Encyclopedia of Family Medicine

Chapter 42 Prevention of Common Diseases (3)
Cryptorchidism.Among patients with testicular malignancies, 1/3 to 1/4 have cryptorchidism.The chance of developing malignant tumors in cryptorchidism patients is dozens or even hundreds of times higher than that of normal people, but as long as they are treated early, they can be completely avoided.

The large intestine suffers from meat.It is an abnormal protrusion on the mucosa of the large intestine, including adenoma, inflammation, and hyperplasia.Only adenomas may become malignant.Adenomas are divided into tubular adenomas, villous adenomas, and mixed adenomas.Villous adenomas are most likely to become malignant, followed by mixed adenomas, and tubular adenomas are least likely to become malignant.The more the number of adenomas, the higher the location, the less likely the possibility of malignant transformation.Colorectal polyps may be asymptomatic, or may have blood in the stool and diarrhea.A fecal occult blood test may provide clues for further investigation.The most reliable inspection method is colonoscopy, which can not only confirm the diagnosis, but also remove polyps by the way.

The way to prevent it is to develop the habit of defecation on time and eat more vegetables and vegetarian food.Appropriately reduce the proportion of fatty meat in the diet and receive regular inspections.

3. Tumor screening
Medical personnel use relevant inspection methods to find early cancer patients among asymptomatic people, which is called tumor screening.Because tumor screening consumes a lot of manpower, material resources and financial resources, and its safety, pertinence and feasibility must also be considered, it cannot be used for everyone aimlessly.Commonly used census methods, objects and intervals are as follows:

Health care and cancer screening.Including thyroid, testes, prostate, ovaries, lymph nodes, mouth and skin. People over the age of 20 are checked every 3 years.People over 1 years old check once a year.

乳房检查。由医师做乳房检查，20~40岁的女性每3年1次，大于45岁的女性每年查1次；自己乳房检查。每月1次；乳房红外线扫描和（或）X线检查，35~40岁的女性检查1次，留作日后对比用。41~50岁的女性每1~2年1次。50岁以上的女性，每年查1次。

Anal finger examination.The anus and rectum are checked by a doctor wearing gloves, and people over the age of 40 are checked once a year.

Occult blood in stool. People over the age of 50 check once a year.

Pelvic exam. Women aged 20 to 40 should go to the hospital for check-ups every 3 years.

宫颈涂片检查。已婚至65岁的女性每隔1年检查1次，如连续2次阴性，以后可每3年查1次。

Sigmoidoscopy. People over the age of 50 should be checked every 3 to 5 years.

Endometrial biopsy.Limited to irregular bleeding after menopause.
4.tumor self-examination

For tumors in the breast, mouth, lymph nodes, skin, male genitals, etc., patients can check them by themselves.now.

(1) Breasts

Breast self-examination should be arranged on the fifth day after menstruation is clean.At this time, it can avoid the influence of thick breast tissue before or during menstruation on the examination.Those who have gone through menopause can fix a certain day of each month.The steps of self-examination are as follows:

① Take off the upper body clothes, stand or sit in front of the mirror, and observe whether the shape of the breast changes;

② Put your hands behind your head.Or raise your hand over your head and make the same observation again;

③ Lean forward slightly, and observe whether the breast and skin are concave, and whether the shape of the nipple and breast has changed.Put your hands on your hips again, and make the same observation;

④ Press your fingers flat on the opposite breast, raise the other hand over your head, and gently touch a small part of it.The sequence should work from the edge of the breast in a slow, inward circular motion to touch the nipple, not missing the area between the breast and the armpit.Don't miss the armpits either;

⑤If you take the supine position, you can put a small pillow under the shoulders, so that the breasts can be flat on the chest wall;
⑥ Gently squeeze the nipple to see if there is any secretion or abnormal invagination;

⑦ Change one hand to check the opposite breast in the same way.

Normal breast skin is smooth.The two sides are basically symmetrical, and the breast tissue is soft.Except for breastfeeding.There should be no discharge from the nipples, and generally there should be no enlarged lymph nodes in the armpits.If you find a lump in your breast or armpit during the self-examination, you should ask a doctor for identification.

(2) Oral

Oral examination can be done alone in front of a mirror, or you can ask someone to help you.Proceed as follows:
① Check the face and neck.When examining the neck, tilt the head back as far as possible to look for abnormalities in the mandibular area and neck.Then touch the neck and mandible area on the left and right sides with your hands, and try to see if there is any difference between the two sides.

② Check the lips.First observe the outside of the upper and lower lips with your eyes, and then touch them with your hands.Then use the thumb and index finger to pull down the lower lip to check the inner side, and finally check the inner side of the upper lip.

③ Check the gums.Check the gums by pulling the open lip and touching with your index finger to see if they are the same as the last time you checked.

④ Check the cheeks.Close your mouth lightly, place your thumb and index finger on the corners of your mouth and pull them apart, observe with your eyes, and touch both cheeks with your hands to see if there is any abnormality.

⑤ Check the tongue.Stick out the tongue, hold the tongue with gauze on the hand, observe and touch the tongue surface, and pull the tongue to the left and right respectively, and observe the two sides of the tongue.

⑥ Check the base of the tongue.Lift the tongue against the palate as much as possible, observe and touch the base of the tongue to check for abnormalities.

⑦ Check the pharynx and palate.Make the "ah" sound and observe the pharynx in a bright place.Then tilt the head back slightly, looking at and touching the palate.

When you find the following abnormalities during self-examination, you should see a stomatologist; there are lumps, nodules, and leukoplakia; red plaques, ulcers, inflammation and other symptoms that do not heal for a long time, and there is no obvious reason for the oral cavity repeated bleeding, numbness, burning or dryness in the mouth, trouble speaking and swallowing.

(3) skin

The self-examination of the skin can be carried out once every six months, mainly to detect abnormal moles, malignant melanoma, skin cancer and obvious lumps in time.

The inspection steps are as follows:
① With the palm facing up, observe the palm, fingers, finger crevices, and forearm, then turn the hand over, and observe the back of the hand, fingers, seams, nail bed, and forearm;
②Stand in front of the full-length mirror, with the forearm bent and the palm facing backward, and observe the back of the arm and the elbow from the mirror;

③ With the arms drooping and the palm facing forward, observe the face, neck, chest, abdomen, pubic bone, thigh, lower elbow and upper arm in turn from the mirror;

④ Lateral position.Arms raised above head, palms facing each other.Start by looking at a hand, arm, underarm, torso, thigh, and lower extremity.Turn around and look the other way;
⑤ Turn your back to the mirror and observe the buttocks and lower limbs;

⑥ For the top of the head and the back of the head and neck, use a mirror or ask family members to help observe, and be careful not to miss the inspection of the scalp;
⑦Sit down, put one leg on a small stool, and use a small mirror to observe the groin and the inner side of the leg.Observe the other leg in the same way;

⑧ Put one leg on the other, first observe the surface of the feet, toenails, and toe seams, and then use a mirror to observe the toes, soles, and toe seams.

(4) Lymph nodes
There are many lymph nodes in the superficial parts of the body.These lymph nodes are very small, usually between 0 and 1 cm in diameter, and are usually not easily palpable.

Check lymph nodes should be carried out in sequence, so as not to miss.Do not panic if you find enlarged lymph nodes.Because there are many reasons for swollen lymph nodes, most cases are not a big problem.But it is still necessary to ask a doctor to identify it.

(5) Male genitalia
Patients can do self-examination of the penis and scrotum.

The foreskin of the adult penis should not cover the urethral opening, and the glans can be exposed when turned up.Excessive foreskin can easily cause inflammation and is also one of the factors of penile cancer. The head of the normal penis is rosy and smooth.

There are spermatic cords, testes, and epididymis in the scrotum. During the inspection, the legs should be slightly separated and the testes on both sides should be touched at the same time.The testicles of normal people are similar in size and smooth and flexible.If the two sides are asymmetrical, or there are nodules and lumps in the testicle, you need to ask a doctor for further examination.

5.Tumor high-risk groups and examination methods

The so-called high-risk groups of tumors mean that their risk of developing cancer is much greater than that of ordinary people.These people need frequent medical examinations in order to rule out or early detection of tumors and timely treatment.Various common tumors have their corresponding high-risk groups.

(1) Gastric cancer

High-risk population
① Men over 35 years old, women over 30 years old;
②Severe gastric ulcer, atrophic gastritis and intestinal metaplasia or atypical hyperplasia were found by X-ray or gastroscopy;
③ Those who have had gastric surgery for more than 10 years;
④ Repeated melena or positive fecal occult blood test;
⑤ Those who usually like to eat hard, pickled products and high-salt foods and have stomach symptoms;
⑥Patients with original gastric pain or other stomach discomfort, whose regularity and nature have changed recently.

Inspection Method

Barium meal film or double contrast X-ray contrast, gastroscopy.

(2) Colorectal cancer
High-risk population
① Men over 35 years old, women over 30 years old, with multiple intestinal polyps or obesity;
②The frequency of stool increases, the stool becomes thinner and flatter and has lasted for more than 1 month;
③Those with mucus and blood in stool;
④Abdominal pain at a fixed location;
⑤ Those with a history of ulcerative colitis.

Inspection Method

Fecal occult blood test, digital rectal examination, colonoscopy or barium enema.

(3) Liver cancer

High-risk population
① Men over 20 years old, women over 25 years old;
②Hepatitis or liver cirrhosis for more than 5 years;
③ Hepatitis B surface antigen (HBSAg) positive;
④ Continuous weak positive alpha-fetoprotein (AFP).

Inspection Method

Alpha-fetoprotein, B-ultrasound, CT examination if necessary.

(4) Esophageal cancer
High-risk objects
① Men are over 45 years old and women are over 40 years old;
② Persistent dysphagia for more than 2 weeks or repeated dysphagia for more than 3 months;
③ There is often more foam in the mouth for more than 2 weeks.

Inspection Method

Esophageal barium meal X-ray examination or esophagoscopy, esophagus mesh cytology.

(5) Breast cancer
High-risk population
①Women over 30 years old, especially menarche before 12 years old, menopausal later than 55 years old, irregular menstruation,
② Those who have not given birth after marriage, or who have given birth after the age of 30, or who have given birth without breastfeeding or rarely breastfeeding,
③ Lumps are felt in the breast, or the skin of the breast is thickened, and the lump or skin thickening has nothing to do with menstruation;
④Repeated nipple discharge or nipple erosion,
⑤ Patients with swollen lymph nodes in one armpit;
⑥ Close relatives have breast cancer patients.

Inspection Method

Breast examination, breast infrared scan, mammogram, needle aspiration cytology or surgical biopsy if necessary.

(6) Cervical cancer
High-risk population
① Women over the age of 50, especially those who have premature sexual life, disordered sexual life, early childbearing, and multiple births;
② Unhealed cervical inflammation and erosion;

③ Irregular vaginal bleeding or increased leucorrhea discharge with odor;

④ Those with poor long-term nutritional status.

Inspection Method

Pap smear cytology, biopsy.

(7) Endometrial cancer (uterine body cancer)

High-risk population
①Age over 50 years old, especially those over 55 years old who have not yet reached menopause;
② Abnormal vaginal bleeding or leucorrhea outside of menstrual period;
③ Obesity, diabetes, hypertension.

Inspection Method

Pelvic exam.Diagnostic curettage or hysteroscopy.

(8) Ovarian cancer
High-risk population
① close relatives have ovarian cancer patients;

②Age over 50 years old;
③ No birth.

Inspection Method

Pelvic examination, B-ultrasound, laparoscopy.

(9) Lung cancer

High-risk population
① Men over 45 years old, women over 40 years old;
②Smokers who have smoked for more than 400 years (year of smoking = number of cigarettes smoked per day × number of years of smoking);
③ Long-term exposure to harmful and toxic substances, such as arsenic, asbestos, dust, etc.;
④ There are recurrent lesions in the same part of the lung, such as inflammation and tuberculosis;
⑤ If there is blood in the sputum, persistent cough, chest pain, and fever, which cannot be controlled after 2-3 weeks of active treatment,
Inspection Method

Sputum exfoliation cytology, chest X-ray, fiberoptic bronchoscopy or CT.

(10) Prostate cancer

High-risk population
① Men over the age of 60;
② Difficulty urinating.

Inspection Method

Anal digital examination, acid phosphatase, B-ultrasound or CT, needle aspiration cytology.

(11) Thyroid cancer

High-risk population
① Head and neck radiation therapy was done in childhood;
②Thyroid mass in children, young people, and men;

③ Hoarseness, excessive thyroid enlargement, and local pain;

④ Thyroid scan shows "cold nodules", blood calcitonin rises, and ultrasonographic nodules are solid lesions;
⑤ After treatment with thyroid tablets, no tumor shrinkage was observed.

Inspection Method

Thyroid biopsy, isotope scan, B-ultrasound, needle aspiration cytology, surgical biopsy.

6.Cancer Red Flags
Cancer is a chronic disease. In the early stage of its onset, some symptoms often appear, which are the danger signs of cancer.They are:

①Palpable lumps in the breast, skin or any part of the body that do not subside for a long time;
② Obvious changes in warts or moles;
③Persistent indigestion;
④Retrosternal discomfort when swallowing, abnormal sensation in the esophagus, slight pain, and choking feeling when eating;

⑤ tinnitus, hearing loss.stuffy nose, nosebleeds, sometimes with headaches or lumps in the neck;

⑥ vaginal bleeding outside the menstrual period or after menopause, especially vaginal bleeding after sexual intercourse;

⑦ Persistent dry cough, bloodshot sputum, hoarse voice;

⑧ Changes in bowel habits, alternating constipation and diarrhea, blood in the stool, and unexplained hematuria;
⑨ Unhealed wound ulcers;

⑩Unexplained weight loss.

The above symptoms are not unique to cancer, they can occur in other benign diseases.On the other hand, if these symptoms are caused by cancer, some may belong to early cancer, and some are not too early.However, people with the above symptoms should see a doctor as soon as possible so that they can get timely diagnosis and treatment.

Lifestyle and Mental Health

Everyone has their own way of life, and a healthy way of life should at least include the following aspects: ① reasonable nutrition; ② exercise; ③ no smoking, no alcoholism; No drug abuse; ⑥ healthy sexual behavior; ⑦ good adaptability to tension or stress, pay attention to mental hygiene.

Whether it is healthy or not needs to be considered from both physical and psychological aspects.Physical health is relatively easy to observe, and the evaluation of health status is shown in the table below.Clinical medicine, and most of the content in this book, is mainly concerned with physical health.

Mental health also has certain standards, which can generally be defined as: normal intelligence, stable and happy mood, coordinated behavior and age characteristics, moderate response, free interpersonal response, self-respect and self-love, good interpersonal relationship, love of work, love of life.

With the progress of society and the improvement of people's lives, the significance of mental health has been paid more and more attention.Mental health belongs to the category of psychology and involves a wide range of content, the most important of which is how to deal with psychological pressure.

In psychology, a state of tension.Stress response and stress stimulus are synonyms.The generation of psychological stress or psychological stress is the result of maladaptation between the body and the environment.In the process of life activities, people constantly produce physiological and psychological needs.Man must satisfy these needs through his own actions.However, each individual's ability to meet his own needs is limited.Psychological imbalances occur when people's needs do not match, or conflict with, their ability to meet those needs.If the situation is mild or short-lived, it can be adjusted quickly. If the situation is so strong and long-lasting that the body and mind cannot bear it, psychological stress will occur.

Factors that can cause psychological stress or psychological stimulation are ubiquitous in life, such as poor working environment, complicated personal relationships, conflicts in family and work, and so on.Sometimes unexpected success or joy is also an important source of psychological stress.Just as infectious diseases can enhance people's immunity, appropriate psychological stress can make people's lives more meaningful and colorful. However, if people are under excessive stress for a long time, it will not only lead to mental disorders, but also cause various diseases. Physical diseases, such as hypertension, coronary heart disease, bronchial asthma, peptic ulcer, irritable bowel syndrome, ulcerative colitis, menopausal syndrome, urticaria, tension headache.The occurrence and development of cancer are also related to excessive stress.

If you are experiencing unmanageable psychological stress or tension in your life, the following measures may help you:

①Acknowledging what you can't change, you may not be able to change some people and things, but you can change the way you treat people and things.

②Only do one thing at a time.If you want to do everything well, it is almost impossible!
③ Less complaining.One should look for the advantage or advantage of one more person or thing, no matter how trivial the advantage or advantage may be, and be happy about it.Learn to put life in perspective and not just whine.

④ Set aside time for rest or entertainment to satisfy your hobbies or hobbies.

⑤ Tell your friends or psychiatrist about your troubles and misfortunes.The more you worry about something, the more serious it becomes.Discussing this worry with each other can bring it back to its true colors.

⑥ Adhere to physical exercise.Physical activity builds your body, makes you feel good, and helps you overcome the conflicts you face in life.

⑦ Do not take medicine without the guidance of a doctor.Such as sedative hypnotics, indigestion drugs, painkillers and so on.These drugs can only relieve symptoms, and once the drug effect passes, the lesion itself still exists.

Dietary Taboos and Dietary Therapy for Common Diseases
1. Bronchial asthma
Bronchial asthma is mostly caused by allergies, with a sudden onset, shortness of breath, and throat wheezing as clinical manifestations.Chinese medicine believes that it is mostly caused by improper diet.The incidence rate in western countries is higher than that in third world countries, and immigrants from developing countries to developed countries also tend to increase the incidence, so it is closely related to the environment.In addition to allergic factors to environmental pollutants, it is also related to excessive sodium chloride content in daily food.The fact that salt sales in different regions of the United States is directly proportional to the local bronchial asthma mortality rate can also prove this point.Modern medicine believes that the disease is mostly caused by allergic factors, so some foods that are prone to allergies should be contraindicated, such as dried shrimps, rapeseed flowers, crabs, fresh rice and other foods, as well as moldy and spoiled foods.Other irritating foods such as tobacco, alcohol, and chili should also be taboo.

In Japan, it is advocated not to eat meat dishes during an asthma attack, because animal foods increase the acidity of the blood and affect the human body's ability to digest heterosexual proteins, which make heterosexual proteins a new allergen and induce asthma.According to medical principles, raw pears, celery, water chestnuts and other foods should not be eaten for cold asthma; mutton, goose, ginger, cinnamon, etc. should not be eaten in hot asthma.Those with asthma and abdominal distension should not eat beans, taro, etc., so as not to aggravate the symptoms of shortness of breath.

(End of this chapter)