紫竹莲 CHEE CHOK LIAN

紫竹莲 CHEE CHOK LIAN 35多年的丰富临床经验和天生具有心灵医疗能量女中医师 - Acupuncturist, Physician, Psychic Channeler

https://www.who.int/zh/news-room/feature-stories/detail/how-do-vaccines-work疫苗如何发挥作用?病菌无处不在,我们的环境以及我们的体内都有病菌存在。一个易感的人如果遇...
12/01/2021

https://www.who.int/zh/news-room/feature-stories/detail/how-do-vaccines-work

疫苗如何发挥作用?

病菌无处不在,我们的环境以及我们的体内都有病菌存在。一个易感的人如果遇到有害生物,便可能因此患病和死亡。
人体有许多防御病原体(致病生物)的方法。皮肤、粘液和纤毛(将碎屑从肺部移除的微小毛发)都可充当物理屏障,首先防止病原体进入身体。
如果病原体确实感染了身体,便会触发体内的防御系统,即所谓的免疫系统,对病原体进行攻击、摧毁或击败它。

身体的自然反应

病原体是一种细菌、病毒、寄生虫或真菌,可在体内引起疾病。每种病原体都由几个部分组成,通常是特定病原体及其引起的疾病所特有的。病原体中导致抗体形成的部分被称为抗原。针对病原体的抗原产生的抗体是免疫系统的重要组成部分。可将抗体视为身体防御系统中的士兵。我们系统中的每种抗体或士兵都受过训练,能够识别一种特定的抗原。我们体内有成千上万种不同的抗体。而当人体第一次接触某种抗原时,免疫系统需要时间来做出反应并产生针对该抗原的抗体。

在此期间,人很容易生病。

一旦产生抗原特异性抗体后,这些抗体便会与免疫系统的其余部分合作,摧毁病原体并阻止疾病。对一种病原体的抗体通常不能抵抗另一种病原体,除非两种病原体像兄弟一样非常相似。身体在对抗原的最初反应中一旦产生抗体,也会同时制造产生抗体的记忆细胞,即使在病原体被抗体击败后,这些记忆细胞也仍能存活。如果身体再次接触同一种病原体,抗体反应会比第一次快得多,也更有效,因为记忆细胞随时准备好产生针对该抗原的抗体。
这意味着,如果人体日后暴露于这种危险病原体,其免疫系统将能够立即做出反应,防止疾病。

疫苗如何提供帮助

疫苗包含特定生物体的弱化或灭活部分(抗原),可在体内引发免疫反应。较新的疫苗包含产生抗原的模型,而不是抗原本身。不管疫苗是由抗原本身还是模型组成,身体都将产生抗原,这种弱化的版本不会在接受疫苗的人身上引起疾病,但却会促使其免疫系统做出反应,且程度与针对实际病原体的第一次反应相当。

有些疫苗需要分几周或几个月多次注射。这有时是必要的,以便产生长效抗体和发展记忆细胞。通过这种方式,身体可受到训练以对抗特定的致病生物,建立对病原体的记忆,以便在未来暴露时能快速对抗病原体。

群体免疫

人们接种疫苗后,很可能受到保护,免受目标疾病的侵害。但是不是每个人都能接种疫苗。患有削弱免疫系统的基础病症(如癌症或艾滋病)或对某些疫苗成分严重过敏的人可能无法接种某些疫苗。但如果这些人生活在接种过疫苗的人群中,他们仍然可以得到保护。如果社区中许多人都接种了疫苗,病原体便很难传播,因为它遇到的大多数人都具有免疫力。因此,接种疫苗的人数越多,无法接种疫苗的人接触有害病原体的可能性就越小。这就是所谓的群体免疫。
这对于那些不仅不能接种疫苗,而且很容易感染疫苗可预防疾病的人来说尤其重要。没有一种疫苗能提供100%的保护,群体免疫也不能为那些不能安全接种疫苗的人提供充分保护。但是通过群体免疫,这些人将因其周围的人获得免疫接种而得到相当大的保护。
接种疫苗不仅可以保护自己,还可以保护社区中那些无法接种疫苗的人。如果可以,请接种疫苗。

纵观历史,人类已成功开发出针对脑膜炎、破伤风、麻疹和脊灰等多种威胁生命疾病的疫苗。

1900年代初,脊灰曾是一种全球疾病,每年导致成千上万人瘫痪。到1950年时,开发出了两种对抗这种疾病的有效疫苗。但是,在世界某些地区,疫苗接种仍不足以遏制脊灰的传播,尤其是在非洲。1980年代,全球团结一致开始了消灭脊灰的努力。多年乃至几十年来,各大洲通过常规免疫和大规模疫苗接种运动,开展了脊灰疫苗接种工作。数百万人,主要是儿童,接种了疫苗,2020年8月,非洲大陆获得了无脊灰认证,现在世界仅剩巴基斯坦和阿富汗仍未消灭脊灰,其余所有地区均已无脊灰。

🧐高度适应性SARS-CoV-2变异株的出现📚Emergence of a Highly Fit SARS-CoV-2 Variant Ralph S. Baric 呼吸系统疾病 • 2020.12.31相关阅读https://nejmq...
12/01/2021

🧐高度适应性SARS-CoV-2变异株的出现📚

Emergence of a Highly Fit SARS-CoV-2 Variant

Ralph S. Baric

呼吸系统疾病 • 2020.12.31

相关阅读

https://nejmqianyan.cn/article/YXQYcibr2032888?sg=AbW1NGsHw3NxPd6F

• 2019年从中国肺炎患者分离出的新型冠状病毒

Sarbe病毒在21世纪出现两次,并且在世界各地引起了大范围流行和全球性大流行。

SARS-CoV-2所致疾病COVID-19的持续大流行对人类社会造成了前所未有的破坏。

自2019年12月出现以来,SARS-CoV-2已在全球蔓延,截至2020年12月初,该病毒已感染超过7,000万人,造成160多万人死亡。先前的研究清楚地表明,大范围流行和全球性大流行的RNA病毒在传播过程中可能会对改变RNA病毒发病机制、毒力、传播能力或上述数项的突变产生选择作用1,而对于动物和人类中出现的冠状病毒,我们对上述过程的研究仍很少。

SARS-CoV-2可能来源于蝙蝠,在中国武汉发现的早期毒株显示出有限的遗传多样性,这提示该病毒可能是从单一来源引入2。2003年出现的SARS-CoV的早期人畜共患变异株影响了棘突蛋白的受体结合域(RBD),从而增强了病毒与人血管紧张素转换酶2(hACE2)受体对接并通过其进入人体细胞的能力3。

相比之下,研究发现早期SARS-CoV-2毒株的棘突蛋白RBD很早便可与hACE2受体高效地相互作用2。

然而,尽管有使复制达到高精确性的CoV RNA校对,但2月底进行的遗传流行病学调查仍发现欧洲南部新出现了影响SARS-CoV-2毒株棘突糖蛋白的D614G突变;之后该变异株迅速传播,现已成为全球最流行的基因型4。

D614G相关SARS-CoV-2的感染者与无突变毒株的感染者相比,更有可能出现较高的上呼吸道病毒载量,但疾病严重程度不受影响。据报道,具有SARS-CoV-2 G614型棘突蛋白的假病毒在连续细胞系中表现出较高传染性,以及对中和作用的较高敏感性。

此外,结构分析显示,G614型棘突蛋白的RBD与祖先D614型的RBD相比,更有可能呈现“开放”构象,这意味着与hACE2受体之间的结合能力提高。然而,在目前发表的论文中,并无从真正SARS-CoV-2重组活病毒中分离出D614G置换的报道,也无关于突变对体内复制和发病机制所产生影响的研究。

在近期的一项研究中,Plante等应用反向遗传学恢复了编码D614G突变的同基因重组SARS-CoV病毒5。G614变异株在培养的永生化细胞和原代人气道上皮细胞中的复制效率高于D614变异株(图1A和图1B)。即使D614与G614变异株的感染比例为1∶1、3∶1或9∶1,当前G614毒株在原代人气道上皮细胞中仍胜过祖先D614毒株。G614变异株似乎也比祖先毒株更稳定,这提示稳定性增加可能与传染性增加相关,但这一发现仍需进一步研究来证实。

1. 携带棘突蛋白D614G置换的SARS-CoV-2的传染性增加
Plante等5近期发表的一项研究表明,携带棘突蛋白D614G置换的SARS-CoV-2变异株使病毒在人肺上皮细胞(图A)、原代人气道组织(图B)和仓鼠上气道(图C)中的传染性和数量增加。这些数据提示D614G突变使病毒的传播性增强。此外,从感染D614病毒的仓鼠采集的血清样本可高效中和来自感染细胞的G614病毒(图D),这提示SARS-CoV-2疫苗(全部是基于棘突蛋白的D614变异体)对G614变异株有预防作用。

在对感染D614或G614变异株的仓鼠进行的研究中,Plante等发现,当前G614变异株在感染后早期即可通过复制在鼻腔冲洗液样本中达到较高滴度,并且胜过祖先D614变异株(图1C);这些观察结果提示,病毒在上气道主要区室中的适应性提高可能与传播增强相关。SARS-CoV-2 G614变异株与祖先毒株相比,并未在仓鼠中引起更为严重的疾病,这个支持我们当前在人类中的发现。目前正在临床试验中评估的COVID-19疫苗是基于最初的D614祖先棘突蛋白序列;因此,作者使用一组血清样本检测了G614变异株是否像祖先毒株一样对中和作用敏感(图1D)。幸运的是,结果表明G614毒株像D614毒株一样对血清样本敏感,之前人们担心G614毒株可以逃逸注射疫苗后产生的免疫力,上述结果可以减轻人们的这一担心。

Plante等提供证据证明了G614变异株适应性超过祖先毒株的遗传和分子基础,并提供强有力证据证明了其在促进病毒全球传播方面发挥的作用。与SARS-CoV 2003流行株中的变异株不同,SARS-CoV-2变异株可能指出了与病毒全球大流行相关的新机制。本研究表明,将遗传流行病学研究与经验性分子病毒学研究相结合对于理解大流行性病毒的进化和传播非常重要,除此之外,研究结果还提出了关于SARS-CoV-2 G614变异株未来进化轨迹的关键问题。在环境压力(如扩大群体免疫、疫苗诱导产生的免疫力、抗病毒治疗和公共卫生干预策略)可通过选择压力促进病毒存活和逃逸时,上述问题变得尤为重要。这些选择压力会驱动抗原变异、促进病毒稳定性和传播性、改变病毒毒力和致病机制,还是会驱动SARS-CoV-2灭绝或进入其他宿主作为病毒库?Plante等明确表示,我们亟须主动,而非被动追踪SARS-CoV-2和其他可能新出现的冠状病毒。


Disclosure forms provided by the author are available with the full text of this article at NEJM.org.

This article was published on December 16, 2020, at NEJM.org.

Ralph S. Baric, Ph.D.
From the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill.

参考文献

1. Lam TT-Y, Zhu H, Guan Y, Holmes EC. Genomic analysis of the emergence, evolution, and spread of human respiratory RNA viruses.

Annu Rev Genomics Hum Genet 2016;17:193-218.

2. Shang J, Ye G, Shi K, et al. Structural basis of receptor recognition by SARS-CoV-2. Nature 2020;581:221-224.

3. Chinese SARS Molecular Epidemiology Consortium. Molecular evolution of the SARS coronavirus during the course of the SARS epidemic in China. Science 2004;303:1666-1669.

4. Korber B, Fischer WM, Gnanakaran S, et al.

Tracking changes in SARS-CoV-2 spike: evidence that D614G increases infectivity of the COVID-19 Virus. Cell 2020;182(4):812.e19-827.e19.

5. Plante JA, Liu Y, Liu J, et al. Spike mutation D614G alters SARS-CoV-2 fitness. Nature 2020 October 26 (Epub ahead of print).

27/04/2020
20/04/2020

Nucleus Education
06/04/2020

Nucleus Education

This video animation on COVID-19 and the coronavirus is a collaboration between Nucleus Medical Media and our friends at the What If Channel. To watch super ...

04/04/2020

While we cannot see small nanoscopic objects like proteins or other molecules that make up virtually all living matter including our cells, tissues, as well as pathogens such as viruses, our computati

Solar Terms 101: Qingming, When Ancestors Are HonoredThe traditional Chinese lunar calendar divides the year into 24 节气 ...
04/04/2020

Solar Terms 101: Qingming, When Ancestors Are Honored

The traditional Chinese lunar calendar divides the year into 24 节气 jiéqì solar terms based on seasonal changes and natural phenomenon.

They play an important role in guiding agricultural activities, even to this day. But even city-dwellers like us can enjoy them. Each solar term has its own associated customs, traditions, and even recipes.

In Solar Terms 101, we delve into what makes each one special.

Name of the solar term: 清明 qīngmíng lit.

'clear and bright.' Also known as Tomb-Sweeping Day.

Gregorian date: Apr 4 +/- a day.

What is Qingming all about?

Qingming is one of the big festivals in the Chinese calendar, and one of only four traditional festivals that are granted a one-day holiday. The festival occurs when the solar longitude reaches 15 degrees, a time that is reflected in the name: 清 qīng, meaning 'clear' and 明 míng, meaning 'bright.' It therefore reflects a season when any remaining snow melts and drizzling spring rains wash away the dust from the previous year and make the world bright and clear again. At the same time, 阳 yáng (positive/active/male) energy rises up from the ground and 阴 yīn (negative/passive/female) energy subsides.

Qingming is fundamentally a day to honor ancestors. The associated Tomb-Sweeping Day is traditionally commemorated by people visiting and tidying family graves, celebrating ancestors through a quiet and solemn gathering as well as burning paper (more on that below). Even for those unable to visit graves, Qingming represents an opportunity to reflect and remember loved ones who have passed.

Tomb-sweeping, freshwater bathing, cold food, and fire

While commemorating ancestors is fundamental to Qingming, other traditions have also taken hold throughout history and vary from region to region. Over the years, the holiday has absorbed the customs of two other festivals: 上巳节 shàngsì jié and 寒食节 hánshí jié, which take place around the same time. On Shangsi Festival, people used to head into nature, bathing in rivers and picnicking in a world reawakened by spring.

On Hanshi Festival, people were required to only eat cold food and refrain from lighting fires. The idea behind these rituals were to bid farewell to the 'old fire' that had been burning throughout the previous year and usher in the new warmth.

People burning offerings to their ancestors on the street is a common sight during Qingming Festival

Speaking of fire, on Qingming, people traditionally also practice 烧纸 shāozhǐ, literally "burning paper." According to this custom, bundles of coarse bamboo-based 'joss' paper (often printed as ersatz 'ghost' or 'hell' money) as well as paper renditions of worldly objects, are burned as an offering to deceased family members so that they can better enjoy the afterlife. You can read more about that tradition here.

What to eat on Qingming

As we all know, no festival in China can exist without a specific delicacy to be enjoyed on that day. For Qingming, the signature snack is 青团 qīng tuán, balls of sticky rice dyed green with seasonal herbs to represent the color and fragrance of spring. Traditionally, wormwood was used to create the green coloring (artemisia absinthium) but nowadays, spinach is commonly substituted.

How do you like your qing tuan? Salty or sweet?

Like many other traditional Chinese snacks, qing tuan can be either sweet or savory, so it's time to pick your tribe: sweet with red bean paste or salty with egg yolk and ground meat. You can easily get some at time-honored bakery Daoxiangcun (稻香村 dàoxiāngcūn) or order them online. If you want to try your hand at making them yourself, click "Read more" for a YouTube recipe complete with in-depth historical notes.

02/04/2020

Think before you share and check the source are among the tips the public is being urged to adopt.

02/04/2020

It’s hard to escape news on the Coronavirus and get sucked in by the latest updates. The fear and anxiety levels are high. People are getting sick. We have g...

https://www.tnb.com.my/announcements/economic-stimulus-package-discount-on-electricity-billEconomic Stimulus Package Dis...
01/04/2020

https://www.tnb.com.my/announcements/economic-stimulus-package-discount-on-electricity-bill

Economic Stimulus Package Discount On Electricity Bill
01/04/2020

Economic Stimulus Package Discount On Electricity Bill for Electricity Consumption Starting 1st April 2020

In view of the Government's Economic Stimulus Package 2020 (PRE2020) and the Government's Economic Stimulus Package (PRIHATIN) recent announcement to reduce the negative impact of the COVID-19 outbreak on the Malaysian economy as well as safeguard the welfare of the people, TNB electricity customers will enjoy discount over a six (6) month period of electricity consumption from 1 April to 30 September 2020.

For residential customers, discount eligibility is based on total monthly consumption, as follows:

0-200 kWh = 50%; 201-300 kWh = 25%; 301-600 kWh = 15%; > 600 kWh = 2%
Total discount = % Discount x Consumption in RM (kWh)

Meanwhile, for non-residential customers, these include the following tariff categories:

Commercial (hotels operators, travel agencies, local airlines offices, shopping malls, convention centers and theme parks) = 15%
Commercial (other than those 6 selected sectors), Industrial, Agriculture (specific) = 2%
Total discount = % Discount x [Consumption in RM (kW + kWh) + ICPT + Other discount (if applicable)]

During the Movement Control Order (MCO) period,

The operation of meter reading and physical bill rendering at customer's premises is temporarily discontinued.
However, bills issued from 20 March onwards will be estimated based on the previous month's consumption.

Customers will still enjoy the eligible discount for their estimate bill for electricity consumption from 1 April 2020.

The bills will be adjusted once the TNB meter reader takes the actual reading at the customer's premises after the MCO period has ended (depending on the situation at the time).

经济刺激方案对电费的折扣
2020年1月4日 GoogleTranslate

自2020年4月1日起实施的针对电力消费的经济刺激方案折扣。

鉴于政府的2020年经济刺激计划(PRE2020)和政府的经济刺激计划(PRIHATIN)最近宣布减少COVID-19疫情对马来西亚经济的负面影响并维护人民的福祉,TNB电力从2020年4月1日至9月30日,客户将享受六(6)个月的用电量折扣。

对于住宅客户,折扣资格基于每月总消费量,如下所示:

0-200千瓦时= 50%; 201-300 kWh = 25%; 301-600 kWh = 15%; > 600 kWh = 2%

总折扣=折扣百分比x消耗的RM(kWh)

同时,对于非住宅客户,这些关税包括以下关税类别:

商业(酒店经营者,旅行社,当地航空公司的办公室,购物中心,会议中心和主题公园)= 15%
商业(6个选定行业除外),工业,农业(特定)= 2%

总折扣=折扣百分比x [RM的消耗量(kW + kWh)+ ICPT +其他折扣(如果适用)]

在运动控制令(MCO)期间,

客户场所的抄表和实物账单渲染操作暂时中断。
但是,从3月20日开始发行的票据将根据上个月的消费量进行估算。

自2020年4月1日起,客户仍可享受他们的估计用电量的合格折扣。

在MCO期限结束后(取决于当时的情况),一旦TNB抄表器在客户处取得实际读数后,将对账单进行调整。

In view of the Government's Economic Stimulus Package 2020 (PRE2020) and the Government's Economic Stimulus Package (PRIHATIN) recent announcement to reduce the negative impact of the COVID-19 outbreak on the Malaysian economy as well as safeguard the welfare of the people, TNB electricity customers...

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35多年的丰富临床经验和天生具有心灵医疗能量女中医师

35多年的丰富临床经验和天生具有心灵医疗能量女中医师

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关节炎症,痛风,风湿症,高尿酸,血管堵塞, 动脉硬化,頸部脖子疼痛,脑中风,坐骨神经痛,扭伤,血腫痛、瘀青痛,足踝痛,腰酸疼痛,月經失調、不孕症,白带异常,水肿症状,前列腺炎, 内分泌紊乱、泌尿系统炎症,痔疮,便秘,肠胃炎,免疫力低下、皮肤病,高血压,高胆固醇,鼻耳炎,神经衰弱症,入睡困难,优郁症,气喘病,大颈疱,口腔炎,疑难杂症等。