Prospects for translational regenerative medicine

Translational medicine is an evolutional concept that encompasses the rapid translation of basic research for use in clinical disease diagnosis, prevention and treatment. It follows the idea "from bench to bedside and back", and hence relies on cooperation between laboratory research and clinical care. In the past decade, translational medicine has received unprecedented attention from scientists and clinicians and its fundamental principles have penetrated throughout biomedicine, offering a sign post that guides modern medical research toward a patient-centered focus. Translational regenerative medicine is still in its infancy, and significant basic research investment has not yet achieved satisfactory clinical outcomes for patients. In particular, there are many challenges associated with the use of cell- and tissue-based products for clinical therapies. This review summarizes the transformation and global progress in translational medicine over the past decade. The current obstacles and opportunities in translational regenerative medicine are outlined in the context of stem cell therapy and tissue engineering for the safe and effective regeneration of functional tissue. This review highlights the requirement for multi-disciplinary and inter-disciplinary cooperation to ensure the development of the best possible regenerative therapies within the shortest timeframe possible for the greatest patient benefit.     

温度和光周期对水稻抽穗期调控的交互作用

光周期和温度是植物开花的2个关键的调控因素,植物成花转变决定于植物对光周期和温度变化的精确测量.作为短日照植物,水稻在长日低温条件下抽穗期推迟,为了阐明温度和光周期对水稻开花时间的调控效应,本文利用1个光周期不敏感的突变体及其野生型,系统地分析了不同温度和光周期处理条件下,调控水稻开花时间几个关键基因（Hd3a,RFT1,Ehd1,Ghd7,RID1/Ehd2/OsId1,Se5）的表达调控模式,结果表明Ehd1-Hd3a/RFT1通路在光周期和温度调控水稻开花途径中保守.Ehd1,Hd3a和RFT1的表达在低温（23℃）条件下急剧下降,表明Ehd1,Hd3a和RFT1表达阻抑是低温条件下水稻开花推迟的主要原因.另外,在长日照条件下,低温（23℃）处理促进了水稻开花抑制子Ghd7的表达,表明低温条件和长日照条件对Ghd7的表达具有协同作用.此外,本文还分析了Hd1与光周期开花调控途径中几个关键基因的调控关系,发现Hd1在长日照条件下负向调控Ehd1的表达而正向调控Ghd7的表达,表明在长日照条件下,Hd1-Ghd7-Ehd1-RFT1通路也是水稻抽穗期调控的一条重要途径.     

Global challenges in stem cell research and the many roads ahead

The field of stem cell research has grown to include a vibrant international community of scientists and clinicians who come from both academia and industry and who strive to shed light on the biology of these remarkable cells and find applications in drug discovery, disease modeling, and regenerative medicine.     

Clinicians’ views and expectations of human microbiome science on asthma and its translations

Human microbiome science examines the microbiota that live in and on the human body and their role in human health. This paper examines clinicians’ views and expectations of microbiome science in asthma care. Drawing on qualitative interviews with 10 clinicians in Canada, we explore their perspectives for insights into translation of human microbiome science. The emphasis on novelty in much microbiome scholarship, we suggest, does not account fully for the ways in which microbiome science translations may be taken up in multiple ways that are both disruptive to and continuous with contemporary biomedicine. We suggest that clinicians drew on scientific discourses of “evidence” and “facts” as a form of boundary work to re-establish a separation between western biomedicine and alternative health practitioners, and clinical expertise and lay knowledge. We conclude with a discussion of human microbiome science and the emergence of post-Pasteurian modes of health in western biomedicine.     

“It just becomes much more complicated”: Genetic counselors' views on genetics and prenatal testing

Many social scientists and commentators have expressed concerns about the acceleration of genetic medicine and testing in the last few decades. While there is a growing body of work on how patients and the lay public view the potential of genetic medicine, there remains relatively little social science research on the personal and professional views of master's-trained genetic counselors, a growing profession of clinicians who are often the key medical actors translating increasingly complex genetic information to patients. This study begins to fill in this lacuna by examining the perspectives of 26 genetic counselors in the USA on some of the central bioethical concerns raised by genetic testing, with a particular focus on prenatal testing. The study finds that while there is general enthusiasm for genetic medicine, and prenatal testing in particular, genetic counselors also have reflexive ambivalence, expressing both skepticism and concern about the usefulness and consequences of acquiring genetic information.     

The aging of biomedical research in the United States

In the past 30 years, the average age of biomedical researchers has steadily increased. The average age of an investigator at the National Institutes of Health (NIH) rose from 39 to 51 between 1980 and 2008. The aging of the biomedical workforce was even more apparent when looking at first-time NIH grantees. The average age of a new investigator was 42 in 2008, compared to 36 in 1980. To determine if the rising barriers at NIH for entry in biomedical research might impact innovative ideas and research, we analyzed the research and publications of Nobel Prize winners from 1980 to 2010 to assess the age at which their pioneering research occurred. We established that in the 30-year period, 96 scientists won the Nobel Prize in medicine or chemistry for work related to biomedicine, and that their groundbreaking research was conducted at an average age of 41-one year younger than the average age of a new investigator at NIH. Furthermore, 78% of the Nobel Prize winners conducted their research before the age of 51, the average age of an NIH principal investigator. This suggested that limited access to NIH might inhibit research potential and novel projects, and could impact biomedicine and the next generation scientists in the United States.     

Reflexivity and countertransference in a psychiatric cultural consultation clinic

A Mexican-American woman who complained of persistent head pain and a bothersome voice was seen by a team consisting of a psychiatrist, social scientists, and spiritualist healers in a Cultural Consultation Clinic of a Psychiatric Consultation Liaison Service. This single case is analyzed to provide an understanding of the interpretive dimensions of psychiatric practice. It is argued that a hermeneutic analysis of clinical phenomena focuses attention on three distinct aspects of interpretation: on the interpretation by clinicians and clients of the discourse of the other in terms of their own clinical models; on the influence of deeply embedded personal meanings on this interpretive process; and on the role of the observer in clinical ethnography. It is argued that to sustain a hermeneutic analysis of psychiatric practice, an account of transference and countertransference in terms of interpretation theory will have to be developed.     

Reflections on humanizing biomedicine

Although biomedicine is responsible for the "miracles" of modern medicine, paradoxically it has also led to a quality-of-care crisis in which many patients feel disenfranchised from the health-care industry. To address this crisis, several medical commentators make an appeal for humanizing biomedicine, which has led to shifts in the philosophical boundaries of medical knowledge and practice. In this paper, the metaphysical, epistemological, and ethical boundaries of biomedicine and its humanized versions are investigated and compared to one another. Biomedicine is founded on a metaphysical position of mechanistic monism, an epistemology of objective knowing, and an ethic of emotionally detached concern. In humanizing modern medicine, these boundaries are often shifted to a metaphysical position of dualism/holism, an epistemology of subject knowing, and an ethic of empathic care. In a concluding section, the question is discussed whether these shifts in the philosophical boundaries are adequate to resolve the quality-of-care crisis.     

Evolving concepts of human state dissociation

The concept of state dissociation in humans was made possible only by applying information obtained from basic science animal research studies to the human condition--without which these often dramatic, and treatable conditions would have remained in the mystical, supra-natural, or psychiatric arenas, without appropriate or effective treatment options. Sleep or wakefulness occurring asynchronously in bits and pieces of the brain is a most useful concept. From our standpoint, the basic science work in the function and mechanism of sleep is pertinent, not only adding to our knowledge in these important areas for the sake of knowledge, but also in providing clinicians with important information that is of immense clinical importance. The payoff of such research has been great, and demands that it should be ongoing. The field of sleep research and sleep medicine is in a unique position to foster close interactions between basic scientists and clinicians, the result being basic science answers to clinical questions, and unanswered clinical questions guiding the direction of and reinforcing the basic science research. The clinical conditions discussed above underscore the value of close cooperation among those working at all levels: molecular, cellular, multi-cellular, and clinical. Continued study of state dissociation by both basic scientists and clinicians will undoubtedly identify and explain even more of these fascinating conditions, with important therapeutic implications. The reciprocal benefits of close collaboration between basic scientists and clinicians will continue to be realized.     

The use of zootherapeutics in folk veterinary medicine in the district of Cubati, Paraíba State, Brazil

Background

Viewed through the micro focus of an interpretive lens, medical anthropology remains mystified because interpretivist explanations seriously downplay the given context in which individual health seeking-behaviours occur. This paper draws upon both the interpretivist and political economy perspectives to reflect on the ethno medical practices within the Korean-Australian community in Sydney.

Methods

We draw on research data collected between 1995 and 1997 for an earlier study of the use of biomedical and traditional medicine by Korean-Australians in Sydney. A total of 120 interviews were conducted with a range of participants, including biomedical doctors, traditional health professionals, Korean community leaders and Korean migrants representing a range of socio-economic backgrounds and migration patterns.

Results and Discussion

First, the paper highlights the extent to which the social location of migrants in a host society alters or restructures their initial cultural practices they bring with them. Second, taking hanbang medicine in the Korean-Australian community as an illustrative case, the paper explores the transformation of the dominant biomedicine in Australia as a result of the influx of ethnomedicine in the era of global capitalism and global movement.

Conclusion

In seeking to explain the popularity and supply of alternative health care, it is important to go beyond the culture of each kind of health care itself and to take into consideration the changes occurring at societal, national and global levels as well as consequential individual response to the changes. New social conditions influence the choice of health care methods, including herbal/alternative medicine, health foods and what are often called New Age therapies.     

Medicen Paris Région: A world-class 'competitiveness cluster' in the Paris region incorporating a neuroscience 'subcluster'

The French public-private partnerships known as "competitive clusters" [p?les de compétitivité (PdC)] are intended to be novel and ambitious engines of regional growth, employment and biomedical innovation. Partly funded by government and local councils, they aim to capitalize on regional expertise by bringing together basic scientists, clinicians, innovative entrepreneurs and local decision-makers around specific themes that have become too costly and complex for any of these actors to tackle alone. Clusters provide the critical mass required both to underpin innovation potential and to authenticate regional claims to international competitiveness. Medicen is a biomedicine and therapeutics cluster comprising 120 partners from four broad "colleges" in the greater Paris region: major industry, small and medium-sized businesses, teaching hospitals/State research bodies, and local councils. Chief among its cooperative R&D projects is the neuroscience subcluster, in which "TransAl" the neurodegenerative disease project, counts Sanofi-Aventis, Servier and the French Atomic Energy Commission [Commissariat à l'Energie Atomique (CEA)] as key partners. One main aim is to develop an experimental model in rhesus monkeys in which a putative cause of Alzheimer's disease, intracerebral accumulation of b-amyloid peptide, is generated by impairing the peptide's clearance. The other aim, in which the nuclear medicine expertise of the CEA will be crucial, is to identify, characterize and validate markers for magnetic resonance and positron emission tomography imaging, and to source biomarkers from cerebrospinal fluid proteomics. A human biological resource centre (DNA and tissue banks) project dedicated to neurological and psychiatric disease should be up and running in 2007. Only through fundamental restructuring of resources on such a large cooperative scale are solutions likely to be found to the major problems of modern medicine, bringing healthcare and regional socioeconomic benefits in its wake.     

Perspectives On Tuberculosis Among Traditional Chinese Medical Practitioners In New York City’s Chinatown

This article discusses the perspectives of Chinatown’s traditional Chinese medical practitioners on tuberculosis among New York City’s Chinese laborers. The practice of traditional Chinese medicine (TCM) in the United States is neither regulated nor well understood. Some public health providers have expressed their concern that the use of TCM could prevent Chinese tuberculosis patients from receiving proper, biomedical treatment. Contrary to the suspicion of public health providers, the traditional Chinese medical practitioners in the context of New York City’s Chinatown provide diverse methods of health care, many being familiar with the biomedical explanation for tuberculosis. All TCM informants in this study stated that biomedicine is more effective than Chinese medicine in treating tuberculosis. TCM in tuberculosis therapy is said to complement biomedicine and to restore bodily balance and the general health of patients. This study discusses the political–economic context shaping the explanation and treatment of tuberculosis among traditional Chinese medical practitioners and broadens our understanding of the various contexts in which TCM and biomedicine can be integrated. Furthermore, it is suggested that an opportunity exists for tuberculosis control programs to incorporate TCM practitioners in the effort to control the disease within New York City.     

中药现代化的理论和方法研究

中药现代化的任务是对当代药物学家的挑战.中药现代化的目标、方法尚无统一的认识.吴凤锷在1989年就提出了中药现代化的方法.随着时间的推移,这一设想已被一些药物学家所认可,并开始了这方面的研究工作.通过多年的思索,对中药现代化的理论依据进行了研究,认为:(1)中药疗效是针对生药而言,即针对多种成分的结合疗效.(2)中药的多种成分特别适合于老年性多种慢性并发症的治疗.(3)中药的安全性是由于多成分、所含各成分相对剂量低的原因.(4)中药的个体针对性强,同病异治,或异病同治.(5)中药服用后进入人体的代谢过程不同于西药,对消化道中菌群产生影响,从而影响人体的生理功能.(6)中药既含有蛋白质、微量元素等功能性营养成分,又含有生物碱、黄酮等药物成分,本质上处于西药与食品之间.由于传统中药有以上特点,故中药的现代化必须保持这些特点.最好的方法就是作者所提出的用单方成药代替生药的方法.从现状看,这一方法既有理论依据,在技术上又是可行的.符合中医的传统理论及中草药的特点.     

干细胞治疗周围神经损伤研究进展

周围神经损伤是临床常见的疾病。损伤后神经的修复和再生是复杂又漫长的过程。严重的神经损伤其预后效果并不令人满意,相应支配区域的功能难以恢复,这给患者及家人带来了极大的痛苦。因此如何更好的对周围神经损伤进行治疗一直是医学界的难题。在神经修复机制的研究中,科学家发现施万细胞对周围神经的修复和再生起到了非常重要的作用,但获取和扩增的困难限制了其临床的应用。随着生物医学的发展,人们把目光投向了干细胞,经实验发现干细胞不仅具有旺盛的增殖能力,而且可以分化为神经系细胞,还能分泌相关的神经营养因子促进神经的修复和再生,这为周围神经损伤后的治疗带来了新的希望。本文就近些年来应用于修复周围神经的干细胞及促进修复机制的研究做以综述。     

The emergence of integrative medicine in Australia: the growing interest of biomedicine and nursing in complementary medicine in a southern developed society

In this article, I examine the process by which some biomedical physicians and nurses in Australia have come to adopt various alternative therapies in their regimens of practice, largely in response to (1) the growing interest on the part of many Australians in what is generally called "complementary medicine", and (2) a recognition that biomedicine is not particularly effective in treating an array of chronic ailments. Some Australian biomedical physicians and nurses have come to embrace "integrative medicine," which purports to blend the best of biomedicine and complementary medicine, and have even created an Australasian Integrative Medical Association and established integrative medical training programs and centers. I argue that the adoption of alternative therapies and the development of integrative medicine on the part of Australian biomedical physicians and nurses constitute another national manifestation of the co-option of complementary and alternative medicine.     

Conceptual Differences between Mexican and Peruvian Archaeology

This essay asks why interpretations of pre-Columbian history and state formation in Mexico and Peru are framed in different terms by archaeologists. While the differences are due in part to the empirical realities of the two civilizations, this essay explores how sociological considerations and theoretical orientations of archaeologists as they interpreted those empirical realities contributed to the construction of the interpretive differences.     

Coding for pathology tests - strengths and weaknesses

Laboratory professionals will increasingly find themselves called upon to assist with the coding of pathology test requests and reported results in the era of the e-Health Record (EHR). EHR users from outside pathology, including patients and clinicians, will expect seamless integration of pathology services, and question variations in test nomenclature, units, reference intervals, and interpretive comments. Scientists and pathologists will need to be ready to work with colleagues outside their traditional scientific disciplines, along with IT and terminology experts, to resolve illogical historical variations, highlight differences that might endanger patient safety, and help lay the foundations for evolving e-health systems that enhance healthcare without eroding the interpretive value of pathology reports from different laboratories. An overview of medical terminologies and Australasian eHealth harmonisation programs is also provided.     

提高检验医学本科实习生综合素质探讨

随着生物医学技术、计算机技术、物理化学技术的迅速发展,临床医学对检验医学提出了更高的要求。作为实验室工作人员,在保证结果准确的基础上,还应对临床医生及病人提出的疑问给予合理、正确地解释。此外,还应该具备和临床医生进行交流,以及合理处理病人投诉的能力。五年制检验医学本科生是检验医学的主力军,培养高素质的检验医学本科生,对检验医学的发展将起关键性作用。     

中医学跨越“卡夫丁峡谷”的可能性

西医学是从自然哲学模式,经近代生物医学模式而发展到现代生物心理社会医学模式的,而中医学仍处于古代自然哲学医学模式的历史阶段,与现代生物-心理-社会医学模式同形而异质。在现代,中医学要么通过生物医学的＂卡夫丁峡谷＂而追随在西方医学之后,要么消解于西方现代医学之中,要么跨越生物医学的＂卡夫丁峡谷＂而直接跃迁至现代医学。而实现跨越的两个基本条件是实现中医学基础理论的创造性转化与中医文化的大众化。