Single parents eligible for medical certificates

Single parents in Central China's Hubei Province will be able to apply for medical certificates after the birth for their children from local healthcare authorities from next year, according to newly revised provincial guidelines on the issuance of certificates, the Wuhan Evening News reported.
The move means they no longer need a marriage certificate for the application.
The medical certificates of birth are a statutory document with details of the babies' age, relationships and nationality, and are required when applying for hukou, or household registration documents.
The provincial health and family planning commission and public security department jointly released the newly revised guidelines that will take effect from January 1.
In the cases of single parents, or babies born with assisted reproductive technology or no intact information on the father, the mother can make a written explanation with a signature, and that will be sufficient to apply for a birth certificate. Local health authorities will need to check the authenticity of the materials before issuing certifications, according to the new guidelines.
The new guidelines also regulate that the organs responsible for issuing the medical certificates of birth can not set preconditions such as the existence of marriage certificates and birth service certificates, and they are banned from receiving any fees for the certificates.

Read full article at: Global Times

Clinical research from China in the medical journals ...

In the Journal of Thoracic Diseases, Dr Xiao Kun and colleagues at the Department of Respiratory Medicine, PLA General Hospital, Beijing, evaluate prognostic indicators for  Community-acquired pneumonia in elderly patients. In their study of 240 patients they found that Pneumonia Severity Index scores were the best indicator in predicting different clinical outcomes of aged patients with CAP, when compared to testing for N-terminal pro B-type natriuretic peptide (proBNP) levels and three other scoring systems. They also found that systolic BP might be as a protective factor for prognosis of CAP.

Celecoxib may be an effective way of preventing the formation of joint adhesions, according to Shanghai researchers. In the journal Experimental and Therapeutic Medicine, 

orthopaedic surgeons from the Sixth Affiliated People's Hospital of Shanghai Jiaotong University report on an animal experiment in which they tested the inhibitory effects of celecoxib and ibuprofen given for 30 days on joint adhesions. Few adhesions were seen in the celecoxib treated animals, suggesting that the drug “may provide a novel and potent approach for their prevention,” they conclude.

In the same journal, cardiologists from the People's Hospital of Zhengzhou University, Henan report that Chinese patients with chronic heart failure have poor outcomes by international standards. Survival rates of 685 patients with chronic heart failure (HF) and reduced ejection fraction (HFrEF) were assessed during follow up of around 30 months.

 The fatality rate was 28%, with most due to pump failure 6% due to sudden deaths. The predictors of mortality were advanced age, BMI, NYHA functional class and lack of oral β-blockers at discharge.

“Patients with heart failure and reduced ejection fraction have poor prognoses in China, particularly those patients with an LVEF of ≤35%. Therefore, cardiologists should strive to improve the prognosis of HF among Chinese patients and focus on the importance of the practical application of HF diagnosis and treatment guidelines,” the researchers said.

In the European Spine Journal, bone specialists from Jinan Military General Hospital, Shandong, show that the most important risk factors for recurrent fractures after vertebroplasty are osteoporosis and treated level at the thoracolumbar junction. In a one year follow up study of 175 patients who underwent vertebroplasty for first-time and single-level osteoporotic vertebral fractures. They found that recurrent fractures developed in 37 (21%) of patients. Higher fracture rates were seen in pateints higher BMD T-score, and treated vertebrae located in the thoracolumbar junction.

Pharma company bribery of doctors: US vs China

Excerpt from an article by Prof  Zhang Weidong, Tianjin First Central Hospital, in the Journal of Thoracic Diseases:

In China, it takes a compulsory five years for a medical student to complete his/her undergraduate education, compared with only four years for other training programs for professionals in financing, marketing, or managerial posts. Thereafter, they find that the 5-year undergraduate training in medical sciences is not sufficient to provide a promising future for their career given the ever-developing medical technology and improving methodology in the medical community; nor would it even qualify them for an opportunity to get a job in a hospital, given the more than one million medical undergraduates nowadays surging out of university gates each year in China. To improve their chances they need to obtain an MD or PhD degree, spending six more years of their lives for the whole process, probably with their aged parents striving in the faraway countryside to earn the hefty tuition they have to pay.

Still, after these arduous years of examinations, probations and training, as well as the life-long learning in their careers, all their work does not translate into a reasonable income and acceptable social position in contrast with their friends with non-medical occupations. Few physicians in China can earn an income greater than $40,000 USD per year. Even salespersons who sell a popular brand of Chinese Dim Sum or tea-pickled eggs can be much richer than you. One may loudly declare that they think nothing of this disparity, always being proud of themselves as an erudite scholar and physician, but when it comes to the travel expense and registration fee for international or domestic meetings, most physicians can’t afford such expenses out of their own pocket and the offer from Pharma who are “honored to sponsor” them is very attractive. What follows? It is an established conception among Chinese people that one has to do “something” for “something” you receive—you know it.

In an extreme case unraveled recently in China, Pharma representatives were found to stay in the physicians’ office, sitting unscrupulously beside the physicians as the latter interviewed and examined their patients and served as the latter’s “assistant” who “helped” by typing electronic prescriptions. Very likely, this role made their sales assignment easier and probably succeeded in obtaining a large bonus from their company for over-fulfillment. For allowing the representative to be their “assistant” the physicians received some benefit.

Chinese experts call for more focus on tobacco control

As health is the people's top priority, the Chinese government should do more to control tobacco, experts say.

At a three-day seminar on tobacco control that ended on Thursday in Beijing, Hu Angang, director of the Research Center for Contemporary China at Tsinghua University, said tobacco is the biggest killer in China, and it is not just a public health issue, but involves the sustainable development of the whole nation.

While the government works on economic renewal, transformation of tobacco industry must be addressed and the tobacco supply reduced, Hu said.

China is the world's largest cigarette producer and consumer. The number of smokers exceeds 300 million, with at least 740 million nonsmokers regularly exposed to secondhand smoke.

Zhi Xiuyi, head of the Lung Cancer Diagnosis and Treatment Center of the Capital Medical University, said the top four killers in China, namely cardiovascular disorders, malignant tumors, respiratory disorders and heart disease, are all related to tobacco.

In 2003, China signed the WHO Framework Convention on Tobacco Control (FCTC) and it became effective in January 2006. The FCTC requires a reduction in tobacco supply as well as consumption. The 12th Five-Year plan (2011-2015) promised to ban smoking in public places.

Experts are widely critical of the current government effort, describing it as lagging far behind the FCTC standard, and no national law is yet in place banning smoking in indoor public places.

Wang Qingbin, associate professor with the China University of Political Science and Law, believes that although local rules were established in 2007 in Shanghai, Guangzhou, Harbin, and other cities,enforcement has been far from satisfactory.

"There are no clear punishment clauses in most of the regulations, and even in cities with punitive stipulations, only a few fines were issued. The responsible departments simply turn a blind eye because they don't have enough money to hire special staff," he said.

Last December, the Ministry of Industry and Information Technology (MIIT), the Ministry of Health and six other government departments  released the China Tobacco Control Program (2012-2015), to reduce tobacco use and reduce tobacco planting. The program is the first at state level  on tobacco control, and marked a new phase for comprehensive tobacco control.

Angela Pratt, a technical officer with the Tobacco Free Initiative of the WHO Representative Office in China, called for more government effort on banning tobacco advertising, graphic warnings on cigarette packs, and raising taxes.

"These measures are included in the FCTC, have proved effective in other countries and helped saved millions of lives," she said.

Source: China Daily

Shanghai courts finds lax supervision allows methadone diversion

A Shanghai court has sentenced a drug addict to seven years in prison for selling the methadone he received in a public drug treatment program to other addicts.
The case was one of 19 that the district court dealt with from July to September that involved addicts reselling their drug treatment medication, according to a court press release.
There are about 14 community hospitals in the city, including one in Huangpu district, that treat drug addicts with methadone, said Tang Zhengming, a press officer for the Huangpu District People's Court.
The defendant, surnamed Chen, 35, was charged with drug trafficking for selling the methadone, which is a synthetic opioid used to ease the withdrawal symptoms of patients recovering from an addiction to drugs such as heroin, according to the press release.
Police arrested Chen on June 16 after he tried to sell 313.56 grams of methadone to a drug addict for 300 yuan ($49).
The court blamed the methadone trafficking problem on lax supervision by the doctors who prescribe and administer the drug.
It advised treatment facilities to assign at least two doctors to supervise patients while they are taking the drug. It also advised doctors to do a better job prescribing an appropriate amount of methadone to their patients. 

Source: Global Times

Xinjiang study links oesophageal cancer to fibre intake

People in China's north-west have been the focus of research which investigated risk factors for oesophageal cancer. 
The research  found high dietary fibre intake can help reduce the incidence of oesophageal cancer, which has a low survival rate.

Shihezi University conducted the hospital based case-control study in remote north-west China (Xinjiang region), where the rates of oesophageal cancer are far greater than anywhere else in the world.

Oesophageal cancer is the sixth leading cause of cancer-related deaths worldwide.

The Chinese participants included 359 oesophageal cancer sufferers and 380 healthy controls. Participants were both male and female; and they came from the same area and were of similar age (average age 61 years).

With the information discovered the researchers advise that new dietary guidelines for China include a recommendation to increase fibre intake to prevent oesophageal  cancer.

Source: Medical Xpress

Anhui doctor suspended after baby incorrectly pronounced dead

The doctor who incorrectly pronounced a baby boy as dead, resulting in the baby almost being put into an incinerator, has been suspended, as have her medical qualifications, Anhui health authorities said Thursday.

The provincial department of public health said they had instructed the Anhui Provincial Children's Hospital in Hefei, to set up an expert panel to save the baby, who was born with congenital health conditions 18 days before being transferred to the hospital, and handle the accident in a serious manner and give administrative punishments to the people responsible for the accident, according to the notice released on its official website.
Jin Yulian, the president of the hospital, said that the attending doctor has been suspended and the nurse who sent the baby to the funeral parlor has been dismissed.
The hospital released an initial investigation report late Thursday saying that the baby was showing no vital signs, and the dereliction of duty of the doctors and nurses on the scene led to the death certificate being issued and the baby being sent to the funeral parlor, the Xinhua News Agency reported.
The report said that because the boy's congenital diseases are hard to cure, the hospital has invited top medical experts across the country to participate in his medical treatment.
 The baby now shows weak vital signs, and could die at any time, according to an announcement by the hospital in a news conference Wednesday morning.
Just 18 days after he was born, the baby was transferred to the children's hospital on October 28 by his parents, both in their 20s.
He was diagnosed with bilateral congenital choanal atresia, a congenital disorder where the back of the nasal passage is blocked, the attending doctor for the baby surnamed Zha was quoted as saying by people.com.cn.
The baby's condition was difficult to remedy, and he must breathe using his mouth, said the vice president of the hospital surnamed Sun.
With slim hope of remedying the congenital disorder, the parents signed an agreement to give up treatment. They left their child in the hospital and left Hefei on November 12.
As the hospital continued with the treatment, the baby's condition worsened Monday.
"His skin is green and purple and he has no breath and heartbeat," said Zha, who declared the baby dead.
However, the boy was found to be alive by a staff member of the funeral parlor surnamed Liu after he was sent for cremation on Wednesday. Liu said that the baby's eyes were wide open, he had weak breath and he waved his left hand over his head, reported the Hefei-based Xin'an Evening News.  
After the parents, who were working in Jiangsu Province, were informed of the issue on Wednesday, the couple told the hospital that they agreed the baby should be handled according to the agreement.
The hospital has received and treated 39 abandoned babies so far this year, which has cost over 900,000 yuan ($147,690), Jin said.
It is a grim reality that more and more new babies with diseases are being abandoned by their parents, causing a burden for hospitals, Deng Liqiang, director of the legal department at the Chinese Medical Doctor Association, told the Global Times on Thursday, adding that this does not mean they should shirk the responsibility and that they should turn to civil affairs bureaus for help.

Source: Global Times

Shanghai medical student used liver toxin to kill room-mate

A medical student of  Fudan University who is accused of poisoning his roommate to death in April will stand trial next week.

Lin Senhao reportedly held some grudge against his roommate, Huang Yang, over trivial matters. Huang, 27, a postgraduate student of Fudan University Medical School, died after drinking water that was laced with N-Nitrosodimethylamine, an organic chemical highly toxic to the liver. He was diagnosed with liver failure and died of poisoning on April 16.

The chemical is often used to induce liver disease in rats in cancer experiments in laboratories.

After being arrested, Lin admitted poisoning his roommate.

Lin told police that he stole the chemical from the university and injected it into the dispenser on March 31.

Source: Shanghai Daily

Curbing antibiotic overuse in China will need major reforms - researchers

by Michael Woodhead

China’s new get-tough approach to overuse of antibiotics is having some impact, but there are still huge obstacles  to reversing the tide of antibiotic resistance, researchers from Zhejiang say.

Rates of antibiotic prescribing in hospitals have declined slightly since mandatory curbs and punishments were introduced in 2009, according to a new analysis by Dr Xiao Yonghong and colleagues at the Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou.

In a review published in PLOS Medicine, Dr Xiao says antibiotic overuse will continue to be a major problem for China unless further restrictions are introduced on hospitals profiting from antibiotic sales, OTC sales of antibiotics and the use of antibiotics in animal feeds.

The analysis notes that misuse of antibiotics in China has led to high rates of antibiotic resistance. The prevalence of superbugs such as MRSA ranges from 50% to over 71%, the researchers note. This is not surprising given that hospitals derive much of their profits for the sales of medications, of which antibiotics are the most commonly prescribed.

Initial reforms to promote better antibiotic stewardship introduced in 2006 have not been successful because they were voluntary and not complied with, the review found. However, stricter mandatory measures introduced since 2009 have begun to show effect on antibiotic use, figures show.

Hospitals were compelled to draw up antibiotic management strategies and set targets with audits. In some cases, hospital managers were dismissed and clinicians had their prescribing rights withdrawn for failing to address the problem of antibiotic overuse.

After these reforms were implemented,  the percentage of prescriptions for antimicrobials decreased from 68% to 58% for inpatients and from 25% to 15% for outpatients.

This is a significant downturn, says Dr Xiao, but a number of issues still need to be addressed to ensure further improvements in antibiotic use.

Overuse of antibiotics continues through OTC sales and in animal feed, but regulation of these areas is hampered because authority is divided between the State Food and Drug Administration, the Ministry of Agriculture and the ministry of Health.  There is also a need for education of clinicians and the public on the need for antibiotic stewardship, says Dr Xiao.

“Finally, and critically, the government should widen the healthcare reforms and provide financial guarantees to medical institutions to ensure that economic incentives from drug sales are eliminated. This will return healthcare institutions to a not-for-profit status and aid professional standards,” the researchers conclude.

Read the full article at: PLOS Medicine

China turns to antidepressants as awareness spreads

By Jonathan Kaiman

Zhang Jin's breakdown began with insomnia, and quickly spiralled into loss of appetite, inability to focus, and long mornings spent sitting weeping on the edge of his bed. So in March 2012, the 40-year-old deputy editor of Caixin, a prestigious Chinese magazine, went to Beijing's Anding hospital, the country's top mental health facility, for treatment.

Zhang's months-long battle with depression took him through three failed antidepressant prescriptions and two doctors – he ditched the first after he recommended electroshock therapy. At one point, he grappled with thoughts of suicide. But eventually, things began to improve. He mustered up the energy to check his text messages; he rediscovered his appetite. Now he's back at work, taking a delicate combination of six antidepressants. It's not a perfect arrangement, but it reduces the risk that he'll relapse.

"In the past, nobody [in China] knew what to do about depression," said Zhang, who recorded his experience in a blogpost. "And now, people might not know what to do immediately, but there are so many more channels for them to learn – friends, the internet. More and more people need antidepressants, and more and more people know what they are."

Read full article at The Guardian

Baby wakes in crematorium after being certified dead at Anhui hospital

A Chinese baby that had been declared dead by a hospital was saved from cremation when it started crying at a funeral parlor in East China's Anhui province on Wednesday morning.

The baby boy, less than one month old, was sent back immediately to the Anhui Provincial Children's Hospital for emergency treatment after he was found alive by a staff from the funeral parlor in Hefei, the provincial capital.

The Anhui Provincial Children's Hospital had issued a death certificate for the boy. He would have been cremated under normal procedures, according to the Hefei Municipal Funeral Parlor.

The baby had suffered from congenital respiratory system malformation since birth and was critically ill. His parents agreed on November 12 to give up his medical treatment, according to a staff member from the hospital.

"Because the baby still had life signs, we continued to give him transfusion to maintain his life for humanitarian reasons," said the staff member on condition of anonymity.

The reasons for the baby being mistakenly confirmed dead need further scrutiny, according to the staff member.

The baby boy is still receiving emergency treatment at the hospital.

A doctor and a nursing worker who were on duty on Wednesday and judged responsible for the accident have been suspended from work and laid off respectively, according to the hospital.

It is investigating the case and said it will release the results to the public in time.

Source: China Daily

Urgent action needed on HIV in Heilongjiang

by Michael Woodhead

A HIV epidemic in Heilongjiang has shown explosive growth since 2009 and homosexual contact has become the dominant route of HIV transmission, research shows.

Dr Shao Bin and co-researchers at the Public Health College of Harbin Medical University says action is urgently needed to curb the HIV outbreak in the northeast.

Analysing data from the provincial surveillance system for HIV infections, they found there had been 3062 HIV-infections in the area up to 2012, with 426 deaths. Since 2007, homosexual transmission has increased and become the dominant route of HIV transmission, accounting for 58% of cases during 2009–2010, and 69% during 2011–2012.

Gay men with HIV infections tended to be younger (21–30), unmarried, urban residents and have college or higher education.

“The current existing prevention strategy is not enough to prevent new infections. … Urgent intervention is needed to recognize and target this population, ,” the researchers said

Full study: Journal of Infection

Psychiatric hospital sued for detaining healthy woman

Huilongguan Hospital in Beijing was sued by a female engineer named Chen Dan for 200,000 yuan ($32,820) for infringement of liberty.

Chen had been taken to the mental hospital by her parents against her will. After spending three days in the inpatient wards, she was pronounced to be not ill. Chen said the hospital violated her rights by failing to conduct any psychiatric exam or diagnosis before admitting her.

The hospital has countersued Chen Dan for 200,000 yuan for damaging its public image. They argued that Chen's parents were responsible for checking her into the hospital, and that they had provided effective medical treatment. Because Chen has refused to accept mediation, the case is still pending.

Source: East China News Service

Tsinghua develops cancer biomarker

Tsinghua University researchers announced on Sunday they had developed a method to measure the concentration of a cell protein that enables the detection of cancer with only a drop of blood.
The amount of the cell protein in a cancer patient exceeds that in a healthy body, they said.
Luo Yongzhang and his team at Tsinghua University identified heat shock protein 90 alpha (Hsp90 alpha for short) - an essential and ubiquitous protein in various cell types - as a "novel tumor biomarker." The team has also developed a quantitative detection kit for clinical use.
"Levels of tumor biomarkers increase in accordance with cancer progression. It has become a useful approach for disease monitoring and efficient evaluation," Luo said.
Clinical trials showed the protein to be a useful tumor biomarker for lung cancer. More clinical trials for six different cancers, including liver cancer, breast cancer and colorectal cancer, have already started, Fu said.
"Very few of the known tumor biomarkers are specific for only one type of cancer, and there may not be any. As for Hsp90 alpha, it is sensitive to many cancers in theory, but we need to carry out more studies to find out."

In 2011, the US National Cancer Institute listed 31 tumor biomarkers for tumor diagnosis worldwide. All were defined by scientists outside China. The protein is the first to be discovered by Chinese.
The validation of Hsp90 alpha was based on a series of scientific studies conducted by Luo's team since 2009.
In 2009, Luo and his colleagues reported the regulatory mechanism of the secretion of the protein by tumor cells, and revealed for the first time the molecular difference between its intracellular and extracellular versions of the protein.
They also found that the plasma level of the secreted protein in cancer patients is significantly higher than it is in healthy people, which showed the great potential that the protein has as a tumor biomarker.
Later, Luo and his team collaborated with biotech company Protgen Ltd to develop the Quantitative Detection Kit for Hsp90 alpha.
With the kit, only 10 microliters of plasma is needed to detect the level of Hsp90 alpha for disease monitoring and therapeutic evaluation.
"This is a much more convenient and cheaper method compared with other traditional means of tumor detection; for example, computed tomography," Luo said.
The kit was used in clinical trials in 2,347 cases in eight hospitals in China.
In April, this kit was approved by the China Food and Drug Administration.

"Usually, doctors use multiple biomarkers to decide a patient's condition, because individual differences may impair their judgment. So the discovery of this new biomarker, Hsp90 alpha, offers a new option for doctors and patients," said Fu Yan, a research staff member of Luo's team.

Source: Peoples Daily

Tianjin prison caters for people with infectious diseases

Xi Meng says he has received two death sentences - one from the court, one from HIV.

The 37-year-old was convicted of homicide in 1998. Seven years into his sentence, he was diagnosed as being HIV positive and moved to Jin Zhong Prison, a facility for inmates with infectious diseases.

"It was hard at first. It felt like my life was shorter than my sentence," said Xi, who is serving a suspended death sentence, which means in 2005 he was facing another decade in prison.

"It was hard to see other prisoners look down on me," he said.

Yet since then, Xi says, medicine and the specialized care he has received at Jin Zhong Prison have been keeping him alive.

The prison, which is under Beijing jurisdiction but is in neighboring Tianjin, was built in 1998 to hold inmates with tuberculosis or hepatitis. A wing for prisoners with HIV and AIDS was added in 2008.

"This is different from other prisons," deputy warden Cao Lihua said. "Medical treatment is the priority and core purpose of Jin Zhong."

He said the prison also understands the importance of music and art in treating its more than 1,500 inmates.

More than 280 inmates, including 22 who are classified HIV positive, are serving their sentences in an environment where treatment, both medical and emotional, comes first.

"If convicts get an infectious disease in another prison, they are sent here. If they are cured here, they can return," Cao said.

Inmates can access consultations with doctors from major downtown hospitals, and any whose condition is deteriorating can get treatment in specialist departments, he said.

Read full article at: China Daily

Low-cost drug list to change pharma in China

by Eric Mu

The Economic Information Daily, a business newspaper published by Xinhua News Agency ran a story on November 17 reporting that the National Development and Reform Commission (NDRC) may soon release a list of drugs that must be sold at low prices in China with the aim of reducing the financial burden of medical care on citizens and hospitals. 

The list may have a significant impact on the pharmaceutical industry: some out-of-production low-cost drugs will be protected and return to the market, while the makers of high cost drugs on the list will have their profit margins squeezed. The article also predicts that the pharmaceutical industry may soon see another round of mergers and acquisitions.

“Low-cost drugs” refers to the cheaper of the drug options used to treat a particular medical condition. The article quotes an informed source as saying that NDRC is expected to set the standard for low-cost drugs at a daily average cost of three yuan for western drugs.

Read more at Danwei

Researcher rejects “air pollution causes black lung" story as urban myth

by Michael Woodhead

Health experts have dismissed online rumours that the recent spate of air pollution in China may cause lungs to turn irreversibly black within six days.

The claims have been made on microblogging sites and state that a Fudan University study in animals had shown that exposure to a week of high levels of small PM2.5 particles could turn the lungs black. The story was said to originate from a study by  Fudan University Professor Song Weimin .The story also claims that the black lung changes are irreversible without expensive and time-consuming medical treatment

According to the claims, which were forwarded by thousands of microblog site users, the academic study in rats found that the irreversible ‘black lung’ syndrome was mediated by release of inflammatory cytokines.

However, Fudan University School of Public Health Professor Song Weimin told news reporters that he had never done any rat inhalation experiments leading to black lung.

He said his study had actually collected PM2.5 on a filter and then these had been applied artificially to rat lungs in vitro.

He said the test conditions represented PM2.5 concentrations that were thousands of times higher than those experienced in the real world. He said his study did not show that the particle turned lung tissue black, nor were the changes seen irreversible.

"The argument that ‘haze for six days turn fresh lung black’ is not correct,” he said.

Source: China Medical Tribune

Statins may replace surgery for chronic subdural haematoma

by Michael Woodhead

Doctors in Tianjin have shown that atorvastatin may be an alternative to surgery for patients with chronic subdural haematoma.

In a study involving 23 patients with chronic subdural haematoma they showed that statin treatment improved symptoms and reduced haematoma volume.

The patients were treated with oral atorvastatin 20 mg/day for one to six months, and haematoma was completely resolved in 77% of patients and showed major shrinkage in the other pateints within three months of starting treatment.

After six months, 18 patients showed no haematoma by CT or MRI scan and none of the 22 patients relapsed during the follow-up period of up to 36 months. All patients had improved symptoms scored.

Dr Wang Dong and colleagues from the Department of Neurosurgery at Tianjin Medical University said chronic subdural haematoma  was common and more prevalent in the aged population.

They noted that surgical intervention was the treatment of choice, but its outcomes may not be satisfactory because of recurrence and physical infirmity associated with aging.

They said aberrant angiogenesis and localised inflammation contribute to the formation of chronic subdural haematoma, and atorvastatin had significant effects on  angiogenesis and inflammation.

“Results of this preliminary prospective study show that the oral administration of atorvastatin is safe and effective in treating chronic subdural haematoma, offering a cost–effective alternative to surgery,” they concluded.

Read the full study at Journal of the Neurological Sciences

China promotes medical tourism

The Chinese government is making efforts to promote the country as a world-class medical tourism destination in its own right.  A big-time push is underway to grasp a share of the lucrative and growing healthcare travel market, one in which six million patients go abroad for treatment each year to the tune of an estimated $100 billion USD.  In 2013, a huge portion of these travelers are heading to Asian medical tourism hot spots like Singapore, Malaysia, and Thailand, China is now selling patients all over the world on the country’s modern hospitals and technology, English-speaking doctors and surgeons, and excellence in both common and cutting-edge procedures that are popular with medical tourists like infertility treatments, stem-cell therapy, traditional Chinese medicine (TCM), and gamma knife radiosurgery for brain cancer, to name a few.

Major Chinese cities like Shanghai and Beijing – with their top-notch facilities and oftentimes Western-trained doctors – have taken serious steps towards becoming legitimate destinations in the competitive medical tourism marketplace.  The former, in fact, established the Shanghai Medical Tourism Products and Promotion Platform (SHMTPPP) which is an official government-supported medical tourism portal.  It is tasked with promoting China as a leading destination for advanced healthcare, and its website provides a wealth of information pertaining to China’s top hospitals, the most popular procedures with overseas patients, and costs.

Read more at Thailand Business News

Salt reduction success in northern China

People in rural northern China reduced their salt intake after participating in a community-based sodium reduction program and having access to salt substitutes, researchers reported in a late-breaking clinical trial at the American Heart Association's Scientific Sessions 2013.  
"We identified a low-cost, practical intervention that was effective in reducing sodium intake," said Nicole Li, Ph.D., study author and research fellow at The George Institute for Global Health in Sydney, Australia. "The WHO and other groups have identified population-based approaches to salt reduction as among the most cost-effective possible strategies for vascular disease prevention in both developed and developing countries."

Researchers with the China Rural Health Initiative - Sodium Reduction Study assessed 120 villages in which the average sodium consumption is 4.7 to 5.9 grams per day—far more than the World Health Organization's recommended 2 grams per day maximum. Americans eat an average of 3.4 grams per day.

Sixty villages receive no intervention and continued with their usual practices.

Citizens of the remaining villages received community health education advising lower sodium intake, with special messages for residents at high risk of heart disease. In addition, a potassium-containing, reduced sodium salt substitute was promoted through a health education program and in village convenience stores. These 60 villages were further divided at random with 30 receiving a price subsidy for the salt substitute, and 30 getting the substitute at full price, which is about twice that of regular salt.

After 18 months, researchers examined 24-hour urine samples of 20 people from each village for sodium and potassium intake.

Those in villages who received the intervention reduced daily sodium intake by 13 mmol (millimoles) compared with non-intervention villages. Seventeen mmol equals about 1 gram of salt.

The intervention also decreased daily sodium by 17 mmol in villages with price-subsidized salt substitutes, increased daily potassium intake by 7 mmol on average across all villages with the intervention and increased daily potassium intake by 9 mmol in villages with price-subsidized salt substitutes.

"The study findings could be applied in similar settings around the world in which salt added during food preparation at home comprises a significant proportion of daily sodium intake," Li said.

The researchers are conducting a larger, five-year study in the same region to determine whether this sodium-reduction intervention impacts incidence of high BP and stroke.

The American Heart Association recommends a diet with less than 1,500 mg (1.5 g) of sodium per day to reduce the risk of cardiovascular diseases. 

Source: Medical Express

Full study: American Heart Journal