Oman Patient in Treating Diabetic Nephropathy in China

'You see, these are all I collect photos of the Great Wall of China, and I particularly want to go to climb the Great Wall. Do you know? The Great Wall is one of the seven wonders of the world. As my condition becomes better, I must go and have a look!” In the ward of Beijing Tongshantang Hospital of traditional Chinese medicine, Syadi, from the kingdom of Oman, was excited to chat with the translator. In fact, this time to treat disease in China, Syadi also wanted to take this opportunity to travel around China and realize his own Chinese dream.

Syadi is a diabetic nephropathy patient from Oman. This year he is 36 years old and he has had the disease for 15 years. In the past 15 years, he has accepted various treatments at some hospitals in Oman. But diabetic nephropathy is refractory disease, his condition always repeated again and again. Fortunately, he has actively accepted treatments, under the care of his families.

“Illness comes in by mouth”, in Chinese was “Bing Cong Kou Ru”, Syadi spoke the four words in Chinese with an accent. Speaking of these four words, it’s because the doctors want Syadi to pay attention to his diet, especially after he come back his country. In Oman, there is a big difference between Oman food culture and Chinese food culture. Chinese food is so rich that it can serve dishes with various tastes. However in Oman, people are particularly fond of sweet foods, and most dishes contain sugar. For Syadi’s condition, it is a complication of diabetes. When he came to the hospital, his body was obese like puffed up with air.

It was half a year ago when he found out the disease. Due to severe back pain, he could not work continuously. “I thought it was because overwork or diabetes and high blood pressure, I had enough rest for several days. But later obvious foams in urine appeared.” And then he had examination in hospital at once, the doctor told him he got Diabetic Nephropathy and admitted in hospital at once.

Syadi was working at the airport. One day, he felt dizziness and fatigue when he stood up during he working. After had a rest for a while, he still could not go on working due to back pain. “I thought it was because overwork or diabetes and high blood pressure, I had enough rest for several days. But later obvious foams in urine appeared.” And then he had examination in hospital at once, the doctor told him he got Diabetic Nephropathy and needed to be hospitalized immediately.

After a period of treatment in Oman, Syadi’s recovery condition was not as smooth as he had hoped. Friends learned that he had been in the hospital for so long, and some of them visited him in the hospital. Once, one of the friends chatted with him in the ward, they talked about the Oriental culture and “the Belt And Road”. The friend said, “you are so fascinated with China, with the opening Chinese economy, let’s go to China to do business.” A joke reminded him, he said: “do you have friends treat disease in China?” Through the introduction by his friend’s friend, he came to Beijing Tongshantang Hospital of traditional Chinese medicine.

With the help of his friend, after getting the visa to China, Syadi went through more than 20 hours on the way and came to the hospital. When he came to the hospital, he had so severe Edema in the whole body, especially lower extremities. The robe could not cover his swollen body. The doctors then made a thorough examination for him and told the nurses to pay more attention.

The sense of responsibility of the health care team has inspired Syadi. Usually doctor, nurse and interpreter three persons accompany him to do treatment, which never experienced in Oman. First time touching Chinese medicine fumigation, Syadi was surprised “fumigation feels good, it make my body sweat a lot, as if every cell in the body does sports. Can you help me to arrange other Chinese medicine treatments? It is amazing!” Syadi said to the nurse.

After more than ten days of characteristic traditional Chinese medicine treatments, his edema was eliminated and urine output recovered to normal. According to Syadi’s diabetes, the doctors added indoor sports on the treatment plan, except for special meals a day. Now Syadi is a handsome man who has obvious change. His blood sugar is controlled and the diabetic nephropathy is solved either.

“After came here, I just know completely different pattern between Chinese medicine and western medicine. The disease explanations of doctors answered my a lot of confusions and taught me a lot of knowledge of traditional Chinese medicine. I also made so many lovely Chinese doctors friends,” Syadi said.

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Stay up late harm, to those around you who like to stay up late

Long night, there are always some rejoicing can not be missed, there are always some depression can not be relieved, there are always some movies must finish brushing, there are always a bunch of his comrades are still waiting online.
However, literally, it can be seen literally that staying up late is a harmful behavior and what specific injuries do it have?

Stay up late harm
Stay up all night "boil" what is it? Long stay up late, what will we lose?
1, the biological clock disorder
The hypothalamus, called the optic nerve of the suprachiasmatic nucleus (SCN), controls the circadian clock. The ganglion corrects the circadian clock by light, directing the body's movements and rest by hormone secretion.
Inverted black and white can easily disrupt the biological clock, the body's various metabolism, material synthesis and so will be affected in the short term naturally will not have any obvious symptoms, but long-term accumulation, you will find yourself more "older" than their peers.
2, loss of the brain
Sleep is an important process of brain self-repair, stay up late for a long time will not only affect the cognitive and emotional function of the brain, causing memory, decreased attention.
More seriously, staying up late for long periods of time leads to abnormal microglial activity in the brain. The primary role of microglia is to engulf metabolites and dead cell debris in the nervous system, but abnormally active microglia engulf Normal brain cells, the brain itself "eat" their own horror scenes.
This is also a major cause of dementia, so staying up late for long periods of time can lead to irreversible brain damage.
3, lose rationality
Staying up late leads to a "strike" in the cerebral cortex, and the cerebral cortex, especially the prefrontal cortex, is closely linked to self-awareness. So when the cerebral cortex "strikes" it is likely to lose control, become irritable and irrational (think of getting up in bed).
This is why police officers like to surprise prisoners in the night.
4, destroy the body
Night came, the biological clock told the body: the rest. So the body automatically reduce the central temperature, reduce the body's alertness and responsiveness, to help the body to sleep faster.
But we also have a hypothalamic-pituitary-adrenal (HPA) axis, which helps the body to enter combat status within a short period of time by secrete adrenaline and cortisol, which made humans escape the Beast many times Attack.
However, when we stayed up late, the hypothalamic-pituitary-adrenal (HPA) axis, which had been suppressed by the clock, became active again as it mistakenly thought we were in danger and began to secrete adrenaline and cortisol, causing the body Instantly full of combat effectiveness, which is the reason why the more stay up all night more spirit.
Unfortunately, these cortisol not only enhance local metabolism (get angry, Zhangdoxian), but also help the liver continue to make blood sugar into fat, and then remind the body need to add more food, and finally, a large number of adrenaline and cortisol will Cause high blood pressure and arrhythmia, which is the main cause of sudden death.

Late sleep late night okay?
Some people say that although I stay up late, but I can get up late, as long as the guarantee sleep 8 hours a day, is not it?
The answer is: No.
As I said earlier, the SCN corrects the circadian clock by light, that is, the human body actually has a "photo-sensitive switch."
When the light goes dark, SCN begins to direct the body to prepare for sleep, such as reducing body temperature, inhibiting the secretion of epinephrine and cortisol, etc .; when the light becomes brighter, SCN will gradually wake up the body, such as increasing body temperature , Increase the secretion of cortisol and so on.
1-2 hours before waking up, cortisol in the blood will gradually return to an increasing level, which is called cortisol awakening, which will make the body's various organizational systems gradually be stimulated, the body began to operate normally, the process Is everyone envy of "natural wake up."
However, if you choose to continue to sleep at this time, the already prepared body and the spirit of hope to continue to sleep will appear fierce contradictions, resulting in the body become confused, the body's hormone secretion will be re-upset, leading to more sleep more sleepy, malaise .
Some are clever and cheat the biological clock with curtains, blindfolds and the like, but without a change of light suddenly wakes up (opens the curtains and removes the blindfold) and the body is not adequately prepared, so there will be a short Time becomes trance, do not even know where they are ...

Do you want to stay up late?
There is a famous chicken soup that says: Dear, nothing in this world is important to let you go through the middle of the night and not sleep until twelve.
Staying up is like smoking, hurting your body does not appear immediately, even in a short time can make you feel more "cool." But everyone knows that this is a detrimental act. At the same time, it is also a very hard to get rid of behavior.
Some people laugh, what is hard to quit smoking? How many times a day
Stay up late is the same, whenever determined to "go to bed earlier tonight," there will always be some attractive things to jump out to lure you.
However, just like smoking for a long time, staying up late for a long time will surely hurt the body. Twenties may not feel it. However, when you are in your thirties and old and have a small family, and you most need to support the family burden, A sharp decline in physical condition, it is terrible.
In order to avoid this tragedy, please do not stay up late!

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IgA nephropathy recurring hematuria how to solve

Problem:
1, IgA nephropathy stages and symptoms of what is the stage?
2, why IgA nephropathy is difficult to treat?
3, Chinese medicine in the treatment of IgA have any contribution?

from google

Staging of IgA nephropathy
According to the process of nephron pathological changes, IgA nephropathy can be divided into five phases:
IgA nephropathy a
There was no abnormality other than a mild increase in mesangium.
At this point only intermittent urine occult blood, usually not be found.
IgA nephropathy two
Mesangial area began to appear focal proliferation and sclerosis phenomenon, but still no other abnormalities.
At this point still only intermittent urine occult blood, which is slightly higher than the frequency of a period, still difficult to find.
IgA nephropathy three
Mesangial proliferation and widening began to diffuse, and glomerular crescent began emerging, tubular, interstitial began to appear focal edema, and cell infiltration.
This stage is a watershed, urinary occult blood began to persist, some patients will also appear urine protein and high blood pressure and other symptoms, diagnosed more at this stage.
IgA nephropathy four
Mesangial proliferation and sclerosis have been severe diffuse, has begun to appear glomerular sclerosis, and renal tubular atrophy and interstitial infiltration is also aggravating, the glomerular crescent has been close to 50%, kidney damage has been very serious.
This stage has been renal insufficiency, in addition to urinary occult blood, urine protein, high blood pressure and other symptoms are more serious, and the impact of renal insufficiency, such as anemia, electrolyte imbalance, bone disease, heart failure, etc. .
IgA nephropathy five
Five and four similar situation, but more serious, glomerular crescent has more than 50%, is developing to the terminal.
This stage of treatment the most difficult, because renal function has been severely reduced, some patients have reached the stage of uremia, so the main conservative treatment.

from google

Difficulties in the treatment of IgA nephropathy

Difficulties in the treatment of IgA nephropathy not only lie in the mesangial area IgA immune complexes difficult to clean up, but also that mesangial area proliferation and sclerosis will lead to a large number of glomerular sclerotic necrosis.
More seriously, this also led to the tubular and interstitial atrophy and infiltration, so that a sharp decline in renal function, about 10% -20% of patients within ten years into the stage of chronic renal failure.
IgA nephropathy is still the main conventional treatment, that is, for urinary occult blood, urine protein, high blood pressure and other symptoms of treatment.
Treatment is relatively poor, mainly dependent on the maintenance of compensatory function of the residual nephron.

IgA nephropathy new treatment ideas

In addition to symptomatic treatment of Western medicine, you can also use traditional Chinese medicine conditioning treatment.
Chinese medicine treatment of IgA nephropathy, the main breakthrough point is to alleviate renal cell sclerosis.
We know that both the glomerular sclerosis and tubular atrophy, the impact on renal function are very large, and this sclerosis is irreversible. If you can delay the rate of hardening, IgA nephropathy will greatly reduce the rate of progress.
Chinese medicine to delay renal cell sclerosis is to improve kidney microcirculation to solve the status of renal cell ischemia and hypoxia.
Because both the deposition of IgA and mesangial hyperplasia, can lead to poor microcirculation of the kidney, for itself is the capillary group of the kidneys, will lead to a large number of renal cells in the hypoxic-ischemic state, which is also sclerosis and atrophy The main reason.
Therefore, the use of traditional Chinese medicine to improve renal microcirculation, combined with Western symptomatic treatment, in order to achieve better results.

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Uric acid really can not accept treatment

from google

Uric acid is high in the body there is a substance called purine due to metabolic disorders, resulting in increased blood uric acid caused by a metabolic disease, the body's daily production and excretion of uric acid is about the same amount of formation, the third One is from the food, two thirds is the body's own synthesis, excretion pathway is one third discharged from the intestine, two thirds excreted from the kidneys. As long as any of the above ways a problem, it will cause elevated uric acid.

Uric acid rises, because it hinder the process of blood secretion of uric acid, uric acid can not be discharged. Uric acid is too high, can also cause other diseases.
Gout in the past more rare gout patients, not only the incidence of the elderly, but also appeared the trend of younger, has become a common disease. In clinical, male uric acid normal: 149 ~ 416μmol / L. Female uric acid normal: 89 ~ 357μmo1 / L. If you exceed the target, uric acid is high.

Note: The normal reference value of each hospital or laboratory slightly different, you can consult a physician.

The normal reference for women about 60-70umol / L lower than men, usually until after menopause uric acid value was gradually increased, and close to the value of adult males.

Children's normal reference value is low [about 180-300umol / L], uric acid in adolescent men began to rise, and gradually reach adult concentrations, women will have to begin to increase after menopause, and slowly reach the adult man's level.

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What are the performance of diabetes and how to diagnose

from google

A typical case of more than three syndromes suggest the disease. Slightly asymptomatic diagnosis depends entirely on laboratory tests, often in health checks or accidental discovery of other diseases. Many patients first discovered complications, and then traced back and the disease. But whether there is no symptoms or complications, the key lies in the first consideration of the possibility of the disease and urine, blood sugar check before diagnosis.

(A) urine glucose test results should pay attention to the following situations. Urine test results for diagnostic purposes only, and diagnosed diabetes depends on blood glucose measurement.

1. If there is a small amount or trace of diabetes, and occasionally appear after meal should be carried out blood glucose and glucose tolerance test, and noted that the spotted solution of copper sulfate was reduced to copper oxide and the like to react, a lot of drugs , Such as morphine, salicylates, chloral hydrate, aspirin, para-aminobenzoic acid, a large number of citric acid, uric acid, and many other carbohydrates can also be raw copper sulfate and false-positive results. It is now widely used glucose oxidase made of urine test strips, to avoid false-positive results.

2. clinically diabetic signs or suspects and urine negative repeatedly, should pay attention to the determination of fasting and 2 hours after a meal blood sugar, so that except for elevated renal glucose threshold.

(B) of the blood glucose determination of blood glucose methods commonly used in three: venous plasma glucose (VPG), capillary blood glucose (CBG) and intravenous whole blood glucose (VBG). Of the two most commonly used before. The results obtained by different methods are slightly different. The results of the VPG method are 10% higher than those of CBG and about 15% higher than that of VBG. In the analysis of blood glucose report should pay attention to the exclusion of other cases caused by increased glucose concentration, such as injection of sugar, a variety of endocrine disorders, brain lesions and stress conditions, which will be described later. Patients with mild or early, especially type Ⅱ disease may be normal fasting blood glucose, can not be easily excluded, must be 2 hours after a meal blood glucose or glucose tolerance test.

(C) glucose tolerance test for patients with normal or slightly higher fasting blood glucose and occasionally diabetic, or suspected patients with diabetes (such as a positive family history, or repeated miscarriage, premature birth, stillbirth, giant baby, dystocia, abortion After the maternal, or repeated sore boil, etc.), to be glucose tolerance test. But the fasting blood glucose significantly increased the diagnosis of dominant cases have been identified, a lot of glucose can burden, should be exempted.

Diagnosis of diabetic fashion to be excluded except for a variety of factors affecting glucose tolerance, including anterior pituitary, adrenal cortex, hyperthyroidism and other endocrine diseases, obesity, liver disease, a variety of drugs (such as thiazide diuretics, female contraceptives, glucocorticoids , Phenytoin, chlorobenzothiadiazine, etc.), stress conditions (such as fever, infection, acute myocardial infarction, surgery, etc.), loss of potassium and so on.

2. 2h after meals blood glucose measurement Equivalent to 100g glucose carbohydrate foods such as steamed 2 2 or rice 2h after the determination of blood glucose, such as more than 140mg / dl were reduced tolerance, ≥ 200mg / dl for diabetes.

Because of low sugar diet or hunger state can reduce impaired glucose tolerance, so should pay attention to adjust the diet 3d pre-test sugar intake of not less than 250g / d, in order to obtain reliable results.

For some patients to assess their β-cell function or glycemic control status, the following determination can be made:

1. Fasting plasma insulin measured in our hospital by radioimmunoassay fasting plasma insulin normal range of 5 ~ 20μu / ml, type I patients are often below 5μu / ml, sometimes as low as undetectable. Type II plasma insulin levels in patients with normal, a few also have low, obese patients often higher than normal, increased significantly hyperinsulinemia, suggesting that insulin resistance. The latter is a component of the metabolic syndrome can be considered as one of the risk factors for coronary heart disease, which has drawn much attention in recent years. Insulin and insulin original immune cross, and therefore can be measured for the general radio immunoassay, and cardiovascular adverse effects, proinsulin may be more than insulin. The study has been the determination of proinsulin used in clinical.

2. Insulin release test During oral glucose tolerance test, plasma insulin concentration can be measured simultaneously to reflect the islet β-cell reserve function. In addition to the low fasting level of type I patients, the level of insulin remained low after the stimulation of sugar, showing a low flat curve, especially the simultaneous calculation of the ratio of glucose to insulin (IRI) / G, suggesting that insulin secretion Low (normal 25μu / mg). Ⅱ type of patients fasting level may be normal or high, delayed release after stimulation. Glucose stimulation, such as insulin did not rise or flat water, suggesting that β-cell dysfunction.

3.C-peptide determination of insulin release from pancreatic β-cells by the liver and kidneys by insulin and other energy-extinction, the peripheral blood of each cycle will be 80% destroyed, and its half-life of only 4.8 minutes, so the blood concentration of only Represents a very small part of its total secretion. C peptide and insulin from the proinsulin split from the same molecular peptides, not by the liver enzyme excretion, only excretion by the role of the kidneys, and its half-life of 10 to 11 minutes, so the blood concentration can be more Good reflection of pancreatic β-cell reserve function. Determination of C-peptide is not affected by insulin antibodies interfere with the determination of insulin-free cross-immune reaction, and is not affected by insulin injection, it has been used in recent years measured C-peptide blood concentration or 24-hour urinary excretion to reflect the beta cell secretion Features.

(1) Serum C-peptide concentration determination: Normal human serum C-peptide was 1.0 ± 0.23 mg / dl when fasting was measured by radioimmunoassay. The concentration was 3.1 ng / ml when the peak value of oral glucose was seen for 60 minutes. Serum C-peptide increased from 1.3 ± 0.3 ng / ml to 4.4 ± 0.8 ng / ml after 60 minutes in normal subjects and only 2.3 ng / ml in type 2 diabetes after 2 hours. The other 5 cases of type Ⅰ patients who had been treated with insulin for more than 5 years, C peptide levels are low, both fasting and after stimulation failed to measure.

⑵ 24-hour urine C peptide determination: normal 24-hour urine C peptide 36 ± 4μg, type I only 1.1 ± 0.5μg, type Ⅱ patients was 24 ± 7μg, C peptide daily release equivalent to about the secretion of insulin 5% of the amount of insulin secretion and only 0.1%.

The above-mentioned C-peptide assay can identify β-cell function in type I patients with insulin treatment, which is not only used for scientific research but also clinically used at present.

4.HbA1c determination of fasting blood glucose and blood glucose fluctuations may reflect the recent 2 to 3 months in the blood glucose, normal HbA1c6%, HbA1 8%, often higher than normal in patients with diabetes.

Fructosamine determination of serum normal fructosamine 2.13 ± 0.24mmol / L (plasma low 0.3mmol / L), reflecting the last 1 to 4 weeks of blood glucose, parallel with HbA1c, regardless of type I diabetes, type Ⅱ Are higher, especially in type Ⅰ as high.

In short, the diagnosis of diabetes can root history, clinical manifestations, supplemented by the above urine sugar, blood glucose and OGTT determined. In addition, the need to identify whether there are various complications and complications, and to assess their severity, type, stage of development and major organ status, etc., is very important for the treatment and prognosis of the disease.

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Diet is an essential part of treatment diabetic nephropathy

Diabetic nephropathy is a complication of diabetes that is caused by uncontrolled high blood sugar. If you have diabetic nephropathy, diet is an essential part of treatment. Well then, what diet should you follow?

1. Limit sodium intake

Recent studies have found that diabetes patients also need to limit sodium intake. Too much salt intake can increase the activity of amylase, which can promote the digestion of starch and make the small intestines to absorb free glucose . This can result in increased blood glucose concentration and worsen the condition. Generally speaking, sodium intake should be below 3g per day.

2. Be careful with fruits intake

Patients with controlled blood sugar level can eat some fruits which should be low sugar content like apple, kiwi, lemon, plum, peach and oranges. But the fruits should be consumed too much. Besides, do not eat fruits after meals because blood sugar level will increase. Moreover, diabetes patients also should not eat watermelon.

3. Drink too much water

Diabetes patients should drink more water appropriately. Water intake can decrease plasma osmotic pressure and have the effect of lowering blood glucose level. Patients in this condition will not feel thirsty. If patients limit water intake, this can lead to blood concentration and metabolic wastes in blood can not be discharged out of the body, which can cause diabetic ketoacidosis.

4. Potassium

Potassium helps counteract the effects of sodium on blood pressure. However, when kidneys are damaged, excess potassium may build up in the blood. High potassium can affect heart rhythm. Thus, choose fruits and vegetables that are low in potassium such as apples, canned apricots, berries, grapes and papaya, etc. Avoid high potassium foods such as bananas, winter squash, avocado, potatoes and tomato products.

5. Phosphorus

With kidney disease, phosphorus will also build up in your blood. Thus, you will need to limit phosphorus and avoid high protein foods.

The aim of proper diet is to control blood sugar level, blood lipid and blood pressure effectively. In addition to dietary therapy, diabetic nephropathy patients need to take Chinese medicines to repair injured kidney tissues and improve kidney function.

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