The Chinese team of Wu Dajing, Ren Ziwei, Fan Kexin and Qu Chunyu won China's first Winter Olympic gold medal in the short track speed skating mixed team relay final.
However, the Heilongjiang Daily's report "Fan Kexin's Third Trip to the Winter Olympics: When He Was Young, His Family was Poor, Chinese New Year's Eve Dumplings were given by Neighbors, and He Defeated Anemia" revealed the unknown bitterness of Fan Kexin, the winter Olympic champion.
Image source: See watermark
Born in 1993, Fan Kexin began to skate since he was a child, and won many first places in the national short track speed skating competition for primary school students in 500 meters, 1000 meters, technical skating and so on. However, in 2008, 15-year-old Fan Kexin suddenly lost her "physical strength", during that time, she was often dizzy, weak, and usually could not use strength for training. When she got home, she couldn't even climb the stairs, and when it was dangerous, she almost buried her sports career. Later, the results of the examination in the hospital showed that her hemoglobin was only 70g/L, and she was diagnosed with iron deficiency anemia!
Fan Kexin's home is a photo wall of her from childhood to adulthood, source: The Paper
Iron deficiency (ID) and iron deficiency anemia (IDA) are important health problems that affect countries around the world, and are more common in adolescents and children and pregnant women of childbearing age, and timely diagnosis and treatment of ID/IDA is an important task in clinical work.
Diagnostic recommendations for iron deficiency anemia
Iron deficiency anemia can be divided into three stages: the depletion phase of iron storage, the phase of iron deficiency erythropoiesis, and the phase of iron deficiency anemia.
Diagnostic criteria for IDA
(IDA is diagnosed if any of the following Articles 1 and 2 to 9 or more are true):
(1) Small cell hypochromic anemia: male Hb
(2) There are clear causes and clinical manifestations of iron deficiency;
(3) Serum ferritin < 14 μg/L;
(4) Serum iron < 8.95 μmol/L, total iron binding force > 64.44 μmol/L;
(5) Ferritin saturation < 0.15;
(6) Bone marrow iron staining shows that bone marrow particles can be stained with iron and disappear, and the iron granule larval cells < 15%;
(7) Erythrocyte free protoporphyrin (FEP) > 0.9 μmol/L (whole blood), blood zinc protoporphyrin (ZEP) > 0.9 μmol/L (whole blood), or FEP/Hb> 4.5 μg/g Hb;
(8) Serum soluble ferritin receptor (sTRF) concentration > 26.5 nmol/L (2.25 mg/L);
(9) Iron therapy is effective.
Definition of diagnostic criteria for IDA
(1) Routine project inspection: the average red blood cell volume and the average red blood cell hemoglobin content were significantly reduced.
(2) Iron metabolism index: serum ferritin level (
Transferrin saturation decreases with ACD with IDA, defined as <100 μg/L; ferritin levels < 300 μg/L in heart failure with IDA; and transferrin saturation is low in iron refractory IDA (IRIDA), but serum ferritin levels are normal or low normal in iron refractory IDA (Figure 1).
Diagnosis of the etiology of ID/IDA
Patients with IDA should look for causes, non-invasive tests such as urea breath tests or anti-Helicobacter pylori antibodies, and gastrointestinal-related tests;
Women with vaginal bleeding should have a gynecological examination;
C-reactive protein is associated with inflammatory/neoplastic diseases in the elderly; multiple factors including clonal hematopoiesis should be excluded;
Patients with suspected IIDA should undergo TMPRSS6 gene sequencing.
ID and IDA treatment recommendations
Blood transfusion therapy
Erythrocyte transfusion is indicated in IDA patients with acute or anaemic symptoms that severely affect physiology, and the domestic transfusion indication is Hb
Iron supplementation therapy
Iron supplementation is routinely given in patients without indications for blood transfusion, which requires consideration of Hb levels, tolerance to oral iron, and comorbidities affecting iron absorption.
Therapeutic iron is divided into inorganic iron and organic iron, which are divided into oral iron and intravenous iron according to the mode of application, each of which has its own advantages and disadvantages (Table 2).
Inorganic iron in oral iron is represented by ferrous sulfate, organic iron includes dextran iron, ferrous gluconate, iron sorbitol, ferrous fumarate, ferrous succinate and polysaccharide iron complex, etc.; in addition to the above iron, traditional Chinese medicine is an important treasure in mainland China, such as spleen and blood tablets/granules, of which the elemental iron content is 20mg/tablet (bag), which has little irritation to the gastrointestinal tract (Table 3).
Treatment of the cause
Adolescents, women of childbearing age, pregnant women, and lactating women should improve their diet and supplement iron-containing foods, such as lean meat, animal offal, green leafy vegetables, etc.;
Women of childbearing age can supplement with prophylactic iron supplementation, supplemented with iron 60 mg/day;
The IDA caused by menorrhagia should regulate menstruation and look for the cause of increased menstruation;
Parasitic infections should be dewormed;
Patients with malignant tumors should be treated with surgery, radiotherapy, or chemotherapy;
Patients caused by peptic ulcer should be treated with acid suppression and stomach protection.
【Reference】
Red Blood Cell Disease (Anemia) Group of Hematology Branch of Chinese Medical Association. Multidisciplinary expert consensus on the diagnosis, treatment and prevention of iron deficiency and iron deficiency anemia. Chinese Medical Journal.2018.98(28):2233-2237.
Source: Beijing Daily, Medical Blood Channel, etc
Editor: Ren Mileage Reviewer: Xiao Ran