HOW TO PREVENT VAGINAL INFECTIONS

Burning, itching, and an unpleasant odor are just some of the common symptoms of vaginal infections. But treatments vary by condition, so it’s important to know which type of vaginal infection you have.

According to Dr Abiodun Akinola, consultant gynecologist and Medical Director, Tobiloba Hospital, Abeokuta, vaginal infections are very common so most women will experience some form of vaginal infection or inflammation during their lifetime. A healthy vagina has many bacteria and yeast. However, some things such as douches, hormone level changes, antibiotics, sexual intercourse, pregnancy and breastfeeding could disturb the vagina’s healthy balance.

The most common types of vaginal infections is yeast infection. It is caused by one of the many species of fungus known as Candida. Candida live naturally in your body in small numbers, including in the vagina, and usually don’t cause any harm. However, Candida thrive in a warm, moist, airless environment and, under those conditions, can grow in number, causing a vaginal infection.

Symptoms of a vaginal yeast infection include a thick, white discharge that some women describe as resembling cottage cheese. Yeast infections also can cause vaginal itching and redness of the vulva; the lips of the external female genital area and vagina.

Bacterial vaginosis. Along with yeast, “friendly” bacteria called lactobacilli live in the vagina. When the number of lactobacilli gets too low, it can trigger a condition called bacterial vaginosis. Why bacteria levels change is not known, but the normal lactobacilli can be replaced by other infection-causing bacteria. With bacterial vaginosis, a woman may see a thick or whitish discharge or one that is slippery and clear. It is not likely to itch or burn. A fishy odour may be noticeable, especially during intercourse.

Trichomonas vaginitis. Of the three most common vaginal infections, trichomonas vaginitis is the only one that is a true sexually transmitted infection it is commonly called “trich,” it is caused by a single-celled parasite, trichomonas vaginalis, and is passed from partner to partner during intercourse.

The symptoms of trichomonas vaginitis are similar to other vaginal infections: burning, irritation, redness, and swelling of the vulva, with a yellow-gray or greenish vaginal discharge, possibly with a fishy odor. Some women also experience pain during urination.

According to Dr Biodun Akinola, other common vaginal infections and causes of vaginal itching include: Chlamydia vaginitis; a sexually transmitted disease that can cause inflammation of the vagina. Some women will have a discharge with chlamydia and some will not. A more common symptom is bleeding, especially after intercourse. “Sexually active women up to age 26 should be tested annually for chlamydia because it so often comes without symptoms and can linger and do a fair amount of damage to fertility, he emphasised

Non-infectious vaginitis; this is when the skin around the vagina becomes sensitive to an irritant such as scented tampons, perfumed soaps, or fabric softeners. This is not an infection, and the solution is simple: Do not use whatever you are reacting to.

Vulvodynia is a condition in which women have chronic pain or discomfort of the vulva without a known cause. The symptoms are similar to vaginal infections: burning, stinging, rawness, soreness, and swelling. Symptoms may be constant or occasional.

Viral vaginosis Viruses also can cause vaginal infections. Most viruses are spread through sexual contact. “The herpes simplex virus is a common cause of viral vaginosis. Symptoms include pain in the genital area from lesions or sores. Most of the time, you can see the sores on the vulva or vagina, but they can also be hidden and seen only during an examination by your gynaecologist.

Akinola stated that, these infections can be treated, but it is important to know which infection you have so that the right medication is prescribed.

How to prevent yeast infections

While vaginal yeast infections are rarely serious, you can prevent them from occurring in the first place.

For most women, yeast infection symptoms are just plain annoying — a vaginal yeast infection is rarely dangerous. Still, you can take steps to prevent yeast infections. The following tips will help you to do just that.

Practice good hygiene

Personal care and hygiene can go a long way when it comes to preventing vaginal yeast infections. Be sure to:

Wash well: Keeping the vagina clean will not only keep you smelling fresh, it can also help prevent yeast infections. When bathing, be sure to clean the inside folds of the vagina where yeast is likely to grow.

Dry thoroughly: Because yeast thrives in moist environments, it’s important to dry the entire vaginal area after taking a shower or bath. You may even want to use a blow dryer on a low, cool setting to get rid of excess moisture.

Wear the right clothes

The way you dress can affect your risk of developing a vaginal yeast infection. To prevent such infections, keep these tips in mind:

Go natural: Cotton and silk underwear absorb moisture, keeping you dry. On the other hand, nylon and other synthetic fabrics hold moisture close to your skin, encouraging the growth of yeast.

Change your clothes: Don’t sit around in sweaty gym clothes or a wet bathing suit. Change into dry clothes as soon as possible. Also, change your underwear often to prevent dampness.

Avoid pantyhose: Pantyhose, tights, and leggings can cause heat and moisture to build up in the crotch area. If you do wear pantyhose, be sure to wear cotton panties underneath, and choose pantyhose with a cotton crotch.

Pass on pyjamas: Avoid snug-fitting pyjama; a loose, flowing nightgown is preferable. And going without underwear while you sleep will help keep your genital area dry and discourage yeast growth.

Skip unnecessary cosmetics

Some cosmetic products can encourage the production of yeast. You can stay well by:

Avoiding scented soaps: bubble baths, and feminine sprays: Perfumes can be irritating to the sensitive area inside the vagina, and that can increase your risk of getting a yeast infection. Also avoid scented sanitary pads and tampons and colored or printed toilet paper — dyes can also be irritating.

Limit heat: Yeast organisms love warm and moist environments. It is best to avoid taking long hot baths or soaking in a hot tub. Also don’t wear tight clothing that will prevent air from circulating around the crotch area, especially in the summer.

Do not douche

Douching washing out the inside of the vagina with liquid destroys not only harmful bacteria, but also the helpful kind that keep yeast under control douche products also wash away the natural protective lining of the vagina, leaving you more susceptible to yeast and other vaginal infections.

Medication and yeast infections

Watch the meds you take: Antibiotics kill not only bad bacteria, but also good bacteria that can prevent an overgrowth of yeast. “Recent antibiotic use, like for a bladder infection, is one of the most common risk factors for getting a yeast infection. Taking oral steroids and birth control pills may also increase your risk. If you have frequent yeast infections, talk to your doctor about the medications you take. There may be alternatives available.

Other Personal Care Tips

As with most illnesses and infections, taking care of your body overall can help you stay healthy. Be sure to:

Get enough sleep: Usually your immune system helps keep yeast under control. But if you get run down from skimping on sleep, your immune system may not be able to do its job. Try keeping a regular sleep schedule and avoiding exercise, caffeine, and heavy meals within three hours of bedtime. Immune-depressing diseases such as diabetes and HIV can also increase the risk of yeast infections. Additionally, if you have diabetes, it’s important to keep your blood sugar levels under control to prevent yeast infections.

Change your diet: Some studies suggest that eating yogurt with active cultures may help the body combat an overgrowth of yeast. Dunham also recommends limiting your intake of sugar. There’s some evidence that sugar may help promote the growth of yeast

http://www.tribune.com.ng/relationships/item/23808-how-to-prevent-vaginal-infections

HOW PARACETAMOL CAUSES ASTHMA, DEVELOPMENTAL DEFECTS, BY RESEARCHERS

KEEPING a packet of paracetamol handy in the bathroom cabinet might seem the safest and most convenient way to tackle pain. After all, it's free from the stomach damaging side-effects of other painkillers, such as aspirin and ibuprofen.
However, evidence is mounting to show that not only does paracetamol cause this kind of damage after all, but the 'everyday' drug may also harm us in many other serious ways.
Indeed, far from being the risk-free panacea so many of us believe it to be, a growing weight of evidence from studies conducted across the world links the drug to a number of very serious side-effects.
These include asthma and developmental defects, such as attention-deficit hyperactivity disorder (ADHD) in children, as well as potentially lethal heart and kidney problems in adults, and even a risk of death from rare, but excruciating, skin reactions.
The evidence has prompted drug watchdogs in Britain and America to warn doctors against routinely prescribing paracetamol.
But this has ignited a row with medical professionals who feel that without it in their medicine bags, they will have nothing with which to treat millions of patients.
Meanwhile, there are also suggestions that for some ailments, the drug is, in fact, no better than a placebo.
A PLACEBO WORKED JUST AS WELL FOR BACK PAIN
Paracetamol has, until now, been regarded as especially helpful for those who cannot take painkilling non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
They may be allergic to NSAIDs or be on medication that interacts dangerously with them, such as blood pressure pills or steroids. Other patients may have stomach ulcers or bleeding disorders, which can be worsened by NSAIDs.
The latest question over paracetamol was raised by a study published in The Lancet last month, which found that the drug is no better than a placebo for lower back pain.
Researchers at the University of Sydney looked at more than 1,650 people who had suffered back pain, for a variety of reasons, for six weeks or less.
One-third received daily doses of paracetamol, another third took the drug as needed, while the remainder were given a dummy placebo pill. All three groups took 17 days to recover, on average.
Dr. Christopher Williams, who led the study, says: "The results suggest that we need to reconsider the universal recommendation to provide paracetamol as a first-line treatment for back pain."
However, that is precisely the way paracetamol is used by the NHS to treat back pain, among other forms of pain.
In 2012 alone there were 72million prescriptions for paracetamol, plus another 78million for paracetamol combined with codeine, according to the Government's Health and Social Care Information Centre.
IS IT SAFE FOR PREGNANT WOMEN?
Over recent months, other evidence has emerged that should make us wary of using paracetamol as a first resort when feeling pain.
In February, a report in the respected journal JAMA Pediatrics warned that children born to women who used the painkiller during pregnancy may have an increased risk of ADHD and other behavioural problems.
Paracetamol 'is the preferred choice' to treat mild or moderate pain in pregnant women, according to British National Health Scheme (NHS) Choices.
The guidance adds: "There is no clear evidence that it has any harmful effects on the unborn baby."
However, this is disputed by researchers who studied 64,000 pregnant Danish mothers and their children born between 1996 and 2002. At each trimester of pregnancy, they asked the mothers if they had taken any paracetamol in the previous three months.
When the children were seven, researchers asked the mothers about their child's behavioural patterns and whether they had been put on the ADHD drug Ritalin.
They found that pregnant mothers' paracetamol use was associated with an almost doubled risk of ADHD and other hyperactivity-related disorders.
The strongest effect was in women who took the painkillers during all three trimesters, regardless of how many they took. Women who reported use for a minimum of one week still had an increased risk.
"We really have to be more careful about what pregnant women put into their bodies - even substances we think are harmless or safe may not be," says the study's author Dr Beate Ritz, a professor of epidemiology at the University of California.
"Expectant mothers should think twice before medicating a slight headache or fever."
Instead, researchers suggest mothers try relaxation techniques that may reduce their sensitivity to pain. The results reinforce concerns raised by the Norwegian Institute of Public Health last year.
Its study of 3,000 pairs of siblings found that those exposed to paracetamol in the womb for more than 28 days of pregnancy had poorer physical co-ordination and communication skills and more behavioural problems compared with their unexposed brothers or sisters.
Seif Shaheen, professor of respiratory epidemiology at Barts and the London School of Medicine, says there are also worries that paracetamol may raise the risk of children developing asthma.
He explains: "We first discovered the possible link in 2000, when we were worried about lab studies on animals, which had indicated that paracetamol may deplete the levels of an antioxidant called glutathione in the lungs."
This antioxidant seems to stop the inflammation in the lungs that can restrict airways and cause asthma.
"Since our first study of mothers and children indicated this may be a problem, another 20 studies worldwide found similar links," he says.
"We have also found that women who say they took paracetamol regularly while pregnant have children who are more likely to develop asthma."
All these studies, however, have been retrospective. They asked people how many times they remember taking paracetamol in the past. This is not precise enough to say conclusively that paracetamol can cause asthma.
THE LINK TO HEART FAILURE
But other concerns about the drug led the UK's treatment effectiveness watchdog, the National Institute for Health and Care Excellence (NICE), to issue draft guidance earlier this year warning GPs against prescribing paracetamol to patients with osteoarthritis, who can take the drug regularly for years on end.
Around a million people see their GP about this 'wear and tear' form of arthritis every year.
A panel of Nice experts declared they were 'extremely concerned' about reported serious side-effects that associate high doses of paracetamol with an increased risk of heart attacks, strokes and heart failure, gastrointestinal bleeding and kidney problems.
The guidance provoked protests from doctors. Organisations such as the Royal College of General Practitioners and the British Society of Rheumatology wrote to Nice to argue that there was no new evidence to support the guidance and added that it would rob patients of the ability to manage their own pain.
In the doctors' newspaper Pulse, GPs were scathing. One wrote: "I'll tell patients: 'I'll refer you to the appliance department for a piece of wood. You can chew on it if the pain gets too much. Trust me, it'll be better for you, I've read the Nice guideline.'"
Subsequently, Nice reversed the guidance. It now recommends GPs continue to use paracetamol as a first-line painkiller option in osteoarthritis.
This U-turn may be in part thanks to the doctors' protest. But it was also the result of conflict with another government drug watchdog, the Medicines and Healthcare Products Regulatory Agency (MHRA).
While Nice is responsible for assessing the effectiveness of medicines, the MHRA's remit is to monitor the safety of drugs.
The MHRA told Nice it was already reviewing the safety of over-the-counter painkillers, and that Nice should hold off until it completes this by the end of the year.
NO BETTER THAN IBUPROFEN
Critics of paracetamol are unhappy with this development. John Dickson, a Middlesbrough GP and community rheumatologist, was once a clinical adviser for Nice guidance on osteoarthritis.
He says that concerns about the safety of paracetamol go back to the Sixties, but were largely dismissed because drugs such as aspirin and morphine were thought more dangerous.
This is thanks to aspirin's risk of stomach bleeding and morphine's risk of overdose and addiction.
"This issue has taken about 45 years to come to a head," he says. "Research shows that paracetamol can act as a placebo for relieving acute and chronic pain. But it is not a safe placebo, like a dummy sugar pill.
"Thanks to the damage it can cause to the kidneys and cardiovascular system, it is at least as dangerous as regularly taking non-steroidal anti-inflammatory drugs such as ibuprofen."
Dr Dickson is particularly concerned by research showing that sustained paracetamol use over months or years causes gastric bleeding.
"This is particularly dangerous for elderly people, because this causes the loss of hemoglobin - the molecule in red blood cells that carries oxygen.
"This significantly harms their quality of life by making them feel ill and listless."
There may be another reason to be wary. The U.S. drug watchdog, the Food and Drug Administration (FDA), has been issuing warnings about paracetamol and its potential link with rare but serious skin reactions.
These reactions - Stevens-Johnson Syndrome, toxic epidermal necrolysis and acute generalised exanthematous pustulosis - are excruciating, with the skin separating from the body and sloughing off, with fatal consequences.
The United States Food and Drug Administration (FDA) has said: 'These reactions can occur with first-time use of paracetamol or at any time while it is being taken.
"Any patient who develops a skin rash or reaction while using paracetamol should stop the drug and seek urgent medical attention right away."
Other American research has linked long-term use of paracetamol with blood cancer.
In one study of nearly 65,000 people, taking paracetamol for at least four days a week for four years was linked to nearly double the risk of being diagnosed with leukemia or lymphoma.
The possible mechanism for this risk has not yet been identified.
RISK OF OVERDOSE
The best known danger of paracetamol is an overdose - intentional or otherwise.
Excess paracetamol can overwhelm the liver's processing abilities and cause damage, resulting in acute liver failure. This can prove fatal.
Concern over this led the Government in 1998 to rule that shops can sell only packs of 16 paracetamol tablets. Pharmacies can sell packs of 32 tablets.
But the danger remains, not least because of 'staggered overdosing' - this is where taking just a little more paracetamol than the recommended dose over the course of several days or weeks leads to a dangerous build-up in the liver.
The concern is that people can unwittingly overdose by also taking other over-the-counter products without realising these contain paracetamol.
Staggered overdosing is just as risky as taking one large overdose, according to a study from the Royal Infirmary of Edinburgh, published in 2012 in the British Journal of Clinical Pharmacology.
Professor Donald Singer, a fellow of the British Pharmacological Society, warns: "Paracetamol is present in a range of over-the-counter medicines for coughs and colds. But two out of five people who take such remedies don't realise this.
"It is a useful drug when used in the right way, but it is a powerful drug with powerful side-effects when taken excessively.
"Doctors should take a good patient history to ensure that people are not already taking it through such products.
"They should also ensure that patients are taking paracetamol at the lowest possible dose that can give relief."
Dr Dickson believes it is time to question our use of paracetamol as the first drug treatment of choice.
"An important alternative for using paracetamol for such conditions as chronic back pain is for GPs to give lifestyle advice, such as getting sufferers to exercise more and avoid bed rest," he said.
"But it is very difficult to get GPs to do that, not least because they are short of time."
He thinks it will take "between five and ten years for GPs and the public to finally grasp that taking paracetamol for such problems is simply unacceptable".
The question is whether that's soon enough, if the new evidence is to be believed.

SEXUAL IMPOTENCE

 Sexual impotence is also referred to as erectile dysfunction and affects more than 10 million men in the country today. Impotence refers to the inability to produce and maintain an erection in order to perform sexually. Sexual impotence is a surprisingly common problem and most men have experienced this condition at least once in their life. While nearly eight percent of men between the ages of 20 to 39 have reported cases of erectile dysfunction, nearly sixty percent of men over 70 suffer from sexual impotence. Cases can range in severity and incidence depending on the underlying causes of the condition. Unfortunately, impotence is surrounded by social stigma and many men choose to suffer in silence rather than consult with a specialist or doctor to treat the situation.

Impotence can be classified into three different types:

• Primary Impotence: Implying chronic erectile dysfunction from the beginning of any type of sexual activity.
• Secondary Impotence: The most common form of sexual impotence, where incidents of impotence occur in between normal sexual activity.
• Impotence with Age: A gradual decline in the sexual performance and the ability to maintain an erection due to age.

Symptoms of Sexual Impotence

Sexual impotence is marked by the repeated inability to achieve or maintain an erection for sexual intercourse. Other impotence symptoms include loss of interest in sex, fatigue, feelings of guilt or anger, and depression. Relationships also tend to suffer due to impotence.

Causes of Sexual Impotence

Sexual impotence or erectile dysfunction is caused by a lack of blood supply to the penis. While this is the primary biological or physical cause for impotence there are several other conditions that can cause impotence. In many cases the presence of some other condition may also cause impotence because of its interference with blood circulation. Some common causes for sexual impotence include:

• Vascular Disease – Vascular disease is a condition that affects the veins and arteries, causing a thickening of arterial walls. This causes the blood flow to get restricted and weakened affecting the extremities and also the genitalia. This in turn leads to difficulties in maintaining an erection or even achieving one.
• Diabetes – Studies show that there is a definite link between diabetes and sexual impotence, though the exact causes are not clearly understood. Experts believe that diabetes affects the blood flow and causes nerve damage that can lead to impotence.
• Alcohol and Smoking – Excessive drinking and smoking can lead to erectile dysfunction by hampering blood circulation. Alcohol also interferes with the balance of hormones and the production of the male hormone testosterone that may result in impotence.
• Diseases and Illnesses – Diseases such as Multiple Sclerosis, Parkinson’s and other conditions that affect the nervous system can make achieving and maintaining an erection difficult, by restricting and preventing the correct response signals sent from the brain to the body.
• Inactivity – Lack of exercise and a sedentary lifestyle can affect the cardiovascular system and in turn affect sexual functioning.
• Psychological – Stress, long work hours, depression, anxiety, guilt, and embarrassment can also cause sexual impotence. Apprehension about impotence can cause anxiety and fear of failure that may lead to a repeated inability to perform sexually.

Remedies for Sexual Impotence

The treatment for sexual impotence depends on its underlying cause. The first step towards a cure for any sexual disorder is to overcome and ignore the stigma that surrounds the condition and speak to a specialist, doctor, or even a therapist if required. A diagnosis is reached only after a number of tests are carried out to identify the underlying cause. The treatment of sexual impotence includes oral medications, penile injections, and mechanical aides such as implants and vacuum pumps. Products such as pumps work well when impotence is caused by vasculogenic factors. Prescription and non-prescription drugs are available to increase sexual libido, balance hormones and improve sexual potency. Many commercially available medications tend to have more of a psychological effect and experts believe that there is no real value in this type of placebo effect treatment. However, there are some drugs such as Viagra that have transformed the way sexual impotence is treated. While an expensive option, medications such as Viagra are very effective, but patients need to keep their health care providers informed of any other health conditions, because of the risk of side effects or interactions.

Hormone therapy for sexual impotence involves the application of skin patches or the administration of injections containing testosterone. Based on the belief that impotence is caused due to a decrease in the levels of testosterone in the body, these injections and patches improve libido and reduce instances of erectile dysfunction. Male hormone replacement therapy is used mainly in older men, but does come with its own set of complications and side effects such as the development of prostate cancer.

When sexual impotence is caused by vascular problems, surgery may be an option. Vascular surgery has a high success rate but it is an expensive option that is irreversible.

When no other medical alternatives seem to be working, penile implants may be considered. Penile implants are prosthetic devices that are surgically implanted into the penis. Penile implants come in two varieties – passive implants that consist of silicon rods inserted into the penis and active implants, which involve the use of inflatable silicon pouches implanted into the penis. These pouches can be manipulated manually to achieve and maintain an erection.

Home remedies for sexual disorders such as impotence include the following:

• Regular massages help relieve nervous energy, relax the body and reduce anxiety. This can help considerably to lower the occurrence of erectile dysfunction during sexual intercourse.
• Home remedies for impotence also include cold hip baths where the pelvis and genitals are immersed in a cold bath for ten minutes every morning and evening. This helps invigorate and activate the nerves in the area and reduces impotence.
• A daily exercise routine that includes yoga has been proven to be highly beneficial in the treatment of sexual impotence. Certain yoga poses such as halasana, dhanurasana, and sarvangasana are especially effective.
• Other home remedies for erectile dysfunction include adding seeds, nuts, fresh fruit and vegetables and grains into your daily diet to improve overall physical and mental health as well as to improve blood circulation.

Diet for Sexual Impotence

Although your diet may have no direct effect on the development or occurrence of sexual impotence, in some situations the condition may be caused by other health conditions that are aggravated by unhealthy eating habits. The main focus should therefore be to eliminate any unhealthy foods from your diet like junk foods, oily and excessively fatty foods. An accurate diagnosis of the underlying causes of impotence will also better help with the formulation of an appropriate diet plan. There are certain foods that promote certain bodily functions and if the problem is caused by any disorder that can be controlled with diet changes you will need to modify your diet accordingly.

In addition to dietary changes based on nutritional advice and your doctor’s suggestions you can also try out some specific foods that are believed to help treat the condition. Do keep in mind that most of these claims are unresearched and they have little to no scientific credibility.

• Certain foods like honey and garlic are thought to be beneficial in the treatment of sex problems. Garlic has remarkable aphrodisiac properties that are said to be safe and natural. Garlic reduces sexual exhaustion and increases the libido. Two to three cloves of raw garlic chewed daily can help treat sexual impotence as well.
• White onions can strengthen the reproductive system and increase the libido, whereas carrots dipped in honey can improve stamina when consumed daily for a month.
• Experts believe that including asparagus in your diet can also treat sexual impotence. Boil the roots of asparagus in milk and drink this concoction twice daily. This also prevents premature ejaculation.
• Dates have long since been considered a strengthening food. Mix dried dates with nuts like almonds and pistachios in equal quantities and consume a handful daily to improve sexual stamina.
• In addition to oily and fatty foods try to cut down on your intake of processed foods that are high in sugar and white flour.

Suggestion for Sexual Impotence

Sexual impotence can cause problems with interpersonal relationships, as well as lower one’s self image and self-confidence. Very often, sexual impotence gives rise to severe depression and mental trauma, whereas in others, psychological factors may be the cause of impotence. The main thing to do is address the problem at the earliest. If this is done, in many cases, there may not even be a need for any form of medical intervention. Just remember that sexual impotence is a lot more prevalent than most of us think it to be; if afflicted with the condition you don’t have to live with it and suffer in silence. Couple counseling can also help greatly as emotional relationships that have a sexual component will suffer a severe strain when such sexual disorders develop. This calls for patience, maturity and understanding from both partners.

References

1. W.P. De Silva, 6.27 - Sexual Problems: Dysfunction, In: Editors-in-Chief: Alan S. Bellack and Michel Hersen, Editor(s)-in-Chief, Comprehensive Clinical Psychology, Pergamon, Oxford, 1998, Pages 603-621, ISBN 9780080427072, 10.1016/B0080-4270(73)0020-5.
2. William A. Sodeman Jr., Thomas C. Sodeman, Male Impotence: Patient and Caregiver's Guide, Instructions for Geriatric Patients (Third Edition), W.B. Saunders, Philadelphia, 2005, Pages 348-349, ISBN 9781416002031, 10.1016/B978-141600203-1.50143-8.