Bioreactors in tissue engineering—principles,applications and commercial constraints

Bioreactor technology is vital for tissue engineering. Usually, bioreactors are used to provide a tissue-specific physiological in vitro environment during tissue maturation. In addition to this most obvious application, bioreactors have the potential to improve the efficiency of the overall tissue-engineering concept. To date, a variety of bioreactor systems for tissue-specific applications have been developed. Of these, some systems are already commercially available. With bioreactor technology, various functional tissues of different types were generated and cultured in vitro. Nevertheless, these efforts and achievements alone have not yet led to many clinically successful tissue-engineered implants. We review possible applications for bioreactor systems within a tissue-engineering process and present basic principles and requirements for bioreactor development. Moreover, the use of bioreactor systems for the expansion of clinically relevant cell types is addressed. In contrast to cell expansion, for the generation of functional three-dimensional tissue equivalents, additional physical cues must be provided. Therefore, bioreactors for musculoskeletal tissue engineering are discussed. Finally, bioreactor technology is reviewed in the context of commercial constraints.     

Focus: The Aging Brain: Palliative Care and the Humanities: Centralizing the Patient at the End of Life

Palliative care is a quickly growing facet of modern medicine. While scientific advancements have broken new ground for the possibilities of end-of-life care, sensitive treatment of the patient as an individual has lagged behind and has frequently led to an unsatisfactory experience for patients, families, and the medical community at large. This essay argues that centralizing patients during the terminal phases of treatment by using humanistic perspectives has the potential to bring new meaning and improved effectiveness to patients and physicians alike.     

广东阳春重阳传统药市药用民族植物学研究

该研究自2013年开始对阳春开展了全面的中药资源普查工作,在全面了解阳春地区药用植物资源的基础上,于2013年和2014年两次对阳春重阳传统药市进行全面跟踪调查。结果表明：阳春重阳传统药市出售的药物种类丰富,共收集鉴定得出134种药用植物,隶属于60科117属,并对收集到的药用植物进行编目,包括俗名、学名、药用部位、用途和用法等。从药用植物的科、属分布上来看,其中种类较多的科有大戟科(11种)、蝶形花科(10种)、菊科(10种)、茜草科(9种)、马鞭草科(6种)、姜科(5种)、防己科(5种)。药用植物的种类广泛分布于各科和属中,而非集中于少数科、属内。此外,还对阳春重阳传统药市所形成的文化基础、植物应用特色和药材地域特色进行了分析,在药市中调查到一批具有当地特色的滋补养生类的药材,得出阳春当地具有将药用植物融入日常饮食的习惯。药市中售卖的药材功效与当地的自然环境密切联系,其中尤以治疗与岭南地区湿热的气候和瘴疠虫蛇等特点所引起的常见疾病为主。同时,对阳春药市的可持续发展提出了意见和建议。     

营利性医院医疗服务自主定价政府监管的思考

营利性医院医疗服务自主定价是践行十八届三中全会“市场在资源配置中起决定性作用”在医疗服务领域的举措。对营利性医院医疗服务自主定价进行阐述,并通过分析营利性医院医疗服务自主定价出现的问题,提出完善其政府监管的具体途径：完善政府对营利性医院自主定价的引导措施,完善营利性医院自主定价信息公示,畅通政府监管的信息传输渠道以及政府监管部门加大对违规自主定价的处罚。     

新医改背景下医疗设备信息化管理存在的问题及解决对策探究

医疗设备是医院的重要资产,可在一定程度上反映医院的诊断能力以及现代化程度。新医改政策出台后,各地均大力推进医药卫生信息化建设,随着医疗设备种类的增加,给医院设备管理带来一定的困难,医疗设备信息化管理已成为医院不可或缺的一部分。我国的医疗设备信息化管理起步较晚,尚处于初级研究阶段,从而导致现阶段医疗设备信息化管理问题较多。本文简短叙述了医疗设备信息化管理现状,以及当前医疗设备信息化管理所存在的问题,并对所描述问题提出针对性的解决方案。     

About hearsay - or reappraisal of the role of the anamnesis as an instrument of meaningful communication

As a result of the ICT revolution and enhancement of diagnostic possibilities, the anamnesis, as an instrument of meaningful communication in disease and a cornerstone of medical practice throughout the ages, has lost in importance. Nowadays, we are on the brink of a more patient-tailored and individualised therapy, so there is a growing need for an open dialogue in the doctor-patient relationship, a situation very similar to the beginning of the professionalisation of assistance in disease in ancient medicine. Reappraisal of the anamnesis and awareness of the patient-doctor relationship are therefore warranted and for that reason its roots and evolution are discussed from a historic perspective. (Neth Heart J 2007;15: 359-62.)     

The Current Status of Preclinical Endocrine Education in U.S. Medical Schools

ObjectiveTo characterize the current landscape of preclinical medical endocrine education in U.S. allopathic medical schools.MethodsU.S. endocrine curriculum directors were asked to voluntarily complete a 16-question email survey surveying the status of endocrine preclinical education at their medical school.ResultsSixty-nine of 155 (45%) endocrine block director respondents completed the online survey between July 2021 and September 2021. A larger incoming class, a longer duration of the endocrine curriculum, and the offering of a separate endocrine curriculum (ie apart from the teaching of other organ systems) were each independently associated with an increased number of faculty teaching the course. Schools that used a gland-/organ-based curriculum only and those that used a combination of gland-/organ-based curriculum with topic-based curriculum differed significantly in their use of large lectures, small groups, and several curriculum components, including point of care glucose testing, continuous glucose monitoring, and insulin pumps.ConclusionThis survey study reports the current landscape of preclinical endocrine education in the United States and describes opportunities to improve interest in pursuing endocrinology as a career.