Prof. Zhuoli Zhang: Interview on Behcet's Disease

Behcet's disease

Behçet's disease is a systemic vasculitis that mainly manifests as recurrent oral ulcers, genital ulcers, and skin lesions, which may lead to uveitis and can also involve the gastrointestinal tract, blood vessels, heart, nervous system, lungs and other internal organs
.

In this issue, Metz Medical interviewed Professor Zhang Zhuoli from the Department of Rheumatology and Immunology of Peking University First Hospital to bring you the experience of diagnosis and treatment of Behcet's disease .

 

 

New Frontiers in Rheumatology: The misdiagnosis rate of Behçet's disease is generally high.

What do you think caused this phenomenon?

Professor Zhuoli Zhang:

Behçet's disease is a common chronic systemic vasculitis disease with a high incidence in the Middle East and the Far East .
It is also the most common vascular inflammatory disease in China.
However, the disease is very easy to be misdiagnosed, and the correct diagnosis It is the premise of treatment, so timely and accurate diagnosis is very important for treatment .

 

(1) Variable clinical symptoms
.

The misdiagnosis of Behçet's disease is mainly due to its variable clinical characteristics, among which the involvement of multiple organs and systems is very prominent

 

(2) There is no specific serological marker for Behcet's disease .

This is also a very important reason for the high misdiagnosis rate of Behcet's disease .

(3 ) Some clinicians have insufficient awareness of Behçet's disease .

In the clinical process, due to the different initial manifestations of Behçet's disease patients and the different disciplines for the first visit, if the receiving doctor's knowledge of Behcet's disease is not deep enough or thoughtful enough, it will also lead to misdiagnosis .

 

What is the significance of the "Behcet Syndrome Diagnosis and Treatment Standards" issued by the Rheumatology Branch of the Chinese Medical Association in 2021 to clinicians?

Professor Zhuoli Zhang:

 

Professor Zhuoli Zhang :

Over the years, the Chinese Medical Association has issued a lot of diagnosis and treatment specifications in various disciplines and diseases.

The release of these treatment specifications is helpful for Chinese doctors to diagnose and treat

Compared with the population of European and American countries, patients with Behçet's disease in China still have their particularities.

We cannot completely copy the standards and norms of Western countries to Chinese patients .
We should formulate Chinese diagnosis and treatment norms according to the characteristics and actual conditions of our patients.

 

New Frontiers in Rheumatism: What progress in diagnosis and treatment of Behcet's disease in 2021 deserves our attention? What do you think are the main research directions of the disease?

 

Professor Zhuoli Zhang:

Behçet's disease is still a complex type of systemic vasculitis disease, which can involve arteries, veins, and large, medium, and small blood vessels
.

Compared with other rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus, the progress of Behçet's disease is not much.
In the Middle East and the Far East, although there are many patients with Behçet's disease, their economic development and scientific research capabilities are relatively weak

Over the years, although we have been improving our understanding of Behçet's disease, the new therapeutic drugs are still relatively limited, especially for Behcet's disease-specific drugs, which are currently less developed
.

However, there has been more understanding of the targeting mechanism of Behçet's disease, especially in terms of specific targets and targeted therapy, and more exploration has been carried out, such as tumor necrosis factor antagonists, although it is a treatment for rheumatoid joints.
It is a commonly used biological agent for inflammation and ankylosing spondylitis, but some organ systems of Behcet's disease are involved, such as Behcet's ophthalmopathy, Behcet's enteropathy, etc.
, and certain curative effects have also been achieved in the clinical treatment process
.

At present, some generic drugs have appeared in the process of clinical research in China, providing more choices for Chinese doctors and patients
.

In the future, new treatments for Behçet's disease, especially precision therapy and individualized therapy, will be a research hotspot

New Frontiers in Rheumatology: Patients with Behçet's disease often require lifelong treatment

Behçet's disease is a chronic autoimmune disease that often requires lifelong treatment
.

For different patients with different severity, the type and dosage of drugs should be determined according to their specific clinical manifestations
.
For patients with long-term stable disease, drug reduction may be considered
.
However, for some patients with serious complications, it is usually necessary to take the drug for a long time or even for life.
These patients have a very high risk of recurrence after stopping the drug
.
For patients with Behçet's disease, it is still too early to achieve disease remission with complete drug withdrawal
.
More research on the relationship between drug withdrawal and recurrence risk is also needed in the future
.

In addition, among all the drugs for the treatment of Behçet's disease, the long-term use of glucocorticoids has more adverse reactions, so the reduction of hormones is one of the hot spots of current discussion, such as the use of immune preparations or even biological preparations to help hormone reduction
.

 

New Frontiers in Rheumatism: What beliefs have supported you all the way to the present? What advice do you have for doctors who are confused?

Professor Zhuoli Zhang:

 

As a senior rheumatologist who has worked in the field of rheumatology for more than 30 years, I think that the reason why most young doctors have a period of confusion may be because of heavy work pressure and life pressure .
How to get through this period of confusion and how to become a good doctor in the future? I would like to share with you some of my personal growth experiences .

(1) It must be loved
.

If you love something, you won't complain even if it's hard work
.

I have been determined to become a doctor since I was a child, so when I applied for the university, I only applied for the clinical medicine major of Peking University, and I did not obey the assignment
.
Over the decades, I have come to this day with my love for medicine and firm belief in my heart
.
Although the work is often very hard, it is precisely because of love that I am willing to give and form a spirit of dedication
.

 

 

Over the past few decades, with my love for medicine and firm belief in my heart, I firmly believe that I will do better and better
.
This belief has supported me to this day
.
In this process, although it is very hard work, as a doctor, we must have the spirit of willingness and dedication
.

 

(2) Summarize experience and find rules
.

In the process of work, constantly sum up experience, look for rules, analyze their own success and failure cases, and learn more from the excellent doctors around them, so as to make their progress faster and reduce setbacks or failures in the growth process
.
This method allows us to walk faster and gain a lot of sense of accomplishment
.

(3) Learn to plan your life
.

Designing your life is very important, not only planning for work, but also planning for life, and learn to grasp the balance between the two
.

Here, I would like to say to our young doctors that when we encounter short-term difficulties or troubles, we must be able to strengthen our beliefs, keep our original aspirations in mind, and work hard in the direction of our hearts, and success is definitely not far from us
.
Today's medical environment and economic conditions have improved a lot compared to 30 years ago
.
China is developing, Chinese rheumatology is developing, and our young rheumatologists will definitely make greater progress in the future
.

Finally, I wish you all a happy Year of the Tiger, and the tiger will prosper! Take your life and career to a new level and realize your life dreams!

Here, I would like to say to our young doctors that when we encounter short-term difficulties or troubles, we must be able to strengthen our beliefs, keep our original aspirations in mind, and work hard in the direction of our hearts, and success is definitely not far from us
.
Today's medical environment and economic conditions are much improved than 30 years ago
.
China is developing, Chinese rheumatology is developing, and our young rheumatologists will definitely make greater progress in the future
.

Here's wishing everyone a Happy Year of the Tiger, and the Tiger is prosperous
.
Take your life and career to a new level and realize your life dreams
.

Behcet's disease

Behcet's disease

Behçet's disease is a systemic vasculitis that mainly manifests as recurrent oral ulcers, genital ulcers, and skin lesions, which may lead to uveitis and can also involve the gastrointestinal tract, blood vessels, heart, nervous system, lungs and other internal organs
.

Blood vessel

In this issue, Metz Medical interviewed Professor Zhang Zhuoli from the Department of Rheumatology and Immunology of Peking University First Hospital to bring you the experience of diagnosis and treatment of Behcet's disease .

Immunization Zhang Zhuoli Diagnosis and Treatment

 

 

New Frontiers in Rheumatology: The misdiagnosis rate of Behçet's disease is generally high.
What do you think caused this phenomenon? New Frontiers in Rheumatology: The misdiagnosis rate of Behçet's disease is generally high.
What do you think caused this phenomenon?

Professor Zhuoli Zhang:

Professor Zhang Zhuoli: Professor Zhang Zhuoli:

Behçet's disease is a common chronic systemic vasculitis disease with a high incidence in the Middle East and the Far East .
It is also the most common vascular inflammatory disease in China.
However, the disease is very easy to be misdiagnosed, and the correct diagnosis It is the premise of treatment, so timely and accurate diagnosis is very important for treatment .

Behçet's disease is a common chronic systemic vasculitis disease with a high incidence in the Middle East and the Far East .
It is also the most common vascular inflammatory disease in China.
However, the disease is very easy to be misdiagnosed, and the correct diagnosis It is the premise of treatment, so timely and accurate diagnosis is very important for treatment .
diagnosis

 

(1) Variable clinical symptoms
.
The misdiagnosis of Behçet's disease is mainly due to its variable clinical characteristics, among which the involvement of multiple organs and systems is very prominent
.
The most common manifestations of Behçet's disease , such as oral ulcers, are also very common in the normal population.
Clinicians often ignore these symptoms and lead to misdiagnosis .
 

(1) Variable clinical symptoms
.
(1) Variable clinical symptoms
.
The misdiagnosis of Behçet's disease is mainly due to its variable clinical characteristics, among which the involvement of multiple organs and systems is very prominent
.
The most common manifestations of Behçet's disease , such as oral ulcers, are also very common in the normal population.
Clinicians often ignore these symptoms and lead to misdiagnosis .
 

 

 

(2) There is no specific serological marker for Behcet's disease .
This is also a very important reason for the high misdiagnosis rate of Behcet's disease .
Systemic lupus erythematosus is also an autoimmune disease and can be diagnosed by autoantibody detection, but Behçet's disease does not have any specific antibodies to assist in the diagnosis .

(2) There is no specificity of Behcet's disease ( 2) There is no specific serological marker for Behcet 's disease .
This is also a very important reason for the high misdiagnosis rate of Behcet's disease .
Systemic lupus erythematosus is also an autoimmune disease and can be diagnosed by autoantibody detection, but Behçet's disease does not have any specific antibodies to assist in the diagnosis .

(3 ) Some clinicians have insufficient awareness of Behçet's disease .
In the clinical process, due to the different initial manifestations of Behçet's disease patients and the different disciplines for the first visit, if the receiving doctor's knowledge of Behcet's disease is not deep enough or thoughtful enough, it will also lead to misdiagnosis .

(3 (3 ) Some clinicians are not aware of Behcet's disease ) Some clinicians do not have enough knowledge of Behcet 's disease .
.
In the clinical process, due to the different initial manifestations of Behçet's disease patients and the different disciplines for the first visit, if the receiving doctor's knowledge of Behcet's disease is not deep enough or thoughtful enough, it will also lead to misdiagnosis .

 

What is the significance of the "Behcet Syndrome Diagnosis and Treatment Standards" issued by the Rheumatology Branch of the Chinese Medical Association in 2021 to clinicians? What is the significance of the "Behcet Syndrome Diagnosis and Treatment Standards" issued by the Rheumatology Branch of the Chinese Medical Association in 2021 to clinicians?

Professor Zhuoli Zhang:

Professor Zhang Zhuoli: Professor Zhang Zhuoli:

 

Professor Zhuoli Zhang :

Professor Zhuoli Zhang :

Over the years, the Chinese Medical Association has issued a lot of diagnosis and treatment specifications in various disciplines and diseases.
The release of these treatment specifications is helpful for Chinese doctors to diagnose and treat
.

Over the years, the Chinese Medical Association has issued a lot of diagnosis and treatment specifications in various disciplines and diseases.
The release of these treatment specifications is helpful for Chinese doctors to diagnose and treat
.

Compared with the population of European and American countries, patients with Behçet's disease in China still have their particularities.
We cannot completely copy the standards and norms of Western countries to Chinese patients .
We should formulate Chinese diagnosis and treatment norms according to the characteristics and actual conditions of our patients.
Suggestions on disease prevention and treatment suitable for Chinese patients are given .

Compared with the population of European and American countries, patients with Behçet's disease in China still have their particularities.
We cannot completely copy the standards and norms of Western countries to Chinese patients .
We should formulate Chinese diagnosis and treatment norms according to the characteristics and actual conditions of our patients.
Suggestions on disease prevention and treatment suitable for Chinese patients are given .

 

New Frontiers in Rheumatism: What progress in diagnosis and treatment of Behcet's disease in 2021 deserves our attention? What do you think are the main research directions of the disease?

New Frontiers in Rheumatism: What progress in diagnosis and treatment of Behcet's disease in 2021 deserves our attention? What do you think are the main research directions of the disease? New Frontiers in Rheumatism: What progress in diagnosis and treatment of Behcet's disease in 2021 deserves our attention? What do you think are the main research directions of the disease?

 

Professor Zhuoli Zhang:

Professor Zhang Zhuoli: Professor Zhang Zhuoli:

Behçet's disease is still a complex type of systemic vasculitis disease, which can involve arteries, veins, and large, medium, and small blood vessels
.
Compared with other rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus, the progress of Behçet's disease is not much.
In the Middle East and the Far East, although there are many patients with Behçet's disease, their economic development and scientific research capabilities are relatively weak
.

Over the years, although we have been improving our understanding of Behçet's disease, the new therapeutic drugs are still relatively limited, especially for Behcet's disease-specific drugs, which are currently less developed
.

However, there has been more understanding of the targeting mechanism of Behçet's disease, especially in terms of specific targets and targeted therapy, and more exploration has been carried out, such as tumor necrosis factor antagonists, although it is a treatment for rheumatoid joints.
It is a commonly used biological agent for inflammation and ankylosing spondylitis, but some organ systems of Behcet's disease are involved, such as Behcet's ophthalmopathy, Behcet's enteropathy, etc.
, and certain curative effects have also been achieved in the clinical treatment process
.

At present, some generic drugs have appeared in the process of clinical research in China, providing more choices for Chinese doctors and patients
.
In the future, new treatments for Behçet's disease, especially precision therapy and individualized therapy, will be a research hotspot
.

New Frontiers in Precision Rheumatology: Patients with Behçet's disease often require lifelong treatment
.
Considering the toxic and side effects caused by long-term medication, under what circumstances would you consider reducing or even stopping the medication? New Frontiers in Rheumatology: Patients with Behçet's disease often require lifelong treatment
.
Considering the toxic and side effects caused by long-term medication, under what circumstances would you consider reducing or even stopping the medication?

Professor Zhuoli Zhang:

Professor Zhang Zhuoli: Professor Zhang Zhuoli:

Behçet's disease is a chronic autoimmune disease that often requires lifelong treatment
.
For different patients with different severity, the type and dosage of drugs should be determined according to their specific clinical manifestations
.
For patients with long-term stable disease, drug reduction may be considered
.
However, for some patients with serious complications, it is usually necessary to take the drug for a long time or even for life.
These patients have a very high risk of recurrence after stopping the drug
.
For patients with Behçet's disease, it is still too early to achieve disease remission with complete drug withdrawal
.
More research on the relationship between drug withdrawal and recurrence risk is also needed in the future
.

In addition, among all the drugs for the treatment of Behçet's disease, the long-term use of glucocorticoids has more adverse reactions, so the reduction of hormones is one of the hot spots of current discussion, such as the use of immune preparations or even biological preparations to help hormone reduction
.

 

New Frontiers in Rheumatism: What beliefs have supported you all the way to the present? What advice do you have for doctors who are confused? New Frontiers in Rheumatism: What beliefs have supported you all the way to the present? What advice do you have for doctors who are confused?

Professor Zhuoli Zhang:

Professor Zhang Zhuoli: Professor Zhang Zhuoli:

 

As a senior rheumatologist who has worked in the field of rheumatology for more than 30 years, I think that the reason why most young doctors have a period of confusion may be because of heavy work pressure and life pressure .
How to get through this period of confusion and how to become a good doctor in the future? I would like to share with you some of my personal growth experiences .

Heavy work stress and life stress

(1) It must be loved
.

(1) It must be loved
.
(1) It must be loved
.

If you love something, you won't complain even if it's hard work
.

I have been determined to become a doctor since I was a child, so when I applied for the university, I only applied for the clinical medicine major of Peking University, and I did not obey the assignment
.
Over the decades, I have come to this day with my love for medicine and firm belief in my heart
.
Although the work is often very hard, it is precisely because of love that I am willing to give and form a spirit of dedication
.

 

 

Over the past few decades, with my love for medicine and firm belief in my heart, I firmly believe that I will do better and better
.
This belief has supported me to this day
.
In this process, although it is very hard work, as a doctor, we must have the spirit of willingness and dedication
.

 

(2) Summarize experience and find rules
.

(2) Summarize experience and find rules
.
(2) Summarize experience and find rules
.

In the process of work, constantly sum up experience, look for rules, analyze their own success and failure cases, and learn more from the excellent doctors around them, so as to make their progress faster and reduce setbacks or failures in the growth process
.
This method allows us to walk faster and gain a lot of sense of accomplishment
.

(3) Learn to plan your life
.

(3) Learn to plan your life
.
(3) Learn to plan your life
.

Designing your life is very important, not only planning for work, but also planning for life, and learn to grasp the balance between the two
.

Here, I would like to say to our young doctors that when we encounter short-term difficulties or troubles, we must be able to strengthen our beliefs, keep our original aspirations in mind, and work hard in the direction of our hearts, and success is definitely not far from us
.
Today's medical environment and economic conditions have improved a lot compared to 30 years ago
.
China is developing, Chinese rheumatology is developing, and our young rheumatologists will definitely make greater progress in the future
.

Finally, I wish you all a happy Year of the Tiger, and the tiger will prosper! Take your life and career to a new level and realize your life dreams!

Here, I would like to say to our young doctors that when we encounter short-term difficulties or troubles, we must be able to strengthen our beliefs, keep our original aspirations in mind, and work hard in the direction of our hearts, and success is definitely not far from us
.
Today's medical environment and economic conditions are much improved than 30 years ago
.
China is developing, Chinese rheumatology is developing, and our young rheumatologists will definitely make greater progress in the future
.

future

Here's wishing everyone a Happy Year of the Tiger, and the Tiger is prosperous
.
Take your life and career to a new level and realize your life dreams
.

 

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