A summary of the causes of heart disease

A lot of people ask me, Dr. Shi, what’s causing my heart attack?
In fact, all heart disease is caused by a similar number of causes, so let me set the stage for this.

Let’s try a different way of thinking and use a metaphor, and you’ll see what’s going on!
What makes you feel so stressed when you enter the society?
Do you have this feeling, since leaving the campus to enter the society, the pressure is more and more, even to suffocate, and the source of this pressure has many aspects.
On its own, stress may be a result of a person’s innate lack of ability, an inefficient way of working, or not getting enough rest, or even a lack of food or nutrition throughout the day.
In addition to your own factors, there are some external factors, such as pressure from your supervisor, who gives you too high performance targets;
Family conflicts may also cause stress;
Your pig teammates at work can’t help you.
Hidden malicious competitors or even saboteurs may be deliberately planted or unfairly treated;
Also, the whole environment is not so friendly.
All of these pressures are exhausting and exhausting.
If you feel this way, you have empathy for understanding what causes heart failure.

The first major cause of heart failure is the heart itself, the heart includes myocardium, valves, coronary vessels and four components of the heart conduction bundle, if the heart itself is born with problems, whether it is hypertrophic, dilated or restricted cardiomyopathy will cause heart failure, which is equivalent to their own ability to insufficient;
If there is a problem with the valve, the flow of blood in the four heart chambers will be increased resistance or ineffective flow (there is reverse flow), which will actually cause the heart to work inefficiently, which is equivalent to the wrong working method;
Coronary artery blood supply problems is coronary heart disease, is obviously an important cause of heart failure, equivalent to not enough to eat how to work;
And the problem of conduction bundle is arrhythmia, no matter too fast too slow or not even the room room is not synchronous, the effect to the heart also is to be able to cause the drop of heart function even heart failure, and heartbeat is equivalent to the social person with not enough rest time.

The second category is the cause of heart failure outside the heart, the first is the heart of the heavy load, high blood pressure is like a strong boss set indicators, all the time is not forcing us to run high intensity, hard work;
The liver, kidneys and lungs, as good brothers of the heart, should work together to contribute to the health of the body, but liver failure, kidney failure or respiratory failure are not like the pig teammate you can never count on, and you even have to spare a heart to take care of him;
The ubiquitous “enemy”, including bacteria and viruses, can damage the heart, or even activate the immune system to cause immune damage to the heart.
The high blood sugar, high blood lipids and low blood potassium in the internal environment of the body make the whole circulatory system operate very slowly and have great resistance, and the burden of the heart increases significantly, and the incidence of heart failure increases accordingly.

In short, the so-called cause of heart failure, even the cause of most heart disease, the cause of other organs, are all autogenous factors, neuroendocrine factors, other important organ damage, infection and immune system, internal environment disorders and so on, you see?
See I will test you, why obesity will increase the incidence of heart failure, what is the main reason?

Obesity is an excess of strategic reserves stored by the body, which can hardly be used when it becomes moldy. It also brings a heavy logistical burden, including to the heart and blood vessels. Therefore, scientific weight loss is a beneficial treatment for all heart diseases.

【 Dr. Shi’s intimate Tips:】 let the heart relaxed, let yourself a little bit happy!
Fortunately however the working environment of the heart is in a relatively closed, stable, harmonious whole inside.
The reality is much more complicated for the social man who is crawling around in the society.
It may be right to the heart so, it may be right to oneself, accept oneself inadequacy, avoid excessive pressure and burden, adequate recuperation, let the heart a bit easier, let oneself happy a bit!

Drug hunters in the evolutionary history of insulin

In the lazy afternoon, Lao Yang was bored to brush the news. A piece of news suddenly lit up his eyes and made him feel sleepy. The news wrote: CNR Beijing on May 6, at the centenary of the discovery of insulin, the research progress of oral insulin is exciting.

Oral Insulin Capsules (ORMD-0801) are a new development that breaks through many technical difficulties and upends tradition.
Experts at the meeting said the discovery of insulin 100 years ago revolutionized the world of incurable diabetes.
However, the existing insulin administration methods are all injection administration, which have deficiencies such as hypoglycemia, weight gain and poor compliance, thus restricting the use of many patients.
Because of this, in the past century, scholars at home and abroad have never stopped the pursuit of non-injectable insulin.
In the oral administration, buccal mucosa, sublingual, nasal cavity, inhalation, skin and other ways of drug administration have been explored, but the road of exploration is rather bumpy.

Ning Guang, director of the Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and academician of the Chinese Academy of Engineering, said in a speech, “Oral insulin capsules mimic the path of human physiology after insulin secretion, which can be absorbed through the intestinal tract and directly into the liver, which is more in line with the physiological state.
Its appearance can help patients to start insulin treatment as early as possible and improve patients’ compliance, so as to better control blood glucose fluctuations and delay the occurrence and progression of complications. It is of great help to improve the quality of life of patients with diabetes and has a positive impact on the treatment strategy of diabetes.

At present, 36 hospitals in China under the leadership of academician Ning Guang and director Wang Weiqing Ruijin Hospital, oral insulin capsule Ⅲ phase clinical study.”
Among them, the Tianmai Biological Oral Insulin Capsules (ORMD-0801) of Hefei Tianmai Biological Technology Development Co., Ltd. (Tianmai Biological) is currently enrolled in the phase Ⅲ clinical trial project, which has been completed.

As one of the nearly 130 million sugar friends in China, Yang has a love-hate relationship with insulin — he doesn’t inject it and speaks sweetly.
Injections, in Uncle Ge’s words, are “trouble.”
Some people say that taking medicine is also OK. Let’s take a look at the current domestic market share of insulin in hypoglycemic drugs in 2020.

Data source: public data collation

Yes, insulin has become the dominant hypoglycemic drug, accounting for half of all sales.
Now that we are talking about insulin, Yang would like to take a look at its history and context.

Eli Lilly’s founding covenant with insulin in the early 20th century

First, back to Long Long Ago, the story goes back to 1897, when Bayer started selling aspirin and was making a lot of money.
The success of these synthetic drugs has opened the door for pharmaceutical companies to create original synthetic drugs.
With the turn of the 20th century, several pharmaceutical companies in the United States, including Eli Lilly, were among the first to set up research and development teams to search molecular libraries for useful compounds.
Eli Lilly, the third-generation head of the company, was so envious of Bayer’s success in Germany that he decided to get his own company involved.

In 1919, Eli Lilly hired a scientist named Alec Krauss to look for potential new product opportunities.
Kraus began researching which diseases offered the most promise for developing new drugs, and he soon zeroed in on a disease for which there was no cure at the time: diabetes.

As far back as 2000 BC, Indian doctors discovered that ants were particularly fond of the urine of certain patients, and Egyptian manuscripts of the same period also recorded “excessive urine volume” in some patients.
This is the earliest documented case of diabetes.
The Indians called the disease “honey urine” and the Greeks called it “polyuria” because the patient urinated too much.
In 1675, an English doctor added the Latin word “sweet” to the name of the disease.
Today, the disease is known as Ⅰ type diabetes.

When Dr. Kraus joined Lilly, diabetes patients typically died within a year of diagnosis.
More than 4,000 years after honey urine was first recorded, there is still no cure for the disease.
Klaus hopes to change all that.

Fortunately, there is a widely accepted view of which drugs are likely to be effective for diabetes, and this view came about by accident.
In 1889, two European doctors, Josef von Mering and Oskar Minkowski, discovered that dogs’ pancreases secreted a hormone that controls how the animals metabolize glucose, a hormone we know today as insulin.

Based on Mellon and Minkowski’s work, scientists concluded that simply injecting insulin into diabetics could cure the disease.
But the problem was stuck on the extraction, until Frederick Banting came along.

In 1921, on a balmy Toronto summer day, Banting and his young assistant, Charles Best, began the drug hunters’ traditional tool of trial and error. After countless refinements, the experiment progressed, but the purity and mass production of the extract became so puzzling that Eli Lilly stepped in.
Klaus reached out to Banting after hearing him speak at Yale.

With the support of Eli Lilly, a suitable diabetic was quickly found at the Toronto General Hospital in 14-year-old Leonard Thompson for the first human trial. Fortunately, it worked. Thompson received insulin injections, which, though not a cure for diabetes, prolonged his life for another 13 years.
Once diagnosed with diabetes, people were lucky to live for a year. Today, with daily insulin injections, diabetics live an average of only 10 years less than the general population.

Image source: Internet

In 1923, when insulin from Eli Lilly was first released in North America, it didn’t matter whether Banting, Kraus, Eli Lilly or insulin had made a difference. What mattered was that Thompson was saved, and then hundreds of millions of sugar friends.

Top 10 Hypoglycemic Drugs by Global Sales in 2020

Data source: public data collation

Since then, the development of insulin has also gone through the course of animal insulin, human insulin and insulin analogues, which has changed the fate of countless diabetes patients.

Image source: Internet

The first generation of insulin — animal insulin. When Kraus obtained the license for the method of extracting insulin, he quickly mobilized Lilly’s Indiana plant to purchase large quantities of pig and cow pancreases to prepare for mass production of the first generation of insulin.
With a budget of $200,000 ($3 million in today’s dollars), the project was developed on an industrial scale within a month, and with the help of more than 100 scientists, by the end of 1922 Eli Lilly finally had a reliable way to produce animal insulin in good quality and in good quantity.
This period lasted for more than 50 years.

After more than half a century of suffering from allergic reactions to animal insulin, a new opportunity arose in 1972.
Genetically engineered drugs were born after Stanford professor Paul Berg, who studied viruses, performed one of the most important experiments of the 20th century, called recombination.
In 1976, herb, Boyle, professor of biochemistry at the university of California and Robert swanson (VCS) opened in San Francisco “genentech” to research and development production of human insulin, genentech took more than a year to isolate human insulin gene, but the r&d expenses very fast, they need new partners, an injection of new funds
When faced with a choice between Eli Lilly and Squibb, the first company to go was Squibb, but Squibb missed out on one of the most significant changes in drug development history because of its judgment.
When it came to Eli Lilly, not daring to risk losing the entire market, it agreed to partner with Genentech in 1978.
Human insulin was first marketed in 1982.

The third generation of insulin, the insulin analogue, once the door was opened, the code would follow.
In the late 1990s, in the in-depth study on the structure and composition of insulin, humans found that modification of the peptide chain may change the physical and chemical properties and biological characteristics of insulin, so as to develop insulin analogs that are more suitable for human physiological needs than traditional human insulin.
In 1996, Eli Lilly introduced the world’s first insulin analogue, Lyproline.
In 2000, Sanofi (France) launched the first long-acting insulin analogue, insulin glargine.
Today, a variety of insulin analogues produced by different companies continue to emerge.

The domestic dream team and its successors

Back at home, let’s see how our insulin-wielding swordsmen are cutting their way through.

Back in 1958, when the People’s Republic of China was founded less than 10 years ago, economic development and material conditions were relatively backward.
The British chemist Sanger won the Nobel Prize in chemistry that year for completing the entire sequencing of insulin, and the academic journal Nature said in a commentary that year that “the synthesis of insulin will be a distant thing.”
On the other side of the world in developing China, in a small room at the Shanghai Institute of Biochemistry, eight 30-somethings are meeting to discuss “what to study”, led by Wang Yinglai, the institute’s slightly older director.

This is a “dream team” in the field of biochemistry in China.
King should biochemical Dr. Lai is the university of Cambridge, enzyme chemist Zou Chenglu from Cambridge, Cambridge protein experts from Cambridge, nucleic acid experts de-bao wang is the Johns Hopkins university postdoctoral, vitamin experts Zhang Youduan also from Cambridge, protein experts NiuJingYi is the Texas state university, PhD, biochemical experts guang-yu zhou is a doctor at the university of leuven in Belgium,
Shen holds a PhD from the University of Toronto, Canada. Xu graduated from the Department of Chemistry, Southwest Associated University.

At the nine-person conference, the idea of moving into the life sciences and synthesizing proteins generated a lot of discussion.
What scholars in developed countries in Europe and America did not know was that Chinese scientists, with relatively “poor” scientific research facilities, dared to challenge the task of “synthetic insulin”, which seemed impossible at that time.
On December 18, 1958, the Institute of Biochemistry formally confirmed the project of synthetic insulin, and invited Peking University and other units to participate in the research.
After a lot of experimental design, and a lot of trial and error, the Chinese drug hunters finally crystallize bovine insulin on September 17, 1965.

China’s insulin market started late, and there is a gap with foreign technology.
At present, the domestic insulin market is mainly dominated by imported products, with international leaders Novo Nordisk, Sanofi and Eli Lilly ranking the top three, occupying 70% of the domestic market share.
Major domestic insulin manufacturers include Tonghua Dongbao, Ganli Pharmaceutical Co., Ltd., Federal Pharmaceutical Co., Ltd. and Jiangsu Wanbang Co., Ltd.

Said to tonghua dongbao and GanLi pharmaceutical, have to mention is currently the largest GanZhong such as Dr, insulin founder GanZhong such as Dr. Graduated from Peking University department of biology, the early reform and opening up is the second batch of Chinese students by Mr. Deng xiaoping advocated traveled abroad, then he has a doctor’s degree at Michigan state university and in the United States Merck postdoctoral, senior biochemist.
In 1995, he came back to China and wanted to develop the recombinant human insulin project in the field of biological medicine, so he started to produce the second generation of human insulin in cooperation with Li Yikui, one of his former classmates at Peking University and the chairman of Tonghua Dongbao.
By 1998, they had put the second generation of recombinant human insulin on the market, making China the third country in the world to produce and sell recombinant human insulin.
At the time, only Eli Lilly and Novo Nordisk had the same product, and Sanofi had no similar product on the market.

In 1998, Dr. Gan Zhongru established Gan Li Pharmaceutical Co., Ltd. to develop the third generation of insulin.
By October 2005, the third generation insulin analogue was on the market.

So will oral insulin capsules be Generation 4 or Generation 3 +?
That doesn’t matter. What matters is that a new generation of drug hunters is still building magic bullets, dreaming of solving the world’s problems, and vying to be the ultimate terminator.

Rheumatism patient basks in the sun, what profit is there? Here are 4 tips to help you get the sun right

At present, the temperature is gradually rising, there are many elderly people, often in the community inside the sun, a lot of people will take the sun as a method of health.
B: That’s true. Traditional Chinese medicine believes that basking in the sun can enhance Yang Qi and is good for our health.
For rheumatic patients, often basking in the sun can also get some benefits, but there are some things that need to be paid attention to, the following take you together to understand.

Rheumatism patient basks in the sun, what profit is there?

May be a lot of people do not know, the occurrence of rheumatism, mainly caused by cold damp evil.
In order to relieve the discomfort and improve the condition, patients should take medicines as prescribed by the doctor to remove the cold and dampness in the body.
And rheumatic patients, if develop the habit of sun, help to promote the body in the Yang, help drive away the cold dampness.
It is very helpful for relieving joint pain.

So for normal people, moderate exposure to the sun, can bring what benefits to the body?

(1) Moderate sun exposure can promote the synthesis of vitamin D. After sufficient vitamin D, the body can better absorb calcium, so as to prevent osteoporosis.

(2) After the body is exposed to the sun, it can also regulate people’s psychological state, help to improve bad mood and maintain an optimistic and cheerful state of mind.

(3) regular exposure to the sun, but also help to enhance the immune ability, improve the body’s ability to resist disease, inhibit the development of inflammation in the body.

From this we can see that regular exposure to the sun is good for health.
But for normal people, we must pay attention to moderate, the sun is still relatively strong in summer, it is easy to tan, dehydration phenomenon.
But for rheumatic patients, there are 4 points to pay attention to, so as to correctly bask in the sun.

Rheumatism patients, if you want to bask in the sun, which 4 points need to pay attention to?

Number one: The best time to get some sun – 10am, 3pm

To rheumatism patient character, most appropriate bask in these two time periods, because the sunshine of this paragraph of time is not very intense.
It has great help to promote blood circulation and metabolism, and is conducive to the synthesis of vitamin D.
However, we need to remind you that because in summer, the day time gets longer, the sun may be very strong at 3 PM, so it is recommended to bask in the sun at 5 or 6 PM in summer.

Number two: time spent in the sun at a time – no more than 30 minutes

Although as mentioned above, regular exposure to the sun has many health benefits, we should also pay attention to the amount of time we spend in the sun.
The best time in the sun every day within half an hour, must not be a long time in the sun, for rheumatism patients with skin diseases, but not in the sun for a long time exposure.

Number three: the best places to bask in the sun – parks, gardens, balconies with Windows open

For rheumatic patients, very suitable for the park, the garden of the community in the sun.
Do not pass for the person with a few more serious illness, daily activity can be restricted, can choose to bask in the sun on the balcony so.
But the need to remind everyone, should open the window, so that the skin is fully exposed to the sun, so that the effect of the sun is better.

Fourth point: protective measures after basking – drink more water, eat more fruits and vegetables

Patients with rheumatism are advised to increase their drinking water intake after sun exposure and to eat more fresh fruits and vegetables.
This can not only supplement the loss of water, but also can play a nutritional effect, especially the vitamin C in fruits and vegetables, can inhibit the production of melanin.

To sum up, basking in the sun is a good way to keep healthy, especially when spring is about to end and summer is coming, it is very suitable for basking in the sun.
For rheumatic patients, the sun is good for health, but need to pay attention to the above 4 points, so as to avoid some unnecessary situations.

3,532 mutant viruses found in India!WHO: The outbreak is spreading to neighboring countries…

The WHO recently released a report showing signs that the outbreak in India is spreading to neighboring countries:
① In Nepal, there was a 137% increase in cases last week;
(2) Confirmed cases of COVID-19 in Laos increased by more than 200 times in one month;
③ Hospitals in Pakistan and Bangladesh are at or near full intensive-care units;
(4) About 98% of new cases in Thailand are from mutated viruses.
And the virus continues to spread further afield.
Two cases of novel coronavirus were detected in the Indian delegation to the G7 foreign ministers’ meeting in the UK on May 5.
Rapid worsening of epidemic in Nepal:
An additional 9,196 cases have been confirmed
A total of 377,603 cases have been confirmed
The International Federation of Red Cross and Red Crescent Societies (IFRC) said in a statement Wednesday that the number of cases diagnosed in Nepal has soared, with the positive detection rate of novel coronavirus reaching 44%.
Officials with the Nepal Red Cross have warned that if the epidemic is not stopped, what happened in India will happen again in Nepal.
The COVID-19 has worsened rapidly in Nepal recently. Some analysts believe that frequent personnel exchanges with India are one of the reasons for the recent worsening of the COVID-19 in Nepal.
The two countries share a long land border and have close people-to-people exchanges.
As the epidemic in India worsened, many Indians entered Nepal.
Nepal has recorded 9,196 new confirmed cases of COVID-19 in the past 24 hours, including 9,023 positive cases of nasopharyngeal swab nucleic acid test and 173 positive cases of novel coronavirus antigen test, according to statistics released by the Ministry of Health and Population on Monday afternoon.
In addition, Nepal has recorded 50 new deaths in the past 24 hours.
As of 15:00 May 7 local time, Nepal has had 377,603 confirmed cases and 3,579 deaths.
Government of India:
There are 3,532 variants of the virus
A third wave is inevitable
A worrying 3,532 strains of the new coronavirus have been detected in 27 states, the Indian government announced on Wednesday, adding that a third wave of the virus was inevitable given the surge in cases.
Vijay Raghavan, chief scientific adviser to the Indian government, said: “Phase 3 is inevitable given the large number of viruses circulating, but it is not yet clear when phase 3 will occur. Hopefully it will happen gradually.
“Previous infections and vaccines can put adaptive pressure on the virus to make the kind of new mutations it’s trying to escape, and we have to be scientifically prepared to deal with that.”
The outbreak continues in India
The positive test rate in Goa was 41%
India yesterday reported more than 414,000 new confirmed cases in a single day, another record high.
What is the current situation of the epidemic across India?
Have the measures taken by the Indian government to prevent and control the epidemic had some effect?
More than 414,000 new cases of COVID-19 have been confirmed in India in the past 24 hours, again the highest number in a single day since the outbreak began in India and globally.
It is also the third time since May that India has recorded more than 400,000 new cases in a single day.
India’s epidemic continues to grow, with a nationwide positive rate of 21% in the past two weeks, according to a survey, meaning that one in five people tested for novel coronavirus has been diagnosed.
In the southern Indian state of Goa, the figure was 41 percent, meaning that for every five people tested there, two were diagnosed.
The surge in cases has also left the local health system operating under pressure.
In some hospitals in Uttar Pradesh, local media have described nurses as doctors, nurses as nurses and family members as caregivers.
In addition, due to the new outbreak of respiratory difficulties and the increase in the proportion of serious illness, local people have also caused panic, in order to “nip in the wind”, many people have started to buy home oxygen generators.
Some wealthy people have even built intensive care units in their homes.
At present, the price of related medical supplies is rising, and it is very difficult to buy them.
At present, more and more places in India join the “curfew” ranks.
In Mumbai, restrictions have been implemented since the end of March and have shown initial results. According to statistics, the number of new cases per day in Mumbai has dropped from more than 10,000 in early April to more than 3,000 at present.
It is hoped that the epidemic in India will turn to a turning point as soon as possible following the widespread adoption of restrictive measures.