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[Original of Truck House] We all know that it is composed of two parts: base oil and additives. On the base oil, almost every card friend can name several well-known companies. However, as one of the biggest factors affecting the performance of engine oil, I believe that few people can make it clear. Therefore, in this article, we will lead you to understand the four major additive companies that currently occupy 90% of the global market.

At present, with the continuous improvement of additive research and development and production technology, the service life of lubricating oil is prolonged, the demand for additive products is growing slowly, and the global additive industry has excess production capacity. After fierce market competition, at present, four major additives, Lubrizol, Infineum, Chevron Oronite and Afton, have basically formed in the world.

● Lubrizol.

Luborun Company was established in 1928, which started with the research, development, production and distribution of lubricating oil additives. Headquartered in wycliffe, Ohio, USA, it is the largest lubricant additive company in the world. Lubrizol produces almost all component additives and compounding agents for lubricating oil and fuel, with a total of 7,100 direct suppliers worldwide, 38 subsidiaries and 21 production plants in 24 countries, and its products are sold to more than 100 countries.

Luborun lubricant additive products have a global market share of about 33%, and its developed additive formula is used to prepare various transportation and industrial commercial lubricants, including gasoline engine oil and diesel engine oil, automatic transmission fluid, marine lubricant, tractor lubricant, fuel oil and industrial lubricants.

● 　Infineon (Infineum)

Runyinglian was formed by the merger of ExxonMobile and Shell’s additive division in 1999, and it is the second largest supplier of lubricating oil additives in the world. Before the merger, both companies had a development history of nearly 70 years. Its business is not only concentrated in Britain, the United States and Singapore, but also tends to develop globally in recent years. Runyinglian’s initial product was pour point depressant, and then developed the technology of engine oil antioxidant and antiwear agent. In recent years, the research and development focused on ashless dispersant and metal cleaner. In 1960s, Runyinglian began to dabble in fuel additives, especially in diesel fluidity improver. At present, the development of fuel additives in Runyinglian focuses on diesel lubricity additives.

● 　Chevron Oronite

Founded in 1917, Chevron Orenai Company is the third largest manufacturer and supplier of lubricating oil additives in the United States, and has strong strength in compounding agents. The main products are gasoline/diesel engine oil compounding agents.
Oil compounding agent, etc. The global business is divided into three regions: the United States, Asia Pacific and EAME (Europe, Africa and Middle East). There are 5 technical centers in the world, which are used for the research and development and testing of catalysts, lubricant additives and other products.

● 　Afton (Afton)

Yafuton was founded in 2004, and its predecessor was Ethyl (ethyl) company, which was responsible for the original petroleum additive business. Yafuton’s product line distribution is very distinctive. Its output of vehicle oil additives accounts for about 55% of the total output, that of drive system oil additives accounts for about 26%, and the rest are industrial oil or industrial oil additives. (Shell) and Bibi (BP) are the two main customers of Aveton.

● Editor’s note:

Taking engine oil as an example, additives will greatly affect its performance and service life. Therefore, although this field is not well known by many people, there is still fierce competition in the field of humble additives to promote the continuous development of this industry and bring us products with better performance. (Photo/Wen Wei Liu)

● Related reading:

2016 Beijing Auto Maintenance Exhibition: Yashi Diesel Engine is Stronger and Lasting

Trucks also need to "drink water". How to add diesel additives?

　　Tianjin Hailufeng Automobile Trading Co., Ltd. is a company that sells high-end cars imported from Mercedes-Benz, BMW, Toyota, Land Rover, Rolls-Royce, Lexus and other luxury car brands in parallel. The company provides follow-up services such as insurance, installment, licensing, modification and car delivery.

　　Model: S 2.9T

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　　22 Cayenne 2.9S Black/Red

　　Quotation: 1.36 million

　　Configuration: 2.9 twin-turbo engine 434 horsepower 8-speed S gearbox front six rear four-piston brakes Adaptive air suspension PDLS headlight reflection 14 seat adjustments Four-zone air conditioning BOSE audio.

　　Optional: 90-liter fuel tank steering wheel heating panoramic sunroof black luggage rack front seat heating front seat ventilation dark LED headlights, dynamic lighting system black external package (high light).

　　22 Porsche Cayenne sides, fashionable metallic paint coating gives it a unique charm. The overall line of the car body is smooth and natural, and the waistline is smart and elegant. With 21-inch wheels, it can be described as dynamic. Functionally, its rearview mirror has automatic folding function, which is very convenient to use. The car also has a smart card and air suspension to support chassis lifting.

　　The interior of 22 Porsche Cayennes adopts family-style design style, the exquisite steering wheel is very sporty, the shape of the central control panel is very textured, the electronic gear handle is delicate, the seat is spacious and comfortable, and the space is spacious. The tail of the 21 Porsche Cayenne uses a penetrating taillight, which is also a very popular design now. Moreover, the tail of the Cayenne is full of layers and looks very fashionable.

　　In the 22 Porsche Cayenne cars, the redesigned control area is simple and fashionable, and the integrated console is decorated with brushed aluminum alloy, which makes the whole space feel luxurious. By adjusting the button on the center console, you can choose to raise the air suspension to the highest position. In order to prove the name of its road suv, the Porsche Cayenne’s tachometer moved from the edge to the center, and the steering wheel was smaller.

　　22 Porsche Cayenne interiors have fine workmanship; The configuration is relatively complete; The comfort of the seat is good; The automatic heating of the steering wheel and the armrest design beside the seat are very user-friendly; Panoramic skylight, compass and other optional configurations cater to the needs of some consumers to pursue individuality. The luxury inside is beyond your imagination. More space; Good handling performance; The safety factor is extremely high.

　　The 22 Porsche Cayennes are equipped with an efficient 3.0-liter turbocharged V6 engine, whose twin scroll turbochargers are located between the cylinder banks, and the output power is 250 kW (340 hp). The length, width and height of 2021 Porsche Cayenne: 4855,1939,1705, wheelbase: 2895, vehicle weight (kg): 2350, body material: mixed steel and aluminum, fuel tank volume (L): 80, trunk volume (L): 580, engine: 3.0T horsepower: 338 V6, and so on.

　　The company mainly sells imported models of major high-end brands. Set wholesale and retail, foreign booking, personalized modification, loan installment and so on. Provide you with one-stop service.

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　　Disclaimer: The above car purchase preferential information is provided by the comprehensive dealers of this website, and the price fluctuates greatly due to market factors, which is only for car purchase reference; The distributor is responsible for its authenticity, accuracy and legality, and this website does not provide any guarantee or assume any legal responsibility.

　　The Paper reporter Zhong Yuhao

　　On the morning of August 11th, the WeChat public account "Health Shandong Service Number" of Shandong Health Medical Big Data Management Center released a message saying that Shandong Health Code realized mutual recognition of inter-provincial nucleic acid test results.

　　According to the news, on July 29th, the State Council issued the Notice on Further Promoting the National Mutual Recognition of Covid-19’s Nucleic Acid Test Results to the Comprehensive Group of novel coronavirus Epidemic Prevention and Control Mechanism, requiring all localities to attach great importance to the national mutual recognition of nucleic acid test results, and the nucleic acid test results displayed in different channels have the same effect. Shandong Province has always adhered to the people-centered development thought, and stood at the height of a chess game of national epidemic prevention and control, fully realizing that nucleic acid test results are a "key trivial matter" to promote the convenient flow of people across the country, and an important means to further scientifically and accurately prevent and control the epidemic. Immediately study and deploy, and realize the display and mutual recognition of inter-provincial nucleic acid test results in Shandong Health Code.

　　According to Shandong Health Medical Big Data Management Center, when residents show their Shandong health codes, they can check the nucleic acid test records in Shandong Province and the nucleic acid test results in other provinces and cities at the same time. Shandong health code selects the latest three records of residents in and outside the province and displays them in the "nucleic acid detection" section of the bright code page. Residents should be reminded that the nucleic acid testing information of residents in other provinces and cities is obtained by Shandong Health Code through the national nucleic acid testing result inquiry service provided by the national government service platform. Therefore, if you can’t query the nucleic acid test results of other provinces and cities smoothly, please contact the nucleic acid test institutions of other provinces and cities in time and urge them to upload the test results to the national government service platform as soon as possible.

　　Previously, in order to implement the requirements of national mutual recognition of nucleic acid test results, the Office of Epidemic Prevention and Control Headquarters in COVID-19, Henan Province issued the Notice on Implementing the Mutual Recognition of Nucleic Acid Test Results in Covid-19 on August 5, ensuring that all localities carried out the mutual recognition of nucleic acid test results in an orderly manner and helped the epidemic prevention and control "a national chess game".

　　The notice requires that the results of nucleic acid testing should be standardized. Cross-city migrant workers in the province implement the province-wide mutual recognition of nucleic acid test results found through the State Council client, national government service platform, Henan Affairs Office, inquiry platform provided by municipalities, websites of nucleic acid testing institutions or APP, and paper nucleic acid test results held by the masses. The results of nucleic acid detection found by foreign (returning) Henan personnel in the State Council through clients, national government service platforms, provincial health codes, websites of nucleic acid detection institutions or APP, and the results of paper-based nucleic acid detection held by the masses, which are within the effective time of prevention and control policies in Henan Province (subject to the time when the report is issued), have the same effect, and all localities should recognize them during inspection.

　　The notice stressed that it is strictly forbidden to refuse to pass on the grounds that the local health code has not been inquired and the nucleic acid test has not been carried out locally. People are refused to enter public places and take public transportation, and people are not allowed to repeat the nucleic acid test. Individuals who illegally use fake or tampered nucleic acid test results shall be dealt with according to the law.

　　The notice requires that the information transmission and sharing channels should be unblocked, and the province should use a unified nucleic acid detection information system. All localities should do a good job of docking with the provincial integrated platform, and urge local nucleic acid detection institutions to upload the detection results to the system in time to reduce the time of data in the intermediate circulation. Ensure that the nucleic acid detection data is uploaded in a timely, accurate and efficient manner, and ensure that the people can check the nucleic acid detection results in time through the Henan Affairs Office. In addition, all localities should strengthen publicity, guidance, supervision and implementation, and strengthen publicity and training for front-line workers in places where nucleic acid test results are mainly detected, such as traffic stations, hotels and tourist attractions, to ensure that grassroots front-line personnel are conscientiously implemented and policies are effective; It is necessary to strengthen the publicity and interpretation of mutual recognition of nucleic acid test results, let the masses know and accept the supervision of the masses. The epidemic prevention and control headquarters at all levels should organize supervision and investigation in a timely manner, and the relevant regions and units that have caused adverse effects due to poor implementation of the work should be informed, and the relevant personnel who have caused serious consequences due to inadequate policy implementation should be seriously investigated for relevant responsibilities.

　　The Paper noted that Tonghua, Jilin and Wuzhou, Guangxi are also promoting the national mutual recognition of nucleic acid test results.

　　According to the news of Tonghua Daily on August 10, on July 29, the State Council issued a notice to the comprehensive group of the joint prevention and control mechanism of novel coronavirus epidemic, requesting to further promote the national mutual recognition of nucleic acid test results and effectively facilitate people’s travel. Tonghua City attaches great importance to the national mutual recognition of nucleic acid test results, and accelerates the implementation without discount, so that epidemic prevention and travel are "correct".

　　According to the report, at present, Laitong people can check the nucleic acid test results and the paper nucleic acid test reports they hold through the the State Council client, the national government service platform, the Kyrgyzstan Office, the website of the nucleic acid testing institution or the APP, so it is no longer necessary to repeat the nucleic acid test in public places, making it more convenient to see a doctor and travel.

　　Wang Quangang, deputy section chief of the medical department of Tonghua Central Hospital, said: "The national mutual recognition of nucleic acid test results makes it more convenient for patients to seek medical treatment. In the past, when the national mutual recognition of nucleic acid test results was not implemented, the returning personnel from other places needed to do another nucleic acid test when they returned to our city for medical treatment, which wasted time and energy. Now it is convenient to come to the hospital and the hospital’s convenience service has been better." The report pointed out that Tonghua City will continue to improve relevant measures and implement the requirements of national mutual recognition of nucleic acid test results at the grassroots level to ensure that relevant personnel at the grassroots level resolutely implement them.

　　Wuzhou Daily reported that the reporter learned from the Municipal Health and Wellness Commission on August 10th that all institutions in our city have actively implemented the national mutual recognition of nucleic acid test results. For the nucleic acid test results, the nucleic acid test results inquired by the citizens through the the State Council client, the national government service platform, the Guangxi Health Code, the website of the nucleic acid testing institution or the APP, and the paper nucleic acid test results held by the citizens within the effective time of the city’s prevention and control policy (subject to the time of issuing the report) have the same effect.

　　It is worth mentioning that the press conference held by the State Council Joint Prevention and Control Mechanism on the afternoon of August 10th also talked about the national mutual recognition of health codes.

　　Mi Feng, spokesperson of the National Health and Wellness Commission and deputy director of the Propaganda Department, said that since the issuance of the notice to promote the national mutual recognition of Covid-19’s nucleic acid test results, all localities have quickly organized and implemented it. Some places have innovated and explored some ways of mutual recognition to further facilitate the use of the masses. For example, in some places, the function of querying the results of nucleic acid testing in other provinces and cities and uploading them to Health Treasure has been added, some have online related services of nucleic acid information, and some can switch the nucleic acid testing databases in the province and the whole country at any time. These practices are all for the convenience of the masses, and now they are progressing smoothly.

　　Mi Feng said, next, we will further improve the timeliness of information sharing, optimize and improve the management of health codes, and make it more convenient for people to travel safely and orderly. If there is no mutual recognition of nucleic acid test results, you can reflect it through the joint prevention and control mechanism in the State Council and public message boards set up in various places.

　　On July 1st and September 1st this year, the State Bureau for Letters and Calls successively opened a "channel" for letters and visits on mobile phones — — The mobile phone petition platform and WeChat WeChat official account will further broaden the channels for expressing people’s demands. These new channels for letters and visits have been in operation for nearly half a year. What is the effect now?

　　What about the new channels of letters and visits such as mobile phone platform and WeChat?

　　By the end of November, there were over 60,000 registered users and 80,000 letters and visits.

　　"It’s great, you don’t have to go out and move your fingers, and the problems reflected will be solved!" Not long ago, Wang of Huai ‘an City, Jiangsu Province reported the inconvenience caused by the renovation of dangerous bridges in the village through the online petition platform. The next day, she inquired that the Jiangsu Provincial Bureau for Letters and Calls had accepted it. On the fourth day, the local government began to solve the problem.

　　On January 1, 2015, the State Bureau for Letters and Calls established and operated the National Information System for Letters and Calls, realizing the nationwide "One Netcom" with vertical connectivity to towns and streets and horizontal coverage of relevant responsible departments.

　　On this basis, on July 1st and September 1st this year, the State Bureau for Letters and Calls successively launched the mobile phone petition platform and WeChat WeChat official account, making it more convenient and efficient. The process and results of the petitions handled by the masses through the mobile phone petition platform can be inquired, tracked, supervised and evaluated. The reporter saw on the WeChat WeChat official account of the State Bureau for Letters and Calls that WeChat official account currently has three functions: information on letters and visits, guide to letters and visits and online letters and visits. By paying attention to this micro-signal, you can submit a complaint request or make suggestions in the online letters and visits channel, and you can also inquire about the handling of letters and visits and evaluate your satisfaction.

　　By the end of November, more than 60,000 users had registered through the mobile phone petition platform of the State Bureau for Letters and Calls and WeChat WeChat official account, and the number of petitions reached 80,000. At the same time, all parts of the country have followed suit. 14 provinces including Anhui, Hunan and Xinjiang have set up mobile phone letters and visits, and 21 provinces including Hebei, Inner Mongolia, Guizhou and Gansu have opened WeChat letters and visits. Online letters and visits have gradually become the main channel for mass letters and visits.

　　How to make online letters and visits efficient and transparent?

　　The process, methods and results are all open online, so that the masses can become "supervisors" and "referees" of letters and visits.

　　"This platform can see every step of the specific process, just like online shopping can see whether the seller has delivered the goods and where it has gone. It is really convenient." Bao, from Haiyang City, Shandong Province, reported the damage of the road in front of his house through online letters and visits, and received a reply on the same day.

　　On July 1 this year, the State Bureau for Letters and Calls promulgated and implemented the Measures for Simple Handling of Letters and Visits (Trial), which requires that opinions should be given within 10 working days after accepting the letters and visits that can be handled simply, so as to accept and handle the letters and visits more conveniently and quickly.

　　At the same time, according to the "Regulations on Letters and Visits" and the "Working Rules for Online Handling of Letters and Visits (Trial)" of the State Bureau for Letters and Calls, all localities have standardized the letters and visits business, so that there are rules to follow. Twenty-four provinces, including Shanxi, Jilin and Ningxia, have formulated rules for handling online letters and visits, further optimizing business processes and putting standardization requirements throughout the whole process.

　　"Relying on the national petition information system, the handling process, handling methods and handling results of petitions can be made public online, and petitioners can inquire about the handling process and results at any time, avoiding going back and forth." In addition, the State Bureau for Letters and Calls also said that it is also the focus of online letters and visits to let the masses evaluate the solution of the letters and visits, let the masses become "supervisors" and "referees" in the work of letters and visits, and actively guide the petitioners to evaluate their satisfaction. At present, the State Bureau for Letters and Calls has revised and improved the satisfaction evaluation method, and promoted all localities to improve the participation rate of the masses and the satisfaction rate of the masses.

　　How do large and small systems break through the "barriers"?

　　Integrate the scattered "small windows" of letters and visits, and "one netcom" allows the masses to travel less and benefit more.

　　At present, the State Bureau for Letters and Calls has realized the interconnection with 31 provinces (autonomous regions and municipalities) and the provincial, municipal and county-level letters and visits working institutions of Xinjiang Production and Construction Corps, more than 80,000 functional departments and towns (streets), and 33 central and state organs and ministries.

　　At the same time, all localities are also stepping up efforts to promote the integration of resources on the online petition platform at the same level. Tianjin, Zhejiang and other places have connected the leadership mailbox with the petition information system, and integrated the scattered online petition "small windows" into an online complaint hall to reduce repeated complaints from the masses and repeated referrals from departments, thus realizing "one netcom". Jiangxi, Shandong, Hubei and other places have established self-service facilities for online letters and visits in counties and townships to better facilitate the masses. From January to November this year, the number of online letters and visits nationwide was 971,000, up 102% year-on-year, which effectively reduced the cost of letters and visits by the masses and realized that the masses traveled less and benefited more.

　　The relevant person in charge of the State Bureau of Letters and Calls said that in recent years, various localities have made great efforts to solve problems, and a number of letters and visits have been effectively resolved. However, in some places, problems were not handled in time and were not solved in place, which led to repeated online complaints; In some places, the previous "handling opinions" are used as the handling results of the backlog report, but the problem of letters and visits has not been substantially solved, and there is a problem of "doing without finishing", so it is necessary to continue to intensify efforts to resolve it.

　　According to the introduction of the State Bureau for Letters and Calls, after continuous adaptation and improvement, the national information system for letters and calls has been running smoothly on the whole. Next, efforts should be made to improve the application and optimize the functions. At present, the coverage of the national petition information system has basically achieved the "vertical to the end" of the five-level petition work institutions at the national, provincial, municipal, county and township (street) levels, but there is still a problem of incomplete coverage of functional departments in most places horizontally. The next step will focus on promoting the full coverage of the application of the petition information system by functional departments.

　　The reporter learned from the teleconference on "One City Code" held on the afternoon of January 24th that in order to further strengthen the epidemic prevention and control work, greatly facilitate people’s travel and improve traffic efficiency, the municipal epidemic prevention and control headquarters decided to promote "One City Code" (Henan Health Code Visit Registration) in Jiaozuo City, realizing the "three codes in one" of trip code, health code and Zhongyuan Bank registration code, and using scientific and technological strength to help the epidemic prevention and control work speed up again.

　　It is understood that the "one city code" will be officially opened on January 27, and the implementation of the new code will be more conducive to the convenience of the masses and improve the ability of accurate investigation, control and traceability. Different from the previous code scanning needs, the new "health code" has a unified interface standard, a unified code scanning entrance and a unified data convergence standard, which provides more accurate data support for timely and comprehensively grasping the epidemic risk and flow of personnel and uniformly formulating site information, risk personnel information and risk personnel code scanning records.

　　It is worth mentioning that the new "health code" will further improve the functional construction:

　　To apply for a new code, counties, townships, villages, grid workers and community administrators can apply for a "place code". After applying, they only need to collect basic information, and after the background entry is activated, they can post it for use;

　　To apply for a new code, residents only need to scan for the first time and fill in the basic information before they can apply for a personal health code;

　　The new code can be used to collect the health code for the family members of residents with old people or children at home;

　　With the new code, the leading institutions of epidemic prevention and control in counties (cities, districts) can make unified judgments on personal health information;

　　New code management, in order to avoid the phenomenon of wrong filling and missing filling, the industry administrator can modify and improve the basic information of the place;

　　Scan code statistical analysis, the person in charge of all kinds of places can analyze and count according to the scan code data of the day;

　　Add a special list, which can be added for epidemic prevention and control personnel to ensure the health code status of epidemic prevention and control personnel.

Interpretation of Global Asthma Management and Prevention Strategy Update in 2022 Edition

Correspondent: Sun Yongchang, professor, chief physician.

SETTING: Department of Respiratory and Critical Care Medicine

A cross-sectional study of the first phase of the global asthma network published by The Lancet shows that by providing effective asthma treatment, the heavy burden of severe asthma symptoms in the world can be reduced. However, the prevalence of asthma in China is increasing year by year, and the overall control level of asthma in China is still not ideal. On World Asthma Day in 2022, global initiative for asthma Expert Group released the 2022 edition of Global Asthma Management and Prevention Strategy (GINA 2022). As an important guide for global asthma prevention and control, what are the important revisions of GINA 2022?

Based on this, this paper interprets the update points of GINA 2022, discusses the management of asthma during COVID-19 epidemic, and puts forward the reference significance for the diagnosis and treatment of asthma in China.

01、The diagnostic procedure of asthma was revised.

1.GINA 2022 pointed out that the examination method needed for diagnosis depends on whether the patient has received controlled treatment or not, and explained the matters needing attention during examination, as shown in Figure 1.

2、For patients who have not received controlled treatment, evidence helpful for asthma diagnosis should be recorded when asthma symptoms appear for the first time; For patients who have received controlled treatment, if the diagnosis basis of asthma has not been recorded before, they should be diagnosed through objective tests, as shown in Table 1.

How to reduce the control treatment to help confirm the diagnosis process of asthma is shown in Table 2.

　　

02、Diagnosis and treatment of asthma in low-and middle-income countriesThe treatment plan provides suggestions.

1.GINA 2022 provides detailed guidance on the diagnosis and management of asthma in resource-poor areas. Among them, differential diagnosis usually needs to include endemic respiratory diseases and infections, tuberculosis and human immunodeficiency virus (HIV)/ AIDS.

2.GINA 2022 does not recommend diagnosis only based on clinical symptoms. When the pulmonary function cannot be measured, the peak expiratory flow (PEF) can be used to confirm that the variable expiratory flow is limited.

3.The World Health Organization (WHO) basic non-communicable diseases (PEN) intervention package lists PEF detection as a basic tool for managing chronic respiratory diseases, and WHO-PEN suggests that compared with COPD and other diagnoses, the improvement of PEF by ≥20% after inhaling 2 sprays of salbutamol for 15 minutes can increase the possibility of asthma diagnosis.

4.GINA 2022 also suggested that after 4 weeks of anti-inflammatory experimental treatment and 1 week of oral glucocorticoid (OCS) treatment if necessary, if the symptoms and PEF are improved, it will help to diagnose asthma (or prompt other diagnosis) before starting long-term controlled treatment.

03、On-demand inhaled glucocorticoids (ICS)- formoterolThe role of frequency of use in asthma control evaluation

ICS- formoterol as a remission agent, its frequency of use (≤2 times/week or > 2 times/week) is not included in the comprehensive evaluation of symptom control. However, the average frequency of using ICS- formoterol on demand should still be considered in the treatment decision.

04、Opinions on the severity of disease and "mild asthma"

GINA 2022 suggested that the word "mild asthma" should be avoided as much as possible in clinical practice; If it is used, the risk of serious attack and the necessity of using ICS-containing treatment scheme should be reminded.

05、Treatment of asthma

In the maintenance treatment of asthma, some issues are still controversial, such as the use of long-acting anticholinergic drugs (LAMA), whether to add some new biological targeted drugs to the fifth grade treatment of asthma, etc. GINA 2022 recommended the above problems and provided evidence. See figure 2.

　

Specific to the treatment of asthma in adults and adolescents, GINA 2022 emphasizes the reasons for two treatment paths:

Path 1, ICS- formoterol is used as a remission agent as needed in the treatment process because it has lower risk of acute attack and similar symptom control effect compared with SABA as a remission agent.

Path 2, GINA 2022 also added other evidence for the low-dose on-demand use of ICS- formoterol in step 1-2, including systematic review showing that the on-demand use of ICS- formoterol significantly reduced the risk of emergency treatment or hospitalization compared with daily ICS combined with on-demand SABA. GINA 2022 included anti-TSLP as a new biotherapy for severe asthma in step 5, and introduced it in detail in the guide to severe asthma.

06、Decision Tree of Refractory and Severe Asthma in Adults and Adolescents

（1）GINA 2022 clearly points out that for patients with refractory asthma whose blood eosinophils are ≥300 /μl, before considering biotherapy, we should evaluate whether there are any non-asthmatic causes, including strongyloides infection (strongyloides infection is usually asymptomatic). For patients with eosinophilia (blood eosinophils ≥1 500 /μl), eosinophilic granuloma with polyangiitis (EGPA) and other reasons should be considered, and the use of anti-IL4R should be avoided, because such patients were not included in the phase III study.

（2）GINA 2022 decision tree mentioned that tezepelumab is an additional biotherapy for severe asthma patients over 12 years old, and it has the greatest benefit in reducing the risk of acute exacerbation for patients with hypereosinophilia or screaming out nitric oxide (FeNO).

（3）Anti-IL4R is added for adults and teenagers.

（4）Anti-IgE is added during pregnancy, and there is very little evidence about the treatment of severe asthma during pregnancy, and the risk of using biotherapy during pregnancy needs to be weighed against the risk of uncontrolled asthma to mother and baby. A registered study found that using omalizumab during pregnancy did not increase the risk of congenital malformation.

（5）GINA 2022 added the results of systematic review and meta-analysis of patients with eosinophilia and type 2 asthma with additional application of anti-IgE, anti-IL5/5R and anti-IL4R.

（6）Maintenance OCS is only used as the last treatment for all age groups when other treatments are ineffective and there is no alternative.

(Note: You can swipe up and down to see more)

07、Asthma-chronic obstructive pulmonary disease (ACO)

(1) Definition: ACO and asthma+chronic obstructive pulmonary disease (COPD) are used to collectively refer to patients with persistent airflow limitation with clinical characteristics of both asthma and COPD. This is not a definition of a single disease, but is used to describe some clinical phenotypes with different pathogenesis.

(2) Diagnosis: See Table 3 for the most helpful clinical features and corresponding recommended treatments to distinguish asthma from COPD, and Table 4 for the pulmonary function features of ACO.

(3) Treatment: initial treatment (see Table 3), ACO should be treated as asthma, and ICS is the key to treatment.

　
　

Referral examination, it is recommended to refer for further diagnosis and evaluation in the following cases:

① Patients with persistent and/or worsening symptoms after treatment;

② The diagnosis is uncertain, especially the need for further differential diagnosis, such as bronchiectasis, post-tuberculosis scar, bronchiolitis, pulmonary fibrosis, pulmonary hypertension, cardiovascular diseases and other diseases that cause respiratory symptoms;

③ Suspected asthma or COPD with atypical symptoms or other symptoms and signs (such as hemoptysis, obvious emaciation, night sweats, fever, bronchiectasis or other structural lung diseases) should be referred as soon as possible without waiting for the treatment trial of asthma or COPD;

④ When chronic airway diseases are suspected, but the characteristics of ACO are few;

⑤ Complications of patients may affect the assessment and management of respiratory diseases;

⑥ According to GINA and GOLD, problems during the treatment and management of asthma, COPD or ACO should also be referred.

08、Other update points

(1) Using electronic cigarettes will increase the risk of respiratory symptoms and acute exacerbation of asthma;

(2) Air filter can reduce the exposure of fine particles, but there is no consistent result for the prognosis of asthma;

(3) Updated the evidence of correlation between air pollution and the utilization of emergency medical care resources for asthma;

(4) Electronic inhaler detection can identify the compliance of patients with refractory asthma;

(5) In the patients who have used the treatment scheme containing moderate-high dose ICS, but the asthma symptoms are still not controlled, high blood eosinophil level and high FeNO level are related to the high risk of acute exacerbation of asthma;

(6) Patients hospitalized due to acute asthma attack should continue or be given a treatment plan containing ICS.

Management of asthma during COVID-19 epidemic

1. Management of asthma during 1.COVID-19 epidemic.

GINA 2022 pointed out that asthma patients did not seem to have an increased risk of COVID-19 infection. However, it should be noted that the risk of death caused by COVID-19 increases in patients who need OCS for asthma and hospitalized patients with severe asthma. It shows that it is very important to continue good asthma management, and active measures should be taken to maintain good symptom control, reduce the risk of acute exacerbation of asthma and minimize the demand for OCS.

2. The requirements of epidemic prevention and control should be considered in the process of asthma management.

If it is impossible to test lung function due to the restriction of local epidemic prevention and control, and the information about lung function is needed, we can consider asking patients to test lung function at home. Some treatment measures, such as oxygen therapy, sputum induction, manual ventilation, non-invasive ventilation and intubation, can lead to the generation of aerosol, so we should follow the local health strategies and health suggestions on the use of personal protective equipment in accordance with the requirements of epidemic prevention and control.

3. Suggestions on vaccination of asthma patients with COVID-19 vaccine.

(1)GINA suggested that patients with asthma should be vaccinated with COVID-19 vaccine in time and booster if possible. At the time of vaccination, the usual vaccine preventive measures are also applicable to asthma patients.

(2) For patients undergoing biotherapy, the first dose of biotherapy and COVID-19 vaccine should not be injected on the same day, so as to identify their adverse reactions more easily.

(3)GINA also reminded that asthma patients should be vaccinated with influenza vaccine every year, and influenza vaccine and COVID-19 vaccine can be vaccinated on the same day. In addition, even if vaccinated, you should wear a mask in public places.

Reference significance for asthma management in China

1.For the diagnosis of asthma in China, we should pay attention to the following points.

(1) It should be emphasized in medical institutions at all levels that the diagnosis of asthma should be based on the objective basis of symptoms and signs and variable airflow limitation.

(2) When the first symptoms appear, whether to carry out further examination should be decided according to its clinical urgency. If necessary, the lung function data or variable airflow limitation data should be recorded. For patients who have received treatment but have no asthma-related data records, relevant examinations should be improved according to their control situation.

2.In the evaluation of asthma control, use "mild asthma" cautiously.

The term "mild asthma" should be avoided in clinical practice. If necessary, patients with infrequent symptoms or mild asthma symptoms may still have severe or fatal attacks, and this risk can be reduced by half or even two-thirds by using low-dose ICS or low-dose ICS- formoterol as needed.

3.About the treatment and management of asthma

(1) Attention should be paid to individualization of treatment, and the treatment decision should take into account the characteristics or phenotypes of patients, which may predict the difference of treatment response between them and other asthma patients. In addition, the patient’s expectation of therapeutic effect, psychological burden and some practical problems (inhaler technology, compliance, ability to use drugs, patient’s cost, etc.) should also be considered.

(2) It should be emphasized that low-dose ICS- formoterol as a remission agent is the first choice for most people.

– END –

Low configuration, cheap materials, and limited functions are hard for manufacturers to accept, but this is indeed the impression of Android tablet in everyone’s mind at present. In the face of Apple’s iPad, these shortcomings are hard to accept, and there are "cheap" iPads like the iPad mini 5.

But it is gratifying that even so, there are still manufacturers working hard to narrow these gaps. We casually open an e-commerce website and search for tablet products. We can find that Huawei is the tablet brand with the highest frequency besides iPad.

According to IDC China’s data, in 2018, Huawei’s tablet market share in China was 28.3%, while other brands were declining, Huawei’s year-on-year growth rate reached 18.9%.

After a lapse of one year, Huawei brought us a brand-new Huawei flat M6 (including 8.4-inch and 10.8-inch versions) in late June this year. The processor was upgraded to Kirin 980, which supports 2K resolution and has the highest four-channel and four-speaker. It has all the parameters, so will it be what consumers expect?

▲ 10.8 inches left and 8.4 inches right

　

Simple design style　

The screen with a narrow front frame and a metal integrated back cover seem to have become an unwritten design standard for tablet computers. On Huawei’s M6 tablet, whether it is 10.8 inches or 8.4 inches, it continues the above style.

▲10.8 inches

The front of both versions is a 2560*1600 resolution 2K LCD high-definition display, and the aspect ratio is 16:10, which is just enough for both audio and video and reading. The black edge of the video will not be too big, and more content can be displayed in horizontal screen.

It is worth mentioning that both screens support Huawei’s self-developed "sharp screen" display enhancement technology, and EMUI also provides the option of stepless color temperature adjustment to ensure that the display effect of the screen can satisfy everyone.

▲8.4 inches

In recent years, the screen borders of almost all devices are narrowing, so that devices with the same screen size can achieve smaller size; The 8.4-inch version of Huawei’s M6 is only 125.2mm wide and weighs 320g, so it is not a problem to hold it with one hand. The 10.8-inch version keeps the shape of four sides with the same width, and the symmetrical equipment is more in line with the aesthetics of Chinese people, while retaining more space for other components.

The 10.8-inch version maintains the shape of four sides with equal width, and the symmetrical equipment is more in line with the aesthetics of Chinese people, and there is also more room for other components.

▲10.8 inches

Both tablets are equipped with front cameras. Although the 8.4-inch version does not have a fingerprint recognition module, users can still quickly unlock it through the face recognition function of the camera.

Due to the lack of internal space, many mobile phones do not have dual speakers, and the external sound quality will inevitably appear thin and weak. Even if the iPad product with the same price has two speakers, the speakers are located on the same side, and the stereo effect used in the horizontal screen is limited.

▲8.4 inches

If nothing else, the sound quality has always been the strength of Huawei’s flat panel. This time, the M6 10.8-inch version of Huawei’s flat panel is equipped with four speakers on the top and left and right sides of the fuselage to form four channels, as well as Harman Kardon’s professional tuning blessing.

The specific sense of hearing, if described in words, is that stereo is very obvious, and when listening to music, besides human voices, you can also clear the accompaniment of instruments in BGM. In contrast, the 8.4-inch version of dual speakers is slightly inferior, but it is still better than most flat panels on the market.

▲10.8 inches

Turning to the back, both tablets have a 13-megapixel camera, which can be used to realize the "smart vision" function of EMUI.

▲8.4 inches

Slide down on the main interface and click on the upper right corner to bring it up. It integrates code scanning, translation, commodity identification, food calorie identification and object inquiry, and makes use of AI to facilitate our lives.

▲ Smart knowledge, instant translation

　

　In order to optimize the "parallel world" of visual experience

In fact, the problem with Android tablet is not the hardware, but the software. With the gradual decline of market demand, not only are there fewer and fewer products, but also fewer and fewer applications that adapt to flat-panel large screens.

Ordinary mobile phone applications (non-HD version) run on the tablet, and the layout is hardly optimized. Although the screen is large, the content that users see in the same interface has not changed much, just like a large mobile phone.

▲ The interface of Taobao, JD.COM and Weibo on the tablet.

In order to solve this problem, Huawei launched the "parallel vision" function on Huawei tablet M6 to split the screen of the application. This "split screen" function is not the same as the split screen on the mobile phone. The "parallel horizon" is to split the screens of different interfaces in the same application, so as to improve the browsing efficiency of users.

▲ The effect of today’s headlines

Open the adapted application, and after switching to landscape mode, it will automatically enter the "parallel view" mode; For example, in today’s headlines, the news list is on the left and the details of the news are on the right, which solves the efficiency problem of horizontal screen browsing to the greatest extent.

▲ The effect of Weibo

The official claims that this function has been adapted to mainstream applications and will be continuously updated in the future. At present, Xiaoan, a Huawei tablet M6, has been adapted to WeChat, Today Headline, Tik Tok, QQ, Zhihu, JD.COM, Weibo, Aauto Quicker and Taobao.

▲ Adapted applications

With the HD version of the application, I believe it can cover most of the usage scenarios. Unfortunately, Parallel Vision only supports the 10.8-inch Huawei tablet M6 at present.

　

　Zhen performance flagship

Compared with the previous generation, the biggest upgrade of Huawei tablet M6 is this Kirin 980 processor. It is officially claimed that the overall performance of Huawei tablet M6 has improved by 208% compared with the previous generation, which is undoubtedly the most powerful Android tablet at present.

Equipped with GPU Turbo3.0 technology, everyday games are not a problem. We have measured that both the glory of the king and Peace Elite, which unlock the frame rate, can almost maintain a full frame of 60 frames when the special effects are fully turned on.

▲ Take an 8.4-inch Huawei flat M6 to "eat chicken"

At the same time, a larger screen means a wider field of vision, especially in "Peace Elite", where the screen is stretched like a four-fold mirror, making it easier to find enemies.

　

　

　Not only entertainment, but also productivity tools.　

Is the Android tablet just an entertainment tool? Huawei obviously doesn’t think so. Huawei’s M6 10.8-inch tablet has a unique "computer mode", which can be accessed by plugging in an intelligent magnetic keyboard.

▲ Enter PC mode.

"Computer Mode" has a similar interface and operating logic to PC, and it is also very simple to use. However, in "computer mode", only the adapted software can run in full screen, otherwise it can only be opened in multi-window mode.

▲Word can be used in full screen in "computer mode"

Even so, it is not difficult to complete some simple writing work with the three-piece office, which is very suitable for writers who need to move around frequently. The text part of this evaluation was coded by Xiao An on M6, and this intelligent magnetic keyboard is very easy to use, with moderate 1.3mm key stroke and strong rebound, and it is very comfortable to type on it.

▲ Intelligent magnetic keyboard

Of course, the productivity of Huawei tablet M6 is not limited to this. With Huawei M-Pen lite stylus (purchased separately), simple painting creation and note-taking can be carried out on the tablet.

▲ Huawei M-Pen Lite has a pressure sensitivity of 2048.

　

　summary　

Even though there is still a big gap between the software ecology of Android tablet and iPad, Huawei is constantly working hard to narrow this gap. Huawei’s tablet M6 makes up for the regret of the previous generation M5 in hardware, with stronger performance, increased support for stylus and optimization of software adaptation, and lower price, which proves that Huawei attaches importance to the tablet market. Android tablets should not be cheap and poorly configured. It can be said that Huawei tablet M6 should be what Android tablet should be. At present, two models of Huawei flat M6 have been sold, and friends who like it may wish to learn more about it ~

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Regular physical activity is an important way to protect cardiovascular health.

so

What kind of physical activity is the most effective?

The World Health Organization suggests that moderate-intensity aerobic exercise should be carried out for at least 30 minutes every day and at least 150 minutes every week. We are familiar with brisk walking, running and cycling.

but

Is aerobic exercise enough?

It is found that compared with people who have no exercise habits, the combination of aerobic exercise and resistance exercise can reduce the total death and cardiovascular disease death risk by 40% ~ 46%, which is better than aerobic exercise or resistance exercise alone.

so

To protect the cardiovascular system, resistance exercise is essential!

NO.1

What is resistance movement?

Resistance exercise is a way to mobilize the contraction of skeletal muscle to resist external resistance.

Muscle function is the guarantee of a quality life. The maintenance of muscle function is related to daily activities, that is, use in and waste out.

Resistance exercise is a kind of exercise that can maintain or enhance muscle strength, volume and endurance. Push-ups, pull-ups, lifting dumbbells and elastic belt exercises are all resistance activities.

Effective resistance exercise is a process of muscle growth and strength enhancement, which not only improves muscle function, but also plays a positive role in promoting metabolism, bone health, blood sugar regulation and fall prevention, and is also very beneficial to improving the risk factors of cardiovascular diseases and promoting cardiovascular health.

NO.2

Resistance exercise is good for cardiovascular health!

Resistance exercise can improve the well-known cardiovascular risk factors, such as blood pressure, blood sugar, blood lipid and weight. This improvement is often more obvious in the elderly and people who already have cardiovascular risk factors.

Resistance exercise is related to the reduction of the risk of cardiovascular disease and death. Compared with adults who don’t carry out resistance exercise, adults who participate in resistance exercise have a 17% lower risk of cardiovascular disease death.

Blood pressure level:

Resistance exercise can improve blood pressure. Compared with people with normal blood pressure, resistance exercise has a more significant effect on reducing systolic and diastolic blood pressure in people with elevated blood pressure and patients with hypertension. The evidence shows that the effect of resistance exercise on reducing systolic blood pressure is similar to that of antihypertensive drugs.

Blood sugar level:

Resistance exercise can improve insulin sensitivity, reduce insulin resistance, and then improve blood sugar level. Resistance exercise can reduce the fasting blood glucose level of the elderly, pre-diabetic people and diabetic patients.

Blood lipid level:

Resistance exercise can improve the levels of total cholesterol, triglyceride and high density lipoprotein cholesterol.

Weight and body composition:

Resistance exercise can reduce the body’s stored fat, increase muscle mass, increase resting metabolic rate, help improve body composition, and have a good effect on lean body weight gain and body fat loss.

Other factors:

Resistance exercise can improve cardiopulmonary function, arteriosclerosis, sleep quality, depression and anxiety symptoms, and improve the quality of life.

NO.3

How to carry out the resistance movement?

"Resistance" in resistance movement

You can choose to resist the external resistance load by means of dumbbells, barbells, water bottles, sandbags, elastic belt and other fitness equipment.

You can also choose to fight against the weight of your limbs and trunk, and do push-ups, pull-ups, squats, etc.

30 ~ 60 minutes of resistance exercise every week can minimize the risk of cardiovascular diseases.

The World Health Organization suggests that resistance exercise involving major muscle groups should be carried out at least two days a week. It should be noted that the high-load resistance exercise of the same group of muscles should not be carried out for two consecutive days, and a day or two of rest can give the muscles the necessary time to adapt and recover.

For healthy adults, 8 ~ 10 kinds of main muscle groups involving the body and limbs can be carried out. Each muscle group is carried out with 1 ~ 3 groups of moderate intensity load, and each group is repeated for 8 ~ 12 times, which is effective for realizing muscle and cardiovascular benefits.

If the physical condition does not allow, it can reduce the load intensity and increase the repetition times, which is helpful to bring health benefits and reduce the risk of sports injury.

For example:

We can do resistance exercise on Tuesdays and Fridays in a week, and the total time of each exercise is 15 ~ 30 minutes. Exercise the muscles of chest, back and upper limbs through push-ups, dumbbell side lifting, biceps bending and triceps stretching, exercise the muscles of waist and abdomen through belly rolling and back stretching, and exercise the muscles of hips and lower limbs through squats and lift heel. Each movement is performed in 2 groups, each group is repeated 10 times, and the rest between groups is 3 minutes.

To carry out resistance exercise, we should be prepared before the exercise.

Warm up fully before exercise, especially for the training part, otherwise it will easily damage the muscles.

We should choose the appropriate amount of exercise according to our own abilities and do what we can.

Relaxation and stretching after exercise are also important.

For the elderly and people with basic diseases, scientific evaluation and inspection should be carried out before resistance exercise, and moderate intensity exercise should be carried out within the scope of one’s ability, and exercise is beneficial.

Original title: "Health Science | This exercise can also protect the cardiovascular system"

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Notice on recommending the use of traditional Chinese medicine to prevent COVID-19 in enterprises and institutions that have resumed work and production.

Prevention and control of pneumonia in novel coronavirus by cities and counties (districts) emergency headquarters;

In order to implement the provincial government’s Notice on Strengthening the Scientific Prevention and Control of Epidemic Situation and Promoting the Resumption of Production of Enterprises in the Province and the No.14 Order of emergency headquarters Province on Epidemic Prevention and Control, and give full play to the core role of traditional Chinese medicine in disease prevention, the Provincial Administration of Traditional Chinese Medicine organized experts from Jiangxi University of Traditional Chinese Medicine and other units to study and formulate a prescription of traditional Chinese medicine for preventing COVID-19 for employees of enterprises and institutions that have resumed work and resumed production on the basis of summarizing the preventive drugs used in our province in the early stage. Now, the prescriptions of traditional Chinese medicine for employees of enterprises and institutions who have resumed production to prevent COVID-19 are recommended for reference.

First, the general population prevention prescription

10g of atractylodes rhizome, 5g of dried tangerine peel, 5g of agastache rugosa, 5g of perilla, 5g of honeysuckle, 5g of cyrtomium rhizome and 10g of raw astragalus root.

Function: Aromatic turbidity, clearing away heat and toxic materials, and consolidating exterior.

Second, the prescription for the prevention of the weak population

15g of Radix Astragali, 10g of Radix Saposhnikoviae, 10g of Rhizoma Atractylodis Macrocephalae, 5g of Herba Agastaches, 5g of Perillae and 5g of Flos Lonicerae.

Function: invigorating qi, consolidating exterior, aromatic and turbid, and clearing away heat and toxic materials.

Prevention and Control of Pneumonia Infected in novel coronavirus Province

Emergency headquarters office

February 21, 2020

Notice on printing and distributing the prevention and control scheme of traditional Chinese medicine in novel coronavirus, Jiangxi Province (Trial Third Edition)

The health committees of counties (cities) directly under the jurisdiction of all districts and cities, and relevant medical institutions directly under the jurisdiction of the province:

In order to give full play to the unique role of traditional Chinese medicine in the prevention and treatment of novel coronavirus epidemic, according to the Notice of the General Office of the National Health and Wellness Committee and the Office of state administration of traditional chinese medicine on Printing and Distributing the Diagnosis and Treatment Plan of novel coronavirus (Trial Sixth Edition) (Guo Wei Ban Yi Han [2020] No.145), we organized experts to analyze and summarize the prevention and treatment of novel coronavirus by traditional Chinese medicine in our province, and combined with the geographical and climatic characteristics of Jiangxi, revised the prevention and treatment plan of traditional Chinese medicine, and formed the "Prevention and Treatment of Traditional Chinese Medicine in novel coronavirus, Jiangxi Province" Is issued to you, please refer to the implementation.

Attachment: Prevention and Treatment Plan of Traditional Chinese Medicine in novel coronavirus, Jiangxi Province (Trial Third Edition)

Jiangxi provincial administration of traditional Chinese medicine

February 21, 2020

Prevention and treatment scheme of traditional Chinese medicine in novel coronavirus, Jiangxi Province

(Trial Third Edition)

In order to give full play to the role of Chinese medicine in the prevention and control of epidemic situation in novel coronavirus, combined with the situation of Chinese medicine participating in the treatment of early confirmed cases in our province and the regional and climatic characteristics, and further improve the prevention and syndrome differentiation treatment of novel coronavirus by Chinese medicine, this scheme is formulated.

I. Characteristics of the disease

(1) Clinical manifestations

Based on the current epidemiological investigation, the incubation period is 1-14 days, mostly 3-7 days. The main manifestations are fever, dry cough and fatigue. A few patients have symptoms such as nasal congestion, runny nose, sore throat, myalgia and diarrhea. Severe patients often have dyspnea and/or hypoxemia one week after onset, and severe patients can rapidly progress to acute respiratory distress syndrome, septic shock, metabolic acidosis that is difficult to correct, bleeding and coagulation dysfunction and multiple organ failure. It is worth noting that severe and critical patients may have moderate to low fever or even no obvious fever during the course of the disease.

Mild patients only showed low fever, slight fatigue, etc., and no pneumonia.

Judging from the current cases, most patients have a good prognosis and a few patients are in critical condition. The prognosis of the elderly and those with chronic basic diseases is poor. The symptoms of children cases are relatively mild.

(2) Laboratory inspection

At the early stage of onset, the total number of white blood cells in peripheral blood is normal or decreased, and the lymphocyte count is decreased. Some patients may have increased liver enzymes, lactate dehydrogenase (LDH), muscle enzymes and myoglobin. Increased troponin can be seen in some critically ill patients. C-reactive protein (CRP) and erythrocyte sedimentation rate increased in most patients, and procalcitonin was normal. In severe cases, D- dimer increased and peripheral blood lymphocytes decreased progressively. Severe and critical patients often have elevated inflammatory factors.

Novel coronavirus nucleic acid can be detected in nasopharyngeal swab, sputum and other lower respiratory secretions, blood, feces and other samples.

In order to improve the positive rate of nucleic acid detection, it is suggested that sputum should be collected as much as possible, and lower respiratory tract secretions should be collected by patients undergoing tracheal intubation, and the samples should be sent for inspection as soon as possible after collection.

(3) Chest imaging

In the early stage, there were many small patches and interstitial changes, especially in the outer lung. Then it develops into multiple ground glass shadows and infiltration shadows in both lungs. In severe cases, lung consolidation can occur, and pleural effusion is rare.

Second, prevention of traditional Chinese medicine

(1) Drug prevention

1. Tea substitute: Radix Pseudostellariae 3g, Flos Lonicerae 3g, Herba Agastaches 3g, Radix Platycodi 3g, and Radix Glycyrrhizae 3g.

2. Basic prescription: Yupingfeng Powder, which consists of raw astragalus root 12g, Saposhnikovia root 10g, Atractylodes macrocephala 10g, Lonicera japonica 10g, Forsythia suspensa 10g, Rhizoma Osmundae 6g, Eupatorium odoratum 10g, Pericarpium Citri Tangerinae 10g, Rhizoma Atractylodis 10g and Radix Platycodi 10g.

(2) Prevention of Heat-sensitive Moxibustion (One Ai and Three Uses)

(1) Smell mugwort

Smell the Ai Xiang produced by heat-sensitive moxibustion moxa sticks several times a day for 30 seconds each time. The aromatic components of pure moxa in heat-sensitive moxibustion moxa sticks and the aromatic medicinal properties of Notopterygium Rhizoma, Radix Angelicae Pubescentis, Herba Asari and Rhizoma Ligustici Chuanxiong have good functions of refreshing the brain, sensitizing the sense of smell, purifying the internal environment of the nasopharynx and improving the immunity of the nasopharynx. Smelling the fragrance can not only publicize the pathogenic factors of upper energizer and dampness, but also prevent the exogenous pathogenic factors.

(2) moxibustion

Selection of points: Zhongwan, Shenque and Guanyuan.

Operation method: hanging moxibustion back and forth along meridian. During moxibustion, the moxa heat moves slowly near the moxibustion point, finding the position where the heat has special feelings such as penetration, distant transmission, diffusion and comfort, and carrying out moxibustion back and forth along the meridian.

Moxibustion amount: once a day, each point is moxibustion for about 45 minutes.

On the basis of the above, those who can accept wheat grain moxibustion add wheat grain moxibustion to Zusanli point, and the effect is better.

Precautions: During moxibustion, the moxibustion recipient should pay attention to cold and warmth, and keep the room temperature at about 25 degrees; It is not advisable to take a bath within 4 hours after moxibustion.

(3) Ai pedicure

Soak your feet with half a stick of moxa stick with heat-sensitive moxibustion in 1000 ml of hot water for 30 minutes every day until the skin on your forehead or nape is moist or slightly sweaty.

This scheme has three uses. The application of dynamic moxibustion can effectively stimulate the movement of menstruation and qi, mobilize the body’s own regulatory function, eliminate dampness and transport the spleen; Cooperate with wheat grain moxibustion to improve human immunity and strengthen the body; Sensitize the sense of smell through the aromatic smell, and publicize the pathogenic factors of upper energizer and dampness; Using hot Folium Artemisiae Argyi water, the meridians of lower limbs are warmed, and the coking is wet and turbid. Treating the triple energizer with the same treatment, giving consideration to both the symptoms and the root causes, has obvious effects of aromatization and dampness elimination, and announces the triple energizer.

Third, Chinese medicine treatment

This disease belongs to the category of "epidemic" disease in traditional Chinese medicine. Because of the feeling of "epidemic", all localities can treat it according to the condition, local climate characteristics and different constitutions, with reference to the following schemes. Doses exceeding pharmacopoeia should be used under the guidance of doctors.

1. Medical observation period

Clinical manifestation 1: fatigue with gastrointestinal discomfort

Recommended Chinese patent medicine: Huoxiang Zhengqi Capsule (pill, water, oral liquid)

Clinical manifestation 2: fatigue with fever

Recommended Chinese patent medicines: Jinhua Qinggan granules, Lianhua Qingwen capsules (granules), Shufeng Jiedu capsules (granules) and Chimonanthus chinensis leaves granules.

2. Clinical treatment period (confirmed cases)

2.1 Qingfei Paidu Decoction

Scope of application: it is suitable for light, ordinary and severe patients, and can be used reasonably in combination with the actual situation of patients in the treatment of critical patients.

Basic prescription: Herba Ephedrae 9g, Radix Glycyrrhizae Preparata 6g, Semen Armeniacae Amarum 9g, Gypsum Fibrosum 15?30g (decocted first), Ramulus Cinnamomi 9g, Rhizoma Alismatis 9g, Polyporus 9g, Atractylodis Macrocephalae 9g, Poria 15g, Radix Bupleuri 16g, Scutellariae 6g, Jiang Banxia 9g, Rhizoma Zingiberis Recens 9g, Radix Asteris 9g, Flos Lonicerae 9g, Rhizoma Belamcandae 9g, Herba Asari 6g, Rhizoma Dioscoreae 12g, Fructus Aurantii Immatur

Administration method: traditional Chinese medicine decoction pieces, decocted in water. One dose a day, twice in the morning and evening (40 minutes after meals), and three doses for a course of treatment.

If conditions permit, you can take half a bowl of rice soup after taking the medicine every time, and you can take an extra bowl for those with dry tongue and body fluid deficiency. (Note: If the patient has no fever, the dosage of gypsum should be small, and the dosage of gypsum can be increased if the patient has fever or strong heat). If the symptoms improve but are not cured, take the second course of treatment. If the patient has special circumstances or other basic diseases, the prescription can be modified according to the actual situation in the second course of treatment, and the drug will be stopped when the symptoms disappear.

Source of prescription: Notice of the General Office of the National Health and Wellness Commission and the Office of state administration of traditional chinese medicine on Recommending the Use of Qingfei Paidu Decoction in the Treatment of Pneumonia Infected by novel coronavirus with Integrated Traditional Chinese and Western Medicine (No.22 [2020] of the Office of Traditional Chinese Medicine).

2.2 heat-sensitive moxibustion treatment

Scope of application: it is suitable for mild, common, clinical observation period and recovery period of lung and spleen deficiency syndrome.

Therapeutic effect: benefiting the temperature and spleen, aromatic and dampness.

2.2.1 Moxibustion points: Shenque, Tian Shu (double) and Daheng (double).

2.2.2 Posture: Take a comfortable supine position and relax the whole body.

2.2.3 Operation:

The moxibustion victim lies on his back, respectively ignites two sections of moxa sticks with a diameter of 2.5 cm and a length of 4cm, and inserts them into a special moxibustion device with an moxa heat reflecting cavity and capable of adjusting the unit heat, wherein the moxibustion device is 22 cm long and 16 cm wide, and the smoke outlet of the moxibustion device is connected with a portable smoke eliminator, and the moxibustion device is placed horizontally with the navel as the center. In the process of moxibustion, the intensity of moxa heat can be adjusted by adjusting the handle of each moxibustion unit, so that the abdominal acupoint area of moxibustion feels hot, uniform, comfortable and not burning. By moving the moxibustion tool up and down, left and right on the navel, we can find the position where the heat sensation is permeated, spread, diffused and comfortable, and then let it stand for moxibustion. During the whole moxibustion process, it is necessary to ensure that the heat is uniform, comfortable and not burning, and the heat-sensitive induction such as deep heat, distal heat, body drying heat and forehead sweating subsides to a certain degree.

2.2.4 Moxibustion amount: once a day, about 40 to 60 minutes, and each moxibustion should not exceed 60 minutes.

2.3 light

(1) Cold-dampness stagnation of lung syndrome

Clinical manifestations: fever, fatigue, body aches, cough, expectoration, chest tightness, anorexia, nausea, vomiting, and sticky stool. The tongue is light, fat, with teeth marks or reddish, and the coating is white, thick, rotten or white, with moist or slippery pulse.

Recommended prescription: Dispelling cold, removing dampness and resisting toxin.

Raw Herba Ephedrae 6g, almond 9g, Ramulus Cinnamomi 9g, Radix Glycyrrhizae Preparata 6g, fried atractylodes 9g, Perilla 6g, Rhizoma Pinelliae Preparata 9g, Pericarpium Citri Tangerinae 9g, Radix Peucedani 9g, Radix Platycodi 9g, Fructus Aurantii 9g, Poria 9g, Ginger 9g and Jujube 9g.

For those with cold and heat, 9g of Bupleurum and 9 g of Scutellaria baicalensis Georgi are added; For those with obvious vomiting and diarrhea, Huoxiang Zhengqi Powder is used.

Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening, before meals.

(2) Syndrome of damp-heat accumulating in lung

Clinical manifestations: low or no fever, slight aversion to cold, fatigue, heavy head and body drowsiness, muscle aches, dry expectoration, sore throat, dry mouth and no desire to drink more, or accompanied by chest tightness, anorexia, loose stool or sticky stool. The tongue is reddish, the coating is white, thick and greasy or thin and yellow, and the pulse is slippery or moist.

Recommended prescription: Qingre Huashi Antitoxic Formula

Semen Armeniacae Amarum 9g, Scutellariae Radix 9g, Fructus Forsythiae 9g, Poria 9g, Fructus Amomi Rotundus 6g (bottom), Talcum 9g (fried), Folium Mori 9g, Herba Ephedrae 6g, Semen Coicis 15g, and Radix Glycyrrhizae 6g.

Bitter mouth, nausea and vomiting, combined with Xiaochaihu decoction; Nausea and nausea with joint pain, combined with Chaihu Guizhi decoction; Asthma, chest tightness, combined with "Xuanbi Decoction" in Treatise on Epidemic Febrile Diseases.

Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening.

2.4 Ordinary type

(1) Damp-toxic stagnation of lung syndrome

Clinical manifestations: fever, cough with little phlegm, or yellow phlegm, shortness of breath, abdominal distension and constipation. The tongue is dark red, the tongue is fat, the coating is yellow and greasy or yellow and dry, and the pulse is slippery or stringy.

Recommended prescription: Modified Qingre Huashi Antitoxic Formula

Semen Armeniacae Amarum 9g, Scutellariae Radix 9g, Fructus Forsythiae 9g, Poria 9g, Fructus Amomi Rotundus 6g (bottom), Talcum 9g (fried), Folium Mori 9g, Rhizoma Phragmitis 9g, Semen Benincasae 9g, Semen Persicae 6g, and Semen Coicis 15g.

For patients with mild diarrhea, 9 g of Radix Puerariae is added; Cough with yellow phlegm, add 9g of buckwheat and 9 g of houttuynia cordata; Cough and rest, don’t lie down, and combine the jujube and xiefei decoction; Throat blocking sore throat, combined with Yinqiao Mabo powder.

Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening.

(2) Cold-dampness blocking lung syndrome

Clinical manifestations: low fever, low body heat, or no fever, dry cough, less phlegm, fatigue, chest tightness, fullness, or nausea, loose stool. The tongue is pale or reddish, with white or greasy fur and moist pulse.

Recommended prescription: Modified formula for dispelling cold, removing dampness and resisting toxin.

Raw Herba Ephedrae 6g, almond 9g, cassia twig 9g, Radix Glycyrrhizae Preparata 6g, fried atractylodes 9g, Herba Agastaches 9g, Magnolia Officinalis 9g, Poria 9g, Pericarpium Citri Tangerinae 9g, Massa Medicata Fermentata 9g, stir-fried malt 9g, Pericarpium Arecae 6g, Herba Artemisiae Scopariae 6g and Bupleuri 9g.

Thirsty, cough phlegm is not easy to come out, add gypsum 915 g; Cough leads to chest pain, combined with Qianjin Weijing Decoction.

Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening.

2.5 heavy duty

(1) Syndrome of lung-closing due to epidemic toxin

Clinical manifestations: red fever, cough, yellow sticky sputum, or blood in sputum, shortness of breath, fatigue, dry mouth, nausea, poor stool, short and red urine. Red tongue, yellow greasy fur, and slippery pulse.

Recommended prescription: 6g of raw ephedra, 9g of almond, 15g of gypsum Fibrosum, 3g of licorice, 10g of Pogostemon Pogostemonis (lower back), 10g of Magnolia officinalis, 15g of Atractylodes lancea, 10g of Amomum tsaoko, 9g of Rhizoma Pinelliae Preparata, 15g of Poria, 5g of raw rhubarb (lower back), 10g of raw Astragalus, 10g of Lepidium Seed and 10g of Paeonia Rubra.

9g of cogongrass rhizome is added for those with obvious blood in sputum.

Administration: 12 doses a day, decocted in water, 100 ml and 200 ml each time, 24 times a day, orally or by nasal feeding.

(2) gas camp two burnt certificates

Clinical manifestations: fever, polydipsia, shortness of breath, delirium, wrong vision, or rash, or vomiting blood, epistaxis, or limb convulsions. The tongue is crimson with little or no coating, and the pulse is heavy and thin, or it is large and numerous.

Recommended prescription: Gypsum Fibrosum 3060g (fried first), Anemarrhena asphodeloides 30g, Radix Rehmanniae 3060g, Cornu Bubali 30g (fried first), Radix Paeoniae Rubra 30g, Radix Scrophulariae 30g, Fructus Forsythiae 15g, Cortex Moutan 15g, Rhizoma Coptidis 6g, Folium Bambusae 12g, Semen Lepidii 15g and Radix Glycyrrhizae 6g.

Administration method: 1 dose per day, decocted with water, first decocted with gypsum and buffalo horn, 100 ml and 200 ml each time, 24 times a day, orally or by nasal feeding.

Recommended Chinese patent medicines: Xiyanping injection, Xuebijing injection, Reduning injection, Tanreqing injection and Xingnaojing injection. Drugs with similar efficacy can be selected according to individual conditions, or they can be used in combination according to clinical symptoms. Traditional Chinese medicine injection can be used in combination with traditional Chinese medicine decoction.

2.6 Critical type (syndrome of internal closure and external detachment)

Clinical manifestations: dyspnea, frequent wheezing or mechanical ventilation, dizziness, dysphoria, sweating with cold limbs, dark purple tongue, thick greasy or dry fur, floating pulse without roots.

Recommended prescription: 15g of Ginseng, 10g of Heishun Tablet (fried first) and 15g of Cornus officinalis. Take Suhexiang Pill or Angong Niuhuang Pill.

Recommended Chinese patent medicines: Xuebijing injection, Reduning injection, Tanreqing injection, Xingnaojing injection, Shenfu injection, Shengmai injection and Shenmai injection. Drugs with similar efficacy can be selected according to individual conditions, or they can be used in combination according to clinical symptoms. Traditional Chinese medicine injection can be used in combination with traditional Chinese medicine decoction.

Note: Recommended usage of heavy and critical traditional Chinese medicine injections.

The use of traditional Chinese medicine injections follows the principle of small dosage and gradual dialectical adjustment in the drug instructions. The recommended usage is as follows:

Virus infection or mild bacterial infection: 0.9% sodium chloride injection 250ml plus Xiyanping injection 100mg bid, or 0.9% sodium chloride injection 250ml plus Reduning injection 20ml, or 0.9% sodium chloride injection 250ml plus Tanreqing injection 40ml bid.

High fever with disturbance of consciousness: 250ml of 0.9% sodium chloride injection and 20 ml of Xingnaojing injection bid.

Systemic inflammatory response syndrome or/and multiple organ failure: 250ml of 0.9% sodium chloride injection and 100 ml of Xuebijing injection.

Immunosuppression: 250ml of 0.9% sodium chloride injection and 100ml bid of Shenmai injection.

Shock: 250ml of 0.9% sodium chloride injection and 100ml bid of Shenfu injection.

2.7 recovery period

(1) Deficiency of lung and spleen-qi syndrome

Clinical manifestations: shortness of breath, fatigue, anorexia, nausea, fullness, weak stool and loose stool’s discomfort. The tongue is pale and fat, and the coating is white and greasy.

Recommended prescription: Rhizoma Pinelliae Preparata 9g, Pericarpium Citri Tangerinae 10g, Radix Codonopsis 15g, Radix Astragali Preparata 30g, fried atractylodes 10g, Poria 15g, Herba Agastaches 10g, Fructus Amomi 6g (below) and Radix Glycyrrhizae 6g.

Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening.

Recommended Chinese patent medicines: Shenling Baizhu Powder and Xiangsha Liujun Pill.

Adjuvant dietotherapy: the monkey in the river is thin with rice.

(2) Deficiency of both Qi and Yin

Clinical manifestations: fatigue, shortness of breath, dry mouth, thirst, palpitation, excessive sweating, anorexia, low or moderate fever, dry cough and little phlegm. The tongue is dry with little body fluid, and the pulse is thin or weak.

Recommended prescription: 10g Radix Adenophorae, 10g Radix Ophiopogonis, 6g Radix Panacis Quinquefolii, 6g Fructus Schisandrae Chinensis, 15g Gypsum Fibrosum, 10g Folium Bambusae, 10g Folium Mori, 15g Rhizoma Phragmitis, 15g Radix Salviae Miltiorrhizae and 6g Radix Glycyrrhizae.

Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening.

(3) yang deficiency, phlegm and blood stasis syndrome

Clinical manifestations: chest tightness and suffocation, shortness of breath when moving, paroxysmal dry cough and choking cough, or coughing a small amount of white phlegm, white face and fear of cold. The tongue is dull, the coating is thin, white or greasy, and the pulse is heavy or astringent.

Chest CT showed obvious signs of pulmonary interstitial lesions.

Recommended prescription: Warming Lung and Chemical Fiber Decoction

15g of cornu Cervi Degelatinatum, 4g of Cinnamomum cassia, 10g of Rhizoma Zingiberis Preparata, 10g of Herba Ephedrae, 20g of Radix Rehmanniae Preparata, 10g of Semen Sinapis Albae, 6g of Radix Glycyrrhizae Preparata, 10g of Lumbricus, 10g of Eupolyphaga Seu Steleophaga, 10g of Rhizoma Chuanxiong, 10g of Semen Persicae and 10g of Carthami Flos.

15g of stir-fried malt and 15g of stir-fried rice buds are added to those who accept the poor; If qi deficiency is prominent, such as shortness of breath, mental fatigue and laziness, Buzhong Yiqi Decoction should be combined; People with yin deficiency such as dry mouth, dry throat, less fur, etc., combined with Shengmai drink; For patients with obvious cough, add 10g of Radix Asteris, 10g of Flos Farfarae, 10g of Stemonae and 10g of Perilla.

Administration method: 1 dose per day, 400ml decoction, taken twice, once in the morning and once in the evening.

Recommended Chinese patent medicine: Jinshuibao capsule (tablet)

Source: Provincial Administration of Traditional Chinese Medicine and Jiangxi Provincial Hospital of Traditional Chinese Medicine.

Nanchang release

Wechat WeChat official account: nc_fabu

Original title: "Authoritative release! The recommended Chinese medicine prescription for preventing COVID-19 is coming! Get out of here "