When it comes to vitamin C, I believe everyone will be familiar with it. Vitamin C is an essential nutrient for the human body and plays an important role in maintaining human health. Appropriate amount of vitamin C supplementation can not only maintain the health of skin and mucous membranes, but also enhance the ability of white blood cells and enhance immunity. So how should vitamin C be added in daily life? Take a look at the following foods.

1. Fresh fruit

Most fruits are rich in vitamin C, such as kiwi, jujube, jujube, orange and so on. Among them, jujube has the highest vitamin C content, which contains about 920mg of vitamin C per 100g. When choosing these fruits, choose the ones that are not damaged. Because the fruit is squeezed, shredded, etc. will cause the loss of vitamin C. It is not advisable to store the fruit for a long time after buying it. Vitamin C is easily destroyed after long storage of the fruit. Therefore, when choosing fruits, choose fresh and complete ones, so as to ensure the vitamin C content.

2. Fresh vegetables

Some vegetables are also rich in vitamin C, such as broccoli, tomatoes, bell peppers. Lettuce, etc., among which the content of vitamin C in bell pepper is higher. Because vitamin C is soluble in water, it has a strong reducibility. In the process of cooking vegetables, they should be washed first and then cut, and it is not suitable to soak in water for a long time to avoid the loss of vitamin C in vegetables. When cooking, avoid cooking for a long time. You can use cold salad or stir fry to reduce the loss of vitamin C in vegetables.

3. Vitamin C supplements

Because vitamin C is easily lost in food, in addition to eating more fresh fruits and vegetables, you can also eat vitamin C supplements, such as vitamin C tablets. Generally, vitamin C tablets are rich in vitamin C. Vitamin C can be supplemented in moderation, which is effective and convenient.

In recent years, friends have been chatting about the nine -, four – and bivalent cervical cancer vaccines.
With the popularity of domestic HPV vaccine, people are becoming more and more aware of the prevention of cervical cancer, more and more attention to their own health.

But there’s still a lot of misunderstanding about HPV, and a lot of young women don’t know much about HPV, so today we’re here to answer that question.

What exactly is HPV?

HPV, the human papillomavirus, is a group of more than 150 types of viruses, about 40 of which infect human reproductive organs and are the main cause of cervical cancer.
The virus is transmitted sexually and by direct contact with the skin. In severe cases, it can lead to precancerous lesions and cancers of the cervix, vagina, vulva and anus.

What are the HPV vaccines?
What is the vaccine that suits oneself vaccinal age?

The recommended age for bivalent vaccine for HPV16 and hPV18 is 9 ~ 45 years old. 1 dose is recommended for 0, 1 dose for 1 month and 3 doses for 6 months.

The recommended ages for quadrivalent vaccines for HPV6, 11, 16 and 18 are 20 to 45 years old, and 1 dose is recommended for 0, 2 and 6 months respectively, with a total of 3 doses.
(1 month between first and second doses, at least 3 months between second and third doses, 3 doses should be completed within 1 year)

The recommended ages for nine-valent vaccines for HPV6, 11, 16, 18, 31, 33, 45, 52 and 58 are 16 to 26 years old, and 3 doses should be given according to the immunization schedule of 0, 2 and 6 months.
(1 month between first and second doses, at least 3 months between second and third doses, 3 doses should be completed within 1 year)

But does HPV infection necessarily lead to cervical cancer?

This is not necessarily the case. Only a long and persistent high risk HPV infection can lead to cervical cancer.
A short period of HPV infection does not lead to cervical cancer.
In fact, sometimes you don’t even know that you are infected with HPV. As long as you keep good sleep and exercise, improve your immunity, it is very likely that HPV will gradually move away from you.

Unfortunately infected HPV, will it affect pregnancy?

As long as have done professional examination, TCT index is normal, and below the circumstance that the cell does not have evil change, it is to do not affect to be pregnant to give birth to a baby completely!

How do you prevent HPV?

The answer is definitely vaccine, vaccine is currently the most effective way to prevent HPV, of course, it does not mean that the injection of the vaccine can be completely carefree, you still want to keep a healthy rest, but the vaccine can effectively reduce the chance of contracting HPV!

So how effective is the HPV vaccine?

Due to the long duration of cervical cancer, the main focus of HPV vaccine clinical research is HPV infection and CIN.
At present, three KINDS of HPV vaccines have significant preventive effect on carcinogenic HPV infection and related diseases, including CIN2, intraepithelial neoplasia of vagina, vulva and anus, and stable immunogenicity after inoculation.
It is estimated that bivalent and quadrivalent vaccines reduce CIN2 and CIN3 by 62.1% and 58.6%, respectively, and reduce squamous cell carcinoma by 70.5% and 64.8%.

Compared with the bivalent vaccine, the quadrivalent vaccine provides much greater cross-protection against non-vaccine HPV types, which may significantly improve overall protection since non-vaccine HPV types cause about 30% of cervical cancer.
Quadrivalent and bivalent vaccines potentially prevent about 70% of invasive cervical cancer.
The nine-valent HPV vaccine can prevent another 20% of invasive cervical cancer.
It is estimated that the number of cases with the nine-valent HPV vaccine has been reduced by 9.3% and 12.5%, respectively, compared with the quadrivalent and bivalent HPV vaccines, and the number of cases of squamous cell cancer has been reduced by 4.8% and 6.6%, respectively, for high-grade intracervical neoplasia (CIN2 and CIN3).
There is no clinical efficacy data to support the cross-protection of nine-valent HPV vaccines.

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.

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.