandatory restrictions, such as mandatory meal sharing and mandatory classification. The timely use of mandatory restrictions also helps to develop habits.”

In addition to “block” the way, Wu Jian reminds, “thin” the action also cannot ignore.
In her opinion, the final formation of habits depends on the mobilization of the enthusiasm of every social subject.
“It is a good idea to know what is right and what is right. For example, the measures taken this time have helped people form good hygiene habits.
What is good for the society should be observed by everyone. To build a resource-saving and environment-friendly society, everyone must pay for it.
“It has been proven that when you tell the public what kind of behavior is healthy, it is acceptable to the general public.”
Jasonwoo said.

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Why Do People with AIDS Experience Blindness as a Complication?

Xiao Wang is a 28-year-old male, who is in his youth. He is in the financial industry and looks handsome. He is a handsome guy who can attract a lot of girls’ attention when walking on the street. He has a successful career and he always feels watching things after working overtime recently. Blurred, there were floating objects or flashes in front of him, and he did not care that overtime caused myopia to increase, but after a month he became more and more fatigued, and his right eye was blurred, leaving only a little light. Xiao Wang was anxious and immediately went to the hospital ophthalmology department for an examination and found that the retina of the right eye was yellowish white, and the retinal blood vessels were ruptured and bleeding. Why is there such a serious situation? Xiao Wang was hospitalized immediately and the doctor in bed told him a heavy tone one day: Your HIV preliminary screening test is uncertain. Currently considering “AIDS combined with giant cell retinitis”, the prognosis is poor. Xiao Wang almost fainted at that time. past.

Time went back 4 years ago. At that time, Xiao Wang was a college student. At one time, after meeting with many social celebrities, he couldn’t resist the temptation to experience the same-sex passion, but after that Xiao Wang never happened again. Things have been said, Xiao Wang’s heart is basically clear about the origin of the infection. After treatment, Xiao Wang’s left eye vision has been preserved, but his right eye is almost blind. Xiao Wang regrets it.

So why is giant cell infection so severe? What lessons should be learned?

Human cytomegalovirus belongs to the herpesvirus family and is one of the most common pathogens causing human viral diseases. Humans are the only host for human CMV infection. Most CMV infections are asymptomatic and are latent. The latent parts are mainly in the salivary glands, breast milk, kidneys, white blood cells or other glands, and can excrete viruses from saliva, breast milk, urine, semen, cervix and vagina secretions for a long time or intermittently. Viruses can be spread vertically and horizontally. The study found that patients with HIV and CMV infection accounted for only 19.59% of patients with CMV-related clinical manifestations, most of whom were latently infected. The onset of CMV infection can involve multiple organs, common gastroenteritis, pneumonia, retinitis, can also cause encephalitis, hepatitis, pancreatitis or adrenal necrosis.

Previous studies have shown that CMV retinitis is a late complication of AIDS patients, and most of them occur in patients with CD4T lymphocytes <50 cells/ul. Therefore, CMV retinitis is often referred to as a landmark disease of AIDS. In addition, many studies at home and abroad have confirmed that hormone therapy is ineffective and refractory ulcerative colitis is closely related to CMV infection. Serological testing Whole blood CMV NDA quantitative testing and pp65 antigen testing are three common clinical laboratory testing methods for diagnosing CMV infection. They are used to detect patients with CMV carrying cells <50μ) or fail to receive HAART. The fourth preferred drug, such as amikacin or streptomycin. Generally, antiviral therapy should be started two weeks after MAC treatment to reduce the drug burden of patients with drug interactions and the incidence of immune reconstitution inflammatory syndrome. If the patient has already received antiviral therapy, antiviral therapy should be continued, and anti-MAC therapy should be given. Attention should be paid to adjusting and optimizing antiviral therapy to reduce the mutual treatment between drugs. The patient’s clinical performance has not improved after 4-8 weeks 2. The patient has persistent bacteremia, which can be considered a treatment failure.

Causes and characteristics of giant cell retinitis
The characteristic changes of CMV retinitis can be seen on fundus examination: yellow-white, villi or granules can be seen on the retina
Lesions, lesions often close to the blood vessels of the retina and cause bleeding. Vitreous inflammation was milder among those who did not fight HIV. Untargeted
Treatment, CMV retinitis will progress, usually within 10-21 days of symptomatic disease progression. According to the degree of retinal opacity and whitening, retinal hemorrhage, and the shape and location of the lesion, the lesions were divided into “outbreak edema type” and “rest granule type”. Not all patients with CMV viremia develop CMV end-organ disease, and not all patients with CMV retinitis have CMV viremia. A positive CMV antibody is not helpful in the diagnosis of CMV retinitis, while a negative CMV IgG usually indicates that retinitis is probably not caused by CMV.

Key points:

  1. CMV retinitis is a late-stage complication of AIDS patients, and it mostly occurs in patients with CD4T lymphocytes <50 cells/ul;
  2. The prognosis of CMV retinitis is poor, and it is often easy to cause blindness;
  3. Patients with CD4T lymphocyte counts less than 200cells/ul are prone to opportunistic infections, review on time, and avoid the incentives for opportunistic infections.
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China’s First COVID-19 mRNA Vaccine Enters Phase I Clinical Trials

The PLA academy of military medical academy of military sciences, suzhou abon technology co., LTD and yunnan Watson (300142) biological technology co., LTD., joint research and development will be coronavirusmRNA genetic engineering vaccine, on June 25, start Ⅰ period in tree orchid (hangzhou) hospital clinical trials.
This is also the first novel coronavirusmRNA vaccine approved for clinical trial in China.

MRNA vaccine is a new form of vaccine in recent years. Its basic principle is to introduce the mRNA expressing antigen target into the body through a specific delivery system, express proteins in the body and stimulate the body to produce specific immunological response, so that the vaccinator can obtain immune protection.
Because it turns the human body into a processing plant for its own drugs, revolutionizing the way vaccines are made.
Due to the high technical threshold of mRNA vaccine, only a few mRNA vaccine varieties developed in the United States and Germany have entered the clinical trial stage, and China has never approved mRNA vaccine to enter the clinical trial before.

The first clinical approval of COVID-19 mRNA vaccine was approved and entered into clinical trials, achieving the breakthrough of “zero” mRNA vaccine in China, indicating that China’s mRNA vaccine research and development level and regulatory capacity have been among the forefront of the world.
Domestic NCP mRNA vaccine has three advantages: more accurate selection of vaccine antigen target, high specificity of induced neutralization antibody, and better safety of vaccine;
All the core raw materials and equipment have been localized, and the production capacity can be rapidly enlarged.
It can be stored at room temperature for a week or for a long time at 4℃. The cold chain cost is low and it is easy to achieve mass vaccination.

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What Are the Toxic Side Effects of Immune Checkpoint Inhibitors?

The adverse reactions of immunopoint inhibitors are usually related to inflammatory reactions. Drugs with a long half-life are more likely to cause immune-related adverse reactions (irAEs).
Generate new immune responses to autoantigens;
A hyperphysiological response to symbiotic bacteria, such as the gastrointestinal tract or skin

The incidence of all G3/4AES ranged from 7% to 13%. In general, irAEs generally occurred early, mostly within a few weeks to three months after administration, and irAEs did not occur until treatment was terminated, and most immune-related adverse reactions were reversible.

It was also found that drugs with a long half-life were more likely to cause irAEs, so shortening the half-life of PD-1 antibody is an effective strategy to reduce the occurrence of toxic and side reactions of immune point inhibitors.

General principles of irAEs treatment (graded according to CTCAE severity) :

1) Level 1: Not bedridden, not recommended hormone, not recommended other immunosuppressive drugs, continue immunotherapy;

2) Level 2: not bedridden, local or systemic hormone therapy oral 0.5-1mg/kg/d is recommended, other immunosuppressive agents are not recommended, and the use of immunotherapy is suspended;

3) Level 3: hospitalized, systemic hormone therapy orally or intravenously with 1-2mg/kg/d. Patients whose symptoms fail to relieve after 3-5 days of hormone therapy may consider using other immunosuppressive agents under the guidance of a specialist, stop immunotherapy, and seriously discuss whether to recover;

4) Hospitalized treatment, ICU should be considered, systemic hormone therapy, intravenous methylprednisolone 1-2mg/kg/d, and gradually reduce the dosage to 1mg/kg/d after 3 consecutive days. Patients whose symptoms fail to relieve after 3 to 5 days of hormone therapy may consider using other immunosuppressive agents under the guidance of a specialist, and stop immunotherapy permanently.

Note: Patients who have used IMMUNOsuppressants before and have a level 3 or more toxic side effect are less likely to respond to repeated use of immunosuppressants, so use caution

Note: It is very important to pay close attention to the occurrence of toxic and side effects after immunosuppressive therapy. The earlier the toxic and side effects are treated, the greater the chance of recovery.
Such as immune myocarditis, severe immune hepatitis, and so on, treatment is not timely may lead to the patient’s death.

Note: antibiotics may reduce the efficacy of tumor immunotherapy.

Note: Patients may have repeated adverse reactions, so pay attention to monitor their own physical conditions.

Cutaneous toxicity is the most common AEs(34-43%) in patients treated with CTLA-4 and PD-1. Rash, pruritus, and vitiligo are the most common, with reactive cutaneous capillary hyperplasia (but mild and self-limiting) being the most common.

AEs with the greatest impact is pulmonary toxicity, with a low incidence, but note the risk factors (whether there is underlying lung disease, lung infection, history of radiotherapy).
The incidence of stage 5 pneumonia was 0.1%.

The worst prognosis was immune myocarditis with an incidence of 0.06%, but 101 patients with severe myocarditis had 46 deaths.
The median duration of immune myocarditis was 27 days, 76% occurred within 6 weeks, and the shortest was 5 days.

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