Medical news - seven China links

1. With more than 10,000 new cases of HIV a year, Yunnan is to fund more NGO anti-HIV programs and improve healthcare for people with the infection.

2. New regulations on genome sequencing are to stop clinics ripping off consumers by offering the sequencing as part of routine health checks or to help predict children’s potential abilities, officials say.

3. Malnutrition is still a major problem in some parts of rural China, with one in every five children under the age of five years in poor areas needing better nutrition. Local governments have been set a benchmark of 29 kg per capita meat consumption standard to benefit children in underdeveloped region.

4. Pilot schemes have been set up in 27 provinces to allow rural migrants to claim medical insurance benefits away from their home town.

5. About 13 million deaths from smoking-related illness could be avoided if China adopted WHO recommendations on tobacco control, a paper in the BMJ says.

6. Adverse effects from drugs - and especially antibiotics - are a major health burden for hospitals in China and also cost thousands a of yuan a year for hospitals and patients alike in extra care costs, a study has suggested.

7. Only 9% of boys and 2% of girls in China get the minimum amount of physical activity per week to maintain health, a study carried out in 11 cities has found.

China's medical news headlines for Sunday 19 January

Hepatitis B vaccine given the all clear

The Shenzhen Bio Kangtai hepatitis B vaccine that was linked to the deaths of 17 infants has now been given the all clear by the Chinese state drug authorities. After an investigation the China Food and Drug Administration and the National Health and Family Planning Commission said the vaccine could be used again as no problems have been found with the hepatitis B vaccine. Authorities tested more than 1300 vaccine samples from six batches that were under suspicion. According to the People's Daily, the CFDA said all samples met the quality standards. The NHFPC said the 17 infant deaths were due to other problems, including severe pneumonia, kidney failure and suffocation.

In Guizhou, retired doctors asked to work in rural clinics

Retired medical specialists in Guizhou are being urged to lend their expertise to rural area clinics, according to China Daily. Professor Sun Fa of Guiyang Medical University told a meeting of the Chinese People's Political Consultative Committee that there were about 600 retired doctors from the province's five top hospitals of whom half were healthy enough to work in rural clinics.
He said they could help the more than 40,000 medical staff in township clinics, many of whom have only medical qualifications from secondary colleges or no degree at all.

Guangdong plans for baby boom

The new two-child family planning policy will not pose a big challenge to public services such as medical care, a top health and family planning official from Guangdong province has said.
Zhang Feng, the former director of the Guangdong population and family planning commission, said 1.1 million to 1.2 million babies are  born in the province each year. and the new policy will see about 130,000 more babies each year. "The baby boom will bring little social impact," he said at the province's annual legislative meeting.

China's smoking ban is unrealistic, says NBC report

A report by Ed Flanagan of the American NBC News says that the recent anti-smoking measures announced by the Chinese government may be as unsuccessful as previous attempts. The article says China has 350 million smokers and the habit is deeply ingrained in society. Previous attempts to curb smoking resulted in "No Smoking' signs being put up but they were widely ignored, says Flanagan. He says the Chinese media have given no details of how the new policy will be enforced. The move also face resistance from the powerful tobacco industry in China, he adds.

 New Yorker profiles China's gene factory BGI in Shenzhen

The New Yorker has an in-depth profile of the gene factory B.G.I., (Beijing Genomics Institute), which is said to be the world’s largest genetic-research centre, located in Shenzhen. The report by Michael Specter says BGI has 178 machines to sequence DNA, and produces at least a quarter of the world’s genomic data. This could help provide new solutions to disease and other areas such as agriculture, he writes.

Chinese genomic sequencing company worries Japan with cheap prenatal testing

Japanese medical authorities are expressing concern over prenatal testing for chromosomal abnormalities now offered by a Chinese company because it does not require clients to undergo counseling, which could lead to unnecessary abortions.
The Chinese company, BGI, recently entered the market and is offering the service in Japan at less than half the cost charged at facilities sanctioned by the Japanese Association of Medical Sciences (JAMS).
Fumiki Hirahara, a doctor of obstetrics at Yokohama City University who is well-versed in prenatal care, expressed concern over BGI’s program, citing the lack of counseling.
“If testing becomes common among expectant mothers, and they lack the mechanism to properly assess the accuracy of the results, it could prove detrimental for them (and their babies),” he said.
Hirahara said Japanese medical personnel started doing prenatal testing in April as part of clinical research, with an eye on evaluating the benefits of genetic counseling.

Shenzhen gene sequencers find clues to autism

Shenzhen's BGI genome centre has found mutation hotspots in people with autism

An international team, including a Shenzhen-based gene sequencing company, has discovered that "random" mutations in the genome are not quite so random after all. 
Their study, to be published in the journal Cell on December 21, shows that the DNA sequence in some regions of the human genome is quite volatile and can mutate ten times more frequently than the rest of the genome. Genes that are linked to autism and a variety of other disorders have a particularly strong tendency to mutate.
Clusters of mutations or "hotspots" are not unique to the autism genome but instead are an intrinsic characteristic of the human genome, according to principal investigator Jonathan Sebat, PhD, professor of psychiatry and cellular and molecule medicine, and chief of the Beyster Center for Molecular Genomics of Neuropsychiatric Diseases at UC San Diego.
"Our findings provide some insights into the underlying basis of autism—that, surprisingly, the genome is not shy about tinkering with its important genes" said Sebat. "To the contrary, disease-causing genes tend to be hypermutable."
Sebat and collaborators from Rady Children's Hospital-San Diego and BGI genome center in China sequenced the complete genomes of identical twins with autism spectrum disorder and their parents. When they compared the genomes of the twins to the genomes of their parents, the scientists identified many "germline" mutations (genetic variants that were present in both twins but not present in their mother or father).
Nearly 600 germline mutations – out of a total of 6 billion base pairs – were detected in the 10 pairs of identical twins sequenced in the study. An average of 60 mutations was detected in each child.
"The total number of mutations that we found was not surprising," said Sebat, "it's exactly what we would expect based on the normal human mutation rate." What the authors did find surprising was that mutations tended to cluster in certain regions of the genome. When the scientists looked carefully at the sites of mutation, they were able to determine the reasons why some genomic regions are "hot" while other regions are cold.
"Mutability could be explained by intrinsic properties of the genome," said UC San Diego postdoctoral researcher Jacob Michaelson, lead author of the study. "We could accurately predict the mutation rate of a gene based on the local DNA sequence and its chromatin structure, meaning the way that the DNA is packaged."
The researchers also observed some remarkable examples of mutation clustering in an individual child, where a shower of mutations occurred all at once. "When multiple mutations occur in the same place, such an event has a greater chance of disrupting a gene," said Michaelson.
The researchers surmised that hypermutable genes could be relevant to disease. When they predicted the mutation rates for genes, the authors found that genes that have been linked to autism were more mutable than the average gene, suggesting that some of the genetic culprits that contribute to autism are mutation hotspots.
The authors observed a similar trend for other disease genes. Genes associated with dominant disorders tended to be highly mutable, while mutation rates were lower for genes associated with complex traits.
Read more: Eurekalert

Envy and discomfort over China's industrial scale push into genomics

Companies like BGI in Shenzhen are sequencing the human genome on a a massive scale

In Shenzhen, the genetic secrets of life roll off machines by the minute. Here at the global headquarters of BGI-Shenzhen, housed in a former shoe factory, the genomic revolution runs on an industrial scale. Powered by an army of young lab technicians and banks of high-end, U.S.-made sequencers that hum 24/7, the DNA of human kind is decoded with conveyor-belt speed and brute force.
But not just human DNA. Once known as the Beijing Genomics Institute, BGI is on a mission to sequence the genomes of a vast array of living things. It has already done rice, the cucumber, the Giant Panda, the Arabian camel, the chicken, the coronavirus behind severe acute respiratory syndrome (SARS), 40 strains of silkworm and the Tibetan antelope, to name just a few.
Its services are in high demand. It has unravelled the DNA of a 4,000-year-old Greenlander dubbed Inuk, teamed with Saudi Biosciences to sequence Arab genomes and with the University of Edinburgh to decode plants, animals and people in Scotland. Canadian and U.S. research groups are repeat customers.
As with many things made in China, the price is hard to beat. Drug companies, doctors and researchers around the world are in awe, and more than a bit envious of BGI’s resources.
As a Canadian government scientist tweeted: “China’s big push in genomics. 128 Illumina sequencers in an old shoe factory and I can’t get a single one for my lab.”
But along with the envy, there is discomfort and, in the United States, outright fear that an enterprise backed in part with bank loans supported by the Chinese government has unfettered access to the genetic building blocks of humanity. DNA, after all, contains the chemical hallmarks of what makes each of us unique – the raw material that may hold the keys to the next breakthroughs in science and medicine.
What might China – with its poor record of enforcing intellectual property laws and history of human-rights abuses – do with this information?
U.S. officials first raised eyebrows after BGI snapped up a record-breaking order for 128 cutting-edge sequencers made by San Diego-based Illumina. but the concerns are more urgent now that the authorities are deliberating whether to allow the Chinese company to buy Complete Genomics of California, a major U.S. sequencing company.
The acquisition would help to cement China’s supremacy as the world’s top genome sequencer, boost its technical prowess and give it a strong U.S. base, but the deal has officials there fretting over both the security of genetic data and national security.
Because the technologies involved “have national security implications related to bioweapons, this bears strict scrutiny,” says Michael Wessel, who sits on the U.S.-China Economic and Security Review Commission. “Are there capabilities here that can be adverse to American interests?” he told the Washington paper Politico last week.
But some feel that such fears have more to do with trade than security. Last week, The Associated Press reported that China has overtaken the United States as the world’s largest trading partner. This week, the United Nations found it also has surpassed the U.S. in patent applications, although the quality of its patents is often disputed.
Harvard University geneticist and entrepreneur George Church, an adviser to many biotech companies, dismisses concerns over China’s dominance in genomics as “misplaced nationalism.” Mark Poznansky, head of the Ontario Genomics Institute, agrees: “There’s recognition that we just can’t compete. I think that’s part of the paranoia.”
BGI argues that there’s “absolutely no basis for such a wild and speculative claim” of national-security threats and bioweapons risks. It says those fears are sour grapes seeded by Illumina, which also bid for Complete Genomics but lost to out to BGI.
Writing to Complete Genomics directors last month, Illumina said BGI is a “foreign state-owned entity,” and the deal raises “national security, industrial policy, personal identifier information protection and other concerns.”
BGI denies that it is state-owned, but, ironically, even as it makes a big play for the world’s DNA, China is cracking down to ensure that the genomes of its own citizens stay home. Its state council is now drafting regulations to protect the country’s “human genetic resources,” fearing that it will lose intellectual-property rights over its citizens’ genetic information.
Source: Globe and Mail