Medical research in China: seven samples from this week's journals

China's medical education system is broken
Chinese medical education is not fit for purpose, a review by Dr  Wu Lijuan of the School of Public Health, Capital Medical University, Beijing, finds. Too many students have to get a an additional Masters or even a Doctorate in academic medicine to get a position at a hospital, and miss out on valuable clinical training. At the same time the clinical component of many degrees is not recognised by some institutions and has to be repeated.
Medical Education Online.

Chinese ethnicity protects against pre-eclampsia
A study of of 67 746 pregnant Chinese women found that 1.92% nulliparous women developed pre-eclampsia. The prevalence of mild and severe pre-eclampsia was 1.42% and 0.49%, respectively. The study authors said the prevalence of pre-eclampsia in China was low compared with Causcasians, perhaps due to differences in BMI or lifestyle.
Journal of Human Hypertension.

Allergic triggers in Guangzhou
The main allergic triggers among allergic people in Guangzhou are cow's milk, eggs in younger children and then the house dust mite allergens Der pteronyssinus and Der farinae in later years, a four year observational study has found.
Multidisciplinary Respiratory Medicine.

New cause of hand foot and mouth disease in Guangdong
An unusual enterovirus type, CVA6, has been identified as a new and major serotype associated with an hand foot and mouth disease epidemic in Guangdong.
Essential Microbiology.

Annual health checks urged for rural residents
About two out of three elderly have physical examinations by a healthcare professional at least annually, a survey of more than 1100 people from four provinces has found.However, rural residents suh as farmers were only half as likely to have a regular check up, prompting the study authors to suggest that  government and public health institutions should assist farmers to acquire the habit of having annual physical examinations. "Village doctors should be supported in delivering health information to the elderly in rural areas," they said.
BMC Healthcare Research.

Rats the source of hemorrhagic fever in China
There are about 1.4 million cases of hemorrhagic fever with renal syndrome every year in China and rats seem to be the main reservoir for infection, a study shows.Trends in cases were associated with the local rodent reservoir, climatic factors and socioeconomic conditions suggesting that it may be possible to develop an "early warning system" for the control and prevention of hemorrhagic fever, researchers said.
PLOS Neglected Tropical Diseases.

What are the most cost effective treatments for myocardial infarction in China?

A study from Beijing Anzhen Hospital and Capital University has found the most cost effective treatment for myocardial infarction in China would be optimum use of the four drugs aspirin, β-blockers, statins, and ACE inhibitors in all eligible patients, or unfractionated heparin in non–STEMI myocardial infarction. Other treatments such as reperfusion therapies in eligible patients with STEMI myocardial infarction and clopidogrel would be less cost effective, the study found. Use of all hospital-based AMI treatment strategies together would be cost-effective and reduce the total CHD mortality rate in China by about 10%. 

Circulation.

Five Chinese medical studies you should know about in January 2014

Soy bad for men's heart health
A high intake of soy may increase the risk of cardiovascular disease in men, contrary to the well known protective effect seen in women, a study from Shanghai has found.
Habitual high soy food intake over 10g per day was associated with up to a 20% higher risk of incident coronary heart disease in middle-aged and older Chinese men. The researchers said elevated plasma IL-8 and PAI-1 might be potential contributing factors.
International Journal of Cardiology

Chronic kidney disease and metabolic syndrome
In China the prevalence of chronic kidney disease s 4.6% in people with metabolic syndrome and 3.3% in people without metabolic syndrome, a study has found. The risk of chronic kidney disease was 50% higher with metabolic syndrome and the findings suggest an increasing prevalence of chronic kidney disease among Chinese adults with metabolic syndrome, according to researchers from the Department of Endocrinology, The First Affiliated Hospital of the Fourth Military Medical University, Xi'an.
Clinica Chimica Acta

Asthma rarely well controlled in China
Asthma tends to be poorly controlled in China compared to other countries in the region. A study has found that only 2% of asthma patients in China had their condition well controlled compared to 14% in Singapore. Patients whose asthma was not well-controlled tended to use more asthma medications, had more emergency hospital visits and hospitalisations for their asthma, and were more likely to miss days off work or school.
Respiratory Medicine

One in five have mild cognitive impairment
A survey of 10,276 Chinese people aged 65 years or older has found that 21% had mild cognitive impairment, and 6% had cognitive decline that was likely early Alzheimer's disease. Cognitive impairment was more common in rural areas 23% compared to urban areas (17%).Vascular-related mild cognitive impairment was the most common type, according to researchers from the Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing.
Alzheimers and Dementia

HIV screening needed
HIV screening and early identification is badly needed among high risk populations in China such as those with TB, according to researchers from the Shandong Provincial Chest Hospital, Shandong University, Jinan. They found a HIV prevalence of 0.28% among TB-referral patients in Shandong, but noted that HIV/TB co-infection rates are high in regions such as Xinjiang ( 4.5%) and Guangxi (4.3%) due to to high rates of injecting drug use and HIV infection, and most cases presented late as AIDS.
Journal of Infection

Hunan woman committed fraud to pay for dialysis

A young woman, who has uremia in Hengshan county, Hunan province, has been sentenced to six years and fined 100,000 yuan ($16,400) for cheating the new rural cooperative medical system out of more than 420,000 yuan to treat her kidney disease, Xiaoxiang Morning News reported.
Nie Shuihua, 24, was not jailed because she has to receive frequent dialysis treatment. But 16 of her relatives and neighbors were given sentences of two to three years and fined 4,000 to 5,000 yuan each for helping her get the money.
Nie, a farmer, was diagnosed with uremia in July 2012. As it was expensive to treat the disease in a hospital in Changsha, the capital of Hunan, Nie bought fake hospitalization invoices to be reimbursed by the rural cooperative medical system.
Asked why Nie resorted to deception, Tang Qiulian, Nie's mother, said that her daughter wanted only to survive.
Source: ecns

Nanjing man with kidney failure survives for 13 years with home-made dialysis machine

Hu Songwen: "The principles of hemodialysis aren't complicated."

by Cang Wei and Song Wenwei 
An impoverished uremia patient has moved the public by constructing his own hemodialysis machine to stay alive.
Doctors agree it's a miracle that Hu Songwen has survived for 13 years because of his homemade hemodialysis machine.
The man recalls his life fell apart when he was diagnosed with uremia in 1993. He was a 21-year-old Nanjing Institute of Meteorology senior.
That morning, his face swelled. He had difficulty urinating. And he couldn't even stand on his own.
A medical examination showed both of his kidneys had failed.
The institute paid Hu's expensive medical bills for a year. It then sent him home to Qutang township in Jiangsu province's Hai'an county.
Hu's parents were factory workers, but each hemodialysis session cost 400 yuan ($64). At that time, his parents earned less than 1,500 yuan a month, but Hu needed more than 4,000 yuan every month to live.
The parents had done everything possible to save their son. In less than a year, they sold all their valuables and borrowed money from all of their relatives. After the money from the government and Hu's friends were spent, they couldn't afford food or housing.
"Do nothing but wait for death?" Hu says.
"I couldn't."
After reading books about the principles of hemodialysis, Hu - who excelled at chemistry and physics in high school - bought a cheap secondhand blood pump online and asked an acquaintance to purchase hemodialysis tubes.
"The principles of hemodialysis aren't complicated," Hu says.
"I had confidence I could overcome the difficulties I'd face."
On March 31, 1999 - a day he says he'll never forget - his homemade hemodialysis machine, filled with purified water and drugs, started to operate in his home's bathroom, which is smaller than 5 square meters.
Every tube used for hemodialysis costs about 100 yuan. To save money, Hu uses each more than 10 times, while they're only used once in hospitals.
He doesn't share the fears of many people around about bacterial infections and pollution.
"I just need to master the drug dosages and make sure to avoid getting any air in my veins," he says.
He used ceramic bowls to pour purified water into a steel pot, and heats the medicine in the microwave.
His 81-year-old mother, Huang Zhongfang, is his only hemodialysis assistant. She uses an old wooden scale to measure the fluid with her trembling hand and then feeds it into the machine.
Read more: China Daily