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"It’s a good thing you came for an examination, or you might have fainted and been taken to the hospital next week."

　　Three years ago, 28-year-old Shi Mairu (pseudonym) was told by a doctor that she had ketoacidosis during a routine physical examination. After a series of tests, she was finally diagnosed with diabetes. Before that, she was unaware of her physical problems.

　　Diabetic ketoacidosis is the most common diabetic emergency. In 2021, "Mocha Official", a blogger in online celebrity, bilibili, was found to be suffering from diabetes when removing a tumor, and finally died of ketoacidosis, which made people feel sad.

　　Chen Hongjie, who works in the trading industry, is 34 years old. He went to the hospital for an examination six months ago. By mistake, he took a blood sugar concentration test, and the result showed insulin resistance. Insulin resistance is one of the pathogenic factors of type II diabetes. But fortunately for Shi Mairu, it is hopeful to achieve clinical reversal and return to normal level because it is found earlier and controlled in the stage of insulin resistance.

　　In recent years, there are not a few young people like Shi Mairu and Chen Hongjie who suddenly suffer from diabetes. The Report on Nutrition and Chronic Diseases of Residents in China (2020) shows that the prevalence rate of diabetes among residents aged 18 and above in China is 11.9%, and the detection rate of pre-diabetes is 35.2%, among which type II diabetes is the main type. Diabetes has the characteristics of younger age, long course of disease and many complications.

　　Diabetes mellitus is a series of metabolic disorder syndromes of sugar, protein, fat, water and electrolyte caused by various pathogenic factors such as genetic factors and endocrine dysfunction, which leads to islet dysfunction and insulin resistance. Clinically, hyperglycemia is the main feature, and the typical symptoms are three more and one less (drinking more, eating more, urinating more and losing weight).

　　Long-term chronic hyperglycemia can cause damage to tissues and organs such as eyes, nerves, kidneys and cardiovascular system, and then a series of complications occur. Because of the large number of patients and serious harm to human health, diabetes has become an important public health problem in China.

　　Diabetes is mostly related to unreasonable diet.

　　Recently, the "Guidelines on Diet and Nutrition for Adults with Diabetes (2023 Edition)" (hereinafter referred to as the "Guidelines") issued by official website, National Health Commission shows that the risk factors of diabetes are mostly related to unreasonable diet, including long-term high-sugar, high-fat and high-energy diets.

　　Indeed, before the diagnosis, both Shi Mairu and Chen Hongjie lived very unhealthy lives.

　　In diet, Shi Mairu likes to eat foods with high oil and sugar, spicy, sweet and greasy taste. Because of work, she has little time to exercise, and it is common to stay up late and have irregular work and rest. "I used to drink sugar-free milk tea and sugar-free drinks with luck, thinking that this would not affect my health. Now that I think about it, I am deceiving myself. "

　　Chen Hongjie used to play games with friends until late at night, and it was inevitable that he would have a beer barbecue after the end. "I know that this lifestyle is unhealthy, but I always feel that I will not have an accident when I am young. Now I really regret it."

　　In view of the daily diet of diabetic patients, the Guide puts forward eight principles and suggestions, including: 1. Diversified foods, developing and establishing reasonable dietary habits; Second, appropriate energy, control overweight and obesity and prevent emaciation; 3. Quantify staple foods, preferably whole grains and foods with low glycemic index; Fourth, actively exercise to improve physical fitness and insulin sensitivity; Five, light diet, limit drinking, prevent and delay complications; Sixth, there is a proper way to eat and raise food, and reasonable selection and application of edible and medicinal substances; Seven, regular meals, reasonable meals, and promote the stability of blood sugar after meals; Eight, self-management, regular nutrition consultation, improve blood sugar control ability.

　　The Guide emphasizes that correcting unhealthy lifestyle, practicing reasonable diet and active exercise are effective means to prevent and control the occurrence and development of diabetes, which can help patients control their blood sugar well, prevent and delay the occurrence of diabetic complications, improve their quality of life and save medical expenses.

　　Dietary management is the core of controlling blood sugar.

　　Dietary management and treatment are the core of blood sugar control in diabetic patients. The Guide suggests that diabetic patients should follow the principle of balanced diet.

　　It is mentioned in the Guide that food diversity is the basis for achieving a reasonable diet and balanced nutrition. The diet of diabetic patients should include five categories of food: sweet potatoes, vegetables and fruits, animal food, soybeans and nuts, cooking oil and salt. The recommended ratio of macronutrients to total energy of diabetic patients is 15%-20% in protein, 45%-60% in carbohydrate and 20%-35% in fat. On the basis of keeping food diverse, we should reduce oil, salt, sugar and wine.

　　The staple food is rich in carbohydrates, which is the core factor affecting the postprandial blood sugar level. The Guide suggests that diabetic patients should not eat too much staple food, and choose more whole grains and low GI foods, among which low GI foods such as whole grains and miscellaneous beans should account for more than 1/3 of the staple food. In addition, we should develop the habit of eating vegetables first and staple food last in order to control blood sugar.

　　At the same time, diabetics should cultivate a light taste. The daily consumption of cooking oil should be controlled within 25 grams, and the daily consumption of salt should not exceed 5 grams. Pay attention to limiting the intake of condiments and foods with high salt content such as soy sauce, chicken essence, monosodium glutamate, pickles, bacon and pickles.

　　People with different syndrome types and different regions can "eat according to syndrome differentiation"

　　In addition to the daily dietary advice, the Guide also mentions the principle of Chinese medicine’s food support with "dialectical diet" as the core. For diabetic patients with different constitutions, selecting foods or medicinal substances with different characteristics can effectively improve the blood sugar level of patients.

　　Traditional Chinese medicine divides diabetes into three categories: first, excessive heat due to yin deficiency, manifested as polydipsia and polydipsia, dry throat and tongue, overeating and hunger, dark red constipation, red tongue with little body fluid and yellow fur, and slippery or thready pulse; Second, deficiency of both qi and yin, manifested as fatigue, palpitation, shortness of breath, night sweats, spontaneous sweating, dry mouth, excessive drinking and urination, vexation and heat, constipation, soreness of waist and knees, pale or dark tongue, teeth marks on the edge of tongue, thin and white fur, or less fur, and weak pulse; Third, deficiency of both yin and yang, manifested as fatigue and spontaneous sweating, cold limbs, soreness in waist and knees, dry helix, excessive drinking and diuresis, edema and oliguria, or diarrhea due to five shifts, impotence and premature ejaculation, pale tongue with white fur, and deep and thin pulse.

　　According to the principle of syndrome differentiation and treatment of traditional Chinese medicine, the daily diet is combined with traditional Chinese medicine health-preserving recipes. Due to yin deficiency and heat excess, medicinal materials with the functions of nourishing yin and clearing away heat are used, such as mulberry leaves, cassia seeds and lotus seeds. The syndrome of deficiency of both qi and yin adopts edible medicinal substances with the functions of benefiting qi and nourishing yin, such as mulberry, medlar, kudzu root, etc. Chinese yam, poria cocos and cinnamon can be used for deficiency of yin and yang.

　　The Guide also refers to the dietary practices in different regions, and recommends all-day dietary recipes suitable for diabetic patients in different regions and seasons according to the food resources and dietary characteristics of people in different regions.

　　For example, in North China where Shi Mairu lives, he likes pasta, livestock and poultry, and vegetables and aquatic products are not consumed much. The recipe follows the principle of food support for diabetic patients, and it is suggested to increase the intake of vegetables and aquatic products, and emphasize the choice of seasonal food according to the characteristics of four distinct seasons.

　　In South China, where Chen Hongjie is located, the dietary characteristics are mainly Cantonese cuisine culture, and the most obvious feature is that "you can’t eat without soup", and the soup often uses edible and medicinal substances; Secondly, South China is rich in rice, which mainly feeds on rice, such as rice rolls, rice noodles, radish cakes, rice cakes and other exquisite cakes. The recipe follows the principle of food support for diabetic patients, and suggests that patients should have a quantitative staple food, and at the same time, reasonably match the seasonal characteristic ingredients in South China.

　　It is never too late to live a healthy life.

　　The Guide also suggests that diabetic patients record their diet, exercise and blood sugar levels, so as to improve the scientific planning level of blood sugar control and self-management.

　　At the suggestion of the doctor, Shi Mairu created a staple food sugar record table, which recorded the staple food she ate and the sugar she ingested at each meal. "Before eating, I will take out the record form to see if there is any excess today. If it is excessive, then restrain it; If not, just eat a little. "

　　When she was first diagnosed, Shi Mairu went through a period of collapse. During that time, she almost didn’t eat staple food and didn’t dare to eat any food with high oil and sugar in order to control sugar, but suddenly giving up sugar made her feel very tormented and it was difficult to stick to it. "With the record sheet, I began to plan my diet reasonably, not as extreme as before, which made it easier for me to stick to it."

　　The Guide also suggests that diabetics should exercise after meals for at least 5 days a week for 30-45 minutes each time, and moderate-intensity exercise should account for more than 50%, step by step and persistently.

　　For young people, diabetes brings more psychological stress than physical pain. In the communication with patients, Shi Mairu found that everyone was generally worried that diabetes would affect future development and marriage and childbirth. And Chen Hongjie often jumped repeatedly between "forced to accept" and "unbelievable" a few months ago. "Although I still have a chance to achieve a reversal, I feel like a damaged wheel. I need to pay attention to the control of blood sugar for the rest of my life so that the wheel will not be damaged."

　　"However, healthy living is not as difficult as imagined." Encouraged by his girlfriend, Chen Hongjie began to change the rules of life, eat a reasonable and nutritious diet, go to bed early and get up early, and seize all the interval exercises. "Health is a kind of accumulation. If you can stay up late less, you will stay up less. If you can drink less milk tea, you will drink less milk tea. If you can exercise more, you will exercise more, even if it is only 10 minutes!" Now, Chen Hongjie’s blood sugar has been basically controlled.

　　"Most people don’t know that diabetes will have an incubation period of 2-3 years. Early detection and correction at this stage can be completely reversed." Chen Hongjie said, "Many young people like me know very little about diabetes, and always feel that it is a very distant thing from us to have diabetes. I want to use my own experience to appeal to young people to pay attention to blood sugar and diabetes. "

　　Chen Hongjie said, "You only need to pay more attention, learn more about the knowledge of preventing diabetes, regulate your behavior under the premise of attention, and try to maintain yourself in a healthy state, which will greatly avoid the occurrence of diabetes."

　　The best time to plant a tree is 10 years ago, followed by now. The same is true for everyone’s healthy life.

　　Zhongqingbao Zhongqingwang Trainee Reporter Si Tan

The picture shows the staff of the Tax Service Office of the Taxation Bureau of Chang ‘an District, Shijiazhuang City guiding taxpayers to bind the billing code. Photo by Xu Guoliang

A few days ago, Mr. Ma of Shijiazhuang Private Home Economics Service Co., Ltd. came to the Tax Service Hall of the Taxation Bureau of Chang ‘an District, Shijiazhuang City to apply for invoicing. Under the recommendation of tax officials, Mr. Ma used his mobile phone to log on to the mobile tax terminal of Hebei Online Taxation Bureau and entered the electronic invoice system. In one minute, an electronic invoice with an amount of 2,500 yuan was sent to the mailbox of the payee. "Very convenient! Usually, I don’t use many tickets, but it takes one hour to invoice from the company to the tax bureau, and I can invoice at any time no matter where I am! " Mr. Ma said happily.

On October 1st, Hebei Provincial Taxation Bureau began to implement the online tax-free electronic invoicing system for small and micro enterprises (hereinafter referred to as the "electronic invoicing system"). Taxpayers can APPly to the tax authorities for issuing VAT electronic ordinary invoices through the mobile phone app of Hebei Online Taxation Bureau.

The staff of the Goods and Services Tax Department of the Provincial Taxation Bureau introduced that the monthly sales are less than 30,000 yuan; VAT taxes have been approved but invoice types have not been approved; Taxpayers who meet the three conditions of unit taxpayer or individual industrial and commercial households with fixed personal income tax can use the electronic invoicing system to invoice customers 24 hours a day without leaving home.

It is understood that users who issue invoices need to pass real-name authentication to register the mobile APP account of "Hebei Online Taxation Bureau Mobile Tax Terminal" to ensure their identity is credible. All invoice data will be transmitted to the anti-counterfeiting tax control system in real time after being generated to ensure real-time correctness and effectiveness. The payee can also receive the electronic invoice immediately and check it on the mobile phone at any time. When taxpayers use the electronic invoicing system for the first time, they must first bind the billing QR code, and the billing code is one for each household. By scanning the billing code with Alipay, the payee can directly push the billing header information to the billing party, which not only saves the trouble of manual input by the billing party, but also is less prone to errors. After invoicing, the payee can view the invoice at any time in the "Invoice Management" interface of Alipay.

On October 25th, Ms. Su of Haixing County successfully issued her first electronic invoice through the mobile phone APP of Hebei Online Taxation Bureau. She used "three unexpected things" to express her inner joy: I didn’t expect it to be so simple that a mobile phone could do it! I didn’t expect it to be so intimate that I could do it without leaving home! I didn’t expect it to be so easy to use, and I can log in 24 hours!

According to statistics, by the end of October, 780 taxpayers in our province had used the electronic invoice issuing system and issued 1,203 electronic ordinary VAT invoices, amounting to more than 360,000 yuan. "The electronic invoicing system has not been put into use for a long time. We need to further strengthen the training and publicity for grassroots tax personnel and taxpayers, so that taxpayers can understand the system as soon as possible and fully enjoy the convenient invoicing service." Dong Xijuan, director of the Goods and Services Tax Division of the Provincial Taxation Bureau, said.

(Chen Jun, Xue Lei, Ma Jianmin)

Panorama of Dongming County Sewage Treatment Plant

　　Recently, some websites and forums have surprised many people with thyroid diseases because of the serious environmental pollution in Dongming County, which has attracted the attention of netizens. On the 23rd, relevant departments and personnel of Dongming County and Heze City responded through this newspaper.

　　Is the environmental pollution in Dongming County so "serious"?

　　"A large amount of wastewater has seriously polluted the groundwater in the urban area of Dongming County (Fangming Chemical Factory is in the county, Hongye Chemical is in the countryside), making the groundwater around it undrinkable, and a large amount of carbon dioxide and sulfur dioxide have seriously polluted the atmosphere, which has brought great hidden dangers to the water safety and health of the entire urban residents." This is the content of a post on a website forum.

　　On June 23, the person in charge of the relevant departments of Dongming County issued a report on groundwater inspection in Dongming County issued by Heze Water Quality Testing Center on June 19. The inspection conclusion was that except fluoride and turbidity, all the others met GB5749-2006 "National Hygienic Standard for Drinking Water".

　　Yin Wenqing, director of the Center for Disease Control and Prevention in Dongming County, told the reporter that in the first half of this year, they sampled and analyzed the drinking water of Dongming Credit Cooperative, West Hospital of Water Affairs Bureau and Highway Bureau, and tested 11 indicators according to GB5749—2006 sanitary standard for drinking water, except for fluoride exceeding the standard, the other 10 indicators were all qualified. In order to verify whether environmental pollution can induce the cause of thyroid tumor, the county conducted a door-to-door survey in Vu Thang Bridge and Jiaoyuan townships. In 2008, no case of thyroid cancer was found in Qiaoxiang, Vu Thang, where chemical enterprises were concentrated (one case was found in 2009), while Jiaoyuan Township, which is located in the Yellow River beach area without chemical enterprises, found three cases of thyroid cancer in 2008.

　　On June 23rd, a monitoring report issued by Heze Environmental Monitoring Center Station pointed out that in June 2009, their wastewater around key enterprises and their subordinate wastewater was discharged into 10 villages in the lower reaches of the river. According to GB5749—2006 sanitary standard for drinking water, 20 indicators were rationally distributed, sampled and tested, and all the other 19 indicators were qualified except fluoride. These 10 villages are Gangzhuang and Liufen villages around dongming petrochemical Group, Zhangzhan village around Yuhuang Chemical Industry, Wulibao, Haozhai and Beiguan villages around Hongye Chemical Industry, Dongguan and Dongsanli villages around Fangming Chemical Industry, and Wang Guan Tun and Wuzhuang villages are also selected on both sides of the north branch of Dongyu River. At the same time, Heze Environmental Monitoring Center added six indicators such as benzene, toluene and ethylbenzene to the water samples of the above 10 villages, but none of them were detected. The county is located in a high fluoride area, and geological conditions are the main reasons for fluoride exceeding the standard.

　　According to reports, in view of the water quality around chemical enterprises, Heze Environmental Monitoring Center Station sampled and tested the drainage water quality of Petrochemical Group, Yongyue Paper (which entered the county sewage treatment plant for reprocessing after sewage treatment), Yuhuang Chemical, Hongye Chemical and sewage treatment plants in June 2009, and the chemical oxygen demand and ammonia nitrogen all reached the standard of general protected areas in the Discharge Standard of Water Pollution Substances for South-to-North Water Diversion Project in Shandong Province.

　　The number of thyroid tumors is as high as 60% or more?

　　"According to the chief physician, the number of people suffering from thyroid tumors has exceeded 60%. According to this calculation, there are 50,000 to 60,000 people in urban areas who are sick, and the development is particularly fast. Many patients have deteriorated." This is what netizens posted.

　　On June 23rd, Quan Hong Tao, the deputy magistrate in charge of health work in Dongming County, told reporters that in 2007, when the People’s Hospital of Dongming County conducted a physical examination for 670 employees in our hospital, the thyroid gland was included in the examination for the first time. A total of 60 people were found to have thyroid diseases, with a prevalence rate of 8.95%, and the last four people were diagnosed as thyroid cancer (thyroid diseases were not listed as physical examination items in other counties and districts of the city). They also investigated the incidence of thyroid disease in the county. In 2008, 401 people were hospitalized with thyroid disease in the county, including 41 people with thyroid cancer.

　　Quan Hong Tao said that the Dongming County Party Committee and the county government attached great importance to it and took the following measures in time: First, the thyroid examination was listed as a routine examination item for the health examination of cadres and workers; Second, in 2008, the county CDC conducted a special survey of thyroid diseases, and checked 3680 people in more than 20 units in the county, and found 522 cases, with an average prevalence rate of 14.2%, far lower than some high-incidence areas in China.

　　According to Wang Naishuo, chief physician of Heze City Center for Disease Control, thyroid disease is a common and frequently-occurring disease, which is on the rise in many parts of the country. There are many reasons to induce thyroid diseases, such as high iodine and iodine deficiency, especially high iodine is the main reason to induce thyroid diseases.

　　According to Quan Hong Tao, Dongming County is a high iodine area, and Dongming County has been taking iodized salt from 1996 to 2005.

　　Point to point verification

　　Rumor: The post said, "There are 12 adults in Wang Junping’s family, the first junior high school teacher in the county. Last year, six people suffered from thyroid tumors. This year, nine people have suffered from this disease."

　　Response: On June 23rd, a certificate signed by Mr. Wang Junping, which was investigated by the floating staff in Dongming, showed that there were 21 members in Mr. Wang’s extended family, 8 of whom suffered from nodular lesions of thyroid disease, but there were three diagnosis reports, no one suffered from thyroid cancer, and no one underwent surgery or medication.

　　Rumor: The post also said that "ten teachers in Muzhuang Primary School in Chengguan Town found that six of them had thyroid tumors, and one of them had undergone resection because of the large tumor".

　　Response: According to Yao Cunshan, the principal of Muzhuang Primary School, there were 12 teachers who had physical examination in 2008. After examination by the County Maternal and Child Health Hospital, two of them suffered from thyroid disease, all of which were benign.

　　Rumor: The post also said, "In the last three years, a strange disease began to appear in our county, that is, most people suffered from thyroid tumors. The number of patients has developed very rapidly since 2008. In 2009, when the retired cadres were examined, the project of adding thyroid tumors was added. According to the chief physician, the number of people suffering from thyroid tumors has exceeded 60%. According to this calculation, there are 50,000 to 60,000 urban residents who are sick, and the development is particularly fast, and many patients have deteriorated. "

　　Response: According to Lu Mingqi, vice president of Dongming County People’s Hospital, the number of people who claimed to have thyroid tumors was over 60%. According to Quan Hong Tao, deputy magistrate of Dongming County, in 2008, the county hospitals conducted health check-ups for 5,099 people from 19 units in the county, and 734 people were found to have thyroid diseases, with a prevalence rate of 14.39%.

　　"Solemn statement" popped up on the Internet.

　　At about 19 o’clock on June 23rd, Baidu Heze Post Bar appeared a statement about the post "Tens of thousands of people suddenly suffer from thyroid tumor in Dongming County".

　　The statement said: Dear netizens, at about 9: 30 pm on June 17, 2009, I published the post "Tens of thousands of people suddenly suffer from thyroid tumors in Dongming County" under the registered name "Chunmiao" in the cat’s eye section of Kaidi Community. The text of this post was written by some retired teachers and cadres in our county according to their own understanding, and I was entrusted to publish it online. The only purpose of publishing this post is to attract the attention of superior leaders, send someone to thoroughly investigate the causes of thyroid tumor in Dongming County and order relevant chemical enterprises to immediately stop discharging sewage into urban sewers.

　　Shortly after I published this post, many websites reprinted this article. But what makes people angry is that, without my knowledge, some individuals and groups actually modified the title of the article when reposting it, and even added illegal terrorist remarks that were inconsistent with the facts in the text! These despicable acts of tampering with the title and text of my post and seriously distorting the original intention of my post have affected my life and the reputation of my hometown.

　　In view of this, I hereby solemnly declare that all my posts about the thyroid condition and signed pictures in Dongming County are only published in the cat’s eye section of Kaidi Community, and any related posts on any other websites are not published by me! At present, the social and political stability and rapid economic development in Dongming County have not proved that there are tens of thousands of people suffering from thyroid diseases caused by pollution problems, let alone the so-called "riots" mentioned on some websites!

　　Finally, I regret the negative reports brought to my hometown because my posts have been maliciously tampered with by some people, and I sincerely hope that all netizens will act together to find clues about these posts with bad purposes and report these dangerous elements that harm national interests and social stability!

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