If there's one thing that gets in the way of you being your healthiest, it's stress. For anyone who's found themselves standing in front of the freezer inhaling spoonfuls of Coffee Heath Bar Crunch ice cream (not my real name!) to avoid finishing a project, or waking up three times in the wee hours of the night in anticipation of a difficult conversation, here's some not-so-shocking news: Research shows that anxiety can make you sleep fewer hours, get sick more often, remember less, become more prone to long-term disease and—as if you needed reminding—eat more. No wonder up to 90 percent of doctor visits are for stress-related complaints, a fact that I suspect too many of you know firsthand (though you experience it as GI distress, back pain, a headache or other physical symptom).
In a recent Self.com poll, 85 percent of women said that worries interfere with their ability to catch zzz's, while 71 percent say they're more irritable due to stress. And given the recent headlines about the state of our economy, it's not surprising that 52 percent of women say they are under considerably more stress than they were six months ago. (What is your stress level?)
Grim, yes, but there IS hope. Just as our bodies are wired to react to stress, we're all also programmed to know how to wind down, whether it's by watching a funny movie, sitting in the sauna, sipping some chamomile tea (while dunking a cookie, of course!) or drinking a glass (or two) of wine with dinner. These activities switch on the brain's pleasure centers, blocking the production of the stress hormone cortisol and churning out happiness-inducing chemicals like serotonin instead.
When I feel a tightening in my back or neck coming on, I cope by doing things I love, like going for a long, slow run in the park with my dog. Try a few of these instant soothers, and watch your own stress go from ARGH! to Ahhh.
Turn up the tunes. Listening to music that has a steady (not frenetic) beat may cause brain waves to keep time and relax you, research from a music symposium at Stanford University in California reports. Load your iPod with a playlist of the songs that make you happiest.
Phone a friend. Pouring your heart out to pals can help you cope with bad feelings and brainstorm new ways to solve problems. And don't forget to return the favor: Lending an ear and offering support can make you feel needed and reduce anxiety. (Or drop them an e-card to say thanks!)
Break a sweat. Exercising for 30 minutes makes your body release chemicals that dull the physiological effects of stress response for up to a full day. But the effect only works when the activity is something you really want to do, so make sure you're psyched about channeling your energy in that cardiovascular direction.
Use a better bulb. Outfit your office lamp with an incandescent bulb, particularly if your cubicle is brightened by fluorescent lights. Incandescent and fluorescent lights work together to more closely mimic outside light. And it's sunshine (or the perception of it) that regulates the body's biorhythms. Not getting enough of it can affect hormone levels, suppressing the immune system and increasing the probability of mood swings, depression and sluggishness.
Pamper yourself. Whether you get a pedicure or splurge on a blowout, giving yourself special treatment reduces your blood pressure and gets your mind off what’s bothering you. Science supports this coping mechanism as well: A warm bath can activate neurons that increase serotonin, and a study from Bowling Green State University in Ohio found that a 15-minute massage can significantly cut anxiety levels. Not up for a splurge? Get the same effect from an at-home pedicure, manicure or blowout.
Dine by candlelight. The effect won't just make you look gorgeous. The dim setting actually signals your brain to release melatonin, the good-for-you sleep hormone which ensures a better night's rest. And catching enough zzz's helps keep your stress levels under control and your immune system humming. Can't sleep? See what your stress dreams are trying to tell you.
Snuggle with your sweetie. A simple 20-second kiss or hug increases endorphin levels, while having sex releases more calming hormones than any other form of sex play, researchers at the University of the West of Scotland at Paisley note.
Keep a journal. Jotting down your stressful thoughts can help you look at them more logically, potentially easing anxiety, mentally and physically. A study in the Journal of Health Psychology finds that a mere month of expressive writing can help reduce hypertension. Keep a pretty notebook handy at all times.
Anticipate something awesome. Or something tiny that makes you smile. The point is to look forward to something each day, whether it’s enjoying your morning java or counting down to an exotic vacation. Practicing this will keep your mind from focusing on what could go wrong that day.
Exhibit your exhilarating moments. Tape up pictures of three amazing days you’ve experienced, such as dancing at your wedding or crossing the finish line of a half-marathon. Honing in on the images for at least 10 seconds can lower muscle tension and stabilize your heartbeat.
Give someone props. Go on, pay a compliment to someone deserving. Research has shown that the more warm personal connections you make, the better your body is at jettisoning the effects of stress.
Stress-eater? Snack away the tension with these stress-busting foods.
Sunday, March 29, 2009
Sunday, March 15, 2009
豐臣秀吉
豐臣秀吉（1537年3月26日－1598年9月18日、日本戰國時代的大名，自室町幕府瓦解後再次統一日本，最高等級的官位是關白。
經歷
青年時期
豐臣秀吉出生於尾張國愛知郡中村（今愛知縣名古屋市中村區），父親為一貧困農戶（有說法是下級武士），父親木下彌右衛門，母親是大政所。幼年時期取名為日吉丸，仕於織田信長成為武士之後改名木下藤吉郎，綽號禿鼠（猴子為後人所說）.
由於秀吉的出身並非顯貴，有關於他早期的文獻記載十分有限，僅大概知道他少年時曾在尾張、三河、駿河等地方活動，並與尾張地方土豪蜂須賀氏有不錯的交情，曾經在遠江國引馬城成為松下之綱（嘉兵衛，城主飯尾連龍部下）的家臣，但離開原因不明。秀吉在1590年分配領地的時候，分封嘉兵衛遠江國久野城1萬6千石。此外，也有些關於他和忍者間互動的傳說。不管如何，青年時代的秀吉大概是個謀求武士職位的浪人之輩。
信長家臣時期
姬路城1554年以足輕的身分成為了織田信長的家臣，深得信長疼愛，在織田家的地位不斷提升。1564年與淺野長勝的養女彌彌結婚。在《武功夜話》記載，秀吉曾在墨俁河上的沖積三角洲上以一個晚上築起一座城砦作為進攻美濃國的安八郡，並擊退慎村醜之助的部隊。藤吉郎1568年改名為木下秀吉（在1568年文書中有秀吉的記載）。1570年信長準備進攻朝倉義景的中途，在金崎遭到盟友淺井長政的背叛的暗示，在撤退途中受到淺井軍攻擊，此戰秀吉負責殿後，保護信長和家康安全撤離（金崎之戰）。
天正元年1573年信長擊敗了淺井長政，長政自盡，淺井的舊屬歸織田家所有，秀吉被封為近江國今濱城城主，將城改名為長濱城，並改木下姓為羽柴（羽柴，取丹羽長秀和柴田勝家姓中各一字）。1576年支援北陸柴田勝家對抗上杉軍，秀吉見勝家佔下風立即撤離，結果勝家在手取川之戰中大敗，使勝家和信長有所不滿。在織田信忠的指揮下，秀吉參與攻擊松永久秀的戰鬥。1577年赤松則房、別所長治、小寺政職臣從信長之下，秀吉受命攻略中國地方，任播磨國國主，根據城為姬路城，受命後不久別所長治及荒木村重背叛織田信長，秀吉與他們戰鬥，1579年使宇喜多氏完全臣服於織田氏，1580年別所長治和荒木村重戰敗，前者戰敗被捕自盡，後者逃離。秀吉開始與毛利氏及山名氏交戰，攻下了鳥取城、三木城、高松城等重要據點，秀吉在此發揮了長時間包圍戰城池戰法–斷糧，使敵軍提早開城投降。
本能寺之變
1582年明智光秀於支援秀吉出兵毛利途中發動兵變，攻佔京都並夜襲投宿在本能寺的織田信長，織田信長焚毀本能寺，屍骨無獲，其長子織田信忠於二條御所戰敗後切腹。當時豐臣秀吉正親自率兵包圍備中國的高松城，由於報信者的失誤，於事變三天後才得知消息。之後，在毛利氏大老小早川隆景主導下，他迅速與毛利氏議和，條件是守將清水宗治自盡，秀吉在5天內強行行軍約200公里返回京都，並隨即與明智軍展開決戰，這次行軍史稱中國大撤退，行動之迅速大大震撼了京師的明智軍。回師之時，秀吉以信長之名為號召，成功收納流竄在各地的信長舊屬，於山崎之戰大敗準備不及的明智光秀，最終明智光秀逃走時被村民殺死，秀吉乘機控制京都一帶，不過無法阻止織田氏家內部出現派系分裂。主要分裂為柴田勝家、織田信雄、織田信孝以及羽柴秀吉等派系。
統一日本時期
秀吉在清洲會議上得到多數織田族人與家臣支持，擁立尚在襁褓的信忠長男三法師（元服後稱織田秀信）繼任家督。但為此得罪了同屬織田重臣的柴田勝家，導致其擁立信長三子織田信孝對抗秀吉。隔年，雙方決裂，秀吉先迫使信孝投降，後來羽柴與柴田軍在賤岳決戰，最初勝家佔盡優勢，中川清秀遭到突擊陣亡，但是秀吉率兵衝上前線使形勢急變，最終秀吉取得勝利。跟著羽柴軍包圍北之庄城，勝家與妻子阿市自殺，此外另一重臣瀧川一益則被迫蟄居，織田信孝不久被殺，丹羽長秀和池田恆興歸服，大致上平定了織田家內反秀吉勢力。1583年，秀吉在石山本願寺的舊址上建大坂城，當時到訪的大友宗麟將它稱為「三國無雙的城」，但城堡在防禦上亦有缺點，在大坂冬之陣中，真田信繁進行了修築加強防禦。
1584年，與其合作的信長次子織田信雄聯合德川家康反對秀吉，羽柴軍便與兩人展開史稱小牧·長久手之戰的戰事。此戰之初擁有兵力優勢的羽柴軍直撲德川領地，但途中卻遭到德川軍伏擊，有「鬼武藏」之稱的大將森長可戰死，秀吉其後撤兵，改為攻擊美濃國織田信雄，信雄投降，迫使雙方談和，德川軍與羽柴軍達成和不戰和議，家康派出次男秀康作為人質。
1585年，秀吉派遣秀長、小早川隆景等將領攻打剛統一四國的長宗我部氏，利用兵力的差距迫使其歸降並保有了土佐一國。此外秀吉派遣藤堂高虎為首的部隊，平定了雜賀眾，首領鈴木重意被斬首處死。此外，秀吉派重兵攻打越中國佐佐成政，開戰派大軍包圍，成政不戰而降。1586年秀吉將其妹旭姬與德川家康進行婚姻，並為家康正室，將自己的母親大政所送回家康身邊成為人質，德川家康此後臣從秀吉。1585年秀吉被近衛前久收為養，就任關白，1586年受賜姓豐臣並就任太政大臣，確立了政權。
1586年，九州大名大友宗麟向秀吉請求支援，1587年派遣秀長率領大軍攻擊島津氏的支城，使義久投降，戰後島津氏被分配到薩摩和大隅兩國。1588年秀吉開始實行刀狩令，加強了兵農分離的政策。
1589年北條氏的家臣豬俁邦憲奪取了真田昌幸管轄下名胡桃城，導致秀吉下令全日本大名討伐北條氏，不服從者將會受到失到領土的處分。秀吉率20萬大軍向北條氏攻擊，攻陷北條各個支城下逐漸向小田原城包圍，7月北條氏政、氏直父子投降。氏政、氏照兩兄弟切腹自盡，氏直被流放到高野山，戰後秀吉為各大名分封新的領土。
1591年，將關白之位讓給外甥豐臣秀次，自稱太閤（前關白的尊稱）。1591年秀吉進行他人生中最後一場日本國內戰爭，派遣了蒲生氏鄉、淺野長政及石田三成聯同東北地方大名平定九戶政實之亂。同年，秀吉命令茶人千利休切腹自盡，原因不明。
征伐朝鮮及晚年
豐臣秀吉的花押。公元1592年豐臣秀吉率兵20萬侵略朝鮮兵員為西日本諸大名為主。戰爭初期，久經沙場的日軍攻勢猛烈、勢如破竹，以極快的速度先後攻佔朝鮮王京漢城與陪都平壤，並迅速攻佔朝鮮境內大量主要城市，直趨明朝邊境。朝鮮王馬上向明朝求救。明神宗派遣遼東總兵李如松率兵入援朝鮮。在明軍（約5萬）和朝鮮三道水師提督李舜臣等的反擊下，日軍屢遭重創。
終於在1593年日軍因損失過大，豐臣秀吉遂與明朝和談。
其時日方代表小西行長偽造秀吉降表與明朝議和，而明方使者沈惟敬就稱秀吉的目的是要求恢復雙方邊貿易。雙方於是締結和約，日軍就此暫退釜山。此為文祿之役。
1595年，豐臣秀吉將豐臣秀次流放到高野山然後令其自盡，此外亦處死其支持者，包括前野長康等人。處死的原因可能是當時人民流傳著殺生關白過去所發生的亂行，加上秀吉打算以年幼的次男秀賴作為家中的繼承人，因此秀吉處死有關人士。
亦有說法指，秀吉曾向明朝開列的條件，包括明朝把公主下嫁天皇（和親），割讓朝鮮南部領土，將朝鮮世子作人質等才退兵。（曰割朝鮮四道與我、曰封通聘、曰封爵，其餘逸而不傳。）
數年後，亦1596年九月，秀吉歡喜地迎接明朝使者，明、朝議和使來日，秀吉宴饗之。然宣讀國書，始知議和實為冊封，大明欲封秀吉為日本國王。秀吉方覺受騙，大怒道：「吾掌握日本，欲王則王，何待髯虜之封！且吾而為王，何以對天皇！」，並欲殺明朝使節，為旁人勸止，於是下令驅逐明朝使節。秀吉不久後再次遣兵入侵朝鮮。日軍盤據釜山，再進逼漢陽。然而明朝援軍（約8萬）加入戰鬥行列後，日軍陷入困境，被迫死守於海岸各城堡。史稱-「慶長之役」）
1598年8月18日，豐臣秀吉於戰役中逝世，死於伏見城，享年62歲。死前他亦已託付前田利家監視德川家康及輔佐豐臣秀賴。而入侵朝鮮的日軍在接獲五大老的命令及以石田三成為首的五奉行安排下逐漸撤軍，可是這場戰役日軍損失巨大；元氣大傷，此役也埋下了德川家康日後成為征夷大將軍的一個重要伏因。而日本與朝鮮的關係，到1607年才恢復正常。
政績
到達日本界港的南蠻船（十六世紀油畫）他的經貿政策多承傳自織田信長，發展南蠻貿易，以樂座樂市和朱印船貿易等振興商業；並利用控制都市及鑄造貨幣等辦法規範經濟；以太閤檢地和刀狩等政策用來確立稅制，徹底地兵農分離，為江戶時代的幕藩體制打下了穩定的基礎。
軼事
豐臣體型瘦小，但動作敏捷極富才智戰略，頗為織田信長欣賞；雖織田以禿鼠（猴子為後人所說，禿鼠之稱出現於信長寫給寧寧之信中可見）稱呼他，卻也不吝於拔擢豐臣秀吉升遷，豐臣遂忠心耿耿於織田；為德川素所忌憚豐臣之能戰。
在前田利家及弗洛伊斯的記載相關書籍秀吉的右手有六隻手指，拇指有多一隻手指，但後來秀吉為了遮掩事實，於是故意隱藏六隻手指的事情。
秀吉死因有不同說法，較為人所知的有胃癌、好色色癆精盡而死。
晚年失去應有判斷力，也是豐臣氏滅亡的原因，將豐臣秀次及其一族處死，以及發動文祿·慶長之役是他秀吉最大的爭議。
經歷
青年時期
豐臣秀吉出生於尾張國愛知郡中村（今愛知縣名古屋市中村區），父親為一貧困農戶（有說法是下級武士），父親木下彌右衛門，母親是大政所。幼年時期取名為日吉丸，仕於織田信長成為武士之後改名木下藤吉郎，綽號禿鼠（猴子為後人所說）.
由於秀吉的出身並非顯貴，有關於他早期的文獻記載十分有限，僅大概知道他少年時曾在尾張、三河、駿河等地方活動，並與尾張地方土豪蜂須賀氏有不錯的交情，曾經在遠江國引馬城成為松下之綱（嘉兵衛，城主飯尾連龍部下）的家臣，但離開原因不明。秀吉在1590年分配領地的時候，分封嘉兵衛遠江國久野城1萬6千石。此外，也有些關於他和忍者間互動的傳說。不管如何，青年時代的秀吉大概是個謀求武士職位的浪人之輩。
信長家臣時期
姬路城1554年以足輕的身分成為了織田信長的家臣，深得信長疼愛，在織田家的地位不斷提升。1564年與淺野長勝的養女彌彌結婚。在《武功夜話》記載，秀吉曾在墨俁河上的沖積三角洲上以一個晚上築起一座城砦作為進攻美濃國的安八郡，並擊退慎村醜之助的部隊。藤吉郎1568年改名為木下秀吉（在1568年文書中有秀吉的記載）。1570年信長準備進攻朝倉義景的中途，在金崎遭到盟友淺井長政的背叛的暗示，在撤退途中受到淺井軍攻擊，此戰秀吉負責殿後，保護信長和家康安全撤離（金崎之戰）。
天正元年1573年信長擊敗了淺井長政，長政自盡，淺井的舊屬歸織田家所有，秀吉被封為近江國今濱城城主，將城改名為長濱城，並改木下姓為羽柴（羽柴，取丹羽長秀和柴田勝家姓中各一字）。1576年支援北陸柴田勝家對抗上杉軍，秀吉見勝家佔下風立即撤離，結果勝家在手取川之戰中大敗，使勝家和信長有所不滿。在織田信忠的指揮下，秀吉參與攻擊松永久秀的戰鬥。1577年赤松則房、別所長治、小寺政職臣從信長之下，秀吉受命攻略中國地方，任播磨國國主，根據城為姬路城，受命後不久別所長治及荒木村重背叛織田信長，秀吉與他們戰鬥，1579年使宇喜多氏完全臣服於織田氏，1580年別所長治和荒木村重戰敗，前者戰敗被捕自盡，後者逃離。秀吉開始與毛利氏及山名氏交戰，攻下了鳥取城、三木城、高松城等重要據點，秀吉在此發揮了長時間包圍戰城池戰法–斷糧，使敵軍提早開城投降。
本能寺之變
1582年明智光秀於支援秀吉出兵毛利途中發動兵變，攻佔京都並夜襲投宿在本能寺的織田信長，織田信長焚毀本能寺，屍骨無獲，其長子織田信忠於二條御所戰敗後切腹。當時豐臣秀吉正親自率兵包圍備中國的高松城，由於報信者的失誤，於事變三天後才得知消息。之後，在毛利氏大老小早川隆景主導下，他迅速與毛利氏議和，條件是守將清水宗治自盡，秀吉在5天內強行行軍約200公里返回京都，並隨即與明智軍展開決戰，這次行軍史稱中國大撤退，行動之迅速大大震撼了京師的明智軍。回師之時，秀吉以信長之名為號召，成功收納流竄在各地的信長舊屬，於山崎之戰大敗準備不及的明智光秀，最終明智光秀逃走時被村民殺死，秀吉乘機控制京都一帶，不過無法阻止織田氏家內部出現派系分裂。主要分裂為柴田勝家、織田信雄、織田信孝以及羽柴秀吉等派系。
統一日本時期
秀吉在清洲會議上得到多數織田族人與家臣支持，擁立尚在襁褓的信忠長男三法師（元服後稱織田秀信）繼任家督。但為此得罪了同屬織田重臣的柴田勝家，導致其擁立信長三子織田信孝對抗秀吉。隔年，雙方決裂，秀吉先迫使信孝投降，後來羽柴與柴田軍在賤岳決戰，最初勝家佔盡優勢，中川清秀遭到突擊陣亡，但是秀吉率兵衝上前線使形勢急變，最終秀吉取得勝利。跟著羽柴軍包圍北之庄城，勝家與妻子阿市自殺，此外另一重臣瀧川一益則被迫蟄居，織田信孝不久被殺，丹羽長秀和池田恆興歸服，大致上平定了織田家內反秀吉勢力。1583年，秀吉在石山本願寺的舊址上建大坂城，當時到訪的大友宗麟將它稱為「三國無雙的城」，但城堡在防禦上亦有缺點，在大坂冬之陣中，真田信繁進行了修築加強防禦。
1584年，與其合作的信長次子織田信雄聯合德川家康反對秀吉，羽柴軍便與兩人展開史稱小牧·長久手之戰的戰事。此戰之初擁有兵力優勢的羽柴軍直撲德川領地，但途中卻遭到德川軍伏擊，有「鬼武藏」之稱的大將森長可戰死，秀吉其後撤兵，改為攻擊美濃國織田信雄，信雄投降，迫使雙方談和，德川軍與羽柴軍達成和不戰和議，家康派出次男秀康作為人質。
1585年，秀吉派遣秀長、小早川隆景等將領攻打剛統一四國的長宗我部氏，利用兵力的差距迫使其歸降並保有了土佐一國。此外秀吉派遣藤堂高虎為首的部隊，平定了雜賀眾，首領鈴木重意被斬首處死。此外，秀吉派重兵攻打越中國佐佐成政，開戰派大軍包圍，成政不戰而降。1586年秀吉將其妹旭姬與德川家康進行婚姻，並為家康正室，將自己的母親大政所送回家康身邊成為人質，德川家康此後臣從秀吉。1585年秀吉被近衛前久收為養，就任關白，1586年受賜姓豐臣並就任太政大臣，確立了政權。
1586年，九州大名大友宗麟向秀吉請求支援，1587年派遣秀長率領大軍攻擊島津氏的支城，使義久投降，戰後島津氏被分配到薩摩和大隅兩國。1588年秀吉開始實行刀狩令，加強了兵農分離的政策。
1589年北條氏的家臣豬俁邦憲奪取了真田昌幸管轄下名胡桃城，導致秀吉下令全日本大名討伐北條氏，不服從者將會受到失到領土的處分。秀吉率20萬大軍向北條氏攻擊，攻陷北條各個支城下逐漸向小田原城包圍，7月北條氏政、氏直父子投降。氏政、氏照兩兄弟切腹自盡，氏直被流放到高野山，戰後秀吉為各大名分封新的領土。
1591年，將關白之位讓給外甥豐臣秀次，自稱太閤（前關白的尊稱）。1591年秀吉進行他人生中最後一場日本國內戰爭，派遣了蒲生氏鄉、淺野長政及石田三成聯同東北地方大名平定九戶政實之亂。同年，秀吉命令茶人千利休切腹自盡，原因不明。
征伐朝鮮及晚年
豐臣秀吉的花押。公元1592年豐臣秀吉率兵20萬侵略朝鮮兵員為西日本諸大名為主。戰爭初期，久經沙場的日軍攻勢猛烈、勢如破竹，以極快的速度先後攻佔朝鮮王京漢城與陪都平壤，並迅速攻佔朝鮮境內大量主要城市，直趨明朝邊境。朝鮮王馬上向明朝求救。明神宗派遣遼東總兵李如松率兵入援朝鮮。在明軍（約5萬）和朝鮮三道水師提督李舜臣等的反擊下，日軍屢遭重創。
終於在1593年日軍因損失過大，豐臣秀吉遂與明朝和談。
其時日方代表小西行長偽造秀吉降表與明朝議和，而明方使者沈惟敬就稱秀吉的目的是要求恢復雙方邊貿易。雙方於是締結和約，日軍就此暫退釜山。此為文祿之役。
1595年，豐臣秀吉將豐臣秀次流放到高野山然後令其自盡，此外亦處死其支持者，包括前野長康等人。處死的原因可能是當時人民流傳著殺生關白過去所發生的亂行，加上秀吉打算以年幼的次男秀賴作為家中的繼承人，因此秀吉處死有關人士。
亦有說法指，秀吉曾向明朝開列的條件，包括明朝把公主下嫁天皇（和親），割讓朝鮮南部領土，將朝鮮世子作人質等才退兵。（曰割朝鮮四道與我、曰封通聘、曰封爵，其餘逸而不傳。）
數年後，亦1596年九月，秀吉歡喜地迎接明朝使者，明、朝議和使來日，秀吉宴饗之。然宣讀國書，始知議和實為冊封，大明欲封秀吉為日本國王。秀吉方覺受騙，大怒道：「吾掌握日本，欲王則王，何待髯虜之封！且吾而為王，何以對天皇！」，並欲殺明朝使節，為旁人勸止，於是下令驅逐明朝使節。秀吉不久後再次遣兵入侵朝鮮。日軍盤據釜山，再進逼漢陽。然而明朝援軍（約8萬）加入戰鬥行列後，日軍陷入困境，被迫死守於海岸各城堡。史稱-「慶長之役」）
1598年8月18日，豐臣秀吉於戰役中逝世，死於伏見城，享年62歲。死前他亦已託付前田利家監視德川家康及輔佐豐臣秀賴。而入侵朝鮮的日軍在接獲五大老的命令及以石田三成為首的五奉行安排下逐漸撤軍，可是這場戰役日軍損失巨大；元氣大傷，此役也埋下了德川家康日後成為征夷大將軍的一個重要伏因。而日本與朝鮮的關係，到1607年才恢復正常。
政績
到達日本界港的南蠻船（十六世紀油畫）他的經貿政策多承傳自織田信長，發展南蠻貿易，以樂座樂市和朱印船貿易等振興商業；並利用控制都市及鑄造貨幣等辦法規範經濟；以太閤檢地和刀狩等政策用來確立稅制，徹底地兵農分離，為江戶時代的幕藩體制打下了穩定的基礎。
軼事
豐臣體型瘦小，但動作敏捷極富才智戰略，頗為織田信長欣賞；雖織田以禿鼠（猴子為後人所說，禿鼠之稱出現於信長寫給寧寧之信中可見）稱呼他，卻也不吝於拔擢豐臣秀吉升遷，豐臣遂忠心耿耿於織田；為德川素所忌憚豐臣之能戰。
在前田利家及弗洛伊斯的記載相關書籍秀吉的右手有六隻手指，拇指有多一隻手指，但後來秀吉為了遮掩事實，於是故意隱藏六隻手指的事情。
秀吉死因有不同說法，較為人所知的有胃癌、好色色癆精盡而死。
晚年失去應有判斷力，也是豐臣氏滅亡的原因，將豐臣秀次及其一族處死，以及發動文祿·慶長之役是他秀吉最大的爭議。
Saturday, March 14, 2009
Biography on Jean Paul Getty
Jean Paul Getty (1892-1976) was a billionaire independent oil producer who founded and controlled the Getty Oil Company and over 200 affiliated companies.
Jean Paul Getty was born on December 15, 1892, in Minneapolis, Minnesota. His father, George Franklin Getty, was a lawyer, but in 1904 he moved his wife, Sarah Risher Getty, and his son to the Oklahoma territory to begin a successful career as an independent oilman. Two years later the family moved to Los Angeles, California, where young Getty attended private school before graduating from Polytechnic High School in 1909. After a European tour he attended the University of Southern California and the University of California at Berkeley; he spent his summers working on his father's oil rigs as a "roustabout." In 1912 Getty enrolled in Oxford University in England, from which he received a degree in economics and political science in 1914.
In 1914 Getty arrived in Tulsa, Oklahoma, determined to strike it rich as a wildcat oil producer. Although he operated independently of his father's Minnehoma Oil Company, his father's loans and financial backing enabled him to begin buying and selling oil leases in the red-bed area of Oklahoma. Getty saw himself as a modern oil man, relying on geological data and not simply on the instinct of the experienced veterans, but he also thrived on the excitement, gamble, risks, and high stakes of the oil business. Getty's own first successful well came in in 1916, and by the fall of that year he had made his first million dollars as a wildcatter and lease broker.
For the next two years Getty "retired" to the life of a wealthy playboy in Los Angeles, but he returned to the oil business in 1919. During the 1920s he and his father continued to be enormously successful both in drilling their own wells and in buying and selling oil leases, and Getty became more active in California than in Oklahoma. He amassed a personal fortune of over three million dollars and acquired a third interest in what was to become the Getty Oil Company.
After his father's death in 1930 Paul Getty became the president of the George Getty Oil Company (successor to Minnehoma Oil), but his mother inherited the controlling interest, as his father had been upset with his son's profligate personal life. During the 1930s Getty followed several paths to both short-term and long-term success. His wells continued to produce, and profits poured in. He also bought a controlling interest in the Pacific Western Oil Corporation, one of the ten largest oil companies in California. After a series of agreements with his mother he obtained the controlling interest in the George Getty Oil Company, and he began real estate dealings, including the purchase of the Hotel Pierre in New York City.
The Getty Oil Company
Getty's ambition was to build up an independent, self-contained oil business involving refining, transporting, and selling oil as well as exploration and drilling. To that end he began in the 1930s to gain control of the Tidewater Oil Company. Getty pursued that goal in a series of complicated maneuvers, which involved tilting with the giant Standard Oil of New Jersey, until in the 1950s he had control of Tidewater, Skelly Oil, and the Mission Corporation. In 1967 these companies merged into the Getty Oil Company, the foundation of Getty's fortune. Getty had a majority or controlling interest in Getty Oil and its nearly 200 affiliated and subsidiary firms, and he remained its president until his death in 1976.
At the outbreak of World War II, Getty, a yachtsman, volunteered for service in the Navy, but his offer was rejected. At the request of Naval officers, however, he took over personal management of Spartan Aircraft, a Skelly and Getty subsidiary. The corporation manufactured trainers and airplane parts, and it later converted to the profitable production of mobile homes.
After the war Getty took a lucrative gamble on oil rights in the Middle East. In 1949 he secured the oil rights in Saudi Arabia's half of the Neutral Zone, a barren tract between Saudi Arabia and Kuwait. He made major concessions to King Saud, which shocked the large oil companies, but after three years and a $30 million investment, Getty found the huge oil deposits which helped make him a billionaire.
In his business career, Getty continued to invest and reinvest; his fortune consisted not of cash, but stocks, corporate assets, and real estate. A loner, he saw himself as a solitary knight in fierce battle with the giant "Seven Sisters" oil firms, and that competitive urge fueled his desire to build a larger and larger fortune.
A "Public" Personal Life
In 1957 Fortune magazine published a list of the richest men in America. Getty's name headed the list, and the resultant publicity turned the reclusive Getty into an object of public fascination and legend. Getty complained about the fame, the requests for money, and the assumption that he would pick up every restaurant check, but he also furthered his own legends: he wrote articles on such topics as "How To Be Rich" and pretended to poverty by wearing rumpled suits and threadbare sweaters. The public was fascinated by Getty's wealth and extravagance and also by his reputed stinginess. After 1959 he stopped living out of hotel rooms and established his home and offices at Sutton Place, a 16th-century, 700-acre manor outside London. The huge estate, with its gardens, pools, trout stream, and priceless furnishings, was also a near garrison, with elaborate security arrangements. Giant Alsatian dogs had the run of the estate, and there were also two caged lions, Nero and Teresa. Numerous stories circulated about Getty's penny-pitching; the most famous incident was the installation of a pay telephone on the Sutton Place grounds. Getty offered various explanations, but the public preferred to see the phone booth as a symbol of his stinginess.
The public also seemed to like to read into Getty's life the lesson that money does not buy happiness. Getty was married five times: to Jeannette Dumont (1923), Allene Ashby (1925), Adolphine Helmle (1928), Ann Rork (1932), and Louisa Lynch (1939); each marriage ended in divorce. He had five sons, two of whom predeceased him, and his relationship with each of them was difficult. His grandson, J. Paul Getty III, was kidnapped in Italy in 1973. Although he was returned for a ransom, part of his ear had been cut off. Getty was a celebrity, and public interest, fueled by envy and admiration, focused on Getty's tragedies as well as his billions.
Besides oil, Getty's major interest was art. He began serious collecting in the 1930s--European paintings, furniture, Greek and Roman sculptures, 18th-century tapestries, silver, and fine Persian carpets, including the 16th-century Ardabil carpet from Tabriz. He housed his collection at Sutton Place and at his ranch house at Malibu, California, one wing of which he opened as the J. Paul Getty Museum in 1954. In 1969 construction began on a new Getty Museum, also on his Malibu property. The huge building is a replica of an ancient Roman villa found near the ruins of Pompeii, and the extensive Getty collection was moved there after his death.
Jean Paul Getty was born on December 15, 1892, in Minneapolis, Minnesota. His father, George Franklin Getty, was a lawyer, but in 1904 he moved his wife, Sarah Risher Getty, and his son to the Oklahoma territory to begin a successful career as an independent oilman. Two years later the family moved to Los Angeles, California, where young Getty attended private school before graduating from Polytechnic High School in 1909. After a European tour he attended the University of Southern California and the University of California at Berkeley; he spent his summers working on his father's oil rigs as a "roustabout." In 1912 Getty enrolled in Oxford University in England, from which he received a degree in economics and political science in 1914.
In 1914 Getty arrived in Tulsa, Oklahoma, determined to strike it rich as a wildcat oil producer. Although he operated independently of his father's Minnehoma Oil Company, his father's loans and financial backing enabled him to begin buying and selling oil leases in the red-bed area of Oklahoma. Getty saw himself as a modern oil man, relying on geological data and not simply on the instinct of the experienced veterans, but he also thrived on the excitement, gamble, risks, and high stakes of the oil business. Getty's own first successful well came in in 1916, and by the fall of that year he had made his first million dollars as a wildcatter and lease broker.
For the next two years Getty "retired" to the life of a wealthy playboy in Los Angeles, but he returned to the oil business in 1919. During the 1920s he and his father continued to be enormously successful both in drilling their own wells and in buying and selling oil leases, and Getty became more active in California than in Oklahoma. He amassed a personal fortune of over three million dollars and acquired a third interest in what was to become the Getty Oil Company.
After his father's death in 1930 Paul Getty became the president of the George Getty Oil Company (successor to Minnehoma Oil), but his mother inherited the controlling interest, as his father had been upset with his son's profligate personal life. During the 1930s Getty followed several paths to both short-term and long-term success. His wells continued to produce, and profits poured in. He also bought a controlling interest in the Pacific Western Oil Corporation, one of the ten largest oil companies in California. After a series of agreements with his mother he obtained the controlling interest in the George Getty Oil Company, and he began real estate dealings, including the purchase of the Hotel Pierre in New York City.
The Getty Oil Company
Getty's ambition was to build up an independent, self-contained oil business involving refining, transporting, and selling oil as well as exploration and drilling. To that end he began in the 1930s to gain control of the Tidewater Oil Company. Getty pursued that goal in a series of complicated maneuvers, which involved tilting with the giant Standard Oil of New Jersey, until in the 1950s he had control of Tidewater, Skelly Oil, and the Mission Corporation. In 1967 these companies merged into the Getty Oil Company, the foundation of Getty's fortune. Getty had a majority or controlling interest in Getty Oil and its nearly 200 affiliated and subsidiary firms, and he remained its president until his death in 1976.
At the outbreak of World War II, Getty, a yachtsman, volunteered for service in the Navy, but his offer was rejected. At the request of Naval officers, however, he took over personal management of Spartan Aircraft, a Skelly and Getty subsidiary. The corporation manufactured trainers and airplane parts, and it later converted to the profitable production of mobile homes.
After the war Getty took a lucrative gamble on oil rights in the Middle East. In 1949 he secured the oil rights in Saudi Arabia's half of the Neutral Zone, a barren tract between Saudi Arabia and Kuwait. He made major concessions to King Saud, which shocked the large oil companies, but after three years and a $30 million investment, Getty found the huge oil deposits which helped make him a billionaire.
In his business career, Getty continued to invest and reinvest; his fortune consisted not of cash, but stocks, corporate assets, and real estate. A loner, he saw himself as a solitary knight in fierce battle with the giant "Seven Sisters" oil firms, and that competitive urge fueled his desire to build a larger and larger fortune.
A "Public" Personal Life
In 1957 Fortune magazine published a list of the richest men in America. Getty's name headed the list, and the resultant publicity turned the reclusive Getty into an object of public fascination and legend. Getty complained about the fame, the requests for money, and the assumption that he would pick up every restaurant check, but he also furthered his own legends: he wrote articles on such topics as "How To Be Rich" and pretended to poverty by wearing rumpled suits and threadbare sweaters. The public was fascinated by Getty's wealth and extravagance and also by his reputed stinginess. After 1959 he stopped living out of hotel rooms and established his home and offices at Sutton Place, a 16th-century, 700-acre manor outside London. The huge estate, with its gardens, pools, trout stream, and priceless furnishings, was also a near garrison, with elaborate security arrangements. Giant Alsatian dogs had the run of the estate, and there were also two caged lions, Nero and Teresa. Numerous stories circulated about Getty's penny-pitching; the most famous incident was the installation of a pay telephone on the Sutton Place grounds. Getty offered various explanations, but the public preferred to see the phone booth as a symbol of his stinginess.
The public also seemed to like to read into Getty's life the lesson that money does not buy happiness. Getty was married five times: to Jeannette Dumont (1923), Allene Ashby (1925), Adolphine Helmle (1928), Ann Rork (1932), and Louisa Lynch (1939); each marriage ended in divorce. He had five sons, two of whom predeceased him, and his relationship with each of them was difficult. His grandson, J. Paul Getty III, was kidnapped in Italy in 1973. Although he was returned for a ransom, part of his ear had been cut off. Getty was a celebrity, and public interest, fueled by envy and admiration, focused on Getty's tragedies as well as his billions.
Besides oil, Getty's major interest was art. He began serious collecting in the 1930s--European paintings, furniture, Greek and Roman sculptures, 18th-century tapestries, silver, and fine Persian carpets, including the 16th-century Ardabil carpet from Tabriz. He housed his collection at Sutton Place and at his ranch house at Malibu, California, one wing of which he opened as the J. Paul Getty Museum in 1954. In 1969 construction began on a new Getty Museum, also on his Malibu property. The huge building is a replica of an ancient Roman villa found near the ruins of Pompeii, and the extensive Getty collection was moved there after his death.
Sik Wai Sin Eating House - Cantonese Tze Char
Notorious for its long history of prostitution, Geylang Road, fronted by low-rise shophouses – protected from urban redevelopment in keeping with its history and heritage – is also famous for the delicious food offerings. And Sik Wai Sin Eating House, once voted Top 50 restaurants in Singapore by the Sunday Times along the likes of Morton’s, Au Jardin, Les Amis, Iggy’s, and Garibaldi, is one of them.
Although located in a dingy tiny coffeeshop, Sik Wai Sin is nothing short of a stalwart in Cantonese-styled Tze Char (literally means “cook and fried” in dialect). In order to bring out the best in each dish, HFB quickly realised that one do not have many choices when it comes to dishes to order – almost every table was eating the same fare!
Stir-fried KaiLan with Garlic was well fried, and wasn’t over-cooked – with stump of the vegetables still retaining crunch. The savoury sauce was flavourful, but dish was oily overall.
One of their signatured dishes, the Homemade Tofu Fried with Giant Prawns, in Egg Sauce was a joy to consume. The tofu was well woked with aroma, and the prawns, lip smacking juicy and crunchy – certainly a brilliant pairing with a bowl of rice.
The Steamed Minced Pork with Salted Fish certainly brings back the good old memories from my grandparents’ time. A dish, which HFB would claim to be traditional, he reckons not many youngsters nowadays would take to this dish because of the fishy smell (from the salted fish). Although another nice dish to go with the rice, HFB finds that the dish was slightly overcooked and thus, the meat was slightly tough. A pathetic serving of the salted fish, nevertheless any extra and the dish will be too salty for consumption.
The Steamed Fishhead is probably their trademark dish, and it was inevitable that one would find this on almost each and every table. Comes in only one serving size (big that is – we tried asking for small), the humongous fishhead can easily feed a handful of adults. Covered in Bean Paste and Pork Lard, it’s probably the latter that sets it apart from the many other steamed fishhead out there. Rid of the muddy taste of a typical fresh-water fish, the fish is fleshy and tender – so much so that even a non-fishhead eater has plenty of meat to go for. Go with a spread of the bean paste and a piece of lard and “nirvana” is the only word that came close to mind.
The last among all dishes served, the Sweet and Sour Pork wasn’t really worth the wait. Although the pork is nicely coated with an intensely tangy sauce captured via an incredible high heated wok, HFB found the meat a little too tough to chew – probably from over-frying. Since being served last, the meat also gets to one towards the end.
*Prices of dishes are not quoted due to restaurant not producing an itemised receipt. However, HFB did remembered not paying more than $30 per pax for the dinner.
Rating
Food: 4/5 (Lean towards being oily but overall still good)
Service: 3/5 (Waited quite awhile for the last dish)
Ambience: 2.5/5 (Hot and stuffy, place is cramp)
Price: 3.5/5 (Affordable but slightly pricey for tze char's standard)
Total: 13/20
287 Geylang Road
Singapore 389334
Although located in a dingy tiny coffeeshop, Sik Wai Sin is nothing short of a stalwart in Cantonese-styled Tze Char (literally means “cook and fried” in dialect). In order to bring out the best in each dish, HFB quickly realised that one do not have many choices when it comes to dishes to order – almost every table was eating the same fare!
Stir-fried KaiLan with Garlic was well fried, and wasn’t over-cooked – with stump of the vegetables still retaining crunch. The savoury sauce was flavourful, but dish was oily overall.
One of their signatured dishes, the Homemade Tofu Fried with Giant Prawns, in Egg Sauce was a joy to consume. The tofu was well woked with aroma, and the prawns, lip smacking juicy and crunchy – certainly a brilliant pairing with a bowl of rice.
The Steamed Minced Pork with Salted Fish certainly brings back the good old memories from my grandparents’ time. A dish, which HFB would claim to be traditional, he reckons not many youngsters nowadays would take to this dish because of the fishy smell (from the salted fish). Although another nice dish to go with the rice, HFB finds that the dish was slightly overcooked and thus, the meat was slightly tough. A pathetic serving of the salted fish, nevertheless any extra and the dish will be too salty for consumption.
The Steamed Fishhead is probably their trademark dish, and it was inevitable that one would find this on almost each and every table. Comes in only one serving size (big that is – we tried asking for small), the humongous fishhead can easily feed a handful of adults. Covered in Bean Paste and Pork Lard, it’s probably the latter that sets it apart from the many other steamed fishhead out there. Rid of the muddy taste of a typical fresh-water fish, the fish is fleshy and tender – so much so that even a non-fishhead eater has plenty of meat to go for. Go with a spread of the bean paste and a piece of lard and “nirvana” is the only word that came close to mind.
The last among all dishes served, the Sweet and Sour Pork wasn’t really worth the wait. Although the pork is nicely coated with an intensely tangy sauce captured via an incredible high heated wok, HFB found the meat a little too tough to chew – probably from over-frying. Since being served last, the meat also gets to one towards the end.
*Prices of dishes are not quoted due to restaurant not producing an itemised receipt. However, HFB did remembered not paying more than $30 per pax for the dinner.
Rating
Food: 4/5 (Lean towards being oily but overall still good)
Service: 3/5 (Waited quite awhile for the last dish)
Ambience: 2.5/5 (Hot and stuffy, place is cramp)
Price: 3.5/5 (Affordable but slightly pricey for tze char's standard)
Total: 13/20
287 Geylang Road
Singapore 389334
Wednesday, March 11, 2009
Sinusitis
Sinusitis is an inflammation of the paranasal sinuses, which may or may not be as a result of infection, from bacterial, fungal, viral, allergic or autoimmune issues. Newer classifications of sinusitis refer to it as rhinosinusitis, taking into account the thought that inflammation of the sinuses cannot occur without some inflammation of the nose as well (rhinitis).
Classification
By location
There are several paired paranasal sinuses, including the frontal, ethmoid, maxillary and sphenoid sinuses. The ethmoid sinuses can also be further broken down into anterior and posterior, the division of which is defined as the basal lamella of the middle turbinate. In addition to the acuity of disease, discussed below, sinusitis can be classified by the sinus cavity which it affects:
Maxillary sinusitis - can cause pain or pressure in the maxillary (cheek) area (e.g., toothache, headache)
Frontal sinusitis - can cause pain or pressure in the frontal sinus cavity (located behind/above eyes), headache
Ethmoid sinusitis - can cause pain or pressure pain between/behind eyes, headache
Sphenoid sinusitis - can cause pain or pressure behind the eyes, but often refers to the vertex of the head
Recent theories of sinusitis indicate that it often occurs as part of a spectrum of diseases that affect the respiratory tract (i.e., the "one airway" theory) and is often linked to asthma. All forms of sinusitis may either result in, or be a part of, a generalized inflammation of the airway so other airway symptoms such as cough may be associated with it.
Left-sided maxillar sinusitis (Absence of the air transparency of left maxillar sinus)
By duration
Sinusitis can be acute (going on less than four weeks), subacute (4-12 weeks) or chronic (going on for 12 weeks or more). All three types of sinusitis have similar symptoms, and are thus often difficult to distinguish.
Acute sinusitis
Acute sinusitis is usually precipitated by an earlier upper respiratory tract infection, generally of viral origin. Virally damaged surface tissues are then colonized by bacteria, most commonly Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. Other bacterial pathogens include other Staphylococcus aureus and other streptococci species, anaerobic bacteria and, less commonly, gram negative bacteria. Viral sinusitis typically lasts for 7 to 10 days, whereas bacterial sinusitis is more persistent. Approximately 0.5% to 2% of viral sinusitis extends into bacterial sinusitis. One hypothesis postulates that the bacterial infection begins with nose blowing.
Acute episodes of sinusitis can also result from fungal invasion. These infections are most often seen in patients with diabetes or other immune deficiencies (such as AIDS or transplant patients on anti-rejection medications) and can be life threatening. In type I diabetes, ketoacidosis causes sinusitis by Mucormycosis.
Rarely, it may be caused by a tooth infection.
Chronic sinusitis
Chronic sinusitis is a complicated spectrum of diseases that share chronic inflammation of the sinuses in common. It is divided into cases with polyps and cases without, and the former is sometimes called chronic hyperplastic sinusitis. The causes are poorly understood and may include allergy, environmental factors such as dust or pollution, bacterial infection, or fungus (either allergic, infective, or reactive). Non allergic factors such as vasomotor rhinitis can also cause chronic sinus problems. Abnormally narrow sinus passages, which can impede drainage from the sinus cavities could also be a factor. A combination of anaerobic and aerobic bacteria are observed, including Staphylococcus aureus and coagulase-negative Staphylococci. Typically antibiotics provide only a temporary benefit, although mechanisms involving hyperresponsiveness to bacteria have been proposed for sinusitis with polyps. Most
Symptoms include: nasal congestion; facial pain; headache; fever; general malaise; thick green or yellow discharge; vertigo or lightheadedness; blurred vision, feeling of facial 'fullness' or 'tightness' which worsens on bending over; aching teeth, and halitosis; and occasionally diarrhea with a mucus-like substance in it. Very rarely, chronic sinusitis can lead to Anosmia, the inability to smell or detect odors.[citation needed] In a small number of cases, chronic maxillary sinusitis can also be brought on by the spreading of bacteria from a dental infection.
Attempts have been made to provide a more consistent nomenclature 6 for subtypes of chronic sinusitis. Many patients have demonstrated the presence of eosinophils in the mucous lining of the nose and paranasal sinuses. As such the name Eosinophilic Mucin RhinoSinusitis (EMRS) has come into being. Cases of EMRS may be related to an allergic response, but allergy is often not documentable, resulting in further subcategorization of allergic and non-allergic EMRS.
A more recent, and still debated, development in chronic sinusitis is the role that fungus may play. Fungus can be found in the nasal cavities and sinuses of most patients with sinusitis, but can also be found in healthy people as well. It remains unclear if fungus is a definite factor in the development of chronic sinusitis and if it is, what the difference may be between those who develop the disease and those who do not. Trials of antifungal treatments have had mixed results.
Symptoms
Sinus headache
Headache/facial pain or pressure of a dull, constant, or aching sort over the affected sinuses can be seen with either acute or chronic stages of sinusitis. This pain is typically localized to the involved sinus and may worsen when the affected person bends over or when in the supine position.
Acute and chronic sinusitis may be accompanied by thick purulent nasal discharge (usually green in colour and with or without blood) and localized headache (toothache) are present and it is these symptoms that can differentiate sinus related (or rhinogenic) headache from other headache phenomena such as tension headache and migraine headache.
Migraine misdiagnosis
Recent studies suggest that up to 90% of "sinus headaches" are actually migraines. The confusion occurs in part because migraine involves activation of the trigeminal nerves which innervate both the sinus region but also the meninges which surround the brain. As a result, direct determination of the site of pain origination can be confused on a cortical level. Additionally, nasal congestion is not an uncommon result of migraine headaches, due to the autonomic nervous stimulation that can also result in tearing (lacrimation) and a runny nose (rhinorrhea). A study found that patients with "sinus headache" respond to triptan migraine medications, and state dissatisfaction with their treatment when they are treated with decongestants or antibiotics.
Predisposing factors
Factors which may predispose to developing sinusitis include: allergies; structural problems such as a deviated septum or small sinus ostia; smoking; nasal polyps; carrying the cystic fibrosis gene (research is still tentative); prior bouts of sinusitis as each instance may result in increased inflammation of the nasal or sinus mucosa and potentially further narrow the openings.
Role of biofilms
Biofilms are complex aggregates of extracellular matrix and inter-dependent microorganisms from multiple species, many of which may be difficult or impossible to isolate using standard clinical laboratory techniques. Bacteria found in biofilms may show increased antibiotic resistance when compared to free-living bacteria of the same species. It has been hypothesized that biofilm-type infections may account for many cases of antibiotic-refractory chronic sinusitis. A recent study found that biofilms were present on the mucosa of 3/4 of patients undergoing surgery for chronic sinusitis.
Diagnosis
Acute sinusitis
Usually sinusitis is diagnosed clinically.
Bacterial and viral acute sinusitis are difficult to distinguish however, disease duration less than 7 days is considered as a viral whereas more than 7 days are considered as a bacterial sinusitis (usually 30% to 50% are bacterial sinusitis). Nosocomial acute sinusitis is confirmed with the help of CT scan of the sinuses.
Chronic sinusitis
For sinusitis lasting more than 12 weeks, criteria are lacking. A CT scan is recommended, but insufficient to confirm diagnosis. Nasal endoscopy, a CT scan, and clinical symptoms are used together. A tissue sample for histology and cultures can also be used. Allergic fungal sinusitis are seen in a person with asthma and nasal polyps. Multiple biopsy is informative to confirm the diagnosis.
Nasal endoscopy involves inserting a flexible fiber-optic tube with a light and camera at its tip into the nose to examine the nasal passages and sinuses. This is generally a completely painless procedure which takes between 5 to 10 minutes to complete.
Treatment
Acute sinusitis
Conservative measures
Over the counter (OTC) medication such as acetaminophen and ibuprofen can relieve some of the symptoms associated with sinusitis, such as headaches, pressure, fatigue and pain. Nasal irrigation or jala neti using a warm saline solution may also be effective.
Antibiotics
Even though antibiotics are prescribed to 60 - 90% of patients in the USA and Western Europe they have not been shown to be effective.
The vast majority of cases resolve without antibiotics, however if the symptoms are prolonged amoxicillin is a reasonable first choice with amoxicillin/clavulanate (Augmentin) being indicated for patients who fail amoxicillin alone. Fluoroquinolones, some of the newer macrolide antibiotics such as clarithromycin, and doxycycline, are used in patients who are allergic to penicillins.
Corticosteroids
Nasal corticosteroids have not been found to be better than placebo either alone or in combination with antibiotics.
Chronic sinusitis
Conservative measures
Nasal irrigation may help with symptoms of chronic sinusitis.
Medical approaches
Based on the recent theories on the role that fungus may play in the development of chronic sinusitis. Trials of antifungal treatments however have had mixed results.
Surgical treatment
For chronic or recurring sinusitis, referral to an otolaryngologist may be indicated for more specialist assessment and treatment, which may include nasal surgery. However, for most patients the surgical approach is not superior to appropriate medical treatment. Surgery should only be considered for those patients who do not experience sufficient relief from optimal medication.
A relatively recent advance in the treatment of sinusitis is a type of surgery called functional endoscopic sinus surgery (FESS), whereby normal clearance from the sinuses is restored by removing the anatomical and pathological obstructive variations that predispose to sinusitis. This replaces prior open techniques requiring facial or oral incisions and refocuses the technique to the natural openings of the sinuses instead of promoting drainage by gravity, the idea upon which the Caldwell-Luc surgery was based.
Another recently developed treatment is balloon sinuplasty. This method, similar to balloon angioplasty used to "unclog" arteries of the heart, utilizes balloons in an attempt to expand the openings of the sinuses in a less invasive manner. Its final role in the treatment of sinus disease is still under debate but appears promising.
A number of surgical approaches can be used to access the sinuses and these have generally shifted from external/extranasal approaches to intranasal endoscopic ones. The benefit of the Functional Endoscopic Sinus Surgery FESS is its ability to allow for a more targeted approach to the affected sinuses, reducing tissue disruption, and minimizing post-operative complications.
For persistent symptoms and disease in patients who have failed medical and the functional endoscopic approach, older techniques can be used to address the maxillary sinus such as the Caldwell-Luc radical antrostomy (e.g. incision in the upper gum, opening in the anterior wall of the antrum, removal of the entire diseased maxillary sinus mucosa and drainage is allowed into inferior or middle meatus by creating a large window in the lateral nasal wall.)
External links
Core Curriculum Syllabus: Nose and Paranasal Sinuses (Baylor College of Medicine)
Sinus Headache - Medterm.com
Sinus infection - MedicineNet.com.
Acute sinusitis - MayoClinic.com, from the Web site of the Mayo Clinic.
Chronic sinusitis - MayoClinic.com, from the Web site of the Mayo Clinic
Classification
By location
There are several paired paranasal sinuses, including the frontal, ethmoid, maxillary and sphenoid sinuses. The ethmoid sinuses can also be further broken down into anterior and posterior, the division of which is defined as the basal lamella of the middle turbinate. In addition to the acuity of disease, discussed below, sinusitis can be classified by the sinus cavity which it affects:
Maxillary sinusitis - can cause pain or pressure in the maxillary (cheek) area (e.g., toothache, headache)
Frontal sinusitis - can cause pain or pressure in the frontal sinus cavity (located behind/above eyes), headache
Ethmoid sinusitis - can cause pain or pressure pain between/behind eyes, headache
Sphenoid sinusitis - can cause pain or pressure behind the eyes, but often refers to the vertex of the head
Recent theories of sinusitis indicate that it often occurs as part of a spectrum of diseases that affect the respiratory tract (i.e., the "one airway" theory) and is often linked to asthma. All forms of sinusitis may either result in, or be a part of, a generalized inflammation of the airway so other airway symptoms such as cough may be associated with it.
Left-sided maxillar sinusitis (Absence of the air transparency of left maxillar sinus)
By duration
Sinusitis can be acute (going on less than four weeks), subacute (4-12 weeks) or chronic (going on for 12 weeks or more). All three types of sinusitis have similar symptoms, and are thus often difficult to distinguish.
Acute sinusitis
Acute sinusitis is usually precipitated by an earlier upper respiratory tract infection, generally of viral origin. Virally damaged surface tissues are then colonized by bacteria, most commonly Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. Other bacterial pathogens include other Staphylococcus aureus and other streptococci species, anaerobic bacteria and, less commonly, gram negative bacteria. Viral sinusitis typically lasts for 7 to 10 days, whereas bacterial sinusitis is more persistent. Approximately 0.5% to 2% of viral sinusitis extends into bacterial sinusitis. One hypothesis postulates that the bacterial infection begins with nose blowing.
Acute episodes of sinusitis can also result from fungal invasion. These infections are most often seen in patients with diabetes or other immune deficiencies (such as AIDS or transplant patients on anti-rejection medications) and can be life threatening. In type I diabetes, ketoacidosis causes sinusitis by Mucormycosis.
Rarely, it may be caused by a tooth infection.
Chronic sinusitis
Chronic sinusitis is a complicated spectrum of diseases that share chronic inflammation of the sinuses in common. It is divided into cases with polyps and cases without, and the former is sometimes called chronic hyperplastic sinusitis. The causes are poorly understood and may include allergy, environmental factors such as dust or pollution, bacterial infection, or fungus (either allergic, infective, or reactive). Non allergic factors such as vasomotor rhinitis can also cause chronic sinus problems. Abnormally narrow sinus passages, which can impede drainage from the sinus cavities could also be a factor. A combination of anaerobic and aerobic bacteria are observed, including Staphylococcus aureus and coagulase-negative Staphylococci. Typically antibiotics provide only a temporary benefit, although mechanisms involving hyperresponsiveness to bacteria have been proposed for sinusitis with polyps. Most
Symptoms include: nasal congestion; facial pain; headache; fever; general malaise; thick green or yellow discharge; vertigo or lightheadedness; blurred vision, feeling of facial 'fullness' or 'tightness' which worsens on bending over; aching teeth, and halitosis; and occasionally diarrhea with a mucus-like substance in it. Very rarely, chronic sinusitis can lead to Anosmia, the inability to smell or detect odors.[citation needed] In a small number of cases, chronic maxillary sinusitis can also be brought on by the spreading of bacteria from a dental infection.
Attempts have been made to provide a more consistent nomenclature 6 for subtypes of chronic sinusitis. Many patients have demonstrated the presence of eosinophils in the mucous lining of the nose and paranasal sinuses. As such the name Eosinophilic Mucin RhinoSinusitis (EMRS) has come into being. Cases of EMRS may be related to an allergic response, but allergy is often not documentable, resulting in further subcategorization of allergic and non-allergic EMRS.
A more recent, and still debated, development in chronic sinusitis is the role that fungus may play. Fungus can be found in the nasal cavities and sinuses of most patients with sinusitis, but can also be found in healthy people as well. It remains unclear if fungus is a definite factor in the development of chronic sinusitis and if it is, what the difference may be between those who develop the disease and those who do not. Trials of antifungal treatments have had mixed results.
Symptoms
Sinus headache
Headache/facial pain or pressure of a dull, constant, or aching sort over the affected sinuses can be seen with either acute or chronic stages of sinusitis. This pain is typically localized to the involved sinus and may worsen when the affected person bends over or when in the supine position.
Acute and chronic sinusitis may be accompanied by thick purulent nasal discharge (usually green in colour and with or without blood) and localized headache (toothache) are present and it is these symptoms that can differentiate sinus related (or rhinogenic) headache from other headache phenomena such as tension headache and migraine headache.
Migraine misdiagnosis
Recent studies suggest that up to 90% of "sinus headaches" are actually migraines. The confusion occurs in part because migraine involves activation of the trigeminal nerves which innervate both the sinus region but also the meninges which surround the brain. As a result, direct determination of the site of pain origination can be confused on a cortical level. Additionally, nasal congestion is not an uncommon result of migraine headaches, due to the autonomic nervous stimulation that can also result in tearing (lacrimation) and a runny nose (rhinorrhea). A study found that patients with "sinus headache" respond to triptan migraine medications, and state dissatisfaction with their treatment when they are treated with decongestants or antibiotics.
Predisposing factors
Factors which may predispose to developing sinusitis include: allergies; structural problems such as a deviated septum or small sinus ostia; smoking; nasal polyps; carrying the cystic fibrosis gene (research is still tentative); prior bouts of sinusitis as each instance may result in increased inflammation of the nasal or sinus mucosa and potentially further narrow the openings.
Role of biofilms
Biofilms are complex aggregates of extracellular matrix and inter-dependent microorganisms from multiple species, many of which may be difficult or impossible to isolate using standard clinical laboratory techniques. Bacteria found in biofilms may show increased antibiotic resistance when compared to free-living bacteria of the same species. It has been hypothesized that biofilm-type infections may account for many cases of antibiotic-refractory chronic sinusitis. A recent study found that biofilms were present on the mucosa of 3/4 of patients undergoing surgery for chronic sinusitis.
Diagnosis
Acute sinusitis
Usually sinusitis is diagnosed clinically.
Bacterial and viral acute sinusitis are difficult to distinguish however, disease duration less than 7 days is considered as a viral whereas more than 7 days are considered as a bacterial sinusitis (usually 30% to 50% are bacterial sinusitis). Nosocomial acute sinusitis is confirmed with the help of CT scan of the sinuses.
Chronic sinusitis
For sinusitis lasting more than 12 weeks, criteria are lacking. A CT scan is recommended, but insufficient to confirm diagnosis. Nasal endoscopy, a CT scan, and clinical symptoms are used together. A tissue sample for histology and cultures can also be used. Allergic fungal sinusitis are seen in a person with asthma and nasal polyps. Multiple biopsy is informative to confirm the diagnosis.
Nasal endoscopy involves inserting a flexible fiber-optic tube with a light and camera at its tip into the nose to examine the nasal passages and sinuses. This is generally a completely painless procedure which takes between 5 to 10 minutes to complete.
Treatment
Acute sinusitis
Conservative measures
Over the counter (OTC) medication such as acetaminophen and ibuprofen can relieve some of the symptoms associated with sinusitis, such as headaches, pressure, fatigue and pain. Nasal irrigation or jala neti using a warm saline solution may also be effective.
Antibiotics
Even though antibiotics are prescribed to 60 - 90% of patients in the USA and Western Europe they have not been shown to be effective.
The vast majority of cases resolve without antibiotics, however if the symptoms are prolonged amoxicillin is a reasonable first choice with amoxicillin/clavulanate (Augmentin) being indicated for patients who fail amoxicillin alone. Fluoroquinolones, some of the newer macrolide antibiotics such as clarithromycin, and doxycycline, are used in patients who are allergic to penicillins.
Corticosteroids
Nasal corticosteroids have not been found to be better than placebo either alone or in combination with antibiotics.
Chronic sinusitis
Conservative measures
Nasal irrigation may help with symptoms of chronic sinusitis.
Medical approaches
Based on the recent theories on the role that fungus may play in the development of chronic sinusitis. Trials of antifungal treatments however have had mixed results.
Surgical treatment
For chronic or recurring sinusitis, referral to an otolaryngologist may be indicated for more specialist assessment and treatment, which may include nasal surgery. However, for most patients the surgical approach is not superior to appropriate medical treatment. Surgery should only be considered for those patients who do not experience sufficient relief from optimal medication.
A relatively recent advance in the treatment of sinusitis is a type of surgery called functional endoscopic sinus surgery (FESS), whereby normal clearance from the sinuses is restored by removing the anatomical and pathological obstructive variations that predispose to sinusitis. This replaces prior open techniques requiring facial or oral incisions and refocuses the technique to the natural openings of the sinuses instead of promoting drainage by gravity, the idea upon which the Caldwell-Luc surgery was based.
Another recently developed treatment is balloon sinuplasty. This method, similar to balloon angioplasty used to "unclog" arteries of the heart, utilizes balloons in an attempt to expand the openings of the sinuses in a less invasive manner. Its final role in the treatment of sinus disease is still under debate but appears promising.
A number of surgical approaches can be used to access the sinuses and these have generally shifted from external/extranasal approaches to intranasal endoscopic ones. The benefit of the Functional Endoscopic Sinus Surgery FESS is its ability to allow for a more targeted approach to the affected sinuses, reducing tissue disruption, and minimizing post-operative complications.
For persistent symptoms and disease in patients who have failed medical and the functional endoscopic approach, older techniques can be used to address the maxillary sinus such as the Caldwell-Luc radical antrostomy (e.g. incision in the upper gum, opening in the anterior wall of the antrum, removal of the entire diseased maxillary sinus mucosa and drainage is allowed into inferior or middle meatus by creating a large window in the lateral nasal wall.)
External links
Core Curriculum Syllabus: Nose and Paranasal Sinuses (Baylor College of Medicine)
Sinus Headache - Medterm.com
Sinus infection - MedicineNet.com.
Acute sinusitis - MayoClinic.com, from the Web site of the Mayo Clinic.
Chronic sinusitis - MayoClinic.com, from the Web site of the Mayo Clinic
Sunday, March 8, 2009
鼻窦炎的症状有哪些？
鼻窦炎中医称为“鼻渊”，是一种非常多见的耳鼻喉科疾病，在成人和儿童中都有较高的发病率我国主要分布在寒带地区发病。慢性鼻窦炎由于病程长，反复发作难以治愈。
鼻窦炎的症状很多，比如：
1．全身症状：鼻窦炎常继发于上感或急性鼻炎这时原有症状加重，出现畏寒、发热食欲不振、便秘、周身不适等，小儿可发生呕吐、腹泻、咳嗽等症状
2．鼻塞：鼻窦炎多可出现—侧持续性偶可发生双侧持续性鼻塞。
3．脓鼻涕：患者脓鼻涕增多且不易擤尽；
4、咽喉刺激症状：如脓鼻涕向后流入咽部及下呼吸道时，刺激咽、喉粘膜引起发库、咳嗽和咳痰，甚至恶心；
5．上颌窦炎的症状：前额部疼晨起轻，午后重。还可能有面颊部胀痛或上列磨牙疼痛多是上颌窦炎。
6．额窦炎的症状：晨起感前额部疼渐浙加重，午后减轻，至晚间全部消失这可能是额窦炎。
7．筛窦炎症状：头痛较轻局限于内眦或鼻根部，也可能放射至头顶部，多是筛窦炎引起
8．蝶窦炎症状：眼球深处疼痛可放射到头顶部，还出观早晨轻、午后重的枕部头痛达可能是蝶窦炎。
9．慢性鼻窦炎症状特点：慢性鼻窦炎除鼻塞流涕、头痛等症状外，还有如下特点：
(1)头痛较轻一般多属闷痛、钝痛。
(2)嗅觉减退或消失
(3)休息滴鼻药、蒸汽吸入或鼻腔通气引流后头痛可减轻。
(4)咳嗽低头、弯腰、用力时头痛加重
(5)吸烟饮酒、情绪激动时可加重头痛。
(6)有时可引起精神不振易困倦、头昏、记忆力减退注意力不集中等等。
鼻窦炎的症状很多，比如：
1．全身症状：鼻窦炎常继发于上感或急性鼻炎这时原有症状加重，出现畏寒、发热食欲不振、便秘、周身不适等，小儿可发生呕吐、腹泻、咳嗽等症状
2．鼻塞：鼻窦炎多可出现—侧持续性偶可发生双侧持续性鼻塞。
3．脓鼻涕：患者脓鼻涕增多且不易擤尽；
4、咽喉刺激症状：如脓鼻涕向后流入咽部及下呼吸道时，刺激咽、喉粘膜引起发库、咳嗽和咳痰，甚至恶心；
5．上颌窦炎的症状：前额部疼晨起轻，午后重。还可能有面颊部胀痛或上列磨牙疼痛多是上颌窦炎。
6．额窦炎的症状：晨起感前额部疼渐浙加重，午后减轻，至晚间全部消失这可能是额窦炎。
7．筛窦炎症状：头痛较轻局限于内眦或鼻根部，也可能放射至头顶部，多是筛窦炎引起
8．蝶窦炎症状：眼球深处疼痛可放射到头顶部，还出观早晨轻、午后重的枕部头痛达可能是蝶窦炎。
9．慢性鼻窦炎症状特点：慢性鼻窦炎除鼻塞流涕、头痛等症状外，还有如下特点：
(1)头痛较轻一般多属闷痛、钝痛。
(2)嗅觉减退或消失
(3)休息滴鼻药、蒸汽吸入或鼻腔通气引流后头痛可减轻。
(4)咳嗽低头、弯腰、用力时头痛加重
(5)吸烟饮酒、情绪激动时可加重头痛。
(6)有时可引起精神不振易困倦、头昏、记忆力减退注意力不集中等等。
近半香港人鼻敏感 医生提醒慎用类固醇鼻喷雾剂
港人鼻敏感问题普遍，一项调查显示，45%受访者有鼻敏感，当中55%属中度至严重患者，打喷嚏、流鼻涕等症状已影响他们的日常生活，但一半没有接受治疗。
医生说，鼻敏感可引发哮喘、鼻窦炎和分泌性中耳炎等，不容忽视，若患者正使用类固醇鼻喷雾剂，须定期接受医生检查，监察鼻膜有否受损。
思纬市场信息公司于去年底，用电话随机访问1000名15至64岁的市民，45%说有鼻敏感，或有一种或以上的鼻敏感症状，包括打喷嚏、流鼻涕、鼻塞和鼻痕痒等，当中逾半是中度至严重鼻敏感患者，即症状每周最少出现4天，且持续4周或以上。
在该1000名受访者中，55%表示娱乐、睡眠、工作或上学等已受鼻敏感影响，但约50%表示没有接受治疗。
耳鼻喉科专科医生虞玮翔说，尘螨是香港最常见的“致敏原”，若父或母均有鼻敏感，子女有相同问题的机会会增加30%，患者应避免接触过敏原，治疗方法包括服用抗组胺剂或使用类固醇鼻喷雾剂。
虞玮翔说，类固醇鼻喷雾剂需医生处方，新一代喷雾剂十分安全，但使用者仍需每数个月接受医生检查一次，以监察类固醇有否令鼻膜变薄，以致出现溃烂和流血的问题。
医生说，鼻敏感可引发哮喘、鼻窦炎和分泌性中耳炎等，不容忽视，若患者正使用类固醇鼻喷雾剂，须定期接受医生检查，监察鼻膜有否受损。
思纬市场信息公司于去年底，用电话随机访问1000名15至64岁的市民，45%说有鼻敏感，或有一种或以上的鼻敏感症状，包括打喷嚏、流鼻涕、鼻塞和鼻痕痒等，当中逾半是中度至严重鼻敏感患者，即症状每周最少出现4天，且持续4周或以上。
在该1000名受访者中，55%表示娱乐、睡眠、工作或上学等已受鼻敏感影响，但约50%表示没有接受治疗。
耳鼻喉科专科医生虞玮翔说，尘螨是香港最常见的“致敏原”，若父或母均有鼻敏感，子女有相同问题的机会会增加30%，患者应避免接触过敏原，治疗方法包括服用抗组胺剂或使用类固醇鼻喷雾剂。
虞玮翔说，类固醇鼻喷雾剂需医生处方，新一代喷雾剂十分安全，但使用者仍需每数个月接受医生检查一次，以监察类固醇有否令鼻膜变薄，以致出现溃烂和流血的问题。
The Real Road to Getting More Dates
Here's a refreshing thought. Maybe it's time to stop worrying so much about what to wear, where to eat, and when to schedule that blow-dry. Instead, try focusing on the important things we all tend to overlook, like getting involved, getting active, and getting busy. Most of our Foxy ideas are gentler on your wallet than a new getup and will help you feel much more confident and content. And who wouldn't want to date someone like that? Bingo!
Be A Joiner
Surf around on sites like Meetup.com, a clever website that hooks you up with all kinds of groups in your area -- from vegan and very liberal, to eco-adventurers, readers, writers, crafters, and more.
Scribble to Yourself
Keep a journal. It's one of the simplest ways to liberate your mind, explore ideas, sketch, and scribble anything you want from memories, hopes and dreams, or just amusing things that make you laugh. Get writing and you'll feel more inspired. We love this adorable journals from Cocoa Crayon -- just looking at them makes us smile!
Pimp Your Pad
Updating the look of your home look can positively impact your attitude big time. It doesn't matter if you live in a tiny studio or a sprawling suburban house, and it doesn't have to cost a lot of money. Check out UrbanOutfitters.com and CB2 for wallet friendly, stylized accents that will add major pop.
Salute The Sun
Try kicking your day off with a few salutations and downward dogs. Doing a few invigorating yoga moves in the morning is a smart way to start your day. Your body feels more limber, your mind more relaxed, and your soul less stressed. You can find poses online, in books, or videos. If your budget allows, try a local class. And beginners, don't get discouraged! Look at it like a deep stretch. Plus, you never know who'll be twisting their torso right next to you.
Get Riding
Pedaling to the park or even around the block a few times makes you feel like a kid again, especially with all that wind blowing through your hair! And it's so much better for the environment too. Get an old-fashioned handlebar basket and you can even do some light errands, all from your rockin' two-wheeler. Woo hoo!
Plant A Seed
Whether it's a small box filled with herbs like basil and rosemary or a full-blown backyard vegetable patch, planting a garden is surprisingly fulfilling. Getting your hands dirty is a really good time, and it's ego-boosting to actually make something grow. Best of all, it can be delicious when you get to enjoy the fruits of your hard earned labor. Plus, it saves you a few bucks at the supermarket!
Boogie Down
Dance, shake your groove thing, make some mack daddy moves... every night! Do it by yourself or with friends. Dancing gets rid of all those pangs of stress that needle you throughout the day. Pick whatever music you like, blast it, and just rock your heart out. We prefer to do it alone because then our inhibitions really let loose.
Read Read Read
Hit your local library and load up on goodies -- novels, mysteries, histories, bios, anything. It's free, it's entertaining, and if it's good enough, it will make you excited to get back to your place every night. Plus it gives you something to chitty chat about when you bump into a new cutie at the coffee shop.
Give Give Give
Get involved in a local charity. All you have to give is your time. Whether you're more comfortable stuffing envelopes or frolicking with abandoned dogs, there are dozens of organizations, efforts, and animals who can use your help. You'll feel so good about yourself, you'll be unstoppable!
Host A Hang-Out
Once a month, throw a movie night with friends at your place. Pick a flick, ask everyone to bring a bag of munchies and let the games begin. Hosting a regular get-together is an easy and entertaining way to stay socially active and not depend on others to create the fun for you.
Be A Joiner
Surf around on sites like Meetup.com, a clever website that hooks you up with all kinds of groups in your area -- from vegan and very liberal, to eco-adventurers, readers, writers, crafters, and more.
Scribble to Yourself
Keep a journal. It's one of the simplest ways to liberate your mind, explore ideas, sketch, and scribble anything you want from memories, hopes and dreams, or just amusing things that make you laugh. Get writing and you'll feel more inspired. We love this adorable journals from Cocoa Crayon -- just looking at them makes us smile!
Pimp Your Pad
Updating the look of your home look can positively impact your attitude big time. It doesn't matter if you live in a tiny studio or a sprawling suburban house, and it doesn't have to cost a lot of money. Check out UrbanOutfitters.com and CB2 for wallet friendly, stylized accents that will add major pop.
Salute The Sun
Try kicking your day off with a few salutations and downward dogs. Doing a few invigorating yoga moves in the morning is a smart way to start your day. Your body feels more limber, your mind more relaxed, and your soul less stressed. You can find poses online, in books, or videos. If your budget allows, try a local class. And beginners, don't get discouraged! Look at it like a deep stretch. Plus, you never know who'll be twisting their torso right next to you.
Get Riding
Pedaling to the park or even around the block a few times makes you feel like a kid again, especially with all that wind blowing through your hair! And it's so much better for the environment too. Get an old-fashioned handlebar basket and you can even do some light errands, all from your rockin' two-wheeler. Woo hoo!
Plant A Seed
Whether it's a small box filled with herbs like basil and rosemary or a full-blown backyard vegetable patch, planting a garden is surprisingly fulfilling. Getting your hands dirty is a really good time, and it's ego-boosting to actually make something grow. Best of all, it can be delicious when you get to enjoy the fruits of your hard earned labor. Plus, it saves you a few bucks at the supermarket!
Boogie Down
Dance, shake your groove thing, make some mack daddy moves... every night! Do it by yourself or with friends. Dancing gets rid of all those pangs of stress that needle you throughout the day. Pick whatever music you like, blast it, and just rock your heart out. We prefer to do it alone because then our inhibitions really let loose.
Read Read Read
Hit your local library and load up on goodies -- novels, mysteries, histories, bios, anything. It's free, it's entertaining, and if it's good enough, it will make you excited to get back to your place every night. Plus it gives you something to chitty chat about when you bump into a new cutie at the coffee shop.
Give Give Give
Get involved in a local charity. All you have to give is your time. Whether you're more comfortable stuffing envelopes or frolicking with abandoned dogs, there are dozens of organizations, efforts, and animals who can use your help. You'll feel so good about yourself, you'll be unstoppable!
Host A Hang-Out
Once a month, throw a movie night with friends at your place. Pick a flick, ask everyone to bring a bag of munchies and let the games begin. Hosting a regular get-together is an easy and entertaining way to stay socially active and not depend on others to create the fun for you.
Saturday, March 7, 2009
中国不排除人民币贬值可能性
中国不排除人民币贬值的可能性，并把贬不贬值的部分责任推给“一些金融危机的起源国家”，因为中国得看“那里到底会出现什么情况”，才会做出相应的决策。
中国人民银行行长周小川昨天在十一届全国人大二次会议的一场记者会，作出上述表示。
他说：“这次金融危机对各方面的政策都会有影响，大家也做了很多预案。也就是说，如果金融危机深化到什程度，或者再出现什么新的现象，我们将会怎样应对。
“因此，我觉得现在的问题反倒是，应该问一些金融危机的起源国家，就是你们那里到底会出现什么情况。如果你们说清楚了你们会出现什么情况，我们自然就比较好说我们会采取什么样的说法了。但很显然，那边的不确定性相当大，我们这边只能做多种预案、多种情景分析，如果没到那种情形，我们也是不会说的。”
中国总理温家宝前天在政府工作报告中明确表示，“我们强调加强扩大内需，绝不能放松出口”。很多学者认为，在目前的经济气候下，中国要刺激出口，就必须让人民币贬值。当然，也有另一方的学者指出，目前全世界面对的形势是需求不足，因此即便让人民币贬值，需求不足还是不能带动出口增长。
银河证券首席经济师左小蕾在接受本报访问时说，周小川是在为中国应对金融危机的政策“留有余地”，若情势继续恶化，而目前已出台的措施又无法缓解或改善，央行必定动用一切可能的手段，包括让人民币贬值。
另一方面，国家发展和改革委员会主任张平在同一个记者会上指出，若4万亿（人民币，下同，约9000亿新元）的刺激经济投资方案不够用，中国不排除进一步“加码”，增加投资。
张平在回答媒体提问时说，制订投资方案时用的是一个“灵活审慎”的方针，中国会根据形势的发展决定是否增加投资。
张平的话证实了外界在“两会”前盛传的说法：中国的刺激经济投资方案可能加大。渣打银行中国首席经济师王志浩在一篇报告中预计，如果地方政府能有效融资，发改委和财政部将对地方政府项目给予充分放行，4万亿投资方案的规模可能扩大至5万亿至6万亿。
报告也说：“有官员暗示不排除再出台一个两年内投资8万亿至10万亿的经济刺激新计划的可能。”
谈及4万亿投资方案的初步成效，张平说：“从目前这一些措施的效果来看，有一些回暖的迹象，包括消费的扩大、投资的扩大，一部分产品价格的回升，一些统计的数据开始出现抬头的趋势。但是不是就够了？……会不会采取新的措施，这就要根据变化的情况来审慎决策。”
另一方面，4万亿这块大“蛋糕”的“切法”也出现变化：民生和社会事业投入大幅增长、基础设施投入则有所削减。
张平透露，民生工程在4万亿中占约4000亿，比他去年11月27日公布的2800亿多出1200亿，增幅达43%。社会事业方面的投入也增加了，从400亿增加至1500亿，增幅达275%。
基础设施则削减最多，在4万亿的比重由45%（1万8000亿）降至37.5%（1万5000亿）。基础设施的投入此前最受争议，一些学者指出，基建项目对消费的乘数效应有限，对刺激内需帮助不大。
中国人民银行行长周小川昨天在十一届全国人大二次会议的一场记者会，作出上述表示。
他说：“这次金融危机对各方面的政策都会有影响，大家也做了很多预案。也就是说，如果金融危机深化到什程度，或者再出现什么新的现象，我们将会怎样应对。
“因此，我觉得现在的问题反倒是，应该问一些金融危机的起源国家，就是你们那里到底会出现什么情况。如果你们说清楚了你们会出现什么情况，我们自然就比较好说我们会采取什么样的说法了。但很显然，那边的不确定性相当大，我们这边只能做多种预案、多种情景分析，如果没到那种情形，我们也是不会说的。”
中国总理温家宝前天在政府工作报告中明确表示，“我们强调加强扩大内需，绝不能放松出口”。很多学者认为，在目前的经济气候下，中国要刺激出口，就必须让人民币贬值。当然，也有另一方的学者指出，目前全世界面对的形势是需求不足，因此即便让人民币贬值，需求不足还是不能带动出口增长。
银河证券首席经济师左小蕾在接受本报访问时说，周小川是在为中国应对金融危机的政策“留有余地”，若情势继续恶化，而目前已出台的措施又无法缓解或改善，央行必定动用一切可能的手段，包括让人民币贬值。
另一方面，国家发展和改革委员会主任张平在同一个记者会上指出，若4万亿（人民币，下同，约9000亿新元）的刺激经济投资方案不够用，中国不排除进一步“加码”，增加投资。
张平在回答媒体提问时说，制订投资方案时用的是一个“灵活审慎”的方针，中国会根据形势的发展决定是否增加投资。
张平的话证实了外界在“两会”前盛传的说法：中国的刺激经济投资方案可能加大。渣打银行中国首席经济师王志浩在一篇报告中预计，如果地方政府能有效融资，发改委和财政部将对地方政府项目给予充分放行，4万亿投资方案的规模可能扩大至5万亿至6万亿。
报告也说：“有官员暗示不排除再出台一个两年内投资8万亿至10万亿的经济刺激新计划的可能。”
谈及4万亿投资方案的初步成效，张平说：“从目前这一些措施的效果来看，有一些回暖的迹象，包括消费的扩大、投资的扩大，一部分产品价格的回升，一些统计的数据开始出现抬头的趋势。但是不是就够了？……会不会采取新的措施，这就要根据变化的情况来审慎决策。”
另一方面，4万亿这块大“蛋糕”的“切法”也出现变化：民生和社会事业投入大幅增长、基础设施投入则有所削减。
张平透露，民生工程在4万亿中占约4000亿，比他去年11月27日公布的2800亿多出1200亿，增幅达43%。社会事业方面的投入也增加了，从400亿增加至1500亿，增幅达275%。
基础设施则削减最多，在4万亿的比重由45%（1万8000亿）降至37.5%（1万5000亿）。基础设施的投入此前最受争议，一些学者指出，基建项目对消费的乘数效应有限，对刺激内需帮助不大。
Recession could last till end 2010, says 'Dr Doom'
The US professor nicknamed "Dr. Doom" for forecasting the financial crisis has said the global recession will last all of this year and probably next, India's Mail Today reported Saturday.
New York University professor Nouriel Roubini said that in the best-case scenario, the recession will continue through 2010 in advanced economies while job losses will persist for an additional year, the paper reported.
He said world governments are falling behind the curve in tackling the crisis with "policymakers moving in the right direction - but (doing) too little too late."
Speaking at a New Delhi conference, Roubini warned that the United States, Europe and Japan must "get their act together" to avoid the global economy sinking further.
"People were hoping it would be a V-shaped recession - a sharp fall, followed by an equally quick recovery," he said.
"But we are in the middle of an ugly U-shaped recession," he said Friday.
Roubini said the bottom of the "U" - the length of time the world economy will continue to contract - would last a minimum of three years starting from December 2007.
But he said there was a "one-in-three chance" that recession would turn into an "L" - a prolonged period of stagnation or shrinking output, coupled with falling prices as demand dries up.
As early as 2005, Roubini said US home prices were riding a speculative wave that would soon sink the economy, but was dismissed as a doomsayer.
In Delhi, he said the problems of the financial system and financial institutions were getting worse, but that the outlook could be improved by governments taking charge of insolvent banks, cleaning them up and then selling them to private investors.
"People say when the US sneezes, the rest of the world catches cold. In this case, the US is just not sneezing, it has a severe case of chronic pneumonia."
"We all sink or swim together," he said, adding there is no way policy action in emerging economic giants India and China can pull the global economy out of the slump.
New York University professor Nouriel Roubini said that in the best-case scenario, the recession will continue through 2010 in advanced economies while job losses will persist for an additional year, the paper reported.
He said world governments are falling behind the curve in tackling the crisis with "policymakers moving in the right direction - but (doing) too little too late."
Speaking at a New Delhi conference, Roubini warned that the United States, Europe and Japan must "get their act together" to avoid the global economy sinking further.
"People were hoping it would be a V-shaped recession - a sharp fall, followed by an equally quick recovery," he said.
"But we are in the middle of an ugly U-shaped recession," he said Friday.
Roubini said the bottom of the "U" - the length of time the world economy will continue to contract - would last a minimum of three years starting from December 2007.
But he said there was a "one-in-three chance" that recession would turn into an "L" - a prolonged period of stagnation or shrinking output, coupled with falling prices as demand dries up.
As early as 2005, Roubini said US home prices were riding a speculative wave that would soon sink the economy, but was dismissed as a doomsayer.
In Delhi, he said the problems of the financial system and financial institutions were getting worse, but that the outlook could be improved by governments taking charge of insolvent banks, cleaning them up and then selling them to private investors.
"People say when the US sneezes, the rest of the world catches cold. In this case, the US is just not sneezing, it has a severe case of chronic pneumonia."
"We all sink or swim together," he said, adding there is no way policy action in emerging economic giants India and China can pull the global economy out of the slump.
Get her to give you her number without fuss
Ever wondered how some men effortlessly get women to leave behind their contact numbers?
There is no trick, you just need to ask differently.
If you inspect how these men do it, it's almost as if they NEVER ask women easy-to-turn-down phrases, such as, "Can I have your number?" or "Would you like to go out this Friday?"
In fact, these questions often push the 'hard to get' button in ladies. Their inner guard goes up just like that.
Instead, these men do it by LEADING the woman with their conversation.
The best way to describe it is that such men use "Casual Command."
It's a subtle way of leading women without appearing like you're asking for her approval.
As an example of "casually commanding" the situation- When you approach a girl and chat with her, you can keep in contact with her by saying: "Hey, I've got to run off now. But we'll exchange numbers now so that we can continue our chat next time."
You are really NOT asking for her number. You come across as being casual, where you don't gain or lose anything, with or without her number.
Instead you're leading the situation. (Incidentally, women like men who project such abilities).
Or if you're asking a lady out over the phone, place a Casual Command in your sentence, such as, "I'm going to Suntec to catch the IT show this Saturday. After that, I'll be looking for a gift for a friend. Tell you what, come along and be my gift-choosing assistant."
Modify it for your own use. The essence of it is - you're laid back but also have a DIRECTION that she can follow at the same time.
I can personally vouch that the success rate of asking women out with such an approach is HIGHER than a more direct invitation to date her.
As the term "Casual Command" suggests:
- it is "casual" (it's totally stress-less as you don't place a lot of importance over getting her out)
- and it is a command (it shows that you're a man of direction. You lead).
See the results for yourself.
There is no trick, you just need to ask differently.
If you inspect how these men do it, it's almost as if they NEVER ask women easy-to-turn-down phrases, such as, "Can I have your number?" or "Would you like to go out this Friday?"
In fact, these questions often push the 'hard to get' button in ladies. Their inner guard goes up just like that.
Instead, these men do it by LEADING the woman with their conversation.
The best way to describe it is that such men use "Casual Command."
It's a subtle way of leading women without appearing like you're asking for her approval.
As an example of "casually commanding" the situation- When you approach a girl and chat with her, you can keep in contact with her by saying: "Hey, I've got to run off now. But we'll exchange numbers now so that we can continue our chat next time."
You are really NOT asking for her number. You come across as being casual, where you don't gain or lose anything, with or without her number.
Instead you're leading the situation. (Incidentally, women like men who project such abilities).
Or if you're asking a lady out over the phone, place a Casual Command in your sentence, such as, "I'm going to Suntec to catch the IT show this Saturday. After that, I'll be looking for a gift for a friend. Tell you what, come along and be my gift-choosing assistant."
Modify it for your own use. The essence of it is - you're laid back but also have a DIRECTION that she can follow at the same time.
I can personally vouch that the success rate of asking women out with such an approach is HIGHER than a more direct invitation to date her.
As the term "Casual Command" suggests:
- it is "casual" (it's totally stress-less as you don't place a lot of importance over getting her out)
- and it is a command (it shows that you're a man of direction. You lead).
See the results for yourself.
Why the "cannot-make-it" guys get all the attractive girls
You may have seen this before - a below-average looking guy, his hand on the waist of a beautiful woman, and both looking blissfully happy as they stroll along Orchard Road, oblivious to the stares of other envious males. He obviously has no problems attracting the good looking ones.
The funny thing is, there are complete opposites too. Attractive-looking males who just cannot score a date.
Yes, there are tall, handsome, and even well educated men who just cannot get to know women.
I know of a graphic designer, let's call him P, who worked for a rather well-known local company. He has above-average looks and things were going well in his life, except when it came to dating.
He was always telling people how he longed to have a gorgeous girlfriend, but just didn't know how to go about getting one. Thankfully for him, a colleague of his who was quite accomplished with women offered to help him in the dating department, correcting his moves and offering advice.
Unfortunately, he did not act on the latters' advice and it was no surprise that P did not see results.
P revealed later: "Even if I got myself a girl, I'm not sure I deserve her. I will wonder if she is with me because she was won over by my moves, or if she was truly interested in me."
So P thinks he does not deserve to have a gorgeous girl in his life. Which leads me to conclude that P thinks such dating skills are only "reserved" for people who are 'worthy'. Either that, or he is just plain confused about wanting a girlfriend in the first place.
But having success with women is not a matter of smooth moves.
If a guy feels he is not fit to have a successful dating life, having social skills or not will not matter. He will still fail with women and in dating.
Many guys go through life hoping to find success with women, but see little or no results as the years pass. The invisible reason (that most of them won't admit to) is they do not believe they are worthy of such success.
First things first - stop with the loser mentality. If you keep thinking: "I'm not her type", or "I don't want to screw up", or "What if she thinks I'm desperate or something?", you will never get out of the dating doldrums.
Why not look at it this way instead? As a man who is in charge of your own social life, the women you meet deserve a taste of your interesting, fun and attractive qualities.
And possessing social skills is simply a means to help you achieve your goal faster and more easily.
It's a fact, guys. Every man I know who has a fantastically active social calendar - even those who aren't good-looking, have beautiful girlfriends. And they know they deserve it.
But be convinced about this first: You are worthy.
About the contributor:
Skilldo is an 'ex-unhappy' Singaporean guy - who grew from being lonely, dateless and single... into breaking out of it, and obtained a fulfilling social life in meeting, dating and entering satisfying relationships with women.
He is the author of 'The Ultimate Singapore Girl-Getter'. A locally-focused guide for Singapore men to approach, date and successfully attract the type of women they want for themselves.
The funny thing is, there are complete opposites too. Attractive-looking males who just cannot score a date.
Yes, there are tall, handsome, and even well educated men who just cannot get to know women.
I know of a graphic designer, let's call him P, who worked for a rather well-known local company. He has above-average looks and things were going well in his life, except when it came to dating.
He was always telling people how he longed to have a gorgeous girlfriend, but just didn't know how to go about getting one. Thankfully for him, a colleague of his who was quite accomplished with women offered to help him in the dating department, correcting his moves and offering advice.
Unfortunately, he did not act on the latters' advice and it was no surprise that P did not see results.
P revealed later: "Even if I got myself a girl, I'm not sure I deserve her. I will wonder if she is with me because she was won over by my moves, or if she was truly interested in me."
So P thinks he does not deserve to have a gorgeous girl in his life. Which leads me to conclude that P thinks such dating skills are only "reserved" for people who are 'worthy'. Either that, or he is just plain confused about wanting a girlfriend in the first place.
But having success with women is not a matter of smooth moves.
If a guy feels he is not fit to have a successful dating life, having social skills or not will not matter. He will still fail with women and in dating.
Many guys go through life hoping to find success with women, but see little or no results as the years pass. The invisible reason (that most of them won't admit to) is they do not believe they are worthy of such success.
First things first - stop with the loser mentality. If you keep thinking: "I'm not her type", or "I don't want to screw up", or "What if she thinks I'm desperate or something?", you will never get out of the dating doldrums.
Why not look at it this way instead? As a man who is in charge of your own social life, the women you meet deserve a taste of your interesting, fun and attractive qualities.
And possessing social skills is simply a means to help you achieve your goal faster and more easily.
It's a fact, guys. Every man I know who has a fantastically active social calendar - even those who aren't good-looking, have beautiful girlfriends. And they know they deserve it.
But be convinced about this first: You are worthy.
About the contributor:
Skilldo is an 'ex-unhappy' Singaporean guy - who grew from being lonely, dateless and single... into breaking out of it, and obtained a fulfilling social life in meeting, dating and entering satisfying relationships with women.
He is the author of 'The Ultimate Singapore Girl-Getter'. A locally-focused guide for Singapore men to approach, date and successfully attract the type of women they want for themselves.
Tuesday, March 3, 2009
Rhinitis
Rhinitis, commonly known as a runny nose, is the medical term describing irritation and inflammation of some internal areas of the nose. The primary symptom of rhinitis is nasal dripping. It is caused by chronic or acute inflammation of the mucous membrane of the nose due to viruses, bacteria or irritants. The inflammation results in the generating of excessive amounts of mucus, commonly producing the aforementioned runny nose, as well as nasal congestion and post-nasal drip. According to recent studies completed in the United States, more than 50 million Americans are current sufferers. Rhinitis has also been found to adversely affect more than just the nose, throat, and eyes. It has been associated with sleeping problems, ear conditions, and even learning problems. Rhinitis is caused by an increase in histamine. This increase is most often caused by airborne allergens. These allergens may affect an individual's nose, throat, or eyes and cause an increase in fluid production within these areas.
Types
Rhinitis is categorized into three types: infective rhinitis includes acute and chronic bacterial infections; Nonallergic (vasomotor) rhinitis includes autonomic, hormonal, drug-induced, atrophic, and gustatory rhinitis, as well as Rhinitis medicamentosa; allergic rhinitis, the most common of the three, is an allergic reaction triggered by pollen, mold, animal dander, dust and other similar inhaled allergens.
Vasomotor rhinitis
This section needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed.
Vasomotor rhinitis is also known as non-allergenic rhinitis, because it often has the same symptoms as allergies, but has different causes. Whereas allergenic rhinitis conditions (such as hayfever) are the result of the immune system overreacting to environmental irritants (pollen, etc), vasomotor rhinitis is believed to be caused by oversensitive or excessive blood vessels in the nasal membrane. These blood vessels (which are controlled in turn by the autonomic nervous system) contract or dilate in order to regulate mucus flow and congestion. But in the vasomotor rhinitis sufferer, oversensitive or excessive blood vessel dilation or contraction causes an overreaction to such stimuli as changes in weather, temperature, or barometric pressure, chemical irritants such as smoke, ozone, pollution, perfumes, and aerosol sprays, psychological stress and emotional shocks, certain types of medications, alcohol, and even spicy food. Thus, while a normal person's nose may run on a very cold day, a vasomotor rhinitis sufferer's nose may start running (or go completely dry) simply by walking into a slightly colder (or slightly warmer) room, or from eating food that is slightly warmer or cooler than room temperature. While a normal person may tolerate a certain degree of cigarette smoke, the vasomotor rhinitis sufferer may experience significant discomfort from the same level of smoke, etc.
The pathology of vasomotor rhinitis is in fact not very well-understood and more research is needed. Vasomotor rhinitis appears to be significantly more common in women than men, leading some researchers to believe hormones to play a role. In general, age of onset occurs after 20 years of age, in contrast to allergic rhinitis which generally appears before age 20. Individuals suffering from vasomotor rhinitis typically experience symptoms year-round, though symptoms may exacerbate in the spring and fall when rapid weather changes are more common.
Many patients can be subject to vasomotor rhinitis and allergic rhinitis simultaneously. Vasomotor rhinitis is a common condition that often goes unrecognized/underrecognized, especially in women. An estimated 17 million United States citizens have vasomotor rhinitis.
Allergic rhinitis
When an allergen such as pollen or dust is inhaled by a person with a sensitized immune system, it triggers antibody production. These antibodies mostly bind to mast cells, which contain histamine. When the mast cells are stimulated by pollen and dust, histamine (and other chemicals) are released. This causes itching, swelling, and mucus production. Symptoms vary in severity from person to person. Very sensitive individuals can experience hives or other rashes. Particulate matter in polluted air and chemicals such as chlorine and detergents, which can normally be tolerated, can greatly aggravate the condition.
Sufferers might also find that cross-reactivity occurs. For example, someone allergic to birch pollen may also find that they have an allergic reaction to the skin of apples or potatoes. A clear sign of this is the occurrence of an itchy throat after eating an apple or sneezing when peeling potatoes or apples. This occurs because of similarities in the proteins of the pollen and the food. There are many cross-reacting substances.
Some disorders may be associated with allergies: Comorbidities include eczema, asthma, depression and migraine.
Allergies are common. Heredity and environmental exposures may contribute to a predisposition to allergies. It is roughly estimated that one in three people have an active allergy at any given time and at least three in four people develop an allergic reaction at least once in their lives. The two categories of allergic rhinitis include:
seasonal - occurs particularly during pollen seasons. Seasonal allergic rhinitis does not usually develop until after 6 years of age.
perennial - occurs throughout the year. This type of allergic rhinitis is commonly seen in younger children.
Allergy testing may reveal the specific allergens a person is sensitive to. Skin testing is the most common method of allergy testing. This may include intradermal, scratch, patch, or other tests. Less commonly, the suspected allergen is dissolved and dropped onto the lower eyelid as a means of testing for allergies. (This test should only be done by a physician, never the patient, since it can be harmful if done improperly). In some individuals who cannot undergo skin testing (as determined by the doctor), the RAST blood test may be helpful in determining specific allergen sensitivity.
Hay fever
Pollen grains from a variety of common plants can cause hay fever.Allergic rhinitis triggered by the pollens of specific seasonal plants is commonly known as 'hay fever', because it is most prevalent during haying season. It is particularly prevalent from late May to the end of June (in the Northern Hemisphere). However, it is possible to suffer from hay fever throughout the year. The pollen which causes hay fever varies from person to person and from region to region; generally speaking, the tiny, hardly visible pollens of wind-pollinated plants are the predominant cause. Pollens of insect-pollinated plants are too large to remain airborne and pose no risk. Examples of plants commonly responsible for hay fever include:
Trees: such as birch (Betula), alder (Alnus), cedar (Cedrus), hazel (Corylus), hornbeam (Carpinus), horse chestnut (Aesculus), willow (Salix), poplar (Populus), plane (Platanus), linden/lime (Tilia) and olive (Olea). In northern latitudes birch is considered to be the most important allergenic tree pollen, with an estimated 15–20% of hay fever sufferers sensitive to birch pollen grains. Olive pollen is most predominant in Mediterranean regions.
Grasses (Family Poaceae): especially ryegrass (Lolium sp.) and timothy (Phleum pratense). An estimated 90% of hay fever sufferers are allergic to grass pollen.
Weeds: ragweed (Ambrosia), plantain (Plantago), nettle/parietaria (Urticaceae), mugwort (Artemisia), Fat hen (Chenopodium) and sorrel/dock (Rumex)
In addition to individual sensitivity and geographic differences in local plant populations, the amount of pollen in the air can be a factor in whether hay fever symptoms develop. Hot, dry, windy days are more likely to have increased amounts of pollen in the air than cool, damp, rainy days when most pollen is washed to the ground.
The time of year at which hay fever symptoms manifest themselves varies greatly depending on the types of pollen to which an allergic reaction is produced. The pollen count, in general, is highest from mid-spring to early summer. As most pollens are produced at fixed periods in the year, a long-term hay fever sufferer may also be able to anticipate when the symptoms are most likely to begin and end, although this may be complicated by an allergy to dust particles.
Prevention and treatment
The goal of rhinitis treatment is to reduce the symptoms caused by the inflammation of affected tissues. In cases of allergic rhinitis, the most effective way to decrease allergic symptoms is to completely avoid the allergen.Vasomotor rhinitis can be brought under a measure of control through avoidance of irritants, though many irritants, such as weather changes, are uncontrollable.
Allergic treatment
Main article: Allergy treatment
Allergic rhinitis can typically be treated much like any other allergic condition.
Eliminating exposure to allergins is the most effective preventive measure, but requires consistent effort.
Many people with pollen allergies reduce their exposure by remaining indoors during hay fever season, particularly in the morning and evening, when outdoor pollen levels are at their highest. Closing all the windows and doors prevents wind-borne pollen from entering the home or office. When traveling in a vehicle, closing all the windows reduces exposure. Air conditioners are reasonably effective filters, and special pollen filters can be fitted to both home and vehicle air conditioning systems.
Because many allergins clings to clothing, skin, and hair, regular cleaning reduces exposure and therefore symptoms. Many people bathe before sleeping, to minimize their exposure to potential allergins that could have stuck to their bodies during the day. Some people use nasal irrigation to physically remove contaminants from their noses.
Frequently cleaning floors and washing bedding can significantly reduce local irritants such as dust, as well as those tracked in by family, pets and visitors.
Several antagonistic drugs are used to block the action of allergic mediators, or to prevent activation of cells and degranulation processes. These include antihistamines, cortisone, dexamethasone, hydrocortisone, epinephrine (adrenaline), theophylline and cromolyn sodium. Anti-leukotrienes, such as Montelukast (Singulair) or Zafirlukast (Accolate), are FDA approved for treatment of allergic diseases. One antihistamine, Azelastine (Astelin), is available as a nasal spray.
More severe cases of allergic rhinitis require immunotherapy (allergy shots) or removal of tissue in the nose (e.g., nasal polyps) or sinuses.
Many allergy medications can have unpleasant side-effects, most notably drowsiness; more serious side-effects such as asthma, sinusitis, and even nasal polyps have also been reported however.
A case-control study found "symptomatic allergic rhinitis and rhinitis medication use are associated with a significantly increased risk of unexpectedly dropping a grade in summer examinations".
Nasal treatments
See also: Anti-inflammatory use of glucocorticoids
Systemic Glucocorticoids such as Triamcinolone or Prednisone are effective at reducing nasal inflammation, but their use is limited by their short duration of effect and the side effects of prolonged steroid therapy. Steroid nasal sprays are effective and safe, and may be effective without oral antihistamines. These medications include, in order of potency: beclomethasone (Beconase), budesonide (Rhinocort), flunisolide (Syntaris), mometasone (Nasonex), fluticasone (Flonase, Flixonase), triamcinolone (Nasacort AQ). They take several days to act and so need be taken continually for several weeks as their therapeutic effect builds up with time.
Topical decongestants: may also be helpful in reducing symptoms such as nasal congestion, but should not be used for long periods as stopping them after protracted use can lead to a rebound nasal congestion (Rhinitis medicamentosa).
Saltwater sprays, rinses or steam: this removes dust, secretions and allergenic molecules from the mucosa, as they are all instant water soluble. A suitable solution is 2-3 spoonful of salt dissolved in one litre of lukewarm water.
Alternative treatments
A large number of over-the-counter treatments are sold without FDA approval, including herbs like eyebright (Euphrasia officinalis), nettle (Urtica dioica), and bayberry (Myrica cerifera), which have not been shown to reduce the symptoms of nasal-pharynx congestion. In addition, feverfew (Tanacetum parthenium) and turmeric (Curcuma longa) has been shown to inhibit phospholipase A2, the enzyme which releases the inflammatory precursor arachidonic acid from the bi-layer membrane of mast cells (the main cells which respond to respiratory allergens and lead to inflammation) but this is only in test tubes and it is not established as anti-inflammatory in humans.
It has been claimed that homeopathy provides relief free of side-effects. However, this is strongly disputed by the medical profession on the grounds that there is no valid evidence to support this claim.
Therapeutic efficacy of complementary-alternative treatments for rhinitis and asthma is not supported by currently available evidence.
Nevertheless, there have been some attempts with controlled trials to show that acupuncture is more effective than antihistamine drugs in treatment of hay fever. Complementary-alternative medicines such as acupuncture are extensively offered in the treatment of allergic rhinitis by non-physicians but evidence-based recommendations are lacking. The methodology of clinical trials with complementary-alternative medicine is frequently inadequate.[citation needed] Meta-analyses provides no clear evidence for the efficacy of acupuncture in rhinitis (or asthma).[citation needed] Currently, evidence-based recommendations for acupuncture or homeopathy cannot be made in the treatment of allergic rhinitis.
Eating locally produced unfiltered honey is believed by many to be a treatment for hayfever, supposedly by introducing manageable amounts of pollen to the body. Clinical studies have not provided any evidence for this belief.
Types
Rhinitis is categorized into three types: infective rhinitis includes acute and chronic bacterial infections; Nonallergic (vasomotor) rhinitis includes autonomic, hormonal, drug-induced, atrophic, and gustatory rhinitis, as well as Rhinitis medicamentosa; allergic rhinitis, the most common of the three, is an allergic reaction triggered by pollen, mold, animal dander, dust and other similar inhaled allergens.
Vasomotor rhinitis
This section needs additional citations for verification. Please help improve this article by adding reliable references. Unsourced material may be challenged and removed.
Vasomotor rhinitis is also known as non-allergenic rhinitis, because it often has the same symptoms as allergies, but has different causes. Whereas allergenic rhinitis conditions (such as hayfever) are the result of the immune system overreacting to environmental irritants (pollen, etc), vasomotor rhinitis is believed to be caused by oversensitive or excessive blood vessels in the nasal membrane. These blood vessels (which are controlled in turn by the autonomic nervous system) contract or dilate in order to regulate mucus flow and congestion. But in the vasomotor rhinitis sufferer, oversensitive or excessive blood vessel dilation or contraction causes an overreaction to such stimuli as changes in weather, temperature, or barometric pressure, chemical irritants such as smoke, ozone, pollution, perfumes, and aerosol sprays, psychological stress and emotional shocks, certain types of medications, alcohol, and even spicy food. Thus, while a normal person's nose may run on a very cold day, a vasomotor rhinitis sufferer's nose may start running (or go completely dry) simply by walking into a slightly colder (or slightly warmer) room, or from eating food that is slightly warmer or cooler than room temperature. While a normal person may tolerate a certain degree of cigarette smoke, the vasomotor rhinitis sufferer may experience significant discomfort from the same level of smoke, etc.
The pathology of vasomotor rhinitis is in fact not very well-understood and more research is needed. Vasomotor rhinitis appears to be significantly more common in women than men, leading some researchers to believe hormones to play a role. In general, age of onset occurs after 20 years of age, in contrast to allergic rhinitis which generally appears before age 20. Individuals suffering from vasomotor rhinitis typically experience symptoms year-round, though symptoms may exacerbate in the spring and fall when rapid weather changes are more common.
Many patients can be subject to vasomotor rhinitis and allergic rhinitis simultaneously. Vasomotor rhinitis is a common condition that often goes unrecognized/underrecognized, especially in women. An estimated 17 million United States citizens have vasomotor rhinitis.
Allergic rhinitis
When an allergen such as pollen or dust is inhaled by a person with a sensitized immune system, it triggers antibody production. These antibodies mostly bind to mast cells, which contain histamine. When the mast cells are stimulated by pollen and dust, histamine (and other chemicals) are released. This causes itching, swelling, and mucus production. Symptoms vary in severity from person to person. Very sensitive individuals can experience hives or other rashes. Particulate matter in polluted air and chemicals such as chlorine and detergents, which can normally be tolerated, can greatly aggravate the condition.
Sufferers might also find that cross-reactivity occurs. For example, someone allergic to birch pollen may also find that they have an allergic reaction to the skin of apples or potatoes. A clear sign of this is the occurrence of an itchy throat after eating an apple or sneezing when peeling potatoes or apples. This occurs because of similarities in the proteins of the pollen and the food. There are many cross-reacting substances.
Some disorders may be associated with allergies: Comorbidities include eczema, asthma, depression and migraine.
Allergies are common. Heredity and environmental exposures may contribute to a predisposition to allergies. It is roughly estimated that one in three people have an active allergy at any given time and at least three in four people develop an allergic reaction at least once in their lives. The two categories of allergic rhinitis include:
seasonal - occurs particularly during pollen seasons. Seasonal allergic rhinitis does not usually develop until after 6 years of age.
perennial - occurs throughout the year. This type of allergic rhinitis is commonly seen in younger children.
Allergy testing may reveal the specific allergens a person is sensitive to. Skin testing is the most common method of allergy testing. This may include intradermal, scratch, patch, or other tests. Less commonly, the suspected allergen is dissolved and dropped onto the lower eyelid as a means of testing for allergies. (This test should only be done by a physician, never the patient, since it can be harmful if done improperly). In some individuals who cannot undergo skin testing (as determined by the doctor), the RAST blood test may be helpful in determining specific allergen sensitivity.
Hay fever
Pollen grains from a variety of common plants can cause hay fever.Allergic rhinitis triggered by the pollens of specific seasonal plants is commonly known as 'hay fever', because it is most prevalent during haying season. It is particularly prevalent from late May to the end of June (in the Northern Hemisphere). However, it is possible to suffer from hay fever throughout the year. The pollen which causes hay fever varies from person to person and from region to region; generally speaking, the tiny, hardly visible pollens of wind-pollinated plants are the predominant cause. Pollens of insect-pollinated plants are too large to remain airborne and pose no risk. Examples of plants commonly responsible for hay fever include:
Trees: such as birch (Betula), alder (Alnus), cedar (Cedrus), hazel (Corylus), hornbeam (Carpinus), horse chestnut (Aesculus), willow (Salix), poplar (Populus), plane (Platanus), linden/lime (Tilia) and olive (Olea). In northern latitudes birch is considered to be the most important allergenic tree pollen, with an estimated 15–20% of hay fever sufferers sensitive to birch pollen grains. Olive pollen is most predominant in Mediterranean regions.
Grasses (Family Poaceae): especially ryegrass (Lolium sp.) and timothy (Phleum pratense). An estimated 90% of hay fever sufferers are allergic to grass pollen.
Weeds: ragweed (Ambrosia), plantain (Plantago), nettle/parietaria (Urticaceae), mugwort (Artemisia), Fat hen (Chenopodium) and sorrel/dock (Rumex)
In addition to individual sensitivity and geographic differences in local plant populations, the amount of pollen in the air can be a factor in whether hay fever symptoms develop. Hot, dry, windy days are more likely to have increased amounts of pollen in the air than cool, damp, rainy days when most pollen is washed to the ground.
The time of year at which hay fever symptoms manifest themselves varies greatly depending on the types of pollen to which an allergic reaction is produced. The pollen count, in general, is highest from mid-spring to early summer. As most pollens are produced at fixed periods in the year, a long-term hay fever sufferer may also be able to anticipate when the symptoms are most likely to begin and end, although this may be complicated by an allergy to dust particles.
Prevention and treatment
The goal of rhinitis treatment is to reduce the symptoms caused by the inflammation of affected tissues. In cases of allergic rhinitis, the most effective way to decrease allergic symptoms is to completely avoid the allergen.Vasomotor rhinitis can be brought under a measure of control through avoidance of irritants, though many irritants, such as weather changes, are uncontrollable.
Allergic treatment
Main article: Allergy treatment
Allergic rhinitis can typically be treated much like any other allergic condition.
Eliminating exposure to allergins is the most effective preventive measure, but requires consistent effort.
Many people with pollen allergies reduce their exposure by remaining indoors during hay fever season, particularly in the morning and evening, when outdoor pollen levels are at their highest. Closing all the windows and doors prevents wind-borne pollen from entering the home or office. When traveling in a vehicle, closing all the windows reduces exposure. Air conditioners are reasonably effective filters, and special pollen filters can be fitted to both home and vehicle air conditioning systems.
Because many allergins clings to clothing, skin, and hair, regular cleaning reduces exposure and therefore symptoms. Many people bathe before sleeping, to minimize their exposure to potential allergins that could have stuck to their bodies during the day. Some people use nasal irrigation to physically remove contaminants from their noses.
Frequently cleaning floors and washing bedding can significantly reduce local irritants such as dust, as well as those tracked in by family, pets and visitors.
Several antagonistic drugs are used to block the action of allergic mediators, or to prevent activation of cells and degranulation processes. These include antihistamines, cortisone, dexamethasone, hydrocortisone, epinephrine (adrenaline), theophylline and cromolyn sodium. Anti-leukotrienes, such as Montelukast (Singulair) or Zafirlukast (Accolate), are FDA approved for treatment of allergic diseases. One antihistamine, Azelastine (Astelin), is available as a nasal spray.
More severe cases of allergic rhinitis require immunotherapy (allergy shots) or removal of tissue in the nose (e.g., nasal polyps) or sinuses.
Many allergy medications can have unpleasant side-effects, most notably drowsiness; more serious side-effects such as asthma, sinusitis, and even nasal polyps have also been reported however.
A case-control study found "symptomatic allergic rhinitis and rhinitis medication use are associated with a significantly increased risk of unexpectedly dropping a grade in summer examinations".
Nasal treatments
See also: Anti-inflammatory use of glucocorticoids
Systemic Glucocorticoids such as Triamcinolone or Prednisone are effective at reducing nasal inflammation, but their use is limited by their short duration of effect and the side effects of prolonged steroid therapy. Steroid nasal sprays are effective and safe, and may be effective without oral antihistamines. These medications include, in order of potency: beclomethasone (Beconase), budesonide (Rhinocort), flunisolide (Syntaris), mometasone (Nasonex), fluticasone (Flonase, Flixonase), triamcinolone (Nasacort AQ). They take several days to act and so need be taken continually for several weeks as their therapeutic effect builds up with time.
Topical decongestants: may also be helpful in reducing symptoms such as nasal congestion, but should not be used for long periods as stopping them after protracted use can lead to a rebound nasal congestion (Rhinitis medicamentosa).
Saltwater sprays, rinses or steam: this removes dust, secretions and allergenic molecules from the mucosa, as they are all instant water soluble. A suitable solution is 2-3 spoonful of salt dissolved in one litre of lukewarm water.
Alternative treatments
A large number of over-the-counter treatments are sold without FDA approval, including herbs like eyebright (Euphrasia officinalis), nettle (Urtica dioica), and bayberry (Myrica cerifera), which have not been shown to reduce the symptoms of nasal-pharynx congestion. In addition, feverfew (Tanacetum parthenium) and turmeric (Curcuma longa) has been shown to inhibit phospholipase A2, the enzyme which releases the inflammatory precursor arachidonic acid from the bi-layer membrane of mast cells (the main cells which respond to respiratory allergens and lead to inflammation) but this is only in test tubes and it is not established as anti-inflammatory in humans.
It has been claimed that homeopathy provides relief free of side-effects. However, this is strongly disputed by the medical profession on the grounds that there is no valid evidence to support this claim.
Therapeutic efficacy of complementary-alternative treatments for rhinitis and asthma is not supported by currently available evidence.
Nevertheless, there have been some attempts with controlled trials to show that acupuncture is more effective than antihistamine drugs in treatment of hay fever. Complementary-alternative medicines such as acupuncture are extensively offered in the treatment of allergic rhinitis by non-physicians but evidence-based recommendations are lacking. The methodology of clinical trials with complementary-alternative medicine is frequently inadequate.[citation needed] Meta-analyses provides no clear evidence for the efficacy of acupuncture in rhinitis (or asthma).[citation needed] Currently, evidence-based recommendations for acupuncture or homeopathy cannot be made in the treatment of allergic rhinitis.
Eating locally produced unfiltered honey is believed by many to be a treatment for hayfever, supposedly by introducing manageable amounts of pollen to the body. Clinical studies have not provided any evidence for this belief.
Sunday, March 1, 2009
接受免费检验 及早发现结肠直肠癌
结肠直肠癌的发病率近年来有不断上升趋势，新加坡防癌协会希望今年鼓励3万人主动接受免费的粪便潜血检验，以及早发现问题，提高治愈几率。
防癌协会昨天为配合3月的结肠直肠癌（Colorectal Cancer）意识月举行记者会时透露，去年共有1万2497人接受免费的粪便潜血检验（Faecal Occult Blood Test，简称FOBT），在检查结果呈阳性后接受结肠内窥镜手术（colonoscopy）的人当中，32人证实患癌，91人切除肠内的癌前息肉（pre-cancerous polyps）。
防癌协会主席顾汶星医生透露，证实患癌者中，11人被发现患有第一期结肠直肠癌，14人则已处于第三期，这显示粪便潜血检验确实有助于发现患癌，大大提高了患者的治愈几率。第三期结肠直肠癌的治愈率达50%，一旦进入第四期，癌症已扩散到其他器官，痊愈几率就更渺茫了。
癌症是新加坡人的首号杀手，结肠直肠癌也是男性最普遍患上的癌症。最新数据显示，在2003年至2007年间，每年平均有1400人被诊断患上结肠直肠癌，不治人数超过600人。在所有患癌的本地男性中，17.8%患有结肠直肠癌；女性癌症病人中也有14.5%患有这类癌症，仅次于乳癌。
担任第8届结肠直肠癌意识月顾问的中央医院肠外科高级顾问邓忠良医生说，通过粪便潜血检验查出自己患癌的病人中，已患上第三期结肠直肠癌的人数不小，而这类病人通常早已出现不适症状却没就诊，突显人们依然缺乏预防延误就医的意识。
邓忠良医生透露，过去调查显示，人们抗拒检验的原因离不开担心费用和害怕检验过程等问题。
对此，曾患结肠直肠癌的NKF主席余福金昨天受邀出席记者会分享他的抗癌过程时，以过来人身分向害怕接受内窥镜手术的人们保证，手术过程并不会引起难以忍受的痛楚和不适。他说，公众可在10到15分钟内完成手术程序，并且可以选择在麻醉浅睡的情况下进行。
余福金也是活跃乐龄理事会主席和公共交通理事会主席，他在2007年11月被诊断患上第三期结肠癌，去年6月完成前后12次的化疗，目前病情已受控制。
邓忠良医生说，相对于美国，在我国进行内窥镜手术并不太昂贵，费用平均介于1000元至1200元，获得津贴的病人可以使用保健储蓄支付全数费用。此外，经济有问题的病人可以向防癌协会提出协助支付费用的申请。
佳宁药局3月间
分派免费检验器
为配合结肠直肠癌意识月，分布在全岛各地的佳宁药局（Guardian Pharmacy）将在3月间分派免费的粪便潜血检验器供50岁以上的公众领取，其中9家佳宁药局今年也将第一次全年免费提供这类检验器。
除了佳宁药局，公众可到防癌协会、18个综合诊疗所等地点领取粪便潜血检验器，询问详情可拨打64215809/836。
防癌协会也将在3月21日于淡滨尼北民众俱乐部举行免费讲座，提高公众对结肠直肠癌的认识。公众可电邮education@singaporecancersociety.org.sg或拨电64215804报名。
余福金后悔没为重病投保
NKF主席余福金在记者会上与大家分享他的抗癌经历。
“千万不要抱着‘不会是我’的态度，要定期接受检查，购买严重疾病保险都是重要环节。”
NKF主席余福金昨天在记者会上与大家分享他的抗癌经历时，劝人们提早进行体检，以免延误医治，同时鼓励国人为严重疾病投保。
他透露，当他获知自己患上第三期结肠直肠癌必须接受手术和化疗后，令他感到最后悔的事是之前没有为自己购买一份投保严重疾病的保单。“我必须掏腰包支付化疗和手术等所有费用，以致口袋‘破了一个大洞’。因此，我给大家的劝告是为自己投保，如果年过50岁就接受内窥镜手术，不要避开公司的常年体验，因为及早发现问题就能减轻医药费和接受治疗时承受的痛苦。”
他坦承，如果之前做了检验，并提早发现癌症，就无需化疗。而保持乐观心情以及尽快恢复正常生活的强烈意志，最终让他战胜病魔。
治疗期间，余福金并没有自怨自艾，勇敢接受事实，甚至立下家规——不许家人把他视为病人。他说，家人出于关心，不愿让他太操劳是自然的，但他在化疗期间尽量维持患病前的生活方式，例如自己驾车去开会和约见朋友，只是更为注意身体发出的信号，疲累时就休息。但要精神饱满，还是要有健康体魄，余福金鼓励人们接受免费的粪便潜血检验。
“毕竟及早知道病情，至少能让你掌控情况进行治疗，自我逃避最不可取，如果问题发现得太迟，受苦的不只是患者，也包括他的家人。”
防癌协会昨天为配合3月的结肠直肠癌（Colorectal Cancer）意识月举行记者会时透露，去年共有1万2497人接受免费的粪便潜血检验（Faecal Occult Blood Test，简称FOBT），在检查结果呈阳性后接受结肠内窥镜手术（colonoscopy）的人当中，32人证实患癌，91人切除肠内的癌前息肉（pre-cancerous polyps）。
防癌协会主席顾汶星医生透露，证实患癌者中，11人被发现患有第一期结肠直肠癌，14人则已处于第三期，这显示粪便潜血检验确实有助于发现患癌，大大提高了患者的治愈几率。第三期结肠直肠癌的治愈率达50%，一旦进入第四期，癌症已扩散到其他器官，痊愈几率就更渺茫了。
癌症是新加坡人的首号杀手，结肠直肠癌也是男性最普遍患上的癌症。最新数据显示，在2003年至2007年间，每年平均有1400人被诊断患上结肠直肠癌，不治人数超过600人。在所有患癌的本地男性中，17.8%患有结肠直肠癌；女性癌症病人中也有14.5%患有这类癌症，仅次于乳癌。
担任第8届结肠直肠癌意识月顾问的中央医院肠外科高级顾问邓忠良医生说，通过粪便潜血检验查出自己患癌的病人中，已患上第三期结肠直肠癌的人数不小，而这类病人通常早已出现不适症状却没就诊，突显人们依然缺乏预防延误就医的意识。
邓忠良医生透露，过去调查显示，人们抗拒检验的原因离不开担心费用和害怕检验过程等问题。
对此，曾患结肠直肠癌的NKF主席余福金昨天受邀出席记者会分享他的抗癌过程时，以过来人身分向害怕接受内窥镜手术的人们保证，手术过程并不会引起难以忍受的痛楚和不适。他说，公众可在10到15分钟内完成手术程序，并且可以选择在麻醉浅睡的情况下进行。
余福金也是活跃乐龄理事会主席和公共交通理事会主席，他在2007年11月被诊断患上第三期结肠癌，去年6月完成前后12次的化疗，目前病情已受控制。
邓忠良医生说，相对于美国，在我国进行内窥镜手术并不太昂贵，费用平均介于1000元至1200元，获得津贴的病人可以使用保健储蓄支付全数费用。此外，经济有问题的病人可以向防癌协会提出协助支付费用的申请。
佳宁药局3月间
分派免费检验器
为配合结肠直肠癌意识月，分布在全岛各地的佳宁药局（Guardian Pharmacy）将在3月间分派免费的粪便潜血检验器供50岁以上的公众领取，其中9家佳宁药局今年也将第一次全年免费提供这类检验器。
除了佳宁药局，公众可到防癌协会、18个综合诊疗所等地点领取粪便潜血检验器，询问详情可拨打64215809/836。
防癌协会也将在3月21日于淡滨尼北民众俱乐部举行免费讲座，提高公众对结肠直肠癌的认识。公众可电邮education@singaporecancersociety.org.sg或拨电64215804报名。
余福金后悔没为重病投保
NKF主席余福金在记者会上与大家分享他的抗癌经历。
“千万不要抱着‘不会是我’的态度，要定期接受检查，购买严重疾病保险都是重要环节。”
NKF主席余福金昨天在记者会上与大家分享他的抗癌经历时，劝人们提早进行体检，以免延误医治，同时鼓励国人为严重疾病投保。
他透露，当他获知自己患上第三期结肠直肠癌必须接受手术和化疗后，令他感到最后悔的事是之前没有为自己购买一份投保严重疾病的保单。“我必须掏腰包支付化疗和手术等所有费用，以致口袋‘破了一个大洞’。因此，我给大家的劝告是为自己投保，如果年过50岁就接受内窥镜手术，不要避开公司的常年体验，因为及早发现问题就能减轻医药费和接受治疗时承受的痛苦。”
他坦承，如果之前做了检验，并提早发现癌症，就无需化疗。而保持乐观心情以及尽快恢复正常生活的强烈意志，最终让他战胜病魔。
治疗期间，余福金并没有自怨自艾，勇敢接受事实，甚至立下家规——不许家人把他视为病人。他说，家人出于关心，不愿让他太操劳是自然的，但他在化疗期间尽量维持患病前的生活方式，例如自己驾车去开会和约见朋友，只是更为注意身体发出的信号，疲累时就休息。但要精神饱满，还是要有健康体魄，余福金鼓励人们接受免费的粪便潜血检验。
“毕竟及早知道病情，至少能让你掌控情况进行治疗，自我逃避最不可取，如果问题发现得太迟，受苦的不只是患者，也包括他的家人。”
中国领导长寿秘诀： 多吃粗粮 少食多餐
中国领导人人均寿命一直居世界前列，专家透露，这与他们多吃粗粮、少食多餐的科学饮食方式有关。
中央社引述内蒙古新闻网报道，原北京医院营养科主任、首长营养保健专家曾煦媛表示，中国领导养身的基本法则是：每天吃够25种食物。另一方面，原北京军区总医院营养科主任李瑞芬则说，领导们吃“四条腿动物”的肉比较少，从营养上来说，四条腿(猪、牛、羊)不如两条腿(鸡、鹅)，两条腿不如一条腿(菌类)，一条腿不如没有腿(鱼)。
曾煦媛所说的25种食物，是指食物的种类，而非25道菜。她列举为领导们安排的食谱：早餐半杯牛奶、一盘小菜、一个小麻酱咸花卷、小碗小米粥或莲子羹；中餐是放10种以上食物的什锦砂锅，一两左右的红豆焖饭或薏米饭；晚餐是汆萝卜丝鲫鱼丸子、小米粥。
曾煦媛说，为中央“老首长们”配餐，讲究的是少食多餐的原则，只有当食物种类够“杂”，才能使营养均衡。正餐七成饱，外加两顿零食。
她指出，食物的烹饪方法同样重要，以蒸、煮、焖、拌、汆为主，这些烹饪方法能够减少营养流失，保证低脂饮食。领导们的食谱中并非完全没有炸和炒，但每星期只吃一次。而不管何种烹饪方法，低盐、低脂、高膳食纤维，是必须遵守的原则。
此外，领导们会多吃健脑、养心食物，如豆类、杏仁、芝麻、核桃、葡萄酒等。领导喝酒前，会吃些含维生素Ｂ群的食物，因为酒精会损伤胃黏膜，让体内缺乏维生素Ｂ群，所以喝酒前须用粗粮、杂粮、瘦肉、花生等“垫底”。
她强调，只注重饮食，远远不够，一些老领导之所以能够长寿，坚持锻炼身体很重要。胡锦涛乒乓球打得不错，温家宝访问日本时则露了一手打棒球。不过，领导们吃的虽简单，但食品来源一定要安全。
据报道，享年91岁的已故元老陈云，生前每天都要吃13粒花生、散步13分钟，会客只三分钟。
中央社引述内蒙古新闻网报道，原北京医院营养科主任、首长营养保健专家曾煦媛表示，中国领导养身的基本法则是：每天吃够25种食物。另一方面，原北京军区总医院营养科主任李瑞芬则说，领导们吃“四条腿动物”的肉比较少，从营养上来说，四条腿(猪、牛、羊)不如两条腿(鸡、鹅)，两条腿不如一条腿(菌类)，一条腿不如没有腿(鱼)。
曾煦媛所说的25种食物，是指食物的种类，而非25道菜。她列举为领导们安排的食谱：早餐半杯牛奶、一盘小菜、一个小麻酱咸花卷、小碗小米粥或莲子羹；中餐是放10种以上食物的什锦砂锅，一两左右的红豆焖饭或薏米饭；晚餐是汆萝卜丝鲫鱼丸子、小米粥。
曾煦媛说，为中央“老首长们”配餐，讲究的是少食多餐的原则，只有当食物种类够“杂”，才能使营养均衡。正餐七成饱，外加两顿零食。
她指出，食物的烹饪方法同样重要，以蒸、煮、焖、拌、汆为主，这些烹饪方法能够减少营养流失，保证低脂饮食。领导们的食谱中并非完全没有炸和炒，但每星期只吃一次。而不管何种烹饪方法，低盐、低脂、高膳食纤维，是必须遵守的原则。
此外，领导们会多吃健脑、养心食物，如豆类、杏仁、芝麻、核桃、葡萄酒等。领导喝酒前，会吃些含维生素Ｂ群的食物，因为酒精会损伤胃黏膜，让体内缺乏维生素Ｂ群，所以喝酒前须用粗粮、杂粮、瘦肉、花生等“垫底”。
她强调，只注重饮食，远远不够，一些老领导之所以能够长寿，坚持锻炼身体很重要。胡锦涛乒乓球打得不错，温家宝访问日本时则露了一手打棒球。不过，领导们吃的虽简单，但食品来源一定要安全。
据报道，享年91岁的已故元老陈云，生前每天都要吃13粒花生、散步13分钟，会客只三分钟。
咳嗽咳出 胃酸倒流？
白领工作时间不固定，迟吃晚餐，吃后没有足够消化就倒头睡觉，胃酸倒流容易不请自来。
继近一个月前感冒引发咳嗽后，笔者干咳已有3个星期。经内窥镜鼻腔检查后，诊断为轻微胃酸倒流。
酸倒流是胃食管逆流疾病的主要症状之一。由于食管下端括约肌无法正常运作，胃酸从胃部逆流入食管。
伊丽莎白医药中心雅善耳鼻咽喉组麦汉华医生受访时解释说，食道进入胃之前，有一道软骨活门，称作食道下端括约肌。
正常情况吞咽时，这片活门会打开；食物由食道进入胃后，这片肌肉活门又会关起来。但当活门不能正常开合时，胃里的食物和胃酸则会倒流进入食道内。
麦医生说：“有时病患会申诉喉咙口好像被痰顶住，其实那是唾液。”
胃酸倒流若不引起重视，则可能演变成食道癌；而解决胃酸倒流应从改变生活习惯做起。
咳嗽，说是小毛病，也有可能是肠胃疾病的征兆。咳嗽看似感冒、发烧、喉咙发炎的症状，也可能是胃酸倒流所引发。
■原因：
①很迟还吃夜宵，食物没有完全消化，饱着肚子睡，易造成胃下垂，使下括肌松弛，导致胃酸倒流入食道。
②裤子太紧，容易把胃酸顶压回食道。
③肥胖，腹部脂肪较多，对胃部造成一定压力。
■主要症状：
·咳嗽持续不愈，喉咙持续疼痛，吞咽有困难。
·胸口有被灼伤的感觉，直达喉咙。
·口中有酸或苦味。
·腹痛、打嗝、胃胀气。
■调整方法：
1）调整生活方式：
·尽量避免在临睡前3至4个小时吃东西，也尽量不要喝水，因为喝下去的是白开水，倒流的是胃酸。
·避免饭后躺卧；少量多餐，减轻对胃部的压力，避免穿紧身衣。
·睡觉时头部垫高约10公分，有助减轻夜间胃酸倒流。
2）减少吃巧克力、咖啡和茶，油腻和煎炸食物，洋葱大蒜、薄荷味食品等。
3）药物控制反胃症状，饭前半小时服用，帮助食物消化。
有轻微胃酸倒流问题时，食管后边软骨部位出现透明水肿，正常情况下应为粉红色。
了解多一些
Q：慢性咳嗽还会引发什么问题？
A：慢性咳嗽或由吸烟、药物或心理烦躁所引致，是复杂的疾病，大致可分为：
喉咙：发炎，红肿，长瘤。
鼻腔：鼻子过敏。
肺：哮喘，肺炎，肺气道有増生物
Q：内窥镜从鼻孔进，不会呕吐？
A：目前鼻咽喉检查，大多从鼻孔而入。医生在为病人两个鼻孔喷射麻醉药，喉咙感觉麻麻后（大约半分钟），就可把内窥镜从两个鼻孔中伸入。
检查全程只会略微感觉得到一点点痒，还能和医生说话，并不会感到疼痛。大约在45分钟后，麻醉药效散尽，喉咙恢复正常感觉状态。
继近一个月前感冒引发咳嗽后，笔者干咳已有3个星期。经内窥镜鼻腔检查后，诊断为轻微胃酸倒流。
酸倒流是胃食管逆流疾病的主要症状之一。由于食管下端括约肌无法正常运作，胃酸从胃部逆流入食管。
伊丽莎白医药中心雅善耳鼻咽喉组麦汉华医生受访时解释说，食道进入胃之前，有一道软骨活门，称作食道下端括约肌。
正常情况吞咽时，这片活门会打开；食物由食道进入胃后，这片肌肉活门又会关起来。但当活门不能正常开合时，胃里的食物和胃酸则会倒流进入食道内。
麦医生说：“有时病患会申诉喉咙口好像被痰顶住，其实那是唾液。”
胃酸倒流若不引起重视，则可能演变成食道癌；而解决胃酸倒流应从改变生活习惯做起。
咳嗽，说是小毛病，也有可能是肠胃疾病的征兆。咳嗽看似感冒、发烧、喉咙发炎的症状，也可能是胃酸倒流所引发。
■原因：
①很迟还吃夜宵，食物没有完全消化，饱着肚子睡，易造成胃下垂，使下括肌松弛，导致胃酸倒流入食道。
②裤子太紧，容易把胃酸顶压回食道。
③肥胖，腹部脂肪较多，对胃部造成一定压力。
■主要症状：
·咳嗽持续不愈，喉咙持续疼痛，吞咽有困难。
·胸口有被灼伤的感觉，直达喉咙。
·口中有酸或苦味。
·腹痛、打嗝、胃胀气。
■调整方法：
1）调整生活方式：
·尽量避免在临睡前3至4个小时吃东西，也尽量不要喝水，因为喝下去的是白开水，倒流的是胃酸。
·避免饭后躺卧；少量多餐，减轻对胃部的压力，避免穿紧身衣。
·睡觉时头部垫高约10公分，有助减轻夜间胃酸倒流。
2）减少吃巧克力、咖啡和茶，油腻和煎炸食物，洋葱大蒜、薄荷味食品等。
3）药物控制反胃症状，饭前半小时服用，帮助食物消化。
有轻微胃酸倒流问题时，食管后边软骨部位出现透明水肿，正常情况下应为粉红色。
了解多一些
Q：慢性咳嗽还会引发什么问题？
A：慢性咳嗽或由吸烟、药物或心理烦躁所引致，是复杂的疾病，大致可分为：
喉咙：发炎，红肿，长瘤。
鼻腔：鼻子过敏。
肺：哮喘，肺炎，肺气道有増生物
Q：内窥镜从鼻孔进，不会呕吐？
A：目前鼻咽喉检查，大多从鼻孔而入。医生在为病人两个鼻孔喷射麻醉药，喉咙感觉麻麻后（大约半分钟），就可把内窥镜从两个鼻孔中伸入。
检查全程只会略微感觉得到一点点痒，还能和医生说话，并不会感到疼痛。大约在45分钟后，麻醉药效散尽，喉咙恢复正常感觉状态。
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