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

Donor database will remove dependence on executed prisoner organs

Computerised organ donor database will improve supply and remove the need to source organs from executed prisoners.

China is set to expand a computerized system to ensure transparent and fair allocation of donor organs, said Vice-Minister of Health Huang Jiefu.
The system is expected to expand nationwide early next year for transplants around the mainland.
Once that happens, donated organs from different procurement organizations will be shared by all transplant centers to improve efficiency and ensure the most medically needy patients benefit, according to Wang Haibo, director of the China Organ Transplant Response System Research Center at the University of Hong Kong.
"The system that is now used only by some will be expanded to all of the transplant centers on the mainland after the coming Spring Festival," said Huang in Guangzhou.
By the middle of November, China had recorded about 480 such organ donations involving 1,294 donor organs under a trial project initiated by the Ministry of Health and the Red Cross Society of China in March 2010.
Of the donations, 47.5 percent came after cardiac death and 43.5 percent after both cardiac and brain death. Those after brain death accounted for the rest, statistics from the allocation system showed.
According to Shi Bingyi, director of the organ transplant institute at No 309 Hospital of the People's Liberation Army in Beijing, the best organ donations come after brain deaths.
Thanks to the project, "China's long-term dependence on executed prisoners as a major source of organ donations for transplants is expected to end within two years", Huang noted.
"We have to create a new deceased organ donation system which is in line with Chinese social and ethical norms, which will also be pragmatic by respecting our nation's reality," he said.
Meanwhile, to ensure the quality of donor organs and transplants, health authorities are considering introducing a set of standards to better manage and evaluate procurement organizations.
At present, China has 164 organ transplant centers recognized by the Ministry of Health and each has a procurement organization comprised of medical professionals from different specialties, Wang said.
According to him, the organization's work includes promoting deceased organ donation, detecting and approaching potential organ donors, coordinating donations, launching computer-assisted organ allocations, donated organ preservation and transportation, and data collection and research.
"The cooperation of organizations made organ sharing among different hospitals possible but its operation should be based on the wide use of the organ allocation system," he noted.
Allocations have been largely hospital based, which can lead to a waste of donated organs and raises public concern about fairness, Wang explained.
Li Peng, a doctor with the procurement center of the General Hospital of Guangzhou Military Command of the PLA, said that it helped facilitate organ donations and improve the efficiency of donated organ use.
According to Li, the procurement center is affiliated to the hospital rather than the transplant center and is led by the hospital president.
It is comprised of dozens of employees, many of them medics in departments such as neurology and intensive care, he said.
"It also freed organ transplant doctors from organ donation coordination work," he said.
Donated organs harvested by different organizations would all get allocated via the system according to factors like medical urgency, waiting-time, medical compatibility and the distance between donor and recipient, he added.
"Such an independent organization coupled with the allocation system could make the process more transparent to ensure fair allocation," Li noted.
Source: China Daily

Would-be doctors deterred by attacks on hospital staff

Pressure on doctors - and attacks by frustrated patients - is putting students off a career in medicine

by Zhang Jin
Med school students who once dreamed of healing the sick and rescuing the dying are reconsidering their job options, as a spate of attacks targeting doctors have led them to fear that they could be targeted as well.
A report in the China Youth Daily has illustrated the jitters medical students are feeling following two recent hospital attacks that left one doctor and a head nurse dead and several others injured.
Zhang Yan, a clinical medicine student at Fudan University, still considers practicing medicine to be a worthy goal.
"The meaning of life lies in serving the people," he said.
Zhang, however, found that curing sickness is no simple matter after interning at local hospitals.
"It's not only your expertise that matters. Your communication skills with different people also count," he said, adding that he believes a lack of trust between doctors and patients has led to worsening relations.
Long waiting times, brief appointments and a lack of quality care and attention have led some patients to seek "a life for a life," attacking doctors and hospital staff who they believe have wronged them or their loved ones.
In one of the most notorious attacks, a teenager fatally stabbed an intern and injured three others at a hospital in Harbin, capital of northeast China's Heilongjiang province, last March.
It is a stark departure from the ideal situation in which "doctors and patients become battle companions and stay in the same trench, fighting their common enemies," said neurosurgeon Zhou Liangfu from Huashan Hospital, which is affiliated with Fudan University.
Peng Yuwen, a professor at the Shanghai Medical College of Fudan University, said doctor-patient tensions can erode medical workers' morale and their willingness to take risks.
"Risk-taking is the most noble trait of a doctor, while tensions between doctors and patients can only create overcautious doctors, which in turn does harm to the patients," Peng said.
"If doctors don't dare to take risks when the patients are in a critical moment of life or death, it means they are giving the patients up," he said.
Medical students and rookie medical practitioners are weighing their options, swaying between staying or leaving.
As a doctor who still conducts clinical rotations in Beijing, doctor Li Yifu earns a monthly salary of less than 3,000 yuan (about 480 U.S. dollars).
Zhou Liangfu, an academic at the Chinese Academy of Engineering, said young doctors suffer from meager pay, which has led some med students to switch to related but different fields after graduating.
Zhou usually tells his students that practicing medicine means letting go of materialistic needs and not thinking about how much money one can make.
"They need to endure hardship and hone their skills first," Zhou said.
But for some who cannot stand to wait too long, this life and death hardship is wearing them out.
Medical schools are receiving students with lower college entrance exam grades compared with several years ago. This has led some schools to lower their enrollment thresholds, allowing students with below-average marks to attend prestigious medical schools.
In China's competitive national college entrance exam system, it is a signal that fewer top students have chosen to practice medicine.
This means the public may risk getting treatment from second-class students in the future.
"I do not object to top students going into finance or turning into civil servants, but if the best students can't become doctors or medical professors, it is a tragedy for our nation," Peng said.
Source: CRI

China's new mental health law - what's changed?

The new Mental Health Law does little to help those with mental illness lead an independent life and be accepted by society.

by Elizabeth M. Lynch
After 25 years of discussion, and two rounds of very vocal public comments in the past year, on October 26, 2012, the Standing Committee of the National People’s Congress finally passed its Mental Health Law.
One of the major improvements to the law since earlier drafts is the removal of the provision that specifically permitted involuntary commitment if the individual’s behavior was deemed to be “disturbing public order” or “endangering public safety”. Earlier drafts which included that clause were vigorously attacked by both Chinese and foreign experts noting that such a provision would give carte blanche to the police to involuntarily commit anyone who expressed a dissenting view.  As Chinese Human Rights Defenders (“CHRD”) highlighted in its seminal report on China’s mental hospitals, The Darkest Corners: Abuses of Involuntary Psychiatric Commitment in China, some of China’s many mental hospital “patients” are in fact dissidents who were involuntarily committed outside of any court process for expressing their dissenting views.
Deletion of this provision is certainly a step forward there are still aspects of the adopted law that make it far less than ideal and demonstrates the continued need for better protections for the mentally ill in China.
However, family members are still able to commit an individual against his or her will
In addition to voluntary commitment, Article 28 of the Mental Health Law still permits family members to involuntarily commit an individual that the family member suspects has a mental illness.  In effect, the Mental Health Law places the family in a separate sphere that assumes that family will not abuse the process.

In reality, the Mental Health Law does little to foster an environment where those with mental illness can lead an independent life and be accepted by society. Furthermore, although the law discusses the very real (and dire) need to increase the number of mental health professionals in China, that has remained aspirational. As of yet, the Chinese government has remained silent on how much money and what incentives it will provide to achieve that goal. Providing adequate and sufficient medical assistance for those suffering from mental illness is just as important to making sure that those individuals will be able to lead a full life.
Read more: China Law and Policy

Stroke likely to recur in Chinese patients as 1 in 4 have aspirin resistance

One in four patients is aspirin resistant and this increases their risk of recurrent stroke

by Michael Woodhead
Aspirin resistance is present in one in four Chinese patients who have a stroke and may explain why there is a high rate of recurrent events, researches from Zhejiang say.
In a study of 634 Chinese stroke patients, Dr Yi Xingyang and other researchers from the Department of Neurology at the 3rd Affiliated Hospital of Wenzhou Medical College, found that 20% had aspirin resistance and a further 5% had partial aspirin resistance.
Patients who had diabetes or high levels of LDL  cholesterol were especially likely to have aspirin resistance, perhaps due to platelet activation and thrombosis, they found.
Rates of recurrent cardiovascular events such as stroke and heart attack were more than 30% in patients with aspirin resistance compared to only12% in the aspirin sensitive patients.
The researchers say resistance to the antiplatelet effects of aspirin is one explanation as to why aspirin may not be absolutely effective in preventing recurrent vascular events, and it is not uncommon for patients to experience a recurrent atherothrombotic vascular event in the subsequent years after their first stroke, despite taking aspirin.The finding that rates of recurrent stroke, heart attack and death and all vascular events were higher in patients with aspirin resistance shows that aspirin resistance seems to be a new predictor of vascular events, they say.
"To reduce the risk of thrombotic complications in patients detected to be aspirin resistant, increasing the dose of aspirin might be beneficial," they suggest.
"In conclusion, aspirin resistance is common in Chinese patients who receive antiplatelet medications. Diabetes and high LDL levels may increase the occurrence of AR due to platelet activation and thrombosis. Patients with AR may have a greater risk of suffering clinically important vascular events. To provide stroke prevention in patients with AR, other medications (e.g., statins, ACE inhibitors) should be considered to prevent the sequelae of vascular disease."
Source: International Journal of Stroke

Child abuse a major cause of brain injuries in Chinese children

Falls and traffic accidents account for most cases of traumatic brain injury in Chinese children

by Michael Woodhead
More than one in twenty cases of serious head injury in Chinese children is cause by child abuse, a new study shows.
The first study to investigate the causes, characteristics and trends of pediatric traumatic brain injuries in China, conducted in 77 hospitals, found that falls were the leading cause of traumatic brain injuries for all ages but peaked at 2 years of age.
Other common causes were being struck by/against objects and traffic collisions, the study of 4200 cases of paediatric traumatic brain injury found. Boys were more likely to have brain injury than girls, accounting for 77% of injuries.
The proportion of traumatic brain injuries caused by traffic collisions ranged from 10% in children 0–2 years old to 19% in 3–6 year olds. Among the traumatic brain injury cases caused by traffic collisions, the largest proportions were among motor vehicle passengers, bicycle/tricycle riders, and motorcycle riders, and each of these categories accounted for about 20% of the crash-related TBIs in each age group.
There were 125 brain injures in 0–2 year olds (6% of all injuries in this age group) that were caused by suspected child abuse. Suspected child abuse was significantly more likely to occur in infants under one year of age.
"Traumatic brain injuries caused by child abuse warrant further research and government attention as a social and medical problem in China,"  conclude the researchers form the Wuhan Children’s Hospital in Hubei.
Due to the lack of any legal requirement for doctors to report suspected child abuse  it is very likely that brain injuries caused by child abuse were under-reported in the study., the researchers add.
"We could only report these cases as “suspected child abuse” because a systematic legal procedure for confirming suspected child abuse cases does not exist in China," they note.
Source: PLOS One

Ambulances will get priority, Ministry of Health decrees

Traffic must give priority to ambulances, Ministry of Health says, but laws must wait two years

Following the death of a patient in a traffic jam on December 7, the Ministry of Health (MOH) and Beijing Health Bureau have announced new regulations to ease ambulances' passage through traffic in emergency cases.
The ambulance was only able to move 3km in 40 minutes.
Public opinion on the MOH Pre-hospital Emergency Medical Treatment was already solicited in October and November of 2011 and will soon be released as a ministerial edict, said the ministry's spokesperson Deng Haihua at a press conference held in Beijing on Wednesday.
The fifth draft of the Beijing Emergency Treatment Medical Service Regulation, which began to be discussed in 2007, has been handed over to the local legislative body, the Beijing News reported on Thursday.
The Beijing regulations will be published within two years, according to reports.
 They will stipulate that ambulances have traffic priority in emergency treatment and while transferring patients in critical condition.
Other drivers that refuse to give way to ambulances will be punished and be held legally accountable if the patients die, Legal Mirror reported Thursday.
Traffic jams are a common obstacle for city ambulances, with drivers complaining that fewer than half of all vehicles give way to them.
According to the statistics from the Beijing Emergency Medical Center, the average speed of ambulances in urban areas is less than 40 kilometers per hour during the daytime when they transfer patients, said the Beijing News.
According to the updated version of the Law of the People's Republic of China on Road Traffic Safety, implemented in 2011, ambulances have priority and can't be limited by driving routes, speed, directions and traffic lights.
However, some Beijing residents argued that the punishment for cars who block ambulances would be difficult to confirm.
After collecting public opinions, law makers in Beijing will consider whether ambulances should be exempt from penalties if they scrape or collide with other cars during emergency treatment, said the Beijing News. 
Laws alone cannot solve all the traffic problems confronted by ambulances, Li Jianren, director of the emergency center, told the Global Times on Thursday.
"Tragedies won't happen if people obey traffic rules and respect others' lives," he said during a phone interview.
Source: Global Times

Chronic cough most often caused by asthma, Guangzhou study shows

One in three patients with chronic cough have asthma-related cough, a study from Guangzhou has found.
Dr Lai Kefang and colleagues in the Guangzhou Institute of Respiratory Diseases at the First Affiliated Hospital of Guangzhou Medical University examined the causes of chronic cough in 640 patients from five regions of China.
   They found that  the most common causes were included asthma (cough-variant asthma VA, 33%)，upper airway cough syndrome (19%), eosinophilic bronchitis (17%) and atopic cough (13%).
Collectively, these four causes accounted for 75% to 88% of chronic cough without significant variation across all regions. Gastroesophageal reflux-related cough was identified in 5% of cases of chronic cough.
Source: Chest

Journal watch - clinical news

Waste water from Beijing hospitals is replete with anti-psychotics, antidepressants and sedatives.  
Source: Chemosphere.

Many Chinese people with depression have chronic back pain or neck pain.
Source: Psychiatric Research

Concern about drug resistant malaria from Plasmodium vivax in Central China.
Source: Korean Journal of Parasitology.

Almost 60% of prostitutes on China-Vietnam border have herpes, 5% have HIV.
Source: Biomedical and Environmental Sciences

Backyard duck breeders in Beijing at risk of avian flu.
Source: PLOS One.

Urban residents believe health insurance is worthwhile

Almost 70% of urban residents support public health insurance

by Zheng Caixiong
A recent survey has found that most urban residents believe public health insurance is a worthwhile deal and it eases their concerns about visiting a doctor.
More than 69 percent of urban residents on the Chinese mainland support public health insurance, in which the government pays most of their medical costs, according to the survey released by the Guangzhou Public Opinion Research Center on Tuesday.
The center interviewed more than 5,000 urban residents by telephone on the Chinese mainland in September.
Eighty-six percent of respondents said government medical insurance has a high price-performance ratio and is a good deal.
Only 6 percent think public medical insurance is not worth the money.
Currently, urban residents are required to pay about 5 percent of their monthly income to join the government's medical insurance plan, in which the government pays more than 50 percent of their medical costs.
The government pays a higher percentage for inpatient treatment.
But there is public concern over the difficulty and high cost of getting medical treatment on the mainland.
More than 67 percent of respondents said medical costs are high, 24 percent found them moderate and 5 percent said they are cheap.
About 50 percent of patients preferred to buy medicines in local drugstores if they were not seriously ill, rather than visit doctors in hospitals because of the high medical costs, complicated procedures and long waiting times.
Zheng Fenming, director of the institute of modernization strategy at the Guangdong Academy of Social Sciences, said the difficulty and high costs of visiting doctors remain major problems in China even though governments at all levels have introduced measures to try to alleviate the situation.
"The previous medical reforms and measures to reduce medical care charges have had little effect," he said on Wednesday.
Zheng urged government departments to further increase medical resources by lowering the threshold to allow more foreign and private funds to establish hospitals.
"State-owned hospitals have basically monopolized the country's medical industry," he said.
Urban residents should buy commercial medical insurance if they want to enjoy high-quality medical treatment after the government has provided basic medical insurance, he said.
"Compared with some developed economies and regions, China's input into medical coverage is still not enough," he added.
Dong Changsheng, a Guangzhou office worker, said government departments should further boost investment in public medical insurance so that more people can benefit from the plan in the coming years.
"I feel comfortable only when I have government medical insurance coverage," he said.
Source: China Daily

Smaller hospitals 'offer huge opportunities' for Big Pharma

China's 10,000 county-level hospitals hold great potential for pharma companies as they treat many patients

by Liu Jie
China's county-level hospitals and community healthcare centres offer huge opportunities for multinational and local pharmaceutical companies, said a report released on Wednesday.
Conducted this year by global management and business strategy advisory firm Boston Consulting Group, the study was based on more than 60 in-person interviews and 900 detailed surveys provided by hospital heads, physicians and patients around China.
According to the report, with their huge base of potential patients and rapid growth, China's 10,000 county-level hospitals hold the greatest potential for pharmaceutical companies.
Covering more than 2,000 lower-tier cities and counties, these hospitals are becoming an increasingly important channel for rural patients to receive preliminary diagnoses and maintenance therapy.
Doctors in these hospitals play key roles when it comes to drug-of-treatment decisions for some diseases, and also given that more than 80 percent of patients renew their prescriptions in county-level hospitals.
However, the county-level hospital market has long been the turf of local Chinese drug makers.
"To succeed, multinational companies will need a broad range of products that can be tailored to local markets, with a special focus on low-price generics and mature products," said Chun Wu, partner and managing director of BCG Greater China.
Segmenting the different markets can also boost margins, she said, adding that hospitals in the larger counties treat far more patients, and sell two to four times more medicines than hospitals in less developed areas.
Regarding community healthcare centers, China's market is small so far, but it holds considerable potential because these facilities are treating an increasing number of patients with chronic diseases such as diabetes and hypertension, said Magen Xia, principal of BCG Greater China.
Sales of drugs for chronic illnesses in these centers are currently as much as a quarter less than in city hospitals, but are growing fast.
The centers and doctors there are playing an increasingly important role when it comes to in-patient care. Instead of just refilling prescriptions, doctors in community healthcare centers are also making some initial diagnoses, participating in disease management, and influencing the brand chosen for drug treatment and decisions to change drugs.
According to the report, more hypertension patients switched from local to multinational brands in the 30 richest cities in China.
"The sheer size and fragmentation of this market is the hurdle that pharmaceutical companies face; while the evolving drug policies are another challenge," said Xia.
Many of these challenges, such as the mandatory inclusion of the drugs in the government's Essential Drug List, zero mark-up requirements and policies that result in insufficient government subsidies, lack consistency or are impossible to fully implement. As a result, drugs not on the government's Essential Drug List are expected to account for a significant portion of the market in community healthcare centers until 2015, said the report.
The national Essential Drug List is expected to be expanded by the end of this year or early next year.
To succeed, companies must identify their key advantages, including scale, manufacturing capability and quality, and actively influence and shape China's Essential Drug List policies in key provinces to favor those advantages.
"It is also important to prioritize the target provinces, taking a pass on those where coverage is minimal or relationships are lacking," said Wu.
Read more: China Daily

Village doctors want a bit more praise, pay and a pension

Village doctors say new government subsidies don't reward them sufficiently for proving public health services

Rural doctors in China say they would like to provide more public health services but they are not paid much for such services and need to earn a living though fee-for-service medicine.
In a series of interviews with 10 groups of village-level basic doctors, researchers found that the rural practitioners felt under-appreciated and underpaid, despite receiving extra subsidies under the governnment's Health System Reform Plan introduced in 2009.
Researchers say that in the last two decades, reduced government health spending, together
with weak supervision of village doctors by county health bureaus, has undermined preventive
health services provision and disease surveillance activities.
According to Dr Yan Ding of the Institute of Public Health, Heidelberg University and Professor Dong Hengjin of School of Public Health, Zhejiang University School of Medicine, the main concern of village doctors appeared to be that providing public health services was time-consuming and limited their ability to perform fee-for-service medical care.
Village doctors frequently mentioned that, despite their contribution to public health, they
felt their effort was not valued by the government. Although subsidies for public health work increased in 2011, all the village doctors interviewed considered it insufficient when compared with the amount of work expected of village doctors. They also remarked that they had no pension to fall back on when they retired, so needed to prioritise earnings and save.
The health reform subsidies were intended to revitalise the provision of basic public health services by improving the ability of the three-tiered system to strengthen disease control and health promotion, as well as providing a package of basic public health services.
This package includes establishing health records for all citizens; screening for major diseases for elderly people, women and children; managing chronic non-communicable diseases; providing health education; increasing vaccine coverage for 15 vaccine-preventable diseases; implementing prevention and control programs for major infectious diseases and geochemical endemic diseases; and ensuring that births occur in hospitals.
To motivate village doctors to provide these preventive services, the government pledged per-person subsidies of 15 renminbi (RMB) for 2009 and 2010, and 25 RMB for 2011.
"An interesting finding is that although village doctors prioritise medical services for which they can charge, they do their best to deliver preventive services that are part of the basic public health package. They claim that providing public health services involves a significant investment of time that has a negative impact on other income-earning activities. Village doctors also question the extent to which they and their public health work are valued," the researchers note.
The conclude: "Improving the delivery of public health services by village doctors is likely to require an increase in the subsidy, improvement in the supervisory relationship between village clinics and township health centres and the creation of a government pension for village doctors."
Source: Bulletin of the WHO

Eight Tibetan medical students get five years in jail for protesting

Medical students were angry at disparaging remarks made by Chinese about the Dalai Lama

Eight Tibetan students of the Sorig Lobling medical school in Chabcha, eastern Tibet have been sentenced to five years in prison even as the school continues to remain under strict surveillance for the third straight week.
The eight students have been identified as Rabten, Wangdue Tsering, Jampa Tsering, Choekyong, Tashi Kunsang, Dola Tsering, Sangye Dhondup, and Kunsang Bum.
Speaking to Phayul, Shawo Dorjee, a Tibetan living in Switzerland said that all those sentenced were below 23 years of age.
“The students were sentenced on December 5 on charges of their involvement in the students’ mass protest in Chabcha on November 26,” Dorjee said citing sources in the region.
“Chinese authorities have accused the eight students of leading the protests because of their role as school prefects.”
It is not known where the students have been jailed.
On November 26, over a thousand Tibetan students from the Chabcha Sorig Lobling School staged a major protest rally against the Chinese government, raising slogans calling for freedom, equality of nationalities, freedom of language, respect for truth, and re-establishment of governance.
Chinese armed forces used violent force to break up the demonstration, injuring many young protesters and hospitalising around 20 students. The school was subsequently placed under complete lock down and Chinese security forces barred students from meeting their parents and relatives.
The next day, three of the medical school’s students, Wangchen Tsering of Ba County, Mama and an identified student were arrested in connection with the protest.
At the beginning of this month, three Tibetan monks of the Chamru Monastery, identified as Sungrab Gyatso, Dragsang, and Yeshe Sangpo were arrested for their reported role in sending out information on the protest.
According to earlier reports, arrested students were interrogated, tortured, and barred from having any visitors.
The protest were triggered after local Chinese authorities distributed a ten-point political questionnaire to the students, critical of the self-immolation protests in Tibet and gave “patriotic education” sessions that contained disparaging remarks against His Holiness the Dalai Lama.
Source: Phayul

In Guangxi, 60% of villagers infected with liver flukes

Liver flukes and minute intestinal flukes are endemic in some parts of Guangxi

by Michael Woodhead
A study of villagers in rural Guangxi province near Nanning has found that around 60% of them are infected with fish-borne trematodiasis, manifesting as liver flukes or intestinal flukes.
The liver flukes caused by Clonorchis sinensis appear to be endemic in the region and can cause chronic diseases and are a neglected public health issue in the area, say parasitologists who carried out a study in six rural villages in southern Guangxi.
Their analysis of faecal samples from more than 700 local residents found an overall egg positive rate of 60% (428/718) for C. sinensis and minute intestinal flukes. In some villages the rates were as high as 70%, and cases of heavy fluke infection were seen in up to 18% of villagers.
The researchers say the rates are higher than previously seen and reflect the endemic nature of the liver flukes in the area. The prevalence of C. sinensis infection was found to be 0.4% in a nationwide survey in China between 1988 and 1992, they note.
The infections come from infected fish int he area say researchers form Korea working in conjunction with scientists from the Guangxi Center for Disease Prevention and Control, Nanning. 
Source: Korean Journal of Parasitology

Intensive diabetes treatment reduces cardiovascular complications

Heart attacks were reduced by intensive treatment with hypoglycaemic drugs, antihypertensives and statins

by Michael Woodhead
In a long term intervention study, researchers from Dalian have shown that macrovascular complications of type 2 diabetes can be prevented through an intensive regimen of hypoglycaemic, antihypertensive and statin drugs.
When used in combination with interventions to promote better diet and more activity, the drug regimens reduced macro vascular complications by two thirds, according to Professor Yang Yu of the Department of Endocrinology at the First Affiliated Hospital of Dalian Medical University.
In a seven year study, Professor Yang and colleagues compared 'intensive' treatment with conventional treatment of type 2 diabetes in 150 patients at the hospital. Half the patients were assigned to the intensive group, and were treated with hypoglycaemic drugs, such as metformin, antihypertensives such as an ACE inhibitor, and lipid lowering drugs such as statins or a Chinese lipid-lowering herb complex called Xue-Zhi-Kang. Patients also received one on one sessions instructing them in diet and exercise.
After seven years, subclinical macrovascular complications such as heart attacks, angina and stroke occurred in 10% (seven) of the intensive treatment group and in 33% (22) of the  conventional group.
The researchers say their findings confirm those seen in the landmark UKPDS trial and show that "primary prevention of macrovascular diseases can be achieved through intensified, multifactorial intervention in patients with short-duration type 2 diabetes.
"Our approach achieved the primary prevention of diabetic macrovascular complications, implying that intensive, multifactorial intervention
should be administered to type 2 diabetic patients as soon as possible to provide the most benefits," they suggest.
"Type 2 diabetic patients should undergo intensive multifactorial interventions with individual targets for the prevention of macrovascular diseases," they conclude.
Source: Diabetes Care

Foreigners blamed for spreading drug resistance to HIV in China

Resistance to protease inhibitors is being transmitted by contact with foreigners to gay men in China

by Michael Woodhead
Resistance to anti-HIV drugs such as protease inhibitors is on the increase in China and foreigners are to blame for introducing the drug resistance gene mutations into the country via gay sex, Beijing researchers say.
A national study of drug resistance genes in 489 gay men from 19 provinces found that one in twenty of them already had  acquired resistance to some anti-HIV drugs depute never having had any drug treatment.  The most common form of drug resistance  seen was to protease inhibitors, although these are rarey used as first-line treatment in China, according to Dr Yang Juan and colleagues at the National Centre for AIDS Control and Prevention in Beijing.
In their study they note that the types of HIV virus seen in China vary from region to region. In Beijing the most common strain of HIV is a unique one not seen elsewhere in China, and which is known as subtype B, which is known to  entered China through visitors from Western countries,
"This suggests that an early driver of infections [in men who have sex with men] in this area may have been through sexual contacts with Westerners," they researchers say.
The finding that more than 70% of drug resistance seen in China was to  the seldom used protease inhibitors also suggests that drug resistance is being transmitted to Chinese people from foreigners, they add.
"Sexual networks of [gay men] extending across international borders facilitates transmission of HIV and primary drug resistance. In China, [gay men] are concentrated in major cities, where they have more chances to have close social and sexual contacts with partners from foreign countries with more diverse and prolonged ART experience. This suggests that the high rate of drug resistance to protease inhibitors among Chinese gay men may be derived from frequent international travel and sex with foreign-born partners."
They also warn that the spread of HIV and drug resistance will not be confined to gay men but will spread to the heterosexual population because many gay Chinese men are married.
"Due to cultural and social pressures, many [gay men] are married to women and/or are engaged bisexual relationships and thus serve as a bridge population in bringing HIV infection and other sexually transmitted diseases to their female partners," they say.
"Our findings confirm the urgent need for transmitted drug resistance surveillance in order to optimise treatment effects of the National antiretroviral therapy Program," they conclude.
Source: Archives of Virology

Shanghai hospitals begin organ collection and transplant program

The organ donation program will replace current ad-hoc organ collection and distribution methods

Shanghai's government yesterday announced the first group of 17 city-level hospitals to carry out human organ collection and transplants.
The announcement marked an official start of work under a national organ donation system in the city.
Under the system, all information about donated organs and patients with organ failure will be put into the national organ distribution and sharing network to ensure organs are given to the patients in the most need on the waiting list.
The measure is expected to change the previous organ distribution situation to a more scientific and fair use of organs.
"Previously, hospitals got organs through their own sources and just used these organs for their own patients," said Dr Fu Zhiren, director of Changzheng Hospital's organ transplantation department. "Sometimes their own patients who are not the most critically sick got the organs, while other patients in more urgent conditions don't have an organ."
He said a national organ distribution network open to all qualified hospitals and patients can ensure a better use of limited organs.
Shanghai has established an expert commission for human organ donation to guide donation and transplants and a city-level expert diagnosis team, which will be involved in death evaluations of donors.
The national organ donation system run by the Red Cross Society of China was established in 2010 and was put into a pilot operation in 16 regions in March 2010.
The system will help China gradually phase out its reliance on organs from executed prisoners, Vice Health Minister Huang Jiefu said in Guangdong Province last month. By September 30 of this year, 38 domestic hospitals had obtained 1,279 organs from 465 donors in the system, Huang said.
The national trial has adopted the criteria of donations after both cardiac death and brain death. Shanghai will also follow such criteria and the death of each possible donor will be evaluated by his or her own doctors and the expert team.
China passed an organ transplant law in 2007, which has greatly strengthened supervision of organ transplants. However, the law failed to solve problems such as questionable sources, an acute shortage of organs, and illegal organ transactions.
About 1.5 million people are on the waiting list for organ transplants in China each year, but only about 10,000 of them get a donated organ due to the lack of organs.
Source: Eastday

Wuhan hospitals ban routine X-rays to curb radiation risk

Usage rate of X-rays in China is 300 times that seen in the UK

Several hospitals in Wuhan, capital of central China's Hubei Province, have canceled chest X-ray examinations due to the possibility of physical harm, according to a report from Changjiang Daily on Tuesday.
Chest X-rays are a common medical examination method; however they can also damage human bodies due to excessive exposure to radiation. According to chinanews.com, the utilisation rate of chest X-ray examinations is 61.8 percent in China, more than 300 times of that of Britain, which is only 0.2%. Moreover, this examination has already been sharply curtailed in most developed countries including the US and Japan.
Liu Junfang, chief of the radiological department of Zhongnan Hospital of the University of Wuhan, said that excessive radiation exposure would harm young children, teenagers, and cause diseases including cancer.
Since 2006, the Wuhan Department of Health has canceled X-rays as part of the regular physical examination for students in middle schools and elementary schools.
Some hospitals in the city also canceled the examination, or stopped recommending the examination to minors six years ago.
Furthermore, experts also suggested that X-ray checks for pregnant women and women with intrauterine devices should also be canceled.
However, Wang Yimin, director of the radiological department of Wuhan PLA 161 Hospital, said the safety level of a chest X-ray examination was still within the national regulations, and some patients choose it due to the low cost.
Source: CRI

Psychiatric hospital used to detain outspoken professor, dissidents say

A law lecturer at Jiliang Universty Hangzhous was sent to a psychiatric institution after speaking about 1989

Authorities in the eastern Chinese province of Zhejiang have had an outspoken professor who talked to his students about the 1989 Tiananmen Square massacre forcibly committed to a psychiatric facility, rights groups and fellow activists said on Tuesday.
Professor Wang Peijian, who teaches at China Jiliang University in Hangzhou, initially resisted being forced into a psychiatric hospital by authorities for expressing “politically sensitive” opinions in class over the past few weeks, the China Human Rights Defenders (CHRD) said in an e-mailed statement.
Wang was informed by a school administrator on Dec. 7 that his classes would be suspended beginning the next day.
"Wang believed that this was because he had spoken to students about his views on, among other topics, the [ruling] Chinese Communist Party’s monopoly on power, the 1989 massacre around Tiananmen Square, and suppression of human rights lawyers," CHRD said.
Hangzhou-based writer Zan Aizong, who is a close friend of Wang's, said Wang had managed to evade psychiatric committal for a while by locking himself inside a room.
"Wang Peijian called me a number of times ... and he told me the school had contacted his brother to try to get him to go along with the school in having him taken to a mental hospital," Zan said.
Wang Peijian had also said that his comments to students that the ruling Communist Party should relinquish power had probably been reported by his students to the authorities, he added.
"The school thought he must be having a mental breakdown, or that his mood must be unstable, and that they should suspend his classes and have him taken to a psychiatric unit," Zan said.
The school's security personnel later succeeded in taking Wang to the No. 7 Hangzhou Psychiatric Hospital, according to sources close to the family.
Wang's brother, Wang Zhuangjian, said he was unable to manage the situation without help, and confirmed that he had collaborated with school security officials.
"Everything went pretty smoothly, with a minimum of physical resistance," he said. "We have already taken the measures most likely to protect my brother."
According to a post on the popular Sina Weibo microblogging service by Beijing-based legal scholar Teng Biao, Wang had been a founding member of the banned opposition China Democracy Party (CDP).
Trained in law, Wang had been refused a license to practice as a lawyer after he graduated and finished his law firm apprenticeship, Teng said.
"He had divorced a few months ago ... and was under huge psychological pressure," Teng's post said.
Chinese psychiatric patients are routinely subjected to abuse of their rights in a system that makes scant distinction between different kinds of mental illness, according to a recent report by CHRD.
While reports have become more widespread in recent years of the incarceration of rights activists and petitioners in psychiatric institutions for political reasons, genuine mental health patients are also highly vulnerable to abuses under the current system, the group said.
The report, titled "The Darkest Corners," detail the grim conditions and human rights abuses faced by people who are committed to psychiatric care against their will, even if they do not pose a demonstrable threat of harm to themselves or to others.
Source: Radio Free Asia

Big pharma looks to TCM in China for drug pipeline

Pharma companies such as GSK and Sanofi see traditional Chinese medicine as a potential pipeline for new drugs

The world’s biggest drugmakers are turning to ancient Chinese remedies to boost product pipelines.
GlaxoSmithKline Plc is testing botanicals -- compounds extracted from plants -- for immune disorders, Sanofi plans to turn traditional Chinese medicines into alternative diabetes and cancer therapies, and Nestle SA teamed last month with billionaire Li Ka-Shing to develop a drug derived from ancient Chinese approaches to cure inflammatory bowel disease.
The confluence of China’s growing middle class and pharmaceutical companies’ need to find new revenue have combined to give Western drugmakers an increasingly open mind about a 2,500 year-old form of medicine they once scoffed at.
“You have 1.3 billion people, many of whom cannot afford Western medicines and who believe that traditional Chinese medicines are good enough,” said Bloomberg Industries analyst Sam Fazeli. “If they can manufacture it on a meaningful scale, and do it with the stamp of a Glaxo or a Sanofi on it, perhaps the consumer will be more interested in buying it than something that’s boiled up in a vat somewhere.”
China’s market for traditional drugs, excluding raw herbs and highly purified compounds extracted from herbs, was $13 billion in 2011 and could grow 14 percent annually over the next five years, according to consultancy McKinsey & Co. Of last year’s total, $6 billion came from medicines sold over the counter, accounting for almost half of China’s market for non- prescription drugs, the consultancy said.
Less stringent U.S. rules for approving plant-based treatments may give drugmakers a quicker path to creating medicines, with more than 500 applications to test treatments lodged with the Food & Drug Administration. Previous attempts to break down herbal medicines into single ingredients failed to yield major breakthroughs so Western drugmakers now target mixtures inspired by ancient recipes to sell globally and in China, where many are raised to trust traditional methods.
Combining Western science with traditional cures is an approach that already extends to Glaxo’s research center in Shanghai. Sick workers can tap an alternative Chinese therapy using suction cups made of glass, as well as the pharmaceuticals that generate most of the Brentford, U.K.-based company’s $44 billion of annual sales.
“Traditional medicine has been practiced for thousands of years but it has always been based on clinical experience and not so much on clinical evidence like Western medicine,” said Zang Jingwu, Glaxo’s head of China research and development. “Our strategy is to integrate existing traditional knowledge of diseases with modern drug discovery technology.”
The U.S. FDA introduced new guidelines for botanical treatments in 2004, applying less strict conditions to those imposed on chemical and biological drugs seeking approval. That opened up a new avenue for producers to replenish their medical research pipelines and replace expiring patents.
It’s no longer essential to identify the active constituents of botanical drugs, while products legally used as dietary supplements in the U.S. with no known safety issues may provide “markedly reduced” information on their toxicology, according to the U.S. regulator.
“Almost all botanicals are complex natural mixtures that are difficult to have full chemical characterization and will need flexibility in regulatory approaches,” said Shaw Chen, who leads the FDA’s botanical review team. The guidelines are “intended to facilitate more development of new treatments, especially for unmet medical needs,” he said.
The agency has received more than 500 applications to test drugs under the guidelines, most of which were approved for human trials, Chen said in an e-mailed response to questions. Many are in phase three trials, typically the last hurdle to qualify for approval, with a handful soon to make the final application to become an allowed drug, he said, declining to be more precise.
Glaxo’s herbal drugs efforts will focus initially on immune disorders such as psoriasis, a chronic disease that causes scaly skin, and drugs that treat inflammation of the digestive system, according to Zhang Xun, Shanghai-based head of research and development for the company’s global natural products unit.
“We want to get quickly into the clinical development stage by collaborating with domestic companies,” said Zhang, adding that the company will “soon” have a product in development with a Chinese partner without being more specific.
Sanofi, France’s largest drugmaker, is in talks with the Hong Kong University of Science and Technology to come up with “modernized” versions of traditional medicines. These could be used to treat chronic diseases such as diabetes and cancer, said Frank Jiang, the company’s head of Asia Pacific research and development.
The Paris-based company wants to first register new drugs in China to target local patients before aiming for the global market through approvals in the U.S.
Read more: Businessweek

Hepatitis B carriers in China fight back against discrimination

People with hepatitis B say they get job rejections

by Maria Siow
One out of every ten people in China are carriers of the hepatitis B virus, who face rampant discrimination.
Many carriers have chosen to fight the discrimination, with varying degrees of success.
On World Hepatitis Day in July, hundreds of hepatitis B carriers gathered in downtown Chengdu in Sichuan province.
Apart from raising awareness about hepatitis B, they were also demanding for equal rights.
A non-contagious condition, hepatitis B is little understood in China.
Hepatitis B can only be transmitted through blood transfusions, sexual contact, and from a pregnant mother to an unborn child.
But even so, schools and employers, even prospective marriage partners, routinely discriminate against Hepatitis B carriers.
One of them is 22-year-old Fang Ming. A recent college graduate, he applied for a job in the aviation industry and cleared various tests and interviews.
"In November, my prospective employer rang me and told me to go for a medical checkup. I cleared all categories except for Hepatitis B. Based on that they said they were not going to hire me," he said.
Fang Ming decided to fight back by bringing a lawsuit against his prospective employer.
"I felt so miserable and upset. It was rampant discrimination. I had to protect my rights."
Fang Ming sought legal advice, and his case has now been submitted to and will be heard by a court in Beijing.
"There are laws to protect the rights of hepatitis B carriers. According to the law, employers cannot refuse to hire someone simply because he's a carrier. If rejected, victims have the right to legal action," said Huang Yizhi, a lawyer from Beijing Ruifeng Law Firm.
"Many people here think that Hepatitis B is like hepatitis A. They are ignorant and fearful, thinking that they can contract the condition simply by working and eating with carriers," she said.
Lawyers say that the willingness by Chinese courts to handle such cases is a sign of the country's progress in protecting individual rights.
Victims often receive legal compensation, even though the amounts range only from a few thousand to 20,000 or 30,000 yuan.
However some cases have also been unsuccessful as the onus and responsibility is on victims to produce evidence and prove beyond a doubt that they have been victimised and discriminated against.
"The willingness of victims in protecting their rights can still serve as a warning and deterrence to employers, not just in terms of monetary compensation, but also the negative harm to the companies' image and reputation," said Ms Huang.
In the past few years, hepatitis B carriers have campaigned for their rights in various ways.
This includes displaying slogans and asking strangers for hugs in public places.
Lei Chuang, who was rejected from a top post-graduate university program due to his Hepatitis B condition, is one of the cause's most visible advocates
He suspended his studies to campaign against hepatitis B carrier discrimination and has even sent an invitation to the Chinese prime minister to have dinner with him.
But while perceptions have slowly been changing, shifting widespread public attitudes will certainly be a long term task.
Source: Channel News Asia

Beijing on new SARS alert after five coronavirus deaths in Middle East

Beijing hospitals are monitoring for severe respiratory infections after five deaths caused by a novel coronavirus

translation by Michael Woodhead
The Beijing Municipal Centre for Disease Control (CDC) says the city has started monitor in city hospitals for a new coronavirus infection that has caused five deaths in the Middle East.
The WHO recently confirmed laboratory reports that a novel coronavirus infection has caused nine cases of serious infection, including five deaths increased. There are now concerns that this will trigger a new"atypical pneumonia (SARS) epidemic. To date, WHO has received nine new coronavirus infection confirmed cases, five cases (including three deaths) from Saudi Arabia , two cases from Qatar , the other two cases (all deaths) from Jordan. 　　
WHO has called on all members to continue to monitor for severe acute respiratory infections, and to consider the novel coronavirus as a possible cause of any unexplained pulmonary infections in patients. The WHO stressed that monitoring should take place worldwide and any countries or regions that see any cluster of severe acute respiratory infection should conduct a thorough investigation. 　　
In response, the director of the Beijing CDC Dr Ying Rendeng said the city has already begun to monitor for coronavirus, with a careful history taken of unexplained pneumonia cases required at all medical institutions at all levels. This aims to be a 'dragnet' for monitoring suspected cases of coronavirus. All emergency doctors have received training in coronavirus characteristics and patient symptoms. Meanwhile, laboratory tests have also been prepared, so that if cases do occur, doctors and laboratories will be able to detect and diagnose them rapidly. Currently, the city has no case reports of any novel coronavirus infection.
WHO says that it is best not to assume that the new coronavirus spread is limited to the above-mentioned Middle Eastern countries. No matter which country a cluster of severe acute respiratory infection is seen, or if these infections occur among health workers, there should be a thorough investigation. 　　The reason why the new virus has caused great concern is because "atypical pneumonia" (SARS) virus that killed hundreds in 2003 was due to coronavirus. However, genetic analysis shows the closest match to the novel coronavirus is a bat coronavirus found in the Netherlands in 2008, rather than the SARS virus of 2003. The cause of the novel coronavirus infections is unclear, with most infected people having severe acute respiratory syndrome associated with acute renal failure.
Source: Hexun

The horrific waits to register at a Beijing hospital - video

Shanghai residents now use antibiotics appropriately

City campaign persuaded residents and doctors not to misuse antibiotics

A recent health survey found that 90 percent of respondents were using antibiotics properly last year following a local government education campaign to curb overuse of the drugs, Shanghai's health promotion authority has announced.
The survey's results show that the local government's education efforts are paying off, said Gu Xiping, a press officer from the Shanghai Municipal Health Promotion Committee.
"Fewer residents are taking antibiotics as a panacea, or asking doctors to prescribe them when they aren't needed," Gu told the Global Times. "Doctors are reducing the amount of antibiotics they prescribe to patients due to both the campaign and a regulation issued last year that capped the amount and types of antibiotics that each doctor can prescribe."
The Shanghai Municipal Health Promotion Committee interviewed 3,375 residents this year about how they use antibiotics. About 80 percent said they understand the importance of restricting their use of antibiotics, a 28 percent increase from 2010, according to a committee press release. The proportion of respondents found to be using antibiotics properly had increased from 75 percent in 2010.
The average amount of antibiotics used for each patient in Shanghai's public hospitals fell by 20 percent from 2010 following the campaign, according to the press release.
Still, patients in Shanghai continued to receive antibiotics at a far higher rate than the world average. About 60 percent of patients treated at local hospitals, including outpatients, were given antibiotics in 2011, according to a study by local health authorities that was published on the news website Eastday.com.
Only 10 percent of patients around the world are treated with antibiotics on average, Du Wenmin, vice director of the Shanghai Clinical Center for Drug Adverse Reactions, told China Radio International.
A major reason for the overuse in China comes from patients, who often insist that doctors proscribe them antibiotics regardless of whether the proscription is necessary, said Zhen Jianying, a doctor from a community health center.
The problem not only wastes medical resources but can also seriously damage a patient's health, said Xu Wensheng, director of the Infectious Disease Department from Changzheng Hospital. "Overusing antibiotics can cause patients to grow resistant to the drugs, which can become a big problem for them in the future," Xu told the Global Times. "It can lead to liver and kidney damage. It is also a waste of money for patients if they are given unnecessary and expensive antibiotics."
The committee has sent educational brochures to more than 621,000 residents detailing the problems of overusing antibiotics.
Source: Global Times.

Rabies kills 13 Beijingers - mostly from pet dog bites

Rabies deaths have doubled and failure to seek post-bite vaccination is to blame

Thirteen Beijing residents have died of rabies this year, more than double the number of deaths in 2011.
Experts have attributed the increase in deaths to a lack of an effective vaccination program in the capital.
Of the 13 victims, most were bitten by pet dogs rather than strays, the Legal Mirror learnt from the Beijing Centers for Diseases Control and Prevention (CDC) Monday. Only five people died of rabies in 2011, the CDC said.
In 12 of the 13 cases, the victims did not seek vaccination after they were bitten, and the 13th victim died before he finished the entire course of vaccinations. A CDC official said rabies often occurs within three months after being bitten, and no one can survive the disease, the report said. A consultant from Beijing Kennel Club, surnamed Xu, said that if dog owners are bitten, even by a vaccinated pet, residents should still seek medical attention for further vaccination.
"Dogs will be vaccinated for free if they are registered at the police station, but some owners evade this as it costs 1,000 yuan ($160)," said Xu.
"We've appealed for residents to get their dogs registered for years, but achieved little," he noted.
Mary Peng, director of the Beijing-based International Center for Veterinary Services, said dog vaccine coverage in the US is around 80 percent, but in China take-up is only 20 percent.
"The Chinese government only permits licensed hospitals to import vaccine, which has proven effective in protecting dogs from rabies," Peng saidBeijing is considering a free compulsory vaccine program for pet dogs in the future, and also a system penalizing residents who fail to vaccinate their pets.
Source: Peoples Daily

Baby dies in incubator after Hebei hospital power cut

Power cut at the Xianxian Maternal and Child Health Hospital blamed for incubator death

Health authorities are investigating a hospital in Xianxian County of Hebei Province, where a newborn baby died in an incubator after a power failure cut off its heat and oxygen supply for about five hours, local media reported.
The baby boy's mother gave birth on December 2 at the Xianxian Maternal and Child Health Hospital. The boy looked strong but with his face looked pale, the doctor sent him to an incubator for oxygen therapy, the parents told Yanzhao Metropolis Daily.
But the next day, a power blackout occurred at the hospital from 1:40am to 6:30am, cutting off oxygen and heat to the incubator, the parents told the newspaper.
The baby's father, Li Dabing, said he was worried whether the baby would catch cold in the incubator when the power failure occurred, but a nurse told him not to worry, as power is usually restored after an hour.
"I was thinking about taking my baby out of that incubator, but the nurse wouldn't help remove the medical equipment, such as tubes, from his body," Li told the newspaper. "I feared that the baby may catch cold there as even I felt cold in cotton-padded clothes."
They waited until the hospital restored power after a worker started the emergency electricity generation system.
The parents said the baby was then found suffering symptoms of exposure to cold, as his face appeared very red, he had a fever and kept sneezing in the incubator.
The baby was pronounced dead last Wednesday, three days after it was born.
"I believe the death of my son is directly related to the hospital's power failure and the cutting off of the oxygen supply," Li said. "As a public hospital, how can the medical workers restore power five hours after the blackout started?"
A hospital vice director surnamed Luo said that the poor condition of the hospital's facilities was to blame for the five-hour-long power failure.
Source: Yanzhou Daily

Nanjing to ditch preferential medical plans for government employees

The city government of Nanjing will replace its preferential medical care system for its employees in 2013 with a uniform medical insurance plan that aims to more fairly cover all the city's residents.
Starting January 1, 2013, all government branches and their affiliated organizations in the city will be required to join the medical insurance plan, which will no longer be paid for by the government.
Some 24 regions in China, including Beijing and Tianjin, have already implemented reforms to their civil service medical care plan after preferential medical care plans for government employees triggered widespread grumbling from the public. 
Source: People's Daily

Mobile telemedicine comes to China

Mobile phone imaging systems will allow doctors to do endoscopies remotely

by Jamie Thompson
JEMS Technology has begun supplying its JEMS mobile medical systems to the Chinese healthcare market. Initial orders have been placed for use of the JEMS systems in endoscopic procedures.
The JEMS server is being integrated into systems that will allow GI physicians to consult on endoscopic procedures remotely, an advantage in China where there is a limited amount of GI physicians and a large landscape.
Healthcare providers who use their smartphones to connect with colleagues and patients in China will benefit from the mobile solution, officials say.
The tool is slated for distribution in both urban and rural areas. Due to the number of healthcare facilities and medically underserved population in China, the company estimates the value of this business opportunity at $50 million.
“The Chinese healthcare market presents a tremendous opportunity; there is great demand for mobile medical solutions in China and the JEMS system is well-suited to serve the needs of healthcare providers in a number of clinical disciplines,” said Ron Perry, director of international business for JEMS.
Source: Healthcare IT News

Foreign firms plan family practice GP clinic expansion in China

China has only 78,000 GPs but US companies plan to open community clinics

by Yang Wanli
Foreign medical clinics are expected to serve more people in China as United Family Healthcare (UFH) opened its fourth high-end community clinic in Beijing on Dec 10, with plans to expand nationwide.
"Family practice will be the core competitive power of the new clinics and we will bring the service of general practitioners' in the US to residents in China," said Pan Zhongying, president of the Beijing United Family Hospital, headquarters of UF — China's largest foreign-invested healthcare provider.
China's Ministry of Health started to promote the training of general parishioners, known as GPs, nationwide in 2006. The support of GPs is to encourage more patients to get treatment in residential clinics, relieving the pressure on hospitals.
Statistics from the ministry show that in 2011, the country only has 78,000 GPs. The ministry will train more GPs, with 300,000 to 400,0000 GPs expected to be working in China by 2020, meaning every 10,000 residents will have access to at least two or three GPs. However, low pay and doubts from patients as to the ability of GPs to properly treat them, has discouraged would-be GPs in medical college.
"GP's have a lower, but a still respectable income in the US, about $160,000 annually. Specialists earn double, but the government has policies supporting GPs, including free tuition fees in college if they are willing to work in rural areas," said Andy Wang, chairman of the department of family medicine in Beijing United Family Hospital.
Wang has worked in the hospital for six years and said the hospital's other three clinics, targeting community family practice, witnessed an increase in visits from local Chinese people. UFH will expand the family practice service nationwide. Qingdao, a coastal city in Shandong province, may be the next location for a clinic.
Source: People's Daily

Rehab to re-take: Shanghai doctor makes films on medical themes

Dr Sun works in rehabilitation medicine but makes movies about health, society and personal relations

by Wang Yizhou
Sun Xudong is a busy and committed film director and scriptwriter. But he is a long way from Hollywood. By day Sun is a doctor in the rehabilitation department of the Shanghai Shunchang Hospital, a public hospital that specializes in aged care in the city's Huangpu district.

At night, in his spare time and over weekends he is a director. He doesn't make films with car chases, guns being fired, impossible heroes and sexy women. His latest film is called Baby, Sorry and is about how a young man saves a child's life by donating stem cells to help her fight cancer. But he only does this after persuading his parents that this will not harm him personally and will help the little girl. The film is one of the new breeds of microfilm and will be screened online probably in January when it is completed and will then be accessible on a range of Internet portals. 
It is also based on true stories that director Sun became involved with. Zhang Yujia was a bright and happy 5-year-old girl who suddenly and inexplicably collapsed one day at her kindergarten. Tests revealed she was suffering from leukemia. 
She was given chemotherapy but her condition worsened until a stem cell donor was found in another city. This young man was willing to provide the stem cells needed to save the girl's life but first he and the doctors had to persuade his traditionally-minded and over-protective parents that this was a good and safe thing to do.
In reality, the girl received the treatment and recovered. Sun's film, however, has a bleaker ending inspired by another case where parents had forbidden a son to transplant stem cells and a child died for lack of treatment.
"For the film I was inspired by the son of one of my teachers. The boy died of the disease because the man whose stem cells matched and who could have saved him could not convince his parents to allow the transplant," Sun said.
The making of Baby, Sorry started in November and Sun and his team - office workers by day and filmmakers by night - have been deeply involved in all aspects of the shoot since then. They are united in the belief that it is important to make the film to try to raise public awareness of the facts about stem cell donations.
The Shanghai born 29-year-old Sun has been helping other people for many years now and uses his position as secretary of the Youth League Committee at the hospital to promote good public health care. 
As a middle school student he used to occasionally visit nursing homes to play chess with some of the elderly residents. His visits became regular and he began helping tidy the rooms or bring the elderly fruit. "I felt happy because they had so much to tell me and so much wisdom to share," he said.
Since then he has been active in many different ways but usually winding up helping others. He was fond of reading and theater and at university set up a literature club and a drama club. The drama club became a success and he persuaded members to give performances in nursing homes and cancer patient rehabilitation centers. 
Last year Sun established a photography club with friends and colleagues and then proposed something different. "Making homemade music videos is growing in popularity on the Internet, so why don't we help those who cannot make them?" he asked. 
He and other members advertised on bulletin boards in universities and eventually helped dozens of people make their own music videos. "Everyone has his or her own little dream and I am glad to be the one that help them realize this," Sun said.
Based on the success of the music video, he decided to try making longer more involved films, a proposal that won support from his friends. With little experience in the field, he did his own research and formed a team of 15 who became actors, directors, cameramen, producers and technical staff and they made their first film in March, a microfilm about environmental concerns that appeared on the Internet. In May there was another film about a young man's journey seeking a mysterious girl who had helped him years beforehand and in August the team made a film about a doctor who gave up the chance of a prestigious award and left his pregnant wife at home in Shanghai while he rushed to Sichuan to help victims of the earthquake there.


Read more: Global Times

Health minister to lead a permitted non-Communist political party

Health Minister Chen Zhu now heads the Chinese Peasants and Workers Democratic Party

Minister of Health Chen Zhu was elected chairman of the Central Committee of the Chinese Peasants and Workers Democratic Party (CPWDP) on Monday.
The decision was announced after the CPWDP, a non-communist political party with about 125,600 members, concluded its five-day 15th National Congress on the same day.
Chen, 59, a French-trained scientist, was appointed as the country's minister of health in June 2007 when he had no political party affiliation.
The CPWDP was founded in August 1930 in Shanghai and mainly comprises leading intellectuals in the fields of health care, population resources and ecological protection.
It is one of eight non-communist parties in China that participate in state affairs under the leadership of the Communist Party of China (CPC).
Source: Global Times