Release date: 2015-02-26
In the past three or four years, there have been fewer and fewer hospitals using death row organs for transplant surgery.
Since 2010, most of the organ transplants have come from organs donated by citizens after their death. Our experts have been internationally recognized. Last year, the expert Ye inspired the team to go to the United States to participate in the organ transplant conference, and was also invited to participate in the conference.
In the past, there was no smooth access distribution system. Doctors had to deal with the judicial system in order to obtain organs. Now they are connected to the primary hospitals. Once potential donors appear, they will immediately inform the doctors that the organ donation is smooth.
"Decommissioning of death row organs, although it will have a little impact, is temporary, and it is positive in the long run, good things!"
From January 1 this year, China has completely stopped using the death row organs, and citizens volunteered to donate as the sole source of organ transplant donors. What kind of impact will this move have on the development of organ transplantation in China? Will the situation of a sharp decline in the number of available human organs occur? Recently, Xinhua Daily Telegrapher visited a number of doctors working in the front line of organ transplantation. Discuss this issue.
Will organ supply drop sharply after deactivation?
According to Gao Xinpu, deputy director of the Business Unit of China Human Organ Donation Management Center, the supply-demand ratio of organ transplantation in China is 1:30. That is to say, if 300,000 people need organ transplant surgery every year, only 10,000 organs are available. transplant.
According to previous news reports, the sources of transplantable organs include death row, living donors between relatives, donations after the death of citizens, and black market transactions that cannot be avoided.
At present, there is no clear public data to show the specific proportion of these sources, but He Xiaoshun, the deputy dean of the First Affiliated Hospital of Sun Yat-sen University and the chief expert of the organ transplant department, told Xinhua Daily Telegrapher, “Before six or seven years ago, The use of death row organs is indeed in the minority."
This situation has been “three-quarters of the decline†since the death penalty approval right was returned to the Supreme People’s Court in 2007. He Xiaoshun said that in the past three or four years, 169 hospitals with organ transplant surgery qualifications in the country (hereinafter referred to as “transplant hospitals†") The use of death row organs has become less and less.
The organ transplant center of the First Affiliated Hospital of Sun Yat-sen University (hereinafter referred to as "Zhongshan First Hospital") began to collect the first place in all organs since the death of citizens. In the past 2014, the center's organ transplant surgery was less than 10% of death row.
The situation is similar to that of the Xiangya Third Hospital of Central South University in Hunan Province and the Institute of Hepatobiliary Diseases of Wuhan University.
Ye Qi concurrently serves as Director of the Transplant Medicine Engineering Technology Research Center of the Ministry of Health of the Third Xiangya Hospital of Central South University, and the Executive Dean of the Institute of Hepatobiliary Diseases of Wuhan University. He told Xinhua Daily Telegrapher that since March 2010, the two institutions he has worked on have completed more than 270 organ donation transplants. “There are few organs from relatives who donate in vivo, mainly from Donations after the death of a citizen."
"Some people worry about stopping the death row, the number of organ sources will drop sharply. This worry is superfluous." He Xiaoshun believes that "there may be a certain degree of decline in the short term, but in the medium and long term, I feel that it is not a problem. â€
He used the data of the Zhongshan First Hospital Organ Transplant Center to further prove that as of the end of 2014, the number of civic organ donation transplants in the Zhongshan First Hospital Organ Transplantation Center was 654, the largest in the country. In the past three years, the number of cases of organ donation after the death of citizens led by the center was completed in 2012; 54 cases were completed in 2013, an increase of 15% over the previous year; in 2014, 70 cases were completed, compared with the previous year. The increase was 30%; in 2015, He Xiaoshun was confident that he could increase to more than 100 cases.
Is the upper ventilator too long and the organ healthy?
The level of medical technology in the field of organ transplantation in China is not much different from that of developed countries in the West.
Associate Professor Wei Weiqiang from the First Affiliated Hospital of Zhongshan Hospital told the reporter that many patients who had undergone liver transplantation at the center had survived for more than 10 years. Among the first-class transplant hospitals in China, the survival rate after liver transplantation can reach 80%. "In the international arena, we can't talk about the lead, but the advanced is definitely no problem." He Xiaoshun has absolute confidence in the standards of domestic counterparts.
In the death row, young and middle-aged people are not a minority. The quality of their organs used before is relatively safe. Now they are completely deactivated. Using the organs donated by citizens after their death, they are very old and can the quality meet the requirements?
Many experts on liver and kidney transplantation interviewed by the reporter said that the problem is not big, but the situation of lung transplantation is not so optimistic.
From the first lung transplant operation in China in 1979 to the end of 2014, the total number of lung transplants in China was only 523, of which 343 were completed at Wuxi People's Hospital affiliated to Nanjing Medical University. The hospital's 1-, 3-, and 5-year survival rates for lung transplant patients were 78%, 61%, and 48%, respectively, and it is one of the top five lung transplant centers in the world.
Although medical technology is at the international advanced level, Chen Jingyu, vice president of the hospital and director of the Jiangsu Provincial Lung Transplantation and Treatment Center, said in an interview with Xinhua Daily Telegrapher that the lung transplant surgery for citizen donation at this stage is still a challenge for them. . In 2014, the number of lung transplants in the country was 147, and his team did 104 cases, of which only 9 were from organ donation after the death of citizens, less than 10%.
Not everyone is willing to donate lungs, but the requirements for donating lungs are higher. Chen Jingyu said that under normal circumstances, when the patient's brain is dead, the attending doctor recommends that the family consider organ donation. The family needs a psychological acceptance process and will still ask the doctor to use the ventilator and other equipment to maintain the patient's life. This process is as short as three or five days, and more than ten days and a half months. During this period, the patient's lungs are often infected and no longer have transplant conditions.
Organ donations were made after the death of 1,699 citizens in the country last year, but most of them were unable to donate lungs because the lungs were infected. "So the total suspension of the death row organs, all depends on the donation of citizens after the death, the number of lung transplants will certainly decline next." Chen Jingyu told Xinhua Daily Telegrapher.
In addition to the delay in time, a problem with lung infection is caused by a lack of awareness of organ maintenance. "If you are willing to donate, you should keep your lungs well and clean your respiratory tract and sputum." Chen Jingyu believes that "after the total suspension of death row organs, if the protection of the lungs is strengthened nationwide, the lungs can be maintained well in the long run. Look, the number of lung transplants is definitely not increasing."
The source of the organ has changed. Is the doctor used to it?
Previously, because the use of death row organs was not completely abolished, China's technological progress in the field of organ transplantation has not been recognized by the international academic community.
Ye inspired to enjoy 40 years of medical treatment in Hunan and Hubei provinces and enjoy the special government allowance granted by the State Council. He is an authoritative expert in the field of liver transplantation in China, but he told Xinhua Daily Telegrapher that he was still remembered in those years of grievances. "When you go abroad for a meeting, wherever you go, there are people pointing behind them; the academic articles on organ transplants can't be published in the international academic world..."
Since 2010, most of the organ transplants that have been handled have come from the organs donated by citizens after their death. Ye inspired them to finally receive international recognition. Last year he took the team to the United States to participate in the academic conference on organ transplantation, and was also invited to participate in the conference. Therefore, Ye Qiu received special support after the release of the request for the complete suspension of the death row.
In mid-April in 2012, at the Global Cardiopulmonary Transplant Annual Meeting in Prague, Chen Jingyu's lung transplant team introduced the clinical experience of lung transplantation in China's heart and brain death donation, which was highly recognized by the international cardiopulmonary transplant community on the day of the annual meeting. The front page of the newsletter introduced the work of Chinese counterparts and also integrated China's cardiopulmonary transplantation into the international family.
Not everyone is responding so positively. The long-standing mode of operation has led some organ transplant doctors to form a fixed mind. They are used to "greeting" directly with the judicial system. The use of donated organs means that they will participate in publicity, and often go to townships and counties to find the source of organs, which is too much trouble. So some people regard it as a fearful way, not optimistic, even pouring cold water.
"This inertia or inertia is probably an obstacle that reform is difficult to advance. In fact, we have made so many organ donations, it is really not difficult, much better than before." He Xiaoshun will continue to work with him on various occasions. The peers "show up".
He told Xinhua Daily Telegrapher that in the past, because there was no smooth access and distribution system, in order to change patients for the liver, the organs had to deal with the judicial system, "to make friends and socialize with them." But now, his Zhongshan First Hospital Organ Transplant Center has a clearly defined radiation area. After a period of running-in, the grassroots hospitals in these places are very clear about the process. Once a potential donor appears, immediately notify him to obtain the donated organs. Very smooth.
“You said that it is easy to deal with your own counterparts, or is it easy to deal with the judicial system?†He Xiaoshun asked the reporter, “So I stopped using the death row, I firmly agree that although it will have some impact, it is temporary and long-term. Positive influence, good thing!"
Source: Xinhuanet
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