Botulinum toxin is a bacterial exotoxin secreted by Clostridium botulinum during the reproduction process. It binds specifically to the surface receptors of the presynaptic membrane of cholinergic nerve endings in vivo, and then translocates into the cell due to adsorptive cellular drinking (internalization of toxin) so that the vesicles can no longer fuse with the presynaptic membrane, thus effectively blocking the release of acetylcholine, a cholinergic neuromediator. release of acetylcholine. At the same time, the toxin binds to the presynaptic membrane and also blocks calcium channels in the nerve cell membrane, thereby interfering with the ability of extracellular calcium to enter the nerve cell to trigger cytokinesis and acetylcholine release. The inhibition of acetylcholine release effectively blocks the physiological function of cholinergic nerve conduction, which is particularly sensitive at the nerve-muscle junction. At sufficiently high doses, it causes generalized relaxation paralysis of random muscles and paralysis of respiratory muscles. Depending on the antigenicity of botulinum toxin can be divided into seven types A, B, C, D, E, F and G. Because type A botulinum toxin has the strongest effect on the human body and is easy to prepare and preserve, it is the most widely used in clinical practice. Botulinum toxin has a disruptive effect on excitatory neuromediators and was originally used as a treatment for muscle nerve hyperfunction. purified botulinum toxin was first obtained by P Tessmer Snip and Hermann Sommer in 1928. In 1979, Botulinum toxin type A was approved by the Food and Drug Administration (FDA) for the treatment of strabismus and facial spasm, and was officially approved as a new drug in 1989. In 1989, a Canadian ophthalmologist named Jean Carruthers inadvertently discovered that the drug, which is used to paralyze muscle nerves, could make the wrinkles under patients’ eyes disappear. She then told her husband, Alastair Carruthers, a professor of dermatology, about the surprise, and the couple began to collaborate on the research, eventually introducing Botulinum toxin type A to the field of skin wrinkle reduction, and published the first report on the subject in 1990, sparking the so-called “Botox revolution” in the history of cosmetology. The first report was published in 1990, sparking the so-called “Botox revolution” in cosmetic history. In 2002, the U.S. Food and Drug Administration (FDA) approved the use of injectable Botulinum toxin type A for cosmetic purposes to eliminate headlines, frown lines and crow’s feet, etc. In 2009, the Chinese FDA approved the clinical use of Botulinum toxin type A produced by Allergan, Inc. In recent years, there has been a dramatic increase in the number of people who have undergone cosmetic treatments with botulinum toxin injections. In the United States, Botox injections topped the list of all types of minimally invasive cosmetic procedures performed in 2008. However, in China, the State Food and Drug Administration’s instructions for the use of therapeutic botulinum toxin type A, the indications are still limited to ocular spasm, facial spasm, and strabismus. Botulinum toxin is not released by living Clostridium botulinum, but first produces a non-toxic precursor toxin in Clostridium botulinum cells, and the precursor toxin is free after the autolysis of Clostridium botulinum death and activated by trypsin in the intestine or protease produced by bacteria before it becomes toxic. Botulinum toxin is particularly resistant to acid, and stomach acid and digestive enzymes cannot destroy it in a short time, so it can be absorbed through the gastrointestinal tract and damage the health of the body. Botulinum toxin is one of the most toxic natural substances and one of the most toxic proteins in the world. As a result, botulinum toxin has been used in warfare to create biological weapons. The lethal dose for an adult weighing 60Kg is 2000-3000 IU, while the clinical dosage of botulinum toxin type A for injection is only 30-200 IU, which is a very small amount compared to the lethal dose, so as long as it is applied correctly, botulinum toxin is very safe in clinical practice. Therefore, as long as it is applied correctly, botulinum toxin is clinically very safe. Let us study the instructions for the use of botulinum toxin type A for treatment by the State Drug Administration. Dosage: 1. eyelid and facial muscle spasms can be injected according to the above-mentioned sites, with a starting amount of 2.5 U/0.1 ml per site. additional injections can be given to those with residual spasms after 1 week of injection; the original amount or double the amount (5.0 U/0.1 ml) can be given to those with recurrence. However, the total dose of 1 injection should not be higher than 55U, and the total dose used in 1 month should not be higher than 200U. 2.Strabismus. For vertical muscle and horizontal strabismus of less than 20 trigeminal degrees, the starting dose is 1.25-2.5U per muscle; for horizontal strabismus of 20-40 trigeminal degrees, the starting dose is 2.5U per muscle, and for horizontal strabismus of 40-50 trigeminal degrees, the starting dose is 2.5U per muscle. later, according to the drug response, increase to 5.0U/time as appropriate; for persistent VI nerve of 1 month or more For persistent VI nerve palsy of 1 month or more, 1.25-2.5 U can be injected into the medial rectus muscle. The volume of each intramuscular injection should not be higher than 5 U. Repeat injections can be given to those with low correction. In cases of recurrent disease, injections may be given in incremental or maintenance doses from time to time. However, the maximum amount per muscle should not exceed 0.1 ml. Repeat injections can be given to those with low correction. For patients with recurrent disease, the injection may be given in increments or maintenance doses, but the maximum dosage per muscle should not exceed 5 U. Adverse reactions: 1. During eyelid and facial muscle spasm treatment, a few patients may experience transient ptosis, lower lid recession, reduced transient eyes, incomplete lid closure, and reduced facial muscle strength, etc., which recover naturally within 3-8 weeks. 2. During strabismus treatment, some patients may experience transient, varying degrees of eyelid ptosis, vertical strabismus, and rarely, pupillary dilatation, which is associated with diffusion of the toxin into the adjacent muscles and recovers spontaneously within a few weeks. Contraindications: Contraindicated in allergic individuals and in those with hypersensitivity to this product. Precautions: 1. This product is highly toxic and must be kept, distributed, registered and used according to the prescribed indications and doses. The person using this product, especially for the treatment of strabismus, should be a specially trained person. The operator should be familiar with the anatomical position of the extraocular muscles and master the technique of using myoelectric amplifiers, and try to be accurate, quantitative, slow injection and reduce leakage. 2. Use with caution in patients with fever, acute infectious diseases, heart, liver and lung diseases, active tuberculosis, blood diseases, pregnant women and children under 12 years of age. 3.Aminoglycoside antibacterial agents (such as gentamicin) can strengthen the effect of botulinum toxin, the above antibiotics are prohibited during the use of this product. 4.It is ineffective or ineffective for greater than 50 trigeminal strabismus, fixed strabismus, Duane’s syndrome with external rectus muscle weakness, surgically overcorrected strabismus, chronic paralytic strabismus, chronic VI or III pair of cranial nerve palsy, and severe muscle fiber contracture. 5. 1:1000 epinephrine should be available for emergency use in case of occasional allergic reactions. Patients should be kept in the hospital for short-term observation after injection. Although it is a boring description of the text, but I hope that every person before the injection can probably read it, to their understanding of the drug are not a minor problem of beauty.