講CUHK單嘢都講到口臭,今日想講下現代醫學急速發展,科學醫學基因學一日千里後對醫學院學生同初級醫生嘅影響
拿,頭盔,我唔係故意要同senior們作對,而係有d好重要嘅概念我覺得一路都無人address過。而醫學界仍然有股好重嘅「當年都係咁捱咁讀,點解你咁多意見」嘅風氣
的確,當年前輩們嘅非人on call生活、要去library睇文獻睇書而唔係方便地用Microsoft surface神速打筆記、開uptodate、開pubmed/medline等等。
無可否認,上個年前代嘅醫生們要增進知識要靠嘅自動波去睇論文去溫書,甚至要自己去R導師做臨床教學等等。無人否認當年環境無咁豐富,上堂無精美PowerPoint、臨床教學今時今日已經好structured,分哂history session, examination session, skills session,有像真度極高嘅假人俾你練習,呢d係上代無嘅luxuries
No one is denying this fact
但上一代都一樣無嘅係咩,大家有無諗過?
就係千千萬萬種過去20年發展出來嘅科學醫學理論同治療方法。
O&G 幾十年前都未知道preeclampsia嘅實際原因係乜,原來可以early pregnancy low dose aspirin prevent or delay onset of preeclampsia。廿年前都無HPV疫苗, 都無話原來screen HPV virology比Pap smears更有效發現子宮頸病變,廿年前無人需要知道呢d
Rheumatology幾十年都無一堆biologics, TNFa, IL inhibitor 。原來autoimmune inflammatory arthritis failed NSAID/MTX可以轉infliximab, adalimumab。psoriatic可以用secukinumab但如果有IBD/enteropathic features要小心IL-17 inhibitor,廿前年無人需要知道呢d
Immunology/ID,幾十年前HIV邊有咁多種antiretroviral?今時今日ART多到就算你de novo resistance都可以換藥換到U=U,廿年前都係得舊式治療,無人需要知種種嘅新式療法。immunology仲多咗幾十種唔同嘅complement, complement inhibitor etc etc嘅investigation
Respiratory醫ILD或pulmonary HTN幾十年前個療法來來去去都係得幾種。今時今日IPF有nintedanib,Pul HTN有成堆endothelin antagonist、PDE5 inhibitor同prostacyclin類嘅藥要知。asthma當年來來去去都係ventolin+inhaled/oral steroid,今時今日分埋IgE asthma, eosinophilic asthma,有成堆唔同嘅SABA-LABA, SAMA-LAMA, IgE monoclonal antibodies, IL-5, IL-4 and IL-13,到底eosinophil要幾多先會大機會有response,用緊steroid嘅eosinophil個cutoff係幾多。
Hematology/oncology幾十年前都未有monoclonal antibodies,無rituximab、nivolumab、targeted therapy等等,幾十年來個發現多咗好多唔同gene mutation同targeted site,EGFR, VEGFR, CTLA-4, PD-1,PD-L1、BRAF,HER-2, you name it you got it。以前癌症病人你大多只要beware of neutropenic fever/infection,今時今日你要screen埋immune checkpoint inhibitor autoimmune hepatitis, pneumonitis, thyroditis, colitis,你要知埋有個病人用緊nivolumab時突然變黃,你要screen咩autoimmune,落咩藥,high dose steroid定點,之後仲可唔可以rechallenge。乳癌病人HER-2依加唔止用herceptin,仲有埋pertuzumab,你仲要screen埋cardiomyopathy,echo drop幾多可以接受,係唔係reversible,可唔可以rechallenge
Endocrine幾十年前糖尿病來來去去都係metformin, gliclazide, insulin今時今日T2DM有GLP-1, SGLT-2, gliptin等等,有埋continuous glucose monitoring device又有bump又有唔同林林總總嘅治療。唔止T1/T2DM,今時今日仲有埋LADA,你要知埋個autoimmune panel screen咩。骨質疏鬆當年玩來玩去都係bisphosphonate,今時今日有denusumab有teriparatide,仲有更多新藥。
Gastroenterology幾十年前IBD來來去去都係steroid/steroid sparing agent 5-ASA/aza,今時今日有TNFa blocker有a4b7 inhibitor vedolizumab。當年hepC得幾種antiviral今時今日有sofosbuvir, velpatasvir, glecaprevir等等,仲變成curative。
Neurology MS幾十年前邊有natalizumab,今時今日如果MS on natalizumab with rapid neurological decline,你要諗埋會唔會可能係JC virus reactivation。GBM以前都係只靠surgical resection,今時今日可以用avastin, temozolomide仲要screen埋MGMT hypermethylation去決定有無得用chemo
呢啲改變同發展只係佔各system嘅一小部分,只係我細小嘅腦袋突然諗到嘅小部分內容。世界不斷發展,學海無涯,我們有愈來愈多嘅知識要學,呢一點無人懷疑過。
醫生擁有比一般人更多嘅權力同地位,就自然需要更大嘅責任。
但係,值得大家反思嘅係,當個knowledge base不斷擴大嘅時候,考試仍然要期望你記埋某張slide嘅角落嘅minute details時,呢個係唔係一個合理嘅期望?
當一個basic trainee去考PACES/long case嘅時候,到底係唔係同以前一樣要知得咁深入?當深度一樣,而個base不斷widen broaden時,新世代嘅醫生應該如何應對?
而考試嘅範圍似乎未有被address過,呢點好值得我地一齊諗諗
同時也有3部Youtube影片,追蹤數超過361萬的網紅Dan Lok,也在其Youtube影片中提到,Find out what's it like to be Married to an Entrepreneur like Dan Lok. Watch until the end to get relationship insights of this power couple. ✒️Click...
「resistance gene」的推薦目錄:
- 關於resistance gene 在 Dr 文科生 Facebook 的最佳解答
- 關於resistance gene 在 IELTS Nguyễn Huyền Facebook 的最讚貼文
- 關於resistance gene 在 陳柏臣醫師的健康診間 Facebook 的最讚貼文
- 關於resistance gene 在 Dan Lok Youtube 的最佳解答
- 關於resistance gene 在 Dan Lok Youtube 的最佳解答
- 關於resistance gene 在 Joanna Soh Official Youtube 的精選貼文
- 關於resistance gene 在 arpcard/rgi - GitHub 的評價
- 關於resistance gene 在 Horizontal Gene Transfer and Antibiotic Resistance - YouTube 的評價
resistance gene 在 IELTS Nguyễn Huyền Facebook 的最讚貼文
TỪ VỰNG CHỦ ĐỀ GENETICALLY MODIFIED FOODS
- genetically-modified foods = genetically-engineered foods = bioengineered foods = foods produced through genetic modification: thực phẩm biến đổi gen
- conventional foods: thực phẩm truyền thống (không bị biến đổi gen)
- use traditional breeding methods: sử dụng phương pháp nhân giống truyền thống
- genetic engineering techniques: các kỹ thuật công nghệ gen
- technological modification of food: sự biến đổi công nghệ thực phẩm
- gene technology: công nghệ gen
- selective breeding: việc chọn giống (chọn lọc nhân tạo, sinh sản có chọn lọc)
- mutation breeding: nhân giống đột biến
- slow the ripening of fruits: làm chậm quá trình chín của trái cây
- to be resistant to…: kháng/ chống lại cái gì
- resistant genes: gen kháng (vi khuẩn,…)
- resistance against plant diseases: kháng lại dịch bệnh ở thực vật
- pose no risk to human health: không gây ra sự nguy hiểm nào cho sức khỏe con người
- to be safe for human consumption: an toàn cho sự tiêu thụ của con người
- have a detrimental impact on…: có tác động xấu lên…
- pose a serious threat to human health: gây ra sự đe dọa nghiêm trọng cho sức khỏe con người
- suffer from various health issues such as cancer: bị hàng loạt các vấn đề về sức khỏe như ung thư
- put somebody at risk of...: đặt ai đó vào rủi ro bị gì
- develop suitable genetic modification: phát triển công nghệ biến đổi gen bền vững
- improve crop protection: cải thiện sự bảo vệ mùa màng
- pass safety assessments: vượt qua các đánh giá về sự an toàn
- decreased/ increased nutrient levels: mức độ dinh dưỡng giảm/tăng
- overuse of chemical fertilizers and pesticides: lạm dụng phân bón hóa học và thuốc trừ sâu
https://ielts-nguyenhuyen.com/tu-vung-ielts-chu-de-genetically-modified-foods/
#ieltsnguyenhuyen
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resistance gene 在 陳柏臣醫師的健康診間 Facebook 的最讚貼文
A biomarker panel accurately distinguished combat-exposed US veterans with and without PTSD. Some of the biomarkers have previously been linked to PTSD (eg elevated heart rate and decreased coagulation factors), others to MDD, anxiety, and other comorbid conditions, (eg platelet volume, insulin resistance, alterations in the SHANK2 gene, and PDE9A expression), and others are new (miRNAs). https://ja.ma/2oM5957
resistance gene 在 Dan Lok Youtube 的最佳解答
Find out what's it like to be Married to an Entrepreneur like Dan Lok. Watch until the end to get relationship insights of this power couple.
✒️Click Here to read the blog article✒️
https://danlok.com/the-truth-and-benefits-of-being-married-to-an-entrepreneur-what-you-must-do-to-stay-married/
★☆★BONUS FOR A LIMITED TIME★☆★
You can download Dan Lok's best-selling book F.U. Money for FREE:
http://marriedentrepreneur.danlok.link
★☆★ SUBSCRIBE TO DAN'S YOUTUBE CHANNEL NOW ★☆★
https://www.youtube.com/user/vanentrepreneurgroup?sub_confirmation=1
Check out these Top Trending Playlist:
1.) How to Sell High Ticket Products & Services: https://www.youtube.com/playlist?list=PLEmTTOfet46PlgDZSSo-gxM8ahZ9RtNQE
2.) The Art of High Ticket Sales - https://www.youtube.com/playlist?list=PLEmTTOfet46NufVkPfYhpUJAD1OBoQEEd
3.) Millionaire Mindset - https://www.youtube.com/playlist?list=PLEmTTOfet46O591glMGzRMoHaIJB-bQiq
Dan Lok, a.k.a. The King of High-Ticket Sales is one of the highest-paid and most respected consultants in the luxury and “high-ticket” space.
Dan is the creator of High-Ticket Millions Methodology™, the world's most advanced system for getting high-end clients and commanding high fees with no resistance.
Dan works exclusively with coaches, consultants, thought leaders and other service professionals who want a more sustainable, leveraged lifestyle and business through High-Ticket programs and Equity Income.
Dan is one of the rare keynote speakers and business consultants that actually owns a portfolio of highly profitable business ventures.
Not only he is a two times TEDx opening speaker, he's also an international best-selling author of over 12 books and the host of Shoulders of Titans show.
Dan's availability is extremely limited. As such, he's very selective and he is expensive (although it will be FAR less expensive than staying where you are).
Many of his clients are seeing a positive return on their investments in days, not months.
But if you think your business might benefit from one-on-one interaction with Dan, visit http://danlok.com
Or consider becoming a member of his high-level mastermind for experts: http://www.danlokinnercircle.com
★☆★ WANT TO OWN DAN'S BOOKS? ★☆★
http://www.amazon.com/Dan-Lok/e/B002BLXW1K
★☆★ NEED SOLID ADVICE? ★☆★
Request a call with Dan:
https://clarity.fm/danlok
★☆★ CONNECT WITH DAN ON SOCIAL MEDIA ★☆★
Blog: http://www.danlok.com/blog/
Podcast: http://www.shouldersoftitans.com/
FB Group: https://www.facebook.com/groups/highticketconsulting/
Twitter: https://twitter.com/danthemanlok
Instagram: https://www.instagram.com/danlok/
YouTube: https://www.youtube.com/user/vanentrepreneurgroup
Linkedin: https://www.linkedin.com/in/danlok
Meetup: http://www.meetup.com/Vancouver-Entrepreneurs-Group-Business-Network/
Amazon: http://www.amazon.com/Dan-Lok/e/B002BLXW1K
This video is about: What's It Like To Be Married To An Entrepreneur - Alpha Man Smart Woman
https://youtu.be/n0ffEhXsp5E
https://youtu.be/n0ffEhXsp5E
resistance gene 在 Dan Lok Youtube 的最佳解答
In this new video series discover how Dan & Jennie first met. Find out relationship insights of an entrepreneur married couple in Alpha Man Smart Woman video series.
★☆★BONUS FOR A LIMITED TIME★☆★
You can download Dan Lok's best-selling book F.U. Money for FREE:
http://howdanjennielokfirstmet.danlok.link
★☆★ SUBSCRIBE TO DAN'S YOUTUBE CHANNEL NOW ★☆★
https://www.youtube.com/user/vanentrepreneurgroup?sub_confirmation=1
Check out these Top Trending Playlist:
1.) How to Sell High Ticket Products & Services: https://www.youtube.com/playlist?list=PLEmTTOfet46PlgDZSSo-gxM8ahZ9RtNQE
2.) The Art of High Ticket Sales - https://www.youtube.com/playlist?list=PLEmTTOfet46NufVkPfYhpUJAD1OBoQEEd
3.) Millionaire Mindset - https://www.youtube.com/playlist?list=PLEmTTOfet46O591glMGzRMoHaIJB-bQiq
Dan Lok, a.k.a. The King of High-Ticket Sales is one of the highest-paid and most respected consultants in the luxury and “high-ticket” space.
Dan is the creator of High-Ticket Millions Methodology™, the world's most advanced system for getting high-end clients and commanding high fees with no resistance.
Dan works exclusively with coaches, consultants, thought leaders and other service professionals who want a more sustainable, leveraged lifestyle and business through High-Ticket programs and Equity Income.
Dan is one of the rare keynote speakers and business consultants that actually owns a portfolio of highly profitable business ventures.
Not only he is a two times TEDx opening speaker, he's also an international best-selling author of over 12 books and the host of Shoulders of Titans show.
Dan's availability is extremely limited. As such, he's very selective and he is expensive (although it will be FAR less expensive than staying where you are).
Many of his clients are seeing a positive return on their investments in days, not months.
But if you think your business might benefit from one-on-one interaction with Dan, visit http://danlok.com
Or consider becoming a member of his high-level mastermind for experts: http://www.danlokinnercircle.com
★☆★ WANT TO OWN DAN'S BOOKS? ★☆★
http://www.amazon.com/Dan-Lok/e/B002BLXW1K
★☆★ NEED SOLID ADVICE? ★☆★
Request a call with Dan:
https://clarity.fm/danlok
★☆★ JOIN DAN'S PRIVATE FB GROUP FOR CONSULTANTS & COACHES ★☆★
Apply here:
https://www.facebook.com/groups/highticketconsulting/
Dan hangs out there quite a bit.
★☆★ CONNECT WITH DAN ON SOCIAL MEDIA ★☆★
Blog: http://www.danlok.com/blog/
Podcast: http://www.shouldersoftitans.com/
FB Group: https://www.facebook.com/groups/highticketconsulting/
Twitter: https://twitter.com/danthemanlok
Instagram: https://www.instagram.com/danlok/
YouTube: https://www.youtube.com/user/vanentrepreneurgroup
Linkedin: https://www.linkedin.com/in/danlok
Meetup: http://www.meetup.com/Vancouver-Entrepreneurs-Group-Business-Network/
Amazon: http://www.amazon.com/Dan-Lok/e/B002BLXW1K
This video is about How Dan Lok & Jennie Lok First Met - Alpha Man Smart Woman
https://youtu.be/3-UEOsXrHqE
https://youtu.be/3-UEOsXrHqE
resistance gene 在 Joanna Soh Official Youtube 的精選貼文
Please READ this box for more info. Do you know what's your body shape? This video will show you the 6 basic female body shapes and how you can plan your workout according to your body shape to see results.
The 6 basic female body shapes are:
1) A Frame (Pear Shape)
2) V Frame (Apple Shape)
3) H Frame (Athletic Build)
4) Ruler Frame (Skinny)
5) 8 Frame (Hour Glass)
6) Oval Frame
Learn what and how much cardio and strength workout you need to do and which area to focus on according to your body shape.
The shape of your body is a direct result of your genes and your lifestyle. So embrace parts of your body that you can't change. Give your body the best fuel and exercise it needs & most importantly respect your body.
Leave your comment and let me know what's your body shape!
P/S
Hi my lovelies, I've been receiving to many repeated questions on weight loss and what workouts you should do. IF YOUR GOAL IS TO LOSE WEIGHT, PLEASE WATCH MY "7 STEPS TO PERMANENT WEIGHT LOSS VIDEO".
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No matter what your fitness goal is, the key is to do regular exercises and to eat clean in order to see results!
If you are a beginner, start with my "Beginner Fat Burning Workout Video"
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After 4 weeks, join us on the 90-Day Weight Loss Challenge. 3 months workout plans and meal plans are available on my website.
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Please like and share this video.
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Lots of Love xx
resistance gene 在 Horizontal Gene Transfer and Antibiotic Resistance - YouTube 的推薦與評價
In this video we discuss horizontal gene transfer in bacteria (conjugation) and its importance in spreading antibiotic resistance genes. ... <看更多>
resistance gene 在 arpcard/rgi - GitHub 的推薦與評價
Resistance Gene Identifier (RGI). Software to predict resistomes from protein or nucleotide data, including metagenomics data, based on homology and SNP ... ... <看更多>