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Thursday, July 12, 2012
台灣藥廠呼應 "走出去" 政策 !!
Nature Genetics刊登: 單一基因突變(FAN1) 造成慢性腎臟病 (CKD) !!!
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FAN1
mutations cause karyomegalic interstitial nephritis, linking chronic kidney
failure to defective DNA damage repair.
Chronic
kidney disease (CKD) represents a major health burden. Its central feature of
renal fibrosis is not well understood. By exome sequencing, we identified
mutations in FAN1 as a cause of karyomegalic interstitial nephritis (KIN), a
disorder that serves as a model for renal fibrosis. Renal histology in KIN is
indistinguishable from that of nephronophthisis, except for the presence of
karyomegaly. The FAN1 protein has nuclease activity and acts in DNA interstrand
cross-link (ICL) repair within the Fanconi anemia DNA damage response (DDR) pathway.
We show that cells from individuals with FAN1 mutations have sensitivity to the
ICL-inducing agent mitomycin C but do not exhibit chromosome breakage or cell
cycle arrest after diepoxybutane treatment, unlike cells from individuals with
Fanconi anemia. We complemented ICL sensitivity with wild-type FAN1 but not
with cDNA having mutations found in individuals with KIN. Depletion of fan1 in zebrafish caused increased DDR, apoptosis
and kidney cysts. Our findings implicate susceptibility to environmental
genotoxins and inadequate DNA repair as novel mechanisms contributing to renal
fibrosis and CKD.
加速推動旭東海普上市!!!
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Liver stiffness predicts liver failure, cancer and mortality in cirrhotic patients
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July 10, 2012 Researchers from Spain established that liver stiffness, measured by transient elastography (TE), is an independent predictor of liver failure, hepatocellular carcinoma (HCC), and mortality in cirrhotic patients coinfected with the human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS), and hepatitis C virus (HCV). Findings available in the July issue of Hepatology, a journal published by Wiley on behalf of the American Association for the Study of Liver Diseases, also show that measurement of liver stiffness predicts potential recovery and survival in patients with cirrhosis, adding to the prognosis value provided by the Child-Turcotte-Pugh (CTP) or model for end-stage liver disease (MELD) scores. According to the World Health Organization (WHO), chronic HCV affects up to 170 million people worldwide, with more than 350,000 of those dying from HCV-related liver diseases annually. WHO also reports that in 2010 nearly 34 million individuals worldwide were living with HIV. Additionally, a 2008 report from the Centers for Disease Control and Prevention (CDC) found that mortality rates were highest among those infected with HCV at nearly five deaths per 100,000 people. In fact, since 1999 deaths from HCV have steadily increased and now exceed HIV infection mortalities. For the present study Dr. Nicolás Merchante from the Unidad de Enfermedades Infecciosas, Hospital Universitario de Valme in Sevilla, Spain conducted a multicenter prospective study of cirrhotic patients coinfected with HIV and HCV beginning in February 2006. A total of 239 consecutive HIV/HCV patients with a new diagnosis of compensated cirrhosis participated in the study to assess the predictive value of liver stiffness as measured by TE. Participants were followed between nine and 34 months, and 13% of patients developed liver failure (decompensation). The incidence of decompensation was 6.7 cases per 100 person-years. Researchers reported 15 patient deaths with ten due to liver disease, and liver transplant was performed on one patient. In 8% of 181 patients with baseline liver stiffness less than 40 kPa developed liver failure compared with 29% of 58 patients with liver stiffness greater than 40 kPa. Medical evidence shows that end-stage liver disease from chronic HCV is a leading cause of death in HIV-infected individuals living in western countries. "For patients with end-stage liver disease, transplantation is often the only treatment option," said Dr. Merchante. "Earlier recognition of cirrhosis and optimal treatment of cirrhotic patients at the initial stages are critical. Our findings indicate that liver stiffness predicts risk of liver failure and liver-related deaths in patients with compensated cirrhosis who are coinfected with HIV and HCV, providing more advanced detection of disease severity." The authors suggest that future studies should evaluate if liver stiffness is also an independent prognostic marker in decompensated cirrhosis, which then could be used in conjunction with CTP and MELD scores in considering patients referred for liver transplantation. More information: "Liver Stiffness Predicts Clinical Outcome in Hiv/Hcv-Coinfected Patients with Compensated Liver Cirrhosis." Nicolás Merchante, Antonio Rivero-Juárez, Francisco Téllez, Dolores Merino, Maria José Ríos-Villegas, Manuel Márquez-Solero, Mohamed Omar, Juan Macías, Ángela Camacho, Montserrat Pérez-Pérez, Jesús Gómez-Mateos, Antonio Rivero, Juan Antonio Pineda on behalf of the Grupo Andaluz para el Estudio de las Hepatitis Víricas (HEPAVIR) de la Sociedad Andaluza de Enfermedades Infecciosas (SAEI). Hepatology; (DOI: 10.1002/hep.35616); Print Issue Date: July, 2012. Journal reference: Hepatology
肝臟纖維掃描儀對肝纖維化的非侵襲性評估
高偉育、蘇建維、侯明志（臨床醫學 2009; 64: 133-40） 肝臟纖維掃描儀（transient elastography (TE, FibroScan?）是一種非侵襲性的新方法，可藉由測量肝硬度（liver stiffness）來評估慢性肝病病患肝纖維化（liver fibrosis）的情形。肝臟纖維掃描儀是一種快速且容易操作的技術，可用於門診或在住院病人的床邊，立即得到結果並有很好的重現性（reproducibility）。約有5%的病例會測量失敗，主要是在肥胖的病人。肝臟纖維掃描儀在慢性C型肝炎患者診斷肝纖維化方面，與肝臟切片結果相較，二者有良好的相關性，合併肝臟纖維掃描儀和血清標記檢驗更可增加診斷的準確性，這樣可避免使用肝切片來對慢性C型肝炎做初期的評估。這個策略可再用於評估其他病因造成的慢性肝疾病。此外，肝臟纖維掃描儀在早期偵測肝硬化及其預後方面，似乎也是一個出色的工具。肝臟纖維掃描儀容易被病人所接受，因此可使用於監測個別病例的肝纖維化惡化和改善之情形。但在臨床上廣泛使用肝臟纖維掃描儀做為診療常規，仍尚需等待更多應用的研究數據以及指導方針來佐證。
東洋: 全球癌症針劑中心(80萬劑) !!!!
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東洋抗癌針劑 擴產1倍 【經濟日報╱記者黃文奇／台北報導】 2012.07.13 03:59 am 台灣東洋（4105）董事長林榮錦昨（12）日表示，公司投資的中壢癌症針劑廠，投資金額將從原本的2億元加碼到5億元，產能再擴充1倍以上達80萬劑，並趕在今年10月底前投產，以打造全球癌症針劑中心。 台灣東洋指出，該廠投產後將結合美國大藥廠，共同生產癌症針劑，並可望拿下台灣第一個打進美國癌症用藥市場的機會。東洋昨日股價收112元，下跌1元。 據了解，未來東洋將以旗下微脂體包覆技術，和美國大藥廠合作抗癌針劑製造，雙方將以結盟方式搶進美洲抗癌藥物市場。東洋表示，未來該廠投產後，不僅會和美國藥廠合作，還將申請全球衛生單位認證，並釋出合作機會，林榮錦企圖心強，喊出「東洋要做全球癌症針劑中心」。 據了解，未來東洋在美洲銷售的抗癌針劑，將以乳癌、骨癌等適應症為主；法人估，該類藥品目前美洲市場規模約30億美元（約新台幣900億元），若以最大產能80萬劑估算，東洋每年獲利可望增加4到8億元。 至於結盟對象，法人圈則傳出，東洋合作對象就是美國嬌生（Johnson & Johnson）藥廠。 對此林榮錦不願證實，他僅表示，「一切都還在進行中，不便透露」；分析師表示，以建廠進度來說，目前應大抵完成硬體設備，近期美國食品藥物管理局（FDA）將來台查廠。 林榮錦說，由於規模擴大，去年原本預估的2億元預算，後來經過幾次追加，已經約達5億元，產能並從原本規劃的40萬劑，擴充到80萬劑。因此，原本預定今年9月前就會投產的時程，稍微延宕了一下，但會趕在今年10月底前投產。 此外，東洋近期也公告，將在10月底前處分香港東洋國際部分股權約49.09%，價金約人民幣1.24億元（約新台幣5.7億元），扣除成本後將挹注東洋約3億元的獲利，款項將分三批入帳。完成股權處分後，上海旭東海普可望加速在大陸的上市計畫。 【2012/07/13 經濟日報】
揭开新版GMP的质量风险管理的面纱
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发布时间：2012-7-12 来源：药品资讯网信息中心 药品质量风险是药品生命周期内有关质量方面危害发生的概率和严重程度二者的结合。药品整个生命周期的质量风险管理，其核心就是对药品的受益-风险进行分析，确保为治疗某种疾病而摄入一种药品的受益超过该药可能带来的风险。药品质量风险管理是2010年版GMP的一个重点内容，在规范内只有3条最基本的描述，因此，要做好药品质量风险管理难度并不小。
六大难点 药品生产企业实施质量风险管理的难点可归纳为以下六方面：
1）实施药品质量风险管理的第一难点，在于在质量风险管理的过程中，应该关注的是危害发生的可能性还是风险的平衡问题。我们在考虑风险因素发生可能性的同时，往往难以兼顾"投入-效益-损失"的平衡。但如果不兼顾这两方面，实施风险管理就失去了意义。 破解之道：药品风险管理本身划分为不同的阶段，在风险识别、分析与评估阶段，更关注风险发生的可能性；在风险控制与审核阶段，则更多地关注投入与效益的平衡分析。
2）质量风险管理的依据不明确，没有明确的标准可采用。GMP要求根据科学知识及经验对质量风险进行评估，但以往我们熟知的药品生产管理对"经验"的说法是不提倡的。更为麻烦的在于对"科学知识"的理解，究竟是指知识体系还是行业内通用的经验或是其他企业的经验，没有明确的答案。这需要企业在贯彻GMP的过程中，明确地建立系统的知识体系，这种知识体系的构建是GMP规范附加的一道看不见的任务。 破解之道：注册批件所批准的工艺是企业最成熟的科学管理的依据，药品最直接有效的风险管理的依据就是GMP规范的要求和药品注册批件。企业在建立质量管理体系及质量风险管理规范的同时，需要围绕药品生产建设系统的知识体系。
3）质量风险管理被新版GMP规范成了药品生产管理的基础工作，所有的操作规程、文件记录及规定的制定依据都是质量风险管理。正是因为GMP相关的一切工作都是围绕质量风险展开的，使得我们面对这个系统的工作体系无从下手。按照GMP的要求，需要对药品生命周期的各个阶段、各种要素都进行质量风险管理，这让我想起高中数学老师的话：如果从平地一下子跳上高楼或者从高楼跳下来，一般是无法办到的，唯一的办法就是分解，将这一系列的任务分解成小的能够完成的任务，然后一步步实施。 破解之道：将药品生产质量管理的这个庞大的GMP体系分解，直到我们可以消化运作的子系统，然后针对具体的情况，运用相应的工具，按照GMP的要求，逐一进行质量风险的评估和管理。
4）质量风险管理已经形成了很多种完全不同的工具模式，运用到药品生产管理中时，思维被工具的模式所固化限制，无法很好地应用风险管理工具。 破解之道：工具是可以根据需要进行选择并调整的，打破风险管理工具本身思维模式的局限，灵活地进行药品质量风险管理。
5）要实施好质量风险管理，需要将GMP各要素的管理有机整合。 麻烦的是，执行98版GMP时，不少企业的各个GMP要素并没有组成为一个有机统一的体系，要在2010版GMP的动态管理中统一起来，根本就是无法做到的事情。而药品质量风险管理正是要求把这些子系统统一起来，以确保整个体系的有序运行。 破解之道：GMP管理从来就强调全员参与，重视整个管理体系的规范和运作。质量风险管理更需要建设资源共享平台和良好的团队协调机制。
6）将药品质量风险管理与药品的副作用混为一谈。药品对于患者来说，可能在治病的同时带来副作用或者带来新的疾病，而药品使用后的效果与患者本人的身体状况、个人差异又有很大的关系。这些与药品的质量风险管理混在一起，让人无法分清楚方向，因为即便产品100%合格，但药品的副作用对于患者来讲，仍是不能忽视的风险，这个风险在药品的生产过程或者质量管理过程中是无法规避的，根本就是完全不同的两个领域的问题。 破解之道：药品质量风险管理的直接目标是持续稳定地生产出符合预定要求的药品，所以，确保产品100%合格以外，要关注不良反应潜在相关的生产问题或质量问题。
细节制胜 具体到药品生产企业来说，我们需要关注的最大的质量风险就是GMP认证，在认证的基础上，再考虑药品的生产管理和质量保证。这里我们就探讨制药企业所要面临的GMP认证相关的风险及其管理。
1）贯彻施行GMP的过程中，要注意GMP规范本身是符合GMP要求的最低的基本规范。新版GMP把规范本身在药品生产质量管理中的地位降低并把GMP与其他法规联系起来，如《药品注册管理办法》、《中国药典》。尽管实施了GMP管理，但还需要首先考虑符合具体药物品种的专门管理，以避免在相关的细节中出现检查缺陷。如疫苗制品、血液制品、生物制品等都有很多配套的专业的法规要求，GMP认证需要企业把好从原来到产品直至使用的各个环节的专业要求。
2）注册批件在GMP认证中的风险管理。与系统的法规体系在认证检查中的风险相比较，其实药品注册批件的内容更值得生产企业关注。但问题在于，对于注册批件的细节，尤其是工艺参数的范围和限度的设置，可能在不同层面给认证带来风险。试想一下，注册批件的基础在于企业自身提出的药品技术资料，技术细节和质量标准都是企业制订的，与新版GMP将实施的主导权下放给企业的理念是一致的，如果企业在生产管理中不实施注册批件中的细节，或者根本就是无法实施的话，GMP认证就是无法进行的事情。 需要注意的是，在准备注册申报材料时，可能在不知不觉中提高了对产品生产条件的要求或者设备的精度要求，或者在某些具体细节的描述上与产品生产的实际有所不符合，这些细节问题在准备GMP认证时企业都需要有较充分的考虑。
3）现场检查的风险管理。北京药监局近期出台了GMP认证检查指南。值得注意的是，新版GMP的检查，不外乎就是指南的内容。新版GMP的认证，不论是有效性还是符合性，都需要注意，如果企业无法做到符合性，那么就需要退而求其次，做好GMP管理的有效性。对于这个有效性的评估，那就要看平时的工作是否真的那么到位。GMP认证的现场检查，主要的问题在于：文件的制定是否规范合理、设备设施的管理是否执行文件的规定、人员培训与操作情况是否满足执行文件规定及GMP的要求，通过上述检查同时要评估企业的质量管理体系的有效性。为了组织好现场检查，工作人员应该全面的熟悉所有相关的文件和记录，管理人员则对相关的风险管理、质量保证要素、生产管理的细节都相当熟悉，并且准备好所有可能相关的文档和资料，以便在第一时间提供给检查员查询，提升企业执行GMP的可信性和可靠性。
Reference: PIC/S執行質量風險管理
Reference: PIC/S執行質量風險管理
九州通與馬偕及亞東醫院合作觀光醫療!!
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台灣醫療團 牽手陸A咖【經濟日報╱記者黃文奇／台北報導】 2012.07.13 04:11 am 外貿協會副秘書長葉明水昨（12）日率領「2012年台灣醫療服務訪問團」，與大陸最大私人醫療集團「九州通」、最大健檢中心「慈銘」共簽署2項結盟協議，未來大陸將轉介有醫療、醫美需求的人士到台灣進行診療，包括馬偕、亞東、國泰醫院及多家醫美中心都將受惠。 貿協醫療訪問團昨日在武漢辦理「台灣醫療服務說明會暨漢台合作交流會」，在葉明水、湖北省委原副秘書長劉克毅、武漢市衛生局副局長張紅星共同見證下，雙方簽署合作協議。 貿協表示，本次醫療訪問團成功促成台灣醫院、診所和大陸2大醫療企業簽訂合作協議，其中之一的九州通，是大陸最大、年營業額近人民幣300億元的私人醫療集團。 在九州通與馬偕紀念醫院及亞東醫院簽署合作協議後，未來將扮演中介角色，引介武漢各地有醫療、醫美需求的大陸民眾來台，赴馬偕、亞東等醫院進行診療。另外，除了九州通外，大陸最大健檢集團「慈銘」也是此次醫療團合作對象；慈銘擁有13家連鎖店，並有超過5萬名會員，未來將與台灣國泰綜合醫院、輔仁牙醫診所、禾睿牙醫診所及玩美牙醫診所合作，並由慈銘轉介武漢有需求的民眾來台診療。葉明水說，今年1月台灣開放「觀光醫療簽證」，暢通大陸人士來台進行健檢醫美服務的管道，由於武漢還不是自由行城市，此觀光醫療簽證無異是一大利多，加上武漢到台灣每周有14班直航班次，因此商機可期。 貿協說，此次訪問團包括台大醫院、馬偕紀念醫院、成大醫院、台中榮總、國泰綜合醫院、彰化基督教醫院及亞東醫院等7家醫院；禾睿、玩美及輔仁等3家牙科，及5家健檢醫美診所共同組成。 【2012/07/13 經濟日報】
酷熱！藥物、食物 也會引起光敏感
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‧聯合新聞網 2012/07/13 炎炎夏日，北市聯醫陽明院區藥師雷才萱提醒，民眾要盡量少吃光敏感藥物和食品，以免暴露在陽光底下的皮膚產生搔癢或是紅疹等光敏感作用... 【聯合報╱記者陳雅芃╱台北報導】 炎炎夏日，北市聯醫陽明院區藥師雷才萱提醒，民眾要盡量少吃光敏感藥物和食品，以免暴露在陽光底下的皮膚產生搔癢或是紅疹等光敏感作用。 雷才萱說，一般人只知到防曬就是擦防曬乳、撐洋傘，不知道有些藥物和食物，長期服用會和陽光產生交互作用，造成皮膚的光敏感性，容易引起皮膚搔癢或紅疹。 她指出，許多女性會使用檸檬片敷臉、柑橘類精油，以及使用A酸、果酸等美白，如果沒有清除乾淨，臉部照到陽光後就容易引起皮膚紅腫發炎。雷才萱說，像抗生素、抗黴素、利尿劑、A酸、果酸及消炎止痛的藥物都容易引起光敏感；另外像胡蘿蔔、芹菜、香菜或是檸檬片、柑橘類的食物，也容易引發皮膚紅腫的光敏感情形。 她表示，光敏感食物只有在皮膚暴露在陽光底下才會發作，引起皮膚搔癢或是紅疹。她建議，民眾除長袖衣褲及戴帽子與太陽眼鏡防曬，也要選購可隔離UVA和UVB的防曬油，避免曬黑以及皮膚老化。
感光食物有：柠檬、白萝卜、木瓜、芹菜、莴苣、土豆、香菜、苋菜、油菜、茄子、紫菜、田螺、菠菜、无花果，九层塔、韭菜、红豆、芒果。 可多吃番茄、奇异果、橘子、卷心菜、草莓等蔬果，它们都有一定防晒作用。哪些食物能防晒 多吃蔬菜和水果，能够使头发吸收到营养。那么骄阳似火烧的夏日，除了遮阳伞、墨镜和防晒霜，是否有可以滋养肌肤、防止晒伤的食物，帮助人们阻隔烈日的曝晒？有。就是人们最熟悉的某些蔬果，它们会神奇地转换成防晒物质，而且比防晒霜更耐用，因为它们不会被水洗掉。
番茄 这是最好的防晒食物。番茄富含抗氧化剂番茄红素，每天摄入16毫克番茄红素可将晒伤的危险系数下降40％。熟番茄比生吃效果更好。同时吃一些土豆或者胡萝卜会更有效，其中的β胡萝卜素能有效阻挡UV。 西瓜 西瓜含水量在水果中是首屈一指的，所以特别适合夏季补充人体水分的损失。吃西瓜不同于喝水或饮料，它对人体不仅仅是水分的补充，西瓜汁中还含有多种重要的有益健康和美容的化学成分，如多种具有皮肤生理活性的氨基酸。这些成分易被皮肤吸收，对面部皮肤的滋润、营养、防晒、增白效果较好。柠檬含有丰富维生素C的柠檬能够促进新陈代谢、延缓衰老现象、美白淡斑、收细毛孔、软化角质层及令肌肤有光泽。据研究，柠檬能降低皮肤癌发病率，每周只要一勺左右的柠檬汁即可将皮肤癌的发病率下降30％。 与柠檬有相似作用的还有橙子、猕猴桃、甜椒和草莓。 坚果 空调、风吹、日晒都会消耗皮肤中的水分。坚果中含有的不饱和脂肪对皮肤很有好处，能够从内而外地软化皮肤，防止皱纹，同时保湿、让肌肤看上去年轻。但不要指望立竿见影，通常需要30天才能令皮肤有所改善。
经我多年研究发现:常期在室外工作的人可以多吃一些仙人掌类植物,在连续食用一个月后,身体可自我分泌一种腊质物,防止体表水份的挥发,有效的防止晒伤;并可使皮肤有一种特别的光感,让女性保持长久的青春活力!! 如果还有疑虑,请注意观察仙人掌,你看它们什么时候被晒坏过? 芦荟，很有效果，加vc一起效果更好。如果你是干性皮肤，可以和ve一起吃；油性皮肤或混合性皮肤就不要吃了。我有试过，野外活动一个月（7-8月份的高原地区），同等条件下，我的胳膊没有出现短袖T恤的黑白分明的痕迹，而其他人包括皮肤白嫩的女生和黑黝黝的男生，他们的胳膊都出现了遮住部分和裸露部分的黑白现象，我的则没有，晒了一一个月的胳膊和没晒的一样。 ps:我吃的是保健品芦荟胶囊，不是药店那种，可以在屈臣士买康力士或健美生的，两个牌子都不错。 ps:单纯的食物防晒效果不大，虽然很多人说富含vc等的食物如番茄猕猴桃等，多吃可以防晒，但究竟要吃多少量才会有效果，要知道科学家研究vc等具有防晒效果的实验，可是用纯的vc做的，而不是拿着一个番茄猕猴桃去做的。当然我并不是说富含vc的食物没有防晒作用，而是说效果不明显，且比较慢，需要坚持几十年吧，除非你皮肤底子比较好。 ps:有些富含vc的东西不能白天吃，吃了不但不能防晒，而且会长斑，这些食物是感光食物，遇光容易形成皮肤色素沉淀。如红薯，木瓜，香菜等，要吃的话就晚上吃吧，关上灯吃，呵呵。。http://zhidao.baidu.com/question/35331209
睡覺有益減重!!!! Sleep deprivation(熬夜) 增加體重 ~~
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Should we sleep more to lose weight? July 10, 2012 in Health Research to be presented at the Annual Meeting of the Society for the Study of Ingestive Behavior (SSIB), the foremost society for research into all aspects of eating and drinking behavior, suggests that sleep behavior affects body weight control and that sleep loss has ramifications not only for how many calories we consume but also for how much energy we burn off. In recent years an increasing number of epidemiological studies have found a relationship between how long we sleep for and obesity as well as type 2 diabetes, suggesting that insufficient sleep increases the risk of gaining weight and developing diabetes. Work carried out by researchers from the German Universities Tubingen and Lubeck and Uppsala University in Sweden has investigated the effect of short term sleep deprivation on hunger as well as on physical activity and energy used by the body. Physical activity was measured by special devices worn on the wrist that detect acceleration. Energy used by the body was assessed by indirect calorimetry, a method which estimates how much heat is produced by a person as they use oxygen. Sleep deprivation increased how hungry participants felt and also raised the amount of the "hunger hormone" ghrelin detected in their blood. In fact, the shorter the amount of sleep a person had experienced the hungrier they were. After just one night of disrupted sleep volunteers moved around less although this was not surprising considering they also felt more tired. In addition, staying awake for one complete night reduced the amount of energy used by the body when resting. This research tells us when we are sleep deprived we are likely to eat more calories because we are hungrier. This alone might cause us to gain weight over time. However sleep loss also means we burn off fewer calories which adds to the risk of gaining weight. Ongoing studies aim to find out if increasing sleep time might help with weight control efforts. While there is still some way to go before sleep improvement is used to treat obesity and diabetes, the available research results clearly supports the notion that sleep is involved in the balance between the amount of calories we eat and the amount we use up through activity and metabolism. Provided by Society for the Study of Ingestive Behavior
台灣11.87億元血管支架健保市場 (2萬7026人)!
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健保統計－支架通血管 一年花50億 2012-07-13 中國時報 邱俐穎／台北報導 中央健保局統計，去年國人就裝了4萬2000支血管支架，其中3萬8000支是心臟血管支架，若是各類血管支架加上手術費用，一年健保花費達50億元，等於是健保5000億總額的1/100，金額相當可觀。健保局醫審及藥材組專門委員施如亮表示，去年國內約有2萬7026人使用血管支架，單單醫材的健保申報費用就達11.87億元，其中又以冠狀動脈血管支架逾2萬4000人最多，等於平均每位患者就裝了1.6支心臟血管支架。若以前2年資料來看，98年國人心臟血管支架約裝了3萬4000支，99年3萬6000支，等於每年以2000支幅度成長。施如亮研判，人口老化、飲食西化，常吃高熱量、高油脂食物都是可能原因。振興醫院心臟血管內科主任殷偉賢指出，台灣整體來看近5到10年心血管疾病死亡率皆持平、未明顯下降，血管支架雖提供患者開刀外的另一個選擇，但只是治標不能治本，患者平時飲食仍要清淡、戒菸、控制三高，才能避免心臟病、中風等疾病。
神經病變－糖尿病引發複視 鬼影幢幢
2012-07-13 中國時報 邱俐穎／台北報導 眼睛出現複視，小心是血糖太高惹禍！68歲吳先生，罹患糖尿病20多年，一天開車突然紅綠燈分為2個，嚇得他趕緊靠邊停車，經檢查後發現右眼球無法往外側移動，竟是糖尿病引發的複視。 書田診所腦神經內科主任醫師黃婷毓表示，人的眼睛共有3對神經操控運動，診治時發現男子只有兩眼直視前方時才會出現雙重影像的複視情形，若只以單眼視物則一切正常，進一步檢查發現，男子右眼無法向外側移動。 黃婷毓說，雖病患長時間接受糖尿病藥物治療，但抽血一驗，糖化血色素竟明顯高於標準值，由於高血糖、高血壓皆是引發神經病變的危險因子，研判是高血糖造成外展神經病變，才會兩眼無法聚焦。 黃婷毓說，複試會讓人失去遠近、立體感，長時間恐影響平衡，出現頭暈、走路不穩等情形，若不治療甚至會引起視網膜、腎臟病等其他糖尿病併發症，造成不可回復的器官損傷，所幸病患經2個月治療和控制血糖，視力已慢慢恢復正常。事實上，以複視作為表現的糖尿病神經病變發生率僅3%，最常見的還是以手麻、腳麻為表現的周邊神經病變，不過民眾常容易忽略。
Gastric bypass surgery alters gut microbiota profile along the intestine
July 10, 2012 in Surgery Research to be presented at the Annual Meeting of the Society for the Study of Ingestive Behavior (SSIB), the foremost society for research into all aspects of eating and drinking behavior, finds that gastric bypass surgery induces changes in the gut microbiota and peptide release that are similar to those seen after treatment with prebiotics. Previous animal research demonstrated that ingestion of a high-fat diet produces weight gain and profoundly affects the gut microbiota composition, resulting in a greater abundance of one type of bacteria called Firmicutes, and a decrease in Bifidobacteria spp and Bacteroidetes. A similar pattern has also been found in obese humans. Feeding of prebiotics, substances that enhance the growth of beneficial bacteria, changes the composition and/or the activity of the gastrointestinal microbiota, to promote the release of gut peptides and to improve glucose and lipid metabolism in diet-induced obese and type 2 diabetic mice. Roux-en-Y gastric bypass (RYGB) surgery is considered the most effective treatment of morbid obesity and diabetes. Recent studies reported substantial shifts in the composition of the gut microbiota towards lower concentrations of Firmicutes and increased Bacteroidetes in obese subjects after RYGB. Most of the human studies on gut microbiota have been carried out using fecal samples which may not accurately represent how RYGB surgery affects the gut microbiota profile along different parts of the intestine. Because RYGB may affect how nutrients are absorbed in different portions of the intestine, a new study conducted by researchers at the University of Zurich measured the bacterial composition and the amounts of different peptides that affect food intake along different intestinal segments after RYGB in rats. They found that 14 weeks after surgery, Bifidobacteria spp, and Bacteroides-Prevotella spp content were significantly increased in several portions of the intestine in RYGB rats compared to control animals. In fact, the changes in gut microbe populations after RGYB resembled those seen after treatment with prebiotics. Gut microbiota changes were also associated with altered production of gastrointestinal hormones known to control energy balance. The lead author on this study, Melania Osto, Ph.D. said "Our findings show that RYGB surgery leads to changes in gut microbiota that resemble those seen after treatment with prebiotics. The results of this study suggest that postsurgical gut microbiota modulations may influence gut peptide release and significantly contribute to the beneficial metabolic effects of RYGB surgery." Provided by Society for the Study of Ingestive Behavior New test helps evaluate cancer drug's merit July 9, 2012 in Cancer (HealthDay) -- A new genetic test to help doctors determine if the drug Erbitux would be an effective treatment for certain colorectal cancer patients has been approved by the U.S. Food and Drug Administration. The KRAS RGQ PCR kit checks for the presence of a certain mutation in the KRAS gene. About 40 percent of people with colon cancer are thought to have the mutation, which leaves Erbitux ineffective. The test is for people whose colorectal cancer has spread to other parts of the body, the FDA said in a news release. The American Cancer Society says more than 141,000 new cases of colon cancer were diagnosed last year in the United States, and nearly 50,000 people died of the disease. Erbitux (cetuximab), co-marketed by Bristol-Myers Squibb and Eli Lilly, was first approved as a colon cancer treatment in 2004. The new diagnostic was developed by Qiagen Manchester Ltd., based in Manchester, England. More information: Visit the FDA to learn more about this approval.
Meditation training may lower respiratory illness burden
July 10, 2012 in Health Training in mindfulness meditation or exercise is linked to a decrease in the severity and duration of acute respiratory infections in adults, according to a study published in the July/August issue of the Annals of Family Medicine. (HealthDay) -- Training in mindfulness meditation or exercise is linked to a decrease in the severity and duration of acute respiratory infections (ARIs) in adults, according to a study published in the July/August issue of the Annals of Family Medicine. To assess the preventive effects of meditation or exercise on incidence, duration, and severity of ARI illness, Bruce Barrett, M.D., Ph.D., of the University of Wisconsin in Madison, and associates conducted a randomized trial involving 149 adults (82 percent female; 94 percent white; mean age, 59.3 years). Participants underwent eight weeks of training in mindfulness meditation (51 participants) or moderate-intensity sustained exercise (47 participants), or were part of an observational control (51 participants). The researchers identified 27 ARI episodes and 257 days of ARI illness in the meditation group, 26 episodes and 241 illness days in the exercise group, and 40 episodes and 453 days in the control group. Data showed that the mean global severity was 144, 248, and 358 for meditation, exercise, and control, respectively, with severity significantly lower for mediation versus control. There was a trend toward lower severity in the exercise versus control group and for lower duration in the exercise and meditation groups versus control. There were significantly fewer ARI-related days of work missed for the exercise and meditation groups versus the control group (32, 16, and 67, respectively). "If these results are confirmed in future studies, there will be important implications for public and private health-related policy and practice, as well as for scientific research regarding mechanisms of health maintenance and disease prevention," the authors write. The study was funded in part by the National Center for Complementary and Alternative Medicine.
張善政：政府帶頭造10朵有感雲 應用、產業發展並重!!
鉅亨網新聞中心 (來源：聯合報系/udndata.com) 2012-07-12 07:16 行政院政務委員張善政昨（11）日表示，新出爐的「雲端運算應用與產業推動方案」，將兼顧應用和產業發展，全力推動讓民眾有感覺的「有感雲」，由經濟部和研考會帶頭推動發展雲端產業。 張善政將於7月18日參加由經濟日報主辦的「雲端大未來」高峰會，昨天接受專訪時表示，台灣很多廠商發展雲端產業「天真的不得了」，停留在幼稚園程度。舉例來說，成立貨櫃機房，就是沒有實務經驗、人云亦云的作法，面臨很多先天技術和後天營運的瓶頸。 張善政指出，政府此次發展雲端運算，有別以往發展產業時只重「產值」，不再「打腫臉充胖子」，今後要強調「價值」，「產值」和「價值」並重，發展出10個「有感雲」遠勝產值的「數字遊戲」。以下是專訪紀要：
問：政府對於雲端產業的發展政策規畫為何？ 答：行政院10 日已召集各部會檢討「雲端運算產業發展方案」，並將方案調整為「雲端運算應用與產業發展方案」，強調應用及產業發展並重的精神。 當前雲端應用面臨技術開發及市場行銷兩大挑戰。實質面計畫上，將在台灣打造一個雲端開發測試平台，整合國內外可用的雲端工具及解決方案，讓開發商可以在平台上測試；一旦「試婚」成功，未來有助於爭取台灣政府雲端標案。 另由研考會打造一個共用的政府雲端運算中心，各部會共用雲端機房及伺服器，全面發展雲端應用。而未來扶植產業研究開發的過程，將要跟應用掛勾，除協助開發，政府也要成為第1個使用者，為台灣雲端應用找出路。 目前政府資通訊預算萎縮，但將優先分配給雲端應用開發。未來3年，雲端計畫每年預算可望超過10億元，將由研考會持續電子化政府的推動，發展政府雲端應用；經濟部則負責研發，並訂下3年繳出成果的落日條款。
問：如何評估政府發展雲端所帶動的產業效益？ 答：我上任後刪除雲端應用及產值的目標，因為發展雲端是要讓每個應用都紮實、讓民眾有感，且有利於節能減碳。 未來雲端目標，是開發深耕且優質的雲端應用，而不單看應用數量及產值，政府計劃要推出10個有衝擊性且民眾有感的雲端服務。 部分雲端應用的軟體可能商機不大，無法賣到全球，但是對社會貢獻度大，因此看雲端效益，不僅要看產值面，更要產值跟價值並進。
問：什麼是優質且有影響性的雲端應用？ 答：例如電子病歷跟食品追溯履歷，就可望成為優質且具影響力的雲端應用。衛生署推動電子病歷，台灣400多所醫療院所中，有200所已完成電子病歷。 未來由政府打造醫療雲，整合電子病歷目錄，民眾需要時可提出要求，並抓取電子病歷，落實雲端開放及分享的概念，X光片等資源共享也可以減少健保支出。
問：政府引進國際大廠來台灣投資雲端產業，策略為何？ 答: 政府面對國際廠商到台灣投資，要很小心，不是阿貓阿狗的企業都接。首先公司要夠大，例如Googl到台灣投資後，帶動臉書及微軟也評估來台投資。 Google在台灣設雲端中心，引起能源應用疑慮，不過，Google除因為台灣用電便宜外，也肯定台灣法規及資訊系統的保障，對台灣整體形象加分，在台灣帶起就業機會雖僅100 到200人，卻可拓展台灣人才國際視野。 國際大廠來台投資雲端中心，對台灣連外頻寬也是一大挑戰，政府將促使電信業者加速建設。
問：如何看待台灣雲端產業發展及商機？ 答：很多台灣廠商發展雲端，還在幼稚園程度。雲端產業挑戰很大，不這麼樂觀。例如貨櫃機房的概念，還需面對很多技術及營運上的瓶頸，可能還需要更周延的思考，以硬體帶軟體銷售的方式也不可行。 廣達等硬體廠商無需政府幫忙就可做的很好，最需要扶植的是中小型軟體應用開發商。目前系統軟體已被微軟、亞馬遜及VMware等大廠盤踞，中小企業做帳軟體、人力管理、庫存管理等應用，還沒有大型軟體公司主導，這就是台廠機會。 【記者蘇秀慧、黃晶琳／台北報導】
儿童肥胖状况堪忧 中国将控制肥胖列入官方规划
发布时间：2012-7-12 来源：药品资讯网信息中心 肥胖越来越是一个大问题，目前中国已经将控制肥胖列入到了官方的规划之中，在9日卫生部举行的例行新闻发布会上，卫生部的官员做了这样一个透露。根据当前卫生部所披露的这一份官方的行动规划，到2015年，中国成年人的肥胖率将会努力控制在12%以内，而儿童青少年的肥胖率将会努力控制到不超过8%。 不过对于这样的一个目标，卫生部疾病预防控制局副局长孔灵芝她个人表示并不乐观，因为任务确实非常艰巨。过去20多年中，中国经济取得了前所未有的个增长，与此同时，中国人的体重包括饮食、运动量等等也发生了很大的变化，因此可以说肥胖越来越是个大问题。 就拿儿童肥胖的状况来讲，据国际肥胖研究协会主办的《肥胖综述》(Obes Rev)月刊近期公布的研究报告估计，中国有12%的儿童超重。在不满17岁的青少年儿童中，有三分之一的孩子至少出现了一种心血管危险因素。(详情) 实际上目前中国儿童的肥胖率已经接近8%，距离我们控制的目标已经是一个临界点，因此可以说，将儿童青少年的肥胖率定为不超过8%，就是希望这个数字不要再继续上涨。 "而要达到这样的一个目标，根据专家的测算，它不仅需要我们重视儿童的教育和行为规范等等，督促他们养成好的行为习惯，同时它也是一个社会化的工程，比如说食品加工企业的生产等等，包括具体到家里，父母在做饭的过程中，油盐要放多少等等。"孔灵芝表示。 这次的官方规划做的很细致。规划中明确指出，要积极开发低盐、低糖、低脂、低热量的健康食品，包括中小学生在校期间，每天会进行多长时间的体育锻炼活动等等，可以说规定的非常非常的细。 肥胖问题一直被我们看作是一个健康的问题，但实际上不仅仅是健康这么简单，它也涉及到人类发展的一个问题，事实上它是一个人口隐性增长的发展问题。 最近还有一条和肥胖相关的新闻很有意思，欧美的一些学者经过研究测算得出的结论，到目前为止它测算出人类超重1500万吨，这是什么概念呢?就是如果根据2005年的这种数据，测算出人类的平均体重的话，那么现在全球全部成年人口的总重量是2.87亿吨，一共超出了1500万吨，折成标准成年人的体重，就好比地球一下子多出了2.4亿个拥有平均体重的人。(详情) 可以说除了人口在增长，我们人类的平均体重也在不断增加，这就相当于我们人类的人口在增长，同时还有隐性增长，对于全球的生态系统的破坏显然是更大了。因此现在来看健康已经不仅仅是个健康的问题，还是一个人口隐性增长的大的发展问题。
我国学者发现新型肝癌标志物
发布时间：2012-7-13 来源：爱唯医学 上海交通大学医学院附属仁济医院上海市肿瘤研究所"癌基因及相关基因国家重点实验室"覃文新研究组发表在《柳叶刀·肿瘤学》上的一项研究显示，DKK1蛋白（Dickkopf-1）可作为肿瘤标志物用于肝细胞癌（HCC）的血清诊断，可用于筛检甲胎蛋白（AFP）阴性患者，对肝脏良、恶性疾病有较好的区分效用。 覃文新研究团队于2003年首次发现并证明分泌蛋白DKK1在人类多种肿瘤包括肝癌中特异高表达，并在人类多种肿瘤细胞的培养上清和肝癌患者血清中检测到其分泌性高表达，因此DKK1可作为肿瘤血清蛋白标志物用于肺癌、肝癌、乳腺癌、宫颈癌等恶性肿瘤的血清诊断。 在此基础上，2008年，覃文新研究员率领研究团队设计并开展了肿瘤血清蛋白标志物DKK1用于HCC血清诊断的大规模临床多中心试验研究。研究者于2008年12月~2009年7月从两个中心入组HCC患者、慢性肝炎患者、肝硬化患者和健康对照者，并从另一家中心入组年龄和性别匹配的队列进行验证，采用ELISA方法检测血清DKK1水平。 共831例受试者接受DKK1水平检测，包括424例HCC患者，98例HBV慢性肝炎患者，96例肝硬化患者和213名健康对照受试者。验证队列共有453例受试者，包括209例HCC患者，73例慢性乙型肝炎患者，72例肝硬化患者和99名健康对照受试者。检测结果表明，HCC患者的DKK1水平高于其他受试者，最佳界值为2.153 ng/ml（操作者特征曲线下面积0.848），在试验队列中的敏感性和特异性分别为69.1%和90.6%（图），在验证队列中则分别为71.3%和87.2%。早期HCC和小肝癌（单个直径<2 cm）患者中的结果与此类似：试验队列中的敏感性和特异性分别为70.9%和90.5%，验证队列中则分别为73.8%和87.2%。DKK1蛋白能够弥补AFP对HCC诊断能力的不足，对AFP阴性（<20 ng/ml）HCC的诊断敏感性为70.4%、特异性为90%，并可从AFP阳性（>20 ng/ml）的慢性乙型肝炎及肝硬化等高危患者中鉴别诊断HCC，鉴别诊断的敏感性达69.1%、特异性为84.7%。若DKK1蛋白与AFP联合应用，HCC的总体诊断率可提高至88%，在试验队列中的敏感性和特异性分别为73.3%和93.4%，在验证队列中则分别为78.5%和87.2%。此外，手术后患者血中的DKK1浓度迅速下降，血清DKK1蛋白亦可作为肝癌疗效监测和预后判断指标。 研究者观点 目前，在临床常规诊断和筛查中广泛使用的肿瘤血清标志物基本为血清蛋白标志物，主要原因在于肿瘤血清蛋白标志物除具有非侵袭性特点外，还具有所需血清样本量少（通常少于100 μl）、无需对血样进行抽提纯化等前处理、检测方法简单易推广、可自动化快速批量检测、重现性高、费用低等优点。DKK1属于肿瘤血清蛋白标志物，具备广阔的临床应用前景。现已初步研制出具有自主知识产权的血清DKK1蛋白检测系统，进一步的后续临床试验在有关单位的通力协作下正在进行中。
Teach Prescribers About Dangers of Long-Acting Pain Meds: FDA
Abuse, misuse, deaths from narcotic painkillers on the rise Monday, July 9, 2012 MONDAY, July 9 (HealthDay News) -- As part of its efforts to curb the abuse of narcotic painkillers, the U.S. Food and Drug Administration is requiring drug makers to educate doctors about the risks of long-acting and extended-release forms of the drugs. "Prescription-drug abuse is our nation's fastest-growing drug problem," FDA commissioner Dr. Margaret Hamburg said during a Monday afternoon press conference. Commonly prescribed drugs that come in longer-acting forms include oxycodone, morphine and fentanyl. The continuing-education programs will be based on FDA-created blueprints. The agency expects the more than 20 companies that make these drugs to provide grants to firms that specialize in medical continuing education. These firms will, in turn, develop and administer the programs under FDA supervision and provide them to doctors for free. Although all opioid painkillers carry risk of abuse, overdose and death, the extended-release and time-release forms of the drugs are particularly risky. Because they act in the body over longer periods, they are more likely to cause problems, Hamburg said. "The number of people harmed by these long-acting or extended-release opioids due to misprescribing, misuse and abuse ... continues to increase dramatically," Hamburg said. In 2008, nearly 15,000 Americans died from overdoses of these drugs. In 2009, there were more than 15,500 deaths from opioid painkillers -- almost four times as many as in 1999, according to the U.S. Centers for Disease Control and Prevention. In addition, more than 2 million emergency-room visits in 2010 involved abuse or misuse of prescription drugs -- almost half of all drug-related visits. Of these visits, more than 15 percent involved opioid medications, Hamburg said. The drugs are widely prescribed. It is estimated that nearly 23 million prescriptions for extended-release and long-acting opioids were issued in 2011, Hamburg said. It is estimated that more than 320,000 prescribers listed with the U.S. Drug Enforcement Administration wrote at least one prescription for opioid painkillers in 2011, according to the FDA. Despite these problems, Hamburg said, patients who need these drugs must have access to them. "Educating health care professionals on how to safely prescribe extended-release and long-acting opioids is essential to address this critical public health issue," she said. The FDA hopes that over the next three years, 60 percent of the 320,000 prescribing doctors will have been trained, Hamburg said. Along with the programs for doctors, the FDA also is mandating that manufacturers provide FDA-approved patient-education materials on the safe use of these drugs. The material appears on a single page in consumer-friendly language, and will be given to patients every time they fill a prescription. Both the drug companies and the FDA will review the progress and success of these programs. Based on the reviews, the agency may require the companies to provide additional elements to ensure success. The first programs under the FDA's new requirement are expected to be launched by March 1. Although no doctor currently is required to take the two- to three-hour continuing-education program, the Obama administration is urging Congress to make such programs mandatory. SOURCES: July 9, 2012, press conference with Margaret Hamburg, M.D., commissioner, U.S. Food and Drug Administration; FDA news release, July 9, 2012 HealthDay
專利藥到期! 醫藥大餅整體將下降.....
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生技展腳步近，生醫股動起來 2012-07-12 【時報-台北電】 生技展即將在7月下旬登場，生醫族群在各家公司都已逐步找到獲利的利基，且各具題材下，昨日股價加溫，法人認為，除了中概題材的東洋（4105）、曜亞（4138）聚焦外，搶攻癌藥商機的杏輝(1734)和搶進國際舞台的原料藥股神隆(1789)、中化生(1762)也備受矚目。 中研院院長翁啟惠認為，國內的生醫產業已開始展露特色，目前已有20個以上新藥進入美國FDA臨床，快的話2014年台灣應有新藥可獲認證上市，而醫材近來在電子產業積極結合，也可望發揮利基，學名藥部分，隨著美國、中國、日本和亞洲等國家紛紛進行醫改政策，配合國內廠商積極開拓海外市場，都將慢慢開花結果。 就初步統計來看，太景、基亞生技的新藥可望打進大陸，東洋集團的布局十分穩健，原料藥的神隆、中化生、台耀等公司國際競爭力強，杏輝與旗下的杏國布局的癌藥研發，近年和日本、德國上市藥廠結盟，並獲代工訂單，未來營運展望樂觀。 由於這次生技展中具特色的是增加兩岸生技專區，也讓中概生技股營運有想像空間，目前除了太景、基亞是在中國ICH架構下投入新藥三期臨床外，東洋、神隆、蘇州中化新建的廠房是為大陸新版CGMP廠量身定做新，預計將可享受大陸醫改商機。另外，美國最高法院最近判決歐巴馬的醫改核心內容並不違憲，因此，未來將擴大美國州政府的醫療補助(Medicaid)的保險範圍，為此，台灣廠商積極除了積極搶進學名藥市場外，血糖機的五鼎、華廣、聯合骨科等也將受惠。 台灣工銀生技創投協理羅敏菁表示，人口老化快速，各國政府積極實施醫改政策，加上專利藥的密集到期引爆的商機，血糖計、原料藥、學名新藥和新藥研發公司將是國內生醫產業最值得關注的族群，未來將具吸金和吸睛效應。羅敏菁認為，2010-2015是專利藥到期的高峰期，總計超過700個，其中包括年銷售額曾破兆元的降膽固醇藥Lipitor，在預期將吸引學名藥廠爭相卡位下，國內廠商有機會沾光。(新聞來源：工商時報─記者杜蕙蓉／台北報導)
New study suggests moderate alcohol consumption may help prevent bone loss
July 11, 2012 in Health This is an electron microscope image showing osteoporotic architecture in the fourth lumbar vertebra of an 89-year-old woman. Credit: Photo courtesy of Alan Boyde. (Medical Xpress) -- Drinking a moderate amount of alcohol as part of a healthy lifestyle may benefit women's bone health, lowering their risk of developing osteoporosis. A new study assessed the effects of alcohol withdrawal on bone turnover in postmenopausal women who drank one or two drinks per day several times a week. Researchers at Oregon State University measured a significant increase in blood markers of bone turnover in women after they stopped drinking for just two weeks. Bones are in a constant state of remodeling with old bone being removed and replaced. In people with osteoporosis, more bone is lost than reformed resulting in porous, weak bones. About 80 percent of all people with osteoporosis are women, and postmenopausal women face an even greater risk because estrogen, a hormone that helps keep bone remodeling in balance, decreases after menopause. Past studies have shown that moderate drinkers have a higher bone density than non-drinkers or heavy drinkers, but these studies have provided no explanation for the differences in bone density. Alcohol appears to behave similarly to estrogen in that it reduces bone turnover, the researchers said. In the current study, published online July 11 in the journal Menopause, researchers in OSU's Skeletal Biology Laboratory studied 40 early postmenopausal women who regularly had one or two drinks a day, were not on any hormone replacement therapies, and had no history of osteoporosis-related fractures. The researchers found evidence for increased bone turnover – a risk factor for osteoporotic fractures – during the two week period when the participants stopped drinking. Even more surprising: the researchers found that less than a day after the women resumed their normal drinking, their bone turnover rates returned to previous levels. "Drinking moderately as part of a healthy lifestyle that includes a good diet and exercise may be beneficial for bone health, especially in postmenopausal women," said Urszula Iwaniec, associate professor in the College of Public Health and Human Sciences at OSU and one of the study's authors. "After less than 24 hours to see such a measurable effect was really unexpected." Iwaniec, OSU's Skeletal Biology Laboratory director Russell Turner, and researcher Gianni Maddalozzo assisted OSU alumna Jill Marrone with the study, which was Marrone's master's thesis. This study is important because it suggests a cellular mechanism for the increased bone density often observed in postmenopausal women who are moderate drinkers, Turner said. The researchers said many of the medications to help prevent bone loss are not only expensive, but can have unwanted side effects. While excessive drinking has a negative impact on health, drinking a glass of wine or beer regularly as part of a healthy lifestyle may be helpful for postmenopausal women. "Everyone loses bone as they age, but not everyone develops osteoporosis," Turner said. "Being able to identify factors, such as moderate alcohol intake, that influence bone health will help people make informed lifestyle choices." Journal reference: Menopause Provided by Oregon State University
中化生Tacrolimus 將出貨500公斤!!
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中化生上半年EPS逾1.2元；Q3營收可望續創高 2012/07/12 10:15 精實新聞 2012-07-12 10:14:55 記者 蕭燕翔 報導 MMF供不應求，原料藥廠中化生(1762)第2季營收4.01億元，創下單季新高，法人預估，單季稅後盈餘近7千萬元，季增率力拼9成，上半年稅後盈餘逾1億元，以目前股本估算，每股稅後盈餘1.25元以上。第3季在MMF動能延續及其他免疫製劑新訂單出貨下，單季營收可望較上季維持個位數成長，續創單季新高。中化生第2季營收亮眼，單季營收4.01億元，創下單季新高，主要動能來自MMF客戶在北美市占率成長，一路追單，其次與美國藥廠Amarin合作開發的新藥原料EPAE，主要用於降低血液中三酸甘油脂濃度，今年首度列入前5大產品線，都挹注Q2的營收。法人預估，在MMF經濟規模擴大有助產品毛利率下，中化生第2季毛利率有較首季走揚空間，單季稅後盈餘近7千萬元，季增率挑戰9成，上半年稅後盈餘逾1億元，每股稅後盈餘1.25元以上。 展望第3季，中化生表示，MMF客戶需求仍暢旺，產能持續供不應求，本季出貨將維持高檔；抗器官排斥用的免疫製劑Everlimus本季將有公斤級的出貨；至於與Endo合作的免疫製劑Tacrolimus最快本季底前將有首批量產出貨，未來4~5年的出貨量上看4、500公斤。 法人預估，中化生今年MMF出貨量將挑戰50噸，搶下北美5成以上市場，第3季營收有機會較第2季成長個位數，再創單季新高，今年全年營收14.1億元，年增21%，稅後盈餘2.2億元，年增率超過3成，以目前股本估算，每股稅後盈餘超過2.8元。
刮痧可治病防病 却不是人人适合
来源：寻医问药网社区 时间：2012-07-12 刮痧可以预防以及治疗疾病，具有强身健体等养生效果，但是，并不是人人都适宜进行刮痧的，下面一起看看不适合刮痧的人群。
1、接触性皮肤病传染者忌用刮痧，因为这会将疾病传染给他人。
2、有出血倾向者，如糖尿病晚期、严重贫血、白血病、再生障碍性贫血和血小板减少患者不要刮痧，因为这类患者在刮痧时所产生的皮下出血不易被吸收。
3、凡体表有疖肿、破溃、疮痈、斑疹和不明原因包块处禁止刮痧，否则会导致创口的感染和扩散。
4、急性扭伤、创伤的疼痛部位或骨折部位禁止刮痧，因为刮痧会加重伤口处的出血。
5、过度饥饱、过度疲劳、醉酒者不可接受重力、大面积刮痧，否则会引起虚脱。
6、眼睛、口唇、舌体、耳孔、鼻孔、乳头、肚脐等部位禁止刮痧，因为刮痧会使这些黏膜部位充血，而且不能康复。
7、精神病患者禁用刮痧法，因为刮痧会刺激这类患者发病。
8、有严重心脑血管疾病、肝肾功能不全、全身浮肿者。因为刮痧会使人皮下充血，促进血液循环，这会增加心肺、肝肾的负担，加重患者病情，甚至危及生命。
9、孕妇的腹部、腰骶部禁用刮痧，否则会引起流产。
刮痧知识：刮头面部不要强求出痧
导读：刮痧知识：刮头面部不要强求出痧。刮拭头面部具有改善头部血液循环，疏通经络，促进全身阳气运行等保健养生作用。在刮拭头面部时，一定要注意刮痧力度，要轻轻地抓，不要强求出痧。
刮痧知识：刮头面部不要强求出痧 常刮头面轻松通气血 刮拭头部具有改善头部血液循环，疏通经络，促进全身阳气运行等作用。刮拭头部后，患者一般有轻松舒服和精神焕发的感觉。另外，刮拭头部还可防治脑栓塞、脑血管意外后遗症、神经衰弱、头痛(各种类型)、高血压、眩晕、记忆力减退、头发早白、感冒、脱发等。刮拭面部，以患者感觉面部气血通畅，肌肉放松，轻松舒服为目标，对面部保养及防皱美容有一定效果，另外还可防治如鼻病、耳病、面瘫、口腔疾病、雀斑、痤疮等病症。
生技基金 本季將續旺
2012/07/12 【經濟日報╱記者何佩儒／台北報導】 美股近來震盪，惟生技類股相對強勁。根據統計，那斯達克生技指數今年以來仍有二成以上的漲幅，加上歷來的第3季生技指數多處上揚，資產管理業者表示，在併購效益帶動，生技股多頭氣勢可望延續，有助生技基金表現。 富蘭克林證券投顧指出，統計2002年至2011年10年期間那斯達克生技指數的季度表現，第3季平均漲幅約3.09%，優於S&P 500指數的下跌0.54%，即使是2002年的科技泡沫或是2008年的金融海嘯發生期間，生技指數第3季的表現都優於大盤。 富蘭克林坦伯頓生技領航基金經理人麥可羅表示，繼製藥大廠葛蘭素史克（GlaxoSmithKline）延長收購美國生化藥廠Human Genome的邀約期限後，近期市場傳出生技公司Celgene亦有意爭取收購，顯示大型生技公司及製藥大廠欲透過併購來壯大企業收入來源及成長動能的意圖，統計2007年以來，主要生技併購案的併購溢價達50%，顯示併購案為生技股帶來強勁的漲升動能。 德盛安聯生技大壩基金經理人傅子平指出，目前市場關注焦點落在幾個潛在的購併案，與幾項在FDA審查階段的藥物是否能如期通過上市；看好購併中小型生技公司的趨勢。
Study reveals new mechanism that might promote cancer's growth and spread in the body
July 10, 2012 in Cancer Researchers have discovered a previously unknown mechanism that promotes the growth and spread of cancer. The mechanism involves key immune cells and a new role for small regulatory molecules called microRNA. The findings suggest a new strategy for treating cancer and perhaps diseases of the immune system. Tiny vesicles released by tumors cells are taken up by healthy immune cells, causing the immune cells to discharge chemicals that foster cancer-cell growth and spread, according to a study by researchers at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) and at Children's Hospital in Los Angeles. The study uses lung cancer cells to show that the vesicles contain potent regulatory molecules called microRNA, and that the uptake of these molecules by immune cells alters their behavior. The process in humans involves a fundamental receptor of the immune system called Toll-like receptor 8 (TLR8). The findings, published in the early edition of the Proceedings of the National Academy of Sciences, suggest a new strategy for treating cancer and diseases of the immune system, the researchers say, and a new role for microRNA in the body. "This study reveals a new function of microRNA, which we show binds to a protein receptor," says principal investigator Dr. Carlo Croce, director of Ohio State's Human Cancer Genetics program and a member of the OSUCCC – James Molecular Biology and Cancer Genetics program. "This tells us that some cancer-released microRNAs can bind and activate a receptor in a hormone-like fashion, and this has not been seen before." MicroRNAs help control the type and amount of proteins that cells make, and they typically do this by binding with the messenger-RNA that encodes a protein. "In this study we discovered a completely new mechanism used by cancer to grow and spread, therefore we can develop new drugs that fight tumors by entering this newly identified breach in cancer's fortress," says co-corresponding author and first author Dr. Muller Fabbri, assistant professor of Pediatrics and Molecular Biology and Immunology at the Keck School of Medicine of the University of Southern California. "Equally exciting, we show that this mechanism involves a fundamental receptor of the immune system, TLR8, suggesting that the implications of this discovery may extend to other diseases such as autoimmune and inflammatory diseases," Fabbri says. Key findings of the study include the following: Lung tumor cells secrete microRNA-21 and microRNA-29a in vesicles called exosomes, and these exosomes are taken up by immune cells called macrophages located where tumor tissue abuts normal tissue. In human macrophages, microRNA-29a and microRNA-21 bind with TLR8, causing the macrophages to secrete tumor-necrosis-factor alpha and interleukin-6, two cytokines that promote inflammation. Increased levels of the two cytokines were associated with an increase in the number of tumors per lung in an animal model, while a drop in those levels led to a drop in the number per lung, suggesting that they also play a role in metastasis. Journal reference: Proceedings of the National Academy of Sciences Provided by Ohio State University Medical Center
Study shows why hypertension increases damage to eyes of diabetic patients
July 12, 2012 in Diabetes Hypertension frequently coexists in patients with diabetes. A new University of Georgia study shows why the co-morbid conditions can result in impaired vision. "Results showed early signals of cell death in eyes from diabetic animals within the first six weeks of elevated blood pressure. Later, the tiny blood vessels around the optic nerve that nourish the retina and affect visual processing showed signs of decay as early as 10 weeks after diabetic animals develop hypertension," said Azza El-Remessy, assistant professor in the UGA College of Pharmacy and director of the UGA clinical and experimental therapeutics program. The study examined animals with early and established stages of diabetes that also had hypertension. The results, which highlight the importance of tight glycemic control and blood pressure control to delay diabetes-related vision loss, were published in the June issue of the Journal of Molecular Vision. The study was the first to understand or explain why combining increased blood pressure with diabetes would hurt blood vessels in the eye. "The fact that controlling blood pressure in diabetic patients is beneficial has been shown through many major clinical trials," said Islam Mohamed, a third-year clinical and experimental therapeutics graduate student who co-authored the paper with El-Remessy. "Our study highlights the synergistic and immediate interaction between systemic hypertension and diabetes as two independent risk factors for persistent retina damage known as retinopathy. This emphasizes the importance of addressing different cardiovascular risk factors in a holistic approach for improving management and prevention of retinopathy." According to the Centers for Disease Control and Prevention, 45 percent of adults in the U.S. suffer from diabetes, hypertension or high levels of cholesterol in the blood called hypercholesterolemia. Approximately 13 percent of U.S. adults suffer from a combination of two of the conditions, and 3 percent have all three. Early intervention is a key factor in improving the outcome for patients. "Health care providers, including pharmacists, should stress the importance of the tight control of blood sugar and blood pressure levels for their patients," El-Remessy said. "Providing patient education and counseling on how each of these metabolic problems independently can have accelerated devastating effects is critical and can result in better prevention and outcomes for the patients."
Cell-Based 'Tracking Devices' Might Help Monitor Treatments
Tuesday, July 10, 2012 TUESDAY, July 10 (HealthDay News) -- Call it a fantastic voyage. Scientists have successfully found a way to inject tiny iron filings into the human body to potentially monitor medical therapies. The particles work as tracking devices that may help physicians determine if certain treatments are working. The development of methods to track cells is critical to stem-cell and other therapies that rely on the delivery of particular cells to a target site, such as the heart or other organ, according to the authors of a small new study. "Eventually we'll be able to prove stem cells are going where they are supposed to be and track cells going into other tissues," said Dr. David Newby, study co-author and professor and chair of cardiology at the Centre for Cardiovascular Science at the University of Edinburgh, in Scotland. The study, published July 10 in Circulation: Cardiovascular Imaging, showed that immune cells tagged with nano-sized iron filings and injected into the bloodstream can be tracked by magnetic resonance imaging (MRI) as they move through the human body. The researchers also demonstrated that the process was safe and did not interfere with normal cell function. A type of normal white blood cell known as macrophages ingest pathogens and cellular debris -- including the filings -- and take them along wherever they go. The iron filings are only about 20 nanometers across. In comparison, the average red blood cell is 8,000 nanometers wide. Newby said the critical question the researchers wanted to answer was whether the tracking cells, once injected into the body, would migrate where the researchers wanted them to go. "We needed to be able to know if they wander off," he said. The research showed it is possible to track tagged, injected cells for seven days. Because MRI technology is nonradioactive, the tracking system would not subject patients to radiation exposure, Newby noted. The study involved two phases. First, the researchers determined that blood cells with attached iron filings moved normally, and were indeed able to survive. Twenty study volunteers participated. Some people were given injections into their thigh muscles of either unlabeled cells, iron-filing labeled cells or just the filings. Others received intravenous injections of the labeled blood cells. To show that the tracking method could be used to facilitate the development of cell-based therapies in the future, the researchers injected one person with labeled immune blood cells, and they tracked the cells as they migrated to an inflamed area of skin on the thigh. The inflammation was caused by a Mantoux tuberculosis test, an injection just under the skin that typically becomes slightly inflamed. "This is a pretty convincing demonstration that there's real merit to this idea of using cells as carriers," said Matthew Tirrell, a professor and Pritzker director of the Institute for Molecular Engineering, at the University of Chicago. Tirrell said the research opens up new territory for other kinds of visualization experiments. "There are few examples of any kind of targeting particles in humans," he said. "To have the confidence and guts to do it is impressive, and I think other people will be building on this work," he said. Newby said that the research team hopes to investigate the use of these techniques to diagnose inflammatory conditions of the heart, such as transplant rejection, myocarditis or inflammation of the heart, and sarcoidosis, where there is inflammation in multiple organs. The work may also be useful in five to 10 years in stem-cell research, he added. SOURCES: David Newby, M.S., professor and chair of cardiology, Centre for Cardiovascular Science, University of Edinburgh, Scotland; Matthew Tirrell, professor and Pritzker director of the Institute for Molecular Engineering, University of Chicago; July 10, 2012, Circulation: Cardiovascular Imaging
Moderate Drinking May Cut Women's Odds for Rheumatoid Arthritis: Study
More than 3 weekly glasses of beer, wine or liquor halved risk of the autoimmune disease Wednesday, July 11, 2012 TUESDAY, July 10 (HealthDay News) -- Drinking more than three alcoholic beverages a week for at least 10 years may halve a woman's risk of developing rheumatoid arthritis, according to a large new study from Sweden. The findings, which appear online July 10 in the journal BMJ, add to a growing body of evidence suggesting that moderate alcohol consumption may have health benefits. Rheumatoid arthritis is an autoimmune disease that occurs when the body engages in friendly fire -- attacking its own joints and tissues. According to the Arthritis Foundation, about 1.3 million people in the United States have rheumatoid arthritis, which disproportionately strikes women. Family history is a risk factor for developing the condition. Other than quitting smoking, little is known about how to lower the risk of developing rheumatoid arthritis. The new study included more than 34,000 Swedish women born between 1914 and 1948. Researchers gathered information about their alcohol consumption, diet, smoking history, physical activity and education in 1987 and 1997. Participants were then followed for seven years. During this time, nearly 200 women were diagnosed with rheumatoid arthritis. Women who reported drinking more than three glasses of alcohol per week in both 1987 and 1997 were 52 percent less likely to develop rheumatoid arthritis than their teetotaling counterparts. A difference in risk, although less marked, existed when light drinkers were included with nondrinkers. In that case, women who drank more than more four glasses of alcohol per week had a 37 percent lower risk for rheumatoid arthritis. These findings held regardless of whether women consumed wine, spirits or beer. In the study, a standard glass of alcohol was defined as approximately a pint of beer, 5 ounces of wine or 1.7 ounces of liquor. Exactly how alcohol may lower arthritis risk is not fully understood. The researchers speculate that it may turn down the body's immune system and decrease the production of proteins involved in the inflammatory process. Inflammation is a hallmark of rheumatoid arthritis. "This study adds more fuel to the fire regarding the beneficial effects of alcohol," said Dr. Martin Jan Bergman, a clinical associate professor of medicine at Drexel University College of Medicine in Philadelphia. "This is one of multiple studies that have shown that alcohol can have a beneficial effect on risk for [rheumatoid arthritis]."
But the key word is "moderate," he said. Additionally, alcohol may do more harm than good for people who already have the condition. "A lot of [rheumatoid arthritis] medications are liver toxins and so is alcohol, so you have to weigh the risks and benefits if you are on any of these medications," he said. Smoking and alcohol consumption often go hand-in-hand, said Dr. David Pisetsky, chief of rheumatology at Duke University Medical Center in Durham, N.C. "Stopping smoking or never starting is the best thing to do for your health if you are at risk for [rheumatoid arthritis]." He added that "moderate alcohol [use] may also help lower this risk." Although the study found an association between alcohol and rheumatoid arthritis risk, it did not prove a cause-and-effect relationship. SOURCES: Martin Jan Bergman, M.D., clinical associate professor, medicine, Drexel University College of Medicine, Philadelphia; David Pisetsky, M.D., chief, rheumatology, Duke University Medical Center, Durham, N.C.; July 10, 2012, BMJ, online HealthDay
Health Tip: Poor Air Quality Affects Kids With Asthma
By Diana Kohnle Wednesday, July 11, 2012 (HealthDay News) -- When the weather heats up and ozone infiltrates the air, kids with asthma should limit their time outside, experts say. The Nemours Foundation offers these suggestions for the parents of asthmatic children when the air quality is poor: Run the air conditioner, and don't let your child spend too much time outside. If your kids participate in outdoor activities, limit them to the early morning hours and away from high-traffic areas. Talk to your child's sports coach about practicing in an indoor, air conditioned environment on very hot days. Send your child to practice with a rescue inhaler, just in case. Ensure that your home is well-ventilated, use an air purifier and avoid wood-burning fires inside the home. Discuss your child's asthma action plan with the pediatrician. HealthDay
Diet, Weight Loss Ease Menopause Symptoms: Study
Wednesday, July 11, 2012 WEDNESDAY, July 11 (HealthDay News) -- Menopausal women who lose weight eating a low-fat diet rich in fruits and vegetables could reduce or eliminate their hot flashes and night sweats, a large new study suggests. One reason the researchers looked at weight loss as a way of dealing with menopausal symptoms was because of long-standing research linking hormone-replacement therapy to heart disease and breast cancer. "We wanted to see if this could be an alternative to hormone therapy," said lead researcher Candyce Kroenke, a research scientist at Kaiser Permanente's Northern California Division of Research in Oakland. "Indeed, women who lost weight in the context of this healthier diet -- decreasing fat, increasing whole grains, fruits and vegetables -- were significantly more likely to reduce or eliminate symptoms," she added. Reduced hot flashes and night sweats, the key menopausal symptoms, were seen in both overweight and normal-weight women who lost weight, Kroenke noted. And the reason for that is fairly simple, she said: Fat tends to retain heat and losing weight helps the body dissipate heat more easily. The report, which was published July 11 in the online edition of Menopause, involved data on more than 17,000 women who took part in the Women's Health Initiative study. The women with menopausal symptoms who were on a low-fat diet rich in whole grains, fruits and vegetables, who were not taking hormone-replacement therapy and who lost at least 10 pounds in a year were more likely to see night sweats and hot flashes reduced or disappear after a year than did women who maintained their weight (the "control" group), the researchers found. Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City, commented that "this definitely goes along with the idea that good diet and exercise and losing weight contribute to general health." And, she added, "It's a quick and easy fix for hot flashes and night sweats." Wu noted that doctors are still reluctant to offer hormone-replacement therapy even though it works. "This is a low-risk fix," she said. "I think it will work for some patients, and patients may only get a partial relief of their symptoms, but any help is good," Wu pointed out. "Diet and weight loss is a healthy habit that will hopefully help menopausal symptoms. There is very little downside to doing it," she added.
Another expert agreed. "Adopting a healthy diet is always a good idea," said Samantha Heller, a nutritionist, exercise physiologist and clinical nutrition coordinator at the Center for Cancer Care at Griffin Hospital in Derby, Conn. "Healthy foods, including vegetables, soy, whole grains, legumes, nuts and fruits, decrease the risk of many chronic diseases and can improve health and well-being considerably. In this case, along with weight loss of 10 pounds or 10 percent of body weight, women who made healthy dietary changes tended to have decreased symptoms of hot flashes and night sweats," Heller noted. "This study also highlights the positive effect of ongoing nutrition education by registered dietitians," she added. "Women in the intervention group, who were counseled by registered dietitians, were three times more likely to lose weight than women in the control group. A big factor in unsuccessful weight loss attempts is people not knowing how or where to begin. Nutrition counseling takes the guesswork out of creating a healthy lifestyle and helps motivate and empower people to stay on track." The research was published just days after a coalition of leading medical groups concluded in a joint statement that hormone-replacement therapy can be useful and safe for many women suffering from the symptoms of menopause. The coalition includes 15 medical groups, including the North American Menopause Society, the American Society for Reproductive Medicine, the Endocrine Society and the American Academy of Family Physicians. SOURCES: Candyce Kroenke, Sc.D., M.P.H., research scientist, Kaiser Permanente Northern California Division of Research, Oakland, Calif.; Jennifer Wu, M.D., obstetrician/gynecologist, Lenox Hill Hospital, New York City; Samantha Heller, M.S., R.D., exercise physiologist, clinical nutrition coordinator, Center for Cancer Care, Griffin Hospital, Derby, Conn.; July 11, 2010, Menopause, online HealthDay
Smartphones may aid eye diagnoses in emergency room
Wednesday, July 11, 2012 By Genevra Pittman NEW YORK (Reuters Health) - Sending patient images to ophthalmologists via smartphone may be an option for emergency room doctors looking to make a quick eye-related diagnosis, a new study suggests. Two ophthalmologists gave higher quality ratings to inner-eye photos when they looked at the images on an iPhone as compared to a desktop computer, according to results published Monday in the Archives of Ophthalmology. That may mean the phones can be used to diagnose and plan treatment for more obvious eye conditions - even when an ophthalmologist isn't available at the hospital, researchers noted. "Not every hospital in the country in the ER has access to an eye doctor always," said Dr. Rohit Krishna, an ophthalmologist from the University of Missouri-Kansas City School of Medicine, who wasn't involved in the new study. Non-eye doctors, Krishna added, "don't always feel really comfortable with eye care. So having tools in your pocket that enable you to do ophthalmologic examination elements are a great asset." He said smartphones could be used to take and send pictures of damage to the eyelid or the front of the eye. When it comes to complicated, inner-eye photos, using a more advanced camera to take a photo - and then sending it to an ophthalmologist via smartphone for diagnosis - is also a good option, he told Reuters Health.
USING AN IPHONE FOR TRIAGE For the new study, Dr. Valerie Biousse from Emory University in Atlanta and her colleagues collected information on 350 patients with a headache, changes in eyesight and other signs of vision problems who came to the ER for treatment. Emergency staff took photos of the interior of their eyes, including the retina, using an ocular camera. Two ophthalmologists looked at those photos and rated their quality on a typical desktop computer, and later assessed 100 of the images on an iPhone. Both reviewers consistently rated the phone images as the same or higher quality on a one-to-five scale than the same photos viewed on the computer. One ophthalmologist said 53 of the photos were the same quality, 46 were better on an iPhone and one was better on the desktop. The other ophthalmologist rated the photos equally 56 times, the iPhone images better 42 times and chose the desktop photos twice. Consulting electronically with an ophthalmologist can give ER staff a better idea of what a patient's prognosis will be, Krishna said, as well as the severity of the eye injury. "Using (an) iPhone to transmit images to colleagues as a help with patient triage in the ER is a new concept," Biousse told Reuters Health in an email. "ER departments are working at improving acute patient care by developing ways to access specialty consultations such as ophthalmology." The next step, Biousse said, is to show whether or not "the triage and acute patient care are expedited and ophthalmologic consultations can be obtained faster and more accurately" when photos are sent from the ER to an ophthalmologist's smartphone. Dr. Charles Wykoff, an ophthalmologist from Retina Consultants of Houston, said his one worry would be doctors using smartphone pictures to rule out all eye problems and then having a patient sent home. "The concern for me is possibly false reassurance when there's a normal picture," he told Reuters Health. "I don't think it replaces the need for a complete eye exam." But if using a smartphone does help ER patients get faster and accurate diagnoses, Wykoff, who wasn't involved in the new study, said he'd be all for it. SOURCE: http://bit.ly/NkRtl9 Archives of Ophthalmology, online July 9, 2012. Reuters Health