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http://www.xieeh-china.com http://xieeh.en.alibaba.com http://xieeh-china.en.alibaba.com

Stretchers / First Aid Products / Treatment Trolleys Hospital Furnitures / Medical Beds

Shenyang Shenda Endoscope Co., Ltd. No.123 Hezuo Street,Dadong District,Shenyang,China Tel:0086-24-88093290 Fax:0086-24-88903118 overseas@china-endoscope.com We b s i t e : e n.c h in a - e n d o s c o p e .c o m


01

Event Calender

02

Hot Shows

12

Exhibitions Pre & Post Reports

12

KIME 2015 At a Glance

13

MEDICAL FAIR INDIA 2015

14

AAOS 2015 Annual Meeting

15

MEDICAL JAPAN 2015

16

Expomed 2015 post show report

17

China Pavilion Index

19

International Market &Trends

19

Fortunes Rise as Molecular and Cellular Approaches Become Indispensable to Translational Medicine

21

Maryland hospitals achieve impressive care quality improvements

21

Liberia succeeds in fighting Ebola with local, sector response

23

Brunei Darussalam, Cambodia, Japan verified as achieving measles elimination

AUTHORITIES IN CHARGE Consultac International Group PUBLISHED BY Consultac Expo Co., Ltd Add: Rm.1605 Tower A, North Ring Center, 18 Yumin Rd., Xicheng, Beijing 100029, P.R.China Tel: +86 (10) 8225 8800 Fax: +86 (10) 8225 0600 Mail: info@consultac.com.cn consultac@126.com www.consultac.com.cn COPYRIGHT Medinfo does not warrant that any or all of such information is complete and correct. The publisher accepts no responsibility for accuracy of information, errors or omission, and rejects any claims arising out of any action which a company or individual mat take on the basis of information contained herein. We would appreciate if you would bring such error to our attention.

23

Keeping Iraq polio free: immunization campaign targets 5.8 million children

25

MIPT researchers grow cardiac tissue on 'spider silk' substrate

Medinfo does not take any responsibility regarding financial standing and status of the companies listed in various trade pages of this publication. Readers are advised to take usual commercial precautions.

26

Mary-Claire King on Inherited Breast/ Ovarian Cancer

Reproduction of contents is welcomed.

28

Hot Topic

28

New treatment for common digestive condition Barrett's esophagus

29

How gum disease treatment can prevent heart disease

30

Genetically engineered Salmonella promising as anti-cancer therapy

31

Medical Supplies

Operations Management


EXHIBITION &CONGRESS CALENDER JANUARY MEDICAL EXPO

Casabalanca, Morocco

ARAB HEALTH

1

Dubai, UAE

FEBRUARY AAOS

Santiago, USA

ROMMEDICA

Bucharest, Romania

2

Tunis, Tunis

Athens, Greece

Barcelona, Spain

3

Atlanta, USA

KIMES

Seoul, Korea

IRAQ HEALTH Basra, Iraq

MEDITEC

Stuttgart, Germany

DUPHAT

Dubai, UAE

IDS

Koeln, Germany

SOUTH EAST ASIAN HEALTHCARE

MEDICAL FAIR INDIA New Delhi, India

PHARMAGORA Paris, France

EXPOMED

Istanbul, Turkey

ECR EUROPE Vienna, Austria

ARAB LAB Dubai, UAE

Casabalanca, Morocco

MEDTRADE

St.Paul, Brazil

JUNE

Gyeonggi-do, Korea

FARMAVIZYON

MEDICARE

EXPOMED / LABTECH

IRANMED

MEDTEC

IMS

MEDTEC

BIO JAPAN

Bangkok, Thailand

Tokyo, Japan

JULY

IMHS JAPAN Tokyo, Japan

AACC

Anaheim, USA

UZBMED

Bangalore, India

SYRIAN MEDICARE

AUGUST

Damascus, Syria

EXPOFARMA

MEDICALL

5

MEDCINE

Skopje, Macedonia

GERONT

Paris, France

Chennai, India

MEDICARE AFRICA Nairobi, Kenya

SEPTEMBER MEDI-PHARM Saigon, Vietnam

MOLDMEDIZIN Moldova, Chisinau

UZMED EXPO

Tashkent, Uzbekistan

7 8 9

WESTAFRICAN HEALTH

Dhaka, Bangladesh

KOREA MEDICAL FAIR Pyongyang, North Korea

Brno, Czech

EXPODENTAL Rome, Italy

11

GNYDM

New York, USA

MEDICA

Düsseldorf, Germany

COMPAMED

Düsseldorf, Germany

DENTAL

Istanbul, Turkey

DECEMBER MEDIST

Istanbul, Turkey New Delhi, India

12

ZDRAVOOKHRANENIYE Moscow, Russia

DENTALEXPO Kiev, Ukraine

Düsseldorf, Germany

MEDICAL FAIR BRNO

Chicago, USA

WOLRD DENTAL

Johannesburg, South Africa

OCTOBER

RSNA

Moscow, Russia

KIHE KAZAKHSTAN

MEDITEX BANGLADESH

NOVEMBER

PHARMTECH

REHACARE

Jakarta, Indonesia

Munich, Germany

Toronto, Canada

Bangkok, Thailand

Legos, Nigeria

EXPO PHARM

OHA CANADA

MEDIPHARM VIETNAM

INDOMEDICA

Nairobi, Kenya

Jakarta, Indonesia

PAN AFRICAN HEALTH

Alma-Ata, Kazahkstan

MEDICARE AFRICA

HOSPITAL INDONESIA

MEDSIB / SIBDENT

Hanoi, Vietnam

Amman, Jordan

Atlanta, USA

MEDICAL FAIR

Suberia, Russia

ME-MEDEXPO

MEDTRADE

BULMEDICA BULDENTAL Sofia, Bulgaria

Kiev, Ukraine

Belgrade, Serbia

FIME

Miami, USA

PUBLIC HEALTH

MEDIDENT

MEDICARE AFRICA

Tashkent, Uzbekistan

Singapore, Singapore

6

Kuala Lumpur, Malaysia

Damascus, Syria

HOSPITAL BUILD

St.Petersburg, Russia

Teheran, Iran

HEALTHCARE

Lisbon, Portugal

PHARMACY RUSSIA

Damascus, Syria

Prague, Czech

NORMEDICA

St.Petersburg, Russia

HOSPITALAR

PROPAKASIA

MAY

Tripoli, Libya

Bologna, Italy

SIMEN

Mexico City, Mexico

Buenos Aires, Argentina

Cairo, Egypt

KOREAPHARM

Las Vegas, USA

PRAGO MEDICA

PITTCON EXPOS

Minsk, Belarus

SALON DE LA SANTE

4

Dubai, UAE

MEDAX

BELARUS MEDICA

Casabalanca, Morocco

IECM

Barcelona, Spain

Kuala Lumpur, Malaysia

HOSPITAL RUSSIA

Birmingham, UK

INFARMA

Baltimore, USA

EXPOSANITA

Yokohama, Japan

FARMAMAQ

EMS TODAY

MAF

Istanbul, Turkey

MEDICEXPO

Kiev, Ukraine

EGYMEDICA

Tel Aivi, Israel

Istanbul, Turkey

HEALTHEXPO

HEALTHY NATION

BIOMED ISREAL

Sydney, Australia

Algiers, Algeria

Dhaka, Bangladesh

MARCH

WESTAFRICAN HEALTH

MEDICAL-EXPO

ASIA PHARMA

Tel Aviv-Yafo, Israel

GPCE

Karachi, Pakistan

APRIL

MEDIZIN

Stuttgart, Germany

HEALTH ASIA

10

Learn more exhibition list, log on:

www.consultac.com.cn


MEDINFO April 2015

Exhibition Pre & Post Reports

KIME 2015 At a Glance 1. Title : 31st Korea International Medical

• Ministry of Food & Drug Safety

& Hospital Equipment Show (KIMES 2015)

• Seoul Metropolitan Government

2. Theme : “The Health of Today, The Happiness of Tomorrow”

• Korea Trade-Investment Promotion Agency (KOTRA) • Korea Health Industry Development Institute

3. Purpose : Assistance to further

• Korean Medical Association

• Central Supply Equipment

• Korean Hospital Association

• Clinical Examination Equipment

•Korean Medical Women's Association

• Hospital Facilities Equipment

• Korean Nurses Association

• Radiology Equipment

• Korea Medical Devices Selling

• Medical Information System

Association

• Surgical Apparatus & Equipment

• Korean Medical News

• Oriental Medicine & Equipment

development of the medical equipment

• Cure Apparatus & Equipment

industries in Korea and neighboring

• Pharmaceutical Equipment

nations, and promotion of the trade, on

• Physiotherapy Apparatus

both the domestic and international levels

• Cosmetic Dermatology & Healthcare

in medical equipment

Equipment

4. Exhibition period : March 5 (Thu.) to 8

• Ophthalmic Apparatus • Animal & Related Products

(Sun.), 2015 (4days) 5. Opening Hours : 10:00 a.m ~ 6:00 p.m 6. Exhibition Site : COEX (Convention & Exhibition Center) (513, Yeongdong-daero, Gangnam-gu, Seoul, 135-731, Korea) 7. Organizers Korea E & Ex Inc. Korea Medical Devices Industrial Coop. Association Korea Medical Device Industry Association 8. Sponsors • Ministry of Trade, Industry and Energy • Ministry of Health & Welfare

13 | SPRING 2015

• Medical Device Component & Service 9. Exhibition Scale : Total 38,350 m² COEX Hall A (1st Fl.), Hall B (1st Fl.), Grand Ballroom (1st Fl.)

• Dental Apparatus • Disposable Apparatus and Others 11. E-mail : kimes@kimes.kr

Hall C (3rd Fl.), Hall D (3rd Fl.)

Extracted from Medica

10. Groups of Exhibits • Consultation & Diagnosis Equipment

www.KIMES.kr

Overall Satisfactory Rate of KIMES 2015 Areas No. of Visitors (Domestics)

Very Satisfied 7.50%

Satisfied Adequate 49.58%

Not Definitely Satisfied Unsatisfied

36.00%

6.29%

0.63%

No. of Visitors (Int'l)

5.06%

27.00%

51.90%

14.56%

1.48%

Quality of Visitors

4.84%

41.21%

45.95%

7.58%

0.42%

Organizer's Promotion Effort

6.69%

52.28%

37.47%

3.35%

0.21%

Exhibition Operations

7.35%

53.89%

33.71%

4.84%

0.21%

Quality of Exhibition Service

7.98%

49.37%

37.39%

5.26%

0.00%

Level of Venue Facilities

8.60%

44.65%

36.48%

9.22%

1.05%


MEDINFO April 2015

Exhibition Pre & Post Reports

Strong Exhibitor Demand and New Visitor Target Groups for the

MEDICAL FAIR INDIA 2015

New Focus “Hospital Infrastructure Sector” The booming Indian health care market

producers, hospital decision-makers as

held alternately in New Delhi and Mumbai

also benefits the 21st MEDICAL FAIR

well as – for the first time – retailers and

every year.

INDIA – India’s No. 1 Trade Fair for

distributors.

Hospitals, Health Centres and Clinics – in

”Medical Fair India is a one of its kind

New Delhi and underlines its leading role

T h e M E D I C A L FA I R I N D I A , h e l d

medical and healthcare event offering

in 2015.

alternately in Mumbai and New Delhi every

an ideal international platform to the

year, last time registered 443 exhibitors

medical and healthcare industry. It is on

A new segment included to extend the

who attracted over 8,000 registered trade

its way to becoming the most successful

MEDICAL FAIR INDIA 2015 for the first

visitors eager to learn about the entire

and exceptional exhibition to showcase

time promises to bring a further rise in

range of innovations from segments such

medical technologies,” summed up Rajiv

the number of trade visitors. Under the

as medical device technology, hospital,

Nath, Chairman of AIMED, the Association

new focal theme “Hospital Infrastructure”

health centres and clinical equipment,

of Indian Medical Device Industry.

not only medical products for clinical

rehabilitation, furnishings for pharmacies

applications will be exhibited but all

and care centres/furniture. The 21st

This year the medical trade fair focalised

products and product groups required

MEDICAL FAIR INDIA will be held in Halls

the new segment “Hospital Infrastructure”

for building, furnishing and operating

11, 12 and 12A of the Pragati Maidan

and kicked off with an accompanying

hospitals, clinics and health centres. This

Exhibition Centre in New Delhi from 21 to

technical conference on the focal themes

expansion of scope addresses additional

23 March 2015.

“Hospital Infrastructure & Planning”

visitor target groups such as hospital

and “Medical Device & Technology”.

directors and owners, hospital managers/

In excess of 10,400 international trade

Comprising high-calibre lectures and

decision-makers and representatives from

visitors, i.e. some 2,400 more than at

panel discussions the conference agenda

ministries. Thus, MEDICAL FAIR INDIA

the previous event, visited the Pragati

offered decision-makers from clinics,

2015 with the addition of new focus sector

Maidan exhibition centre to learn about

medical professionals, retailers and

shall take a complete healthcare event,

product innovations in the Indian health

industry and healthcare agents an ideal

and not just seen as event for medical

care sector from 21 to 23 March. However,

platform to learn about trends and network

devices & technology.

the MEDICAL FAIR INDIA 2015 not

with experts. In addition to the conferences

only scored outstanding results in terms

independent workshops allowed the

The conference programme will also

of visitor attendance. Exhibitor figures

exhibitors to present themselves to the

be as extensive as ever: an additional,

have also been on the constant rise over

visitors of the MEDICAL FAIR INDIA 2015.

high-calibre conference on “Hospital

the past few years. At this event 447

Infrastructure” comprising new forums and

exhibitors from 18 countries presented a

workshops will provide an opportunity for

comprehensive product portfolio on net

Extracted from Medica

in-depth exchange of experience. Here

exhibition space that has now risen to

www.medicalfair-india.com

exhibitors can showcase their products

over 5,250 m². 289 exhibitors from abroad

and their companies to a wide expert

underscored the international importance

audience including medical professionals,

of the MEDICAL FAIR INDIA, which is

SPRING 2015 | 14


MEDINFO April 2014

Exhibition Pre & Post Reports

AAOS 2015 Annual Meeting AAOS was founded in 1933, the

on cutting-edge orthopaedic topics, and

of and accessible to the diverse population

Academy is the preeminent provider of

more than 900 paper presentations, 560

i t s e r v e s . T h e H u m a n i t a r i a n Aw a r d

musculoskeletal education to orthopaedic

posters, and 200 instructional courses by

recognizes living Fellows, International,

surgeons and others in the world. Its

world-renowned faculty. In addition,other

and Emeritus members of the American

continuing medical education activities

highlights included more than 650

Academy of Orthopaedic Surgeons who

include a world-renowned Annual Meeting,

technical exhibits showcased the “latest

have distinguished themselves through

multiple CME courses held around the

and greatest” orthopaedic products and

outstanding musculoskeletal-related

country and at the Orthopaedic Learning

services. On Specialty Day—Saturday,

humanitarian activities in the United

Center, and various medical and scientific

March 28—more than a dozen specialty

States or abroad. The Tipton Leadership

publications and electronic media

societies had explore current research

Award recognizes living AAOS Fellows

materials.

findings in various areas of orthopaedics.

or Candidate Members who have

The 2015 AAOS Annual Meeting had

demonstrated outstanding leadership

gain a completely success! According to the official department, the exhibition had

a professional platform for the medical industry by creating an ideal setting that allows companies from America and around the world to showcase their latest healthcare products, equipment and services to doctors, hospitals, buyers and health sector professional. The 2015 Annual Meeting had more exciting learning opportunities, with 30 symposia

orthopaedic community, patients and/or

attracted 17,939 professional members

the American public.

included Physicians and Allied Health, attendance: 31,370.

Advantages of participating AAOS Annual Meeting:

On a collaborative effort, the Central

•Showcased your latest products and

exhibitors: 10,356 and others: 3075,total The 2015 AAOS Annual Meeting provided

qualities that have led to benefits for the

Program Committee, Exhibits Committee and Orthopaedic Video Theater Committee have combined the abstracts from selected

services alongside pioneers and business leaders to a large specialized audience of professionals and decision makers from

scientific portions of the Annual Meeting.

the healthcare sector.

The Diversity Award recognizes living

•Identified business and investment

Academy Fellows and Emeritus members

opportunities in the areas of healthcare,

who have distinguished themselves

pharmaceutical products, medical supplies

through their outstanding commitment to

and services.

making orthopaedics more representative

•Meet representatives from regional and international companies that are taking part in the show, seeking potential partnerships. Over the last few years, AAOS has attracted massive interest from international traders in all sectors. The 2016 AAOS Annual Meeting will be held in Orange County Convention Center, Orlando, Florida. Welcome to the next grand exhibition meeting which must be your wise choice!

15 | SPRING 2015


MEDINFO April 2014

Exhibition Pre & Post Reports

MEDICAL JAPAN 2015 Japan’s first comprehensive medical trade show concluded with great success! were exhibited at Nursing Expo Japan

show specialised in clinical testing and

2015, including nursing uniforms, nursing

diagnostic technologies.

goods, nursing bags for home visits,

B to B trade show specialised in the latest

stethoscopes, nursing/nursing care

regenerative medicine techniques!

furniture, hygiene products, health care

Industry Associations (in random order)

equipment such as medical aspirators and sphygmomanometers, rehabilitation

723 exhibitors from 20 countries/ regions

supplies, welfare vehicles, hearing aids, communication support equipment such

The 7 shows in detail

as emergency reporting systems and

products/services for hospital innovation!

majority of visitors were nurses, nursing

B to B trade show covering all the Exhibitors showcased healthcare information/remote medical care technologies, hospital facilities, medical supplies, preventive healthcare & healthcare equipment/systems, assisted living products & supplies and home healthcare products at Hospital + Innovation Expo Japan 2015. Medical experts in charge of management/facilities/ systems visited this show to discuss introduction of products and technologies. Active negotiations and consultations were conducted everywhere at this trade show covering all the products/services for hospital innovation. B to B trade show specialised in all the necessary nursing and nursing care products! All nursing and nursing care products

guidance systems for the disabled. The care workers, rehabilitation physicians, physiotherapists, and occupational therapists. The show provided an ideal platform to have fruitful business meetings and expand business in Japan. B to B trade show specialised in clinical testing and diagnostic technologies! IVD products & reagents, transport systems, contract services, diagnostic imaging and supplies & accessories for laboratories were all gathered at Clinical Laboratory & Diagnostics Expo Japan 2015. Professionals including technicians/ doctors from medical institutions/clinical trial laboratories and medical equipment dealers visited this show to discuss introduction of products and technologies. Active negotiations and consultations were conducted everywhere at this trade

•Japan Hospital Association •Osaka Hospitals Association •Osaka Nursing Association •Osaka Medical Instruments Association •Kyoto Hospitals Association •Kyoto Pharmaceutical Association •Hyogo Hospitals Association •Hyogo Pharmaceutical Association •Wakayama Dental Association •Wakayama Pharmaceutical Association •Nara Nursing Association •Shiga Hospitals Association •Shiga Nursing Association •Tottori Pharmaceutical Association •Tokushima Dental Association •Tokushima Nursing Association •Kyoyu Medical Instrument Association •All Japan Hospital Association(AJHA) •Japan Association for Clinical Engineers •Osaka Private Hospital Association •Osaka Pharmaceutical Association •Osaka Scientific Instruments Association •Kyoto Dental Association •Kyoto Private Hospitals Association •Kyoto Medical Instruments Association •Hyogo Private Hospital Association •Hyogo Nursing Association •Wakayama Hospitals Association •Wakayama Nursing Association •Nara Hospitals Association •Shiga Dental Association •Shiga Pharmaceutical Association •Tokushima Pharmaceutical Association

MEDICAL JAPAN was supported by 59 associations

SPRING 2015 | 16


MEDINFO April 2014

Exhibition Pre & Post Reports

Expomed 2015 post show report Record Growth at expoMED ExpoMEDIstanbul and the co-located eventlabtechMED once again excelled in both exhibitor and visitor attendance. For 21 years the event has grown from strength to strength making it the premier meeting place for the medical industry across Turkey and Eurasia. The 2014 event saw topical debates, world class speakers and aisles of innovation bringing over 34,000 total attendees over four high impact days.

W H AT D O O U R EXHIBITORS SAY?

IT THE BEST FAIR FOR THIS SECTOR IN TURKEY OPENNING OPPORTUNITIES B O T H F O R I N T E R N AT I O N A L A N D DOMESTIC COMPANIES. THIS FAIR IS PRESTIGIOUS GENERAL MANAGER, TEKNOSAN SAN. TİC.LTD.ŞTİ

What was NEW? WEBSITE To give exhibitors maximum visibility to visitors pre event a new website was launched to include a searchable exhibitor directory. In 2015 the directory will enable exhibitors

PRODUCT SHOWCASE The Product Showcase area showed visitors the most innovative products at expoMED. 5 companies participated and put their brand at the forefront of expoMED.

WHO VISITED? The launch of the elite+ programme attracted a record number of international VIP buyers, with 577 prequalified visitors from 20 countries being hosted by expoMED. Top ten visitor markets hosted on the elite+ programmewere:

to upload their own company and product

1.Turkey

WE MET TURKISH AND REGIONAL PA R T N E R S H I P S ( M I D D L E E A S T, EASTERN EUROPE). REED TUYAP IN TURKEY IS A VERY IMPORTANT PLACE TO DO BUSINESS WITH A STRONG MARKET AND A GOOD LOCATION. BUSNESS DVT MANAGER, CAHOUET FRANCE

information directly.

2.Iraq

ELITE+ VIP BUYERS

3.Georgia

The elite+ programme attracted 577

5.Bulgaria

THE TURKISH DOMESTIC VISITORS ARE GOOD. I LOOK FORWARD TO INCREASING OUR SALES THROUGH THIS EXHIBITION. SENIOR SALES MANAGER SUZHOU SELEN CLEANROOM TECHNOLOGY

VISITOR COLOURED BADGES

WE HAVE ATTENDED EXPOMED FOR 13 YEARS . EVERY YEAR IT IS MORE QUALIFIED AND PROFITABLE. WE CONGRATULATE REED TUYAP ON THEIR PROGRESS GENERAL MANAGER, ORSA ORTOPEDİ LTD.ŞTİ

Visitors were clearly badged and

GOOD LEADS! PROFESSIONAL EVENT (#1 IN ITS SECTOR) , MANY INTERNATIONAL LEADS. ASST MANAGING DIRECTOR, 3B SCIENTIFIC 17 | SPRING 2015

high profile buyers from Turkey and key countries surrounding Turkey such as Georgia, Iraq, Iran, Russia, Serbia and Libya.

ExpoMED invested in a new registration process to ensure visitor quality and identifiability. identifiable during the event with colourcodes according to visitor type.

MEETINGS The distributor meetings programme enabled international exhibitors to meet with distributors during the show via a pre show online booking system. All major distributors in Turkey were invited to join the programme.

4.Germany 6. Iran 7. Tunisia 8. Libya 9. Greece 10. Macedonia Purchasing managers and owners of Private hospitals, head of purchasing commissions of major medical faculties in Turkey including, Florence Nightingale, Acıbadem, Memorial,Liv, Bayındır, Medical Park, İstanbul Cerrahi, Medicana Hospitals, German Hospital Group (Istanbul) and International Ministries from Georgia, North Iraq, North Cyprus, Germany.

Extracted from Medica

www.expomedistanbul.com


MEDINFO April 2015

China Pavilion Index

NINGBO FREE TRADE ZONE TENSO MEDICAL INSTRUMENTS Co.,LTD stethoscope, sphygmomanometer www.tensomed.com

VITAIMED.INSTRUMENT.CO.LTD

Colostomy bags, Urostomy Bag, Urine Bag, Urine Meter www.vitaimed.net

Weihai Hongyu Nonwoven Fabric Products Co.,Ltd

DISPOSABLE NONWOVEN FABRIC PRODUCTS www.hongyunonwoven.com

ZIBO HENGCHANG PLASTIC & RUBBER PRODUCTS CO., LTD Vinyl Disposable Exam Gloves www.hengchangchina.com

Suzhou Youbetter Medical Apparatus Co.,Ltd

Tianjin Walkman Biomaterial Co., Ltd

Weigao Orthopaedic Device Co.,Ltd

XBO Medical Systems Co., Ltd.

implantable materials, artificial organs,second-class, orthopedic (orthopedic) surgical instruments www.youbetter.cn

UPASS 5.5 spine fixation system,Cervi-Lock,anterior cervical plate system,SINO spine fixation system, Milestone cage system,Weimesh system www.weigaoholding.com

Suzhou Sunan Zimmered Medical Instrument Co., Ltd

Locking Compression Plates, Metallic bone plates, Metallic bone Screws, Interlocking Intramedullary nails, Spinal implants, Instruments www.zimede.com

Anterior Cervical Plating System,Posterior Thoracolumbar Fixation System( CANFIX) www.walkman.com.cn

MRI magnetic resounance imaging www.xboms.com

Wuhu Ruijin Medical Equipment Co., Ltd

Trauma surgery, Joint Surgery System, Spine and, microsurgery, Chest and brain surgery system, Sterilizer www.whruijin.com

Canwell Medical Co.,Ltd ELISA,CLIA,RAPID TEST www.gongchang.com

SUZHOU XINRONG BEST MEDICAL INSTRUMENT CO.,LTD

Spinal, Normal Plate, locking plate, Interlocking nails, Screw, Prothesis of hip joint, External, Fixation, Surgical Instrument www.xrbest.en.alibaba.com

JiangSu BaiDe Medical Instrument Co.,Ltd.

Main products include:Multifunctional external fixator, surgery power system,internal fixation plate,screw,locking plate system,spine system and support instruments www.bd-ortho.com

SPRING 2015 | 18


MEDINFO April 2015

China Pavilion Index

Beijing Fule Science & Technology Development Co., Ltd.

CareMax Rehabilitation Equipment Co,.Ltd

Jiangsu Yuyue Medical Equipment & Supply Co., Ltd.

SHANGHAI KINETIC MEDICAL CO., LTD

Medical & Rehabilitation www.yuyue.com.cn

Kyphoplasty System, Plasma Radiofrequency (RF) Surgical System www.kineticmedinc.com.cn

Shanghai Kindly Enterprise Development Group Co., Ltd

BoTEC Medical Innovation Co.,Ltd

Zibo Jiashang Medical Device Co., Ltd

Beijing AKEC Medical Co.,Ltd

primary total knee replacement,hip joint system www.ak2003.com.cn

Orthopedic Implants www.botec-med.com

spinal series products, trauma series products, multifunctional external fixator, knee meniscus suturing device, rehabilitation instrument and related instruments www.fulekeji.com

Oxygen Mask, Tracheostomy Tube, Stomach Tube, Three - Way Stopcock

www.jsmed.cn

Bain Medical Equipment (Guangzhou) Co., Ltd

Sunray Medical Apparatus Co., Ltd

B e i j i n g J i n h e n g w e i Te c h n o l o g y development Co., Ltd

Shenzhen Delica Electronics Co. Ltd.

Xiamen Double Engine Medical Material, Co., Ltd.

JIANGXI HONGDA MEDICAL EQ UIPMENT GROUP LTD.

Fistula needle sets, Dialysis kit, Dialyzer, Tubing setsfor hemodialysis, Dialysis machine www.bainmedical.com

electrosurgical unit www.ahanvos.com

Orthpedic trauma, intramedullary, spinal internal fixation, instrument www.double-engine.com

19 | SPRING 2015

Fetal Monitor, Fetal Doppler, Patient Monitor www.sunray.cn

Transcranial Doppler, EEG, Neuro Monitor System www.delicasz.com

DISPOSABLE SYRINGE, DISPOSABLE INFUSION SET, DISPOSABLE VAGINAL SPECULUM www.jxhd.cn

Rollator , walker , Cane & Crutch ,shower chair, Wheelchair http://www.caremax-med.com/

Disposable needles, Syringes, nfusion Sets, Medical Device www.kdlchina.cn

Weihai Hongyu Nonwoven Fabric Products Co.,Ltd

DISPOSABLE NONWOVEN FABRIC PRODUCTS www.hongyunonwoven.com

JIANGXI YIKANG MEDICAL INSTRUMENT GROUP CO.,LTD Sterile hypodermic syringes for single use, Infusion sets for single use, Intravenous needles for single use, Transfusion blood collection for single use, Vacuum blood collection for single use, The disposable use asepsis catheter www.jxyikang.com

Zibo Eastmed Healthcare Products Co., Ltd. syringes, catheter, infusion sets www.eastmedcn.com

Anhui Harmory Medical Packaging Material Co., Ltd

medical Coated Paper, blister packing firm, sterilization pouch www.harmory.com.cn


MEDINFO April 2015

International Market &Trends

Fortunes Rise As Molecular and Cellular Approaches Become Indispensable To Translational Medicine Cell analysis has emerged as an ultrasensitive tool. It explicates molecular mechanisms and pathways. It even reveals the nature of cell heterogeneity. Accordingly, cell analysis has been applied in a range of disciplines—genomics, proteomics, transcriptomics, and epigenomics. Because cell analysis is being deployed ever more widely, it is becoming more than a scientific phenomenon. It is becoming a market phenomenon, too. In fact, cell analysis will represent a global market of $35.5 billion by 2020, according to IQ4I Research. Cell analysis market growth is attributed to a range of factors. These include: Greater emphasis in healthcare technology for early and accurate diagnosis of life threatening diseases. Increasing government and corporate funding and investment in cell based research.

of cells of interest as well as the characterization of cellular heterogeneity. Relevant techniques include: • Single cell analysis—a technique for analyzing individual cells and assessing changing cell behavior and function over time, whether cells are in their natural states or perturbed by external factors. • Live cell imaging—a microscopic process for visualizing and quantifying cellular dynamics in real time. • High-content screening—a means of studying many cell features simultaneously in complex biological systems. • Laser capture microdissection—an automated sample preparation technique that enables isolation of specific cells from a mixed population. • Optical microscopy—STED, STORM, TIRF, FLIM, and other technologies.

• Nanobiodevices—nanopillar arrays or nanowire arrays on a quartz chip, devices that allow ultrafast detection of circulating tumor cells for cancer metastasis diagnosis. Molecular and Image-Based Approaches There are many molecular approaches such as polymerase chain reaction (PCR) assays, sequencing, microarrays, microfluidics, and cell separation techniques. Image-based approaches rely on microscopes, fluorescence in situ hybridization (FISH) assays, highcontent screening, spectrophotometry, and cytometry techniques. Among the molecular approaches usually performed at the genomic level, PCR accounted for the largest revenue: $4,843 million in 2013. PCR also has a healthy CAGR in the global cell analysis

Higher demand from end users such as diagnostic laboratories for cell analysis products. Potential countervailing factors include stringent government regulations, a lack of skilled personnel to perform some of cell analysis techniques (such as highcontent screening and next-generation sequencing), and the high cost of some of the commercial instruments. Ultimately, these potential growth inhibitors could be recognized as outsourcing opportunities. For example, high-content screening services could be outsourced to contract research organizations.

Cell-Level Techniques

Cell analysis encompasses the isolation

Cell analysis is becoming more than a scientific phenomenon; it is becoming a market phenomenon, too. In fact, cell analysis will represent a global market of $35.5 billion by 2020, according to IQ4I Research. SPRING 2015 | 19


MEDINFO April 2015

International Market &Trends techniques market. The sequencing segment is expected to have a CAGR as high as 12.7% during the forecast period. Among image-based approaches, cytometry generated highest revenue. High-content screening is projected to have a CAGR as high as 12.5% between 2014 and 2020.

Cell Analysis Products

The cell analysis products include consumables, instruments, and services. Of these, consumables commanded the largest market share in 2013, mainly due to the sale of reagents. Among cell analysis instruments, microscopes accounted for highest revenue. The microfluidic devices segment is expected to show a double-digit CAGR during the forecast period (2014–2020). During this time, the services segment is also estimated to show a favorable CAGR. Cell analysis represents a multidisciplinary market. It has applications in varied therapeutic areas. One such area is immunology. It has generating the highest revenue for the global cell analysis market in 2013. Genetic testing is forecast to have the highest growth rate. The diagnostics segment, a field with which cell analysis is closely identified, accounts for the highest revenue of in the same year, with stem cell analysis showing the highest growth rate (reaching double digits) during the forecast period.

Market Characteristics

The academic and research institutes

20 | SPRING 2015

accounted for highest revenue in 2013 among the end users, surpassing all other segments, which included hospitals, pharmaceutical companies, biotech companies, contract research organizations, cell banks, and diagnostic laboratories. Contract research organizations, however, are expected to post a larger CAGR during the forecast period, mainly because of the outsourcing business they generate from high-content screening. From a geographic perspective, North America commanded the largest market share, followed by Europe. These mature re g i o n s , w hi ch benefi ted from hi gh investments in healthcare infrastructure and relatively generous provision of government funds, also showed improved market growth. The Asia Pacific region, however, is expected to have the highest CAGR (11.3%) during the forecast period due to increased healthcare awareness, improved economic growth, and increasing disposable incomes. The outsourcing of high-content screening services to contract research organizations in emerging countries also contributes to the Asia Pacific region’s high growth rate. During past three years, market growth has been driven by significant mergers and acquisitions, collaborations, new product launches, and product approvals from regulatory bodies. New product launches accounted for more than 50% of the growth between 2011 and 2015, meeting customer needs and also expanding the

cell analysis global market with innovative technologies and products. In March 2015, Kapa Biosystems (U.S.) launched library preparation products such as HyperPlus and RNA-Seq kits for NGS DNA and RNA analysis by providing highquality mechanical shearing and efficient RNA depletion. In the same month, Roche Diagnostics (Switzerland) launched the Cobas DPX test, a RT-PCR duplex assay for detecting parvovirus B19 and hepatitis. A virus in human plasma, whereas Cambridge Epigenetix (U.K.) launched TrueMethyl kits for amplicon sequencing and pyrosequencing applications. Rain Dance Technologies (U.S.) announced the availability of the ThunderBolts NGS target-enrichment system to rapidly detect and analyze somatic mutations from CTC (circulating tumor cells) DNA or FFPE (formalin-fixed paraffin-embedded) tissue samples. Major players in cell analysis market include Agilent Technologies (U.S.), Becton Dickinson (U.S.), Bio-Rad Laboratories (U.S.), Danaher (U.S.), GE Healthcare (U.K.), Merck (Germany), Olympus (Japan), PerkinElmer (U.S.), Promega (U.S.), Qiagen (Netherlands), Sigma-Aldrich (U.S.), and Thermo Fisher Scientific (U.S.). Danaher is a dominant player with a share of 22.4%, followed by Thermo Fisher Scientific, Becton Dickinson, Merck KGaA, Agilent Technologies, and Sigma Aldrich.

cardinalhealth.mediaroom.com


MEDINFO April 2015

International Market &Trends

Maryland hospitals achieve impressive care quality improvements Beth Walsh

Mar 26, 2015

Hospitals in Maryland have focused on

Among the findings are that hospitals

breathe for those unable to do so — can

patient safety with impressive results.

have:

lead to infections)

The Maryland Hospital Association’s

• Achieved a 90 percent compliance rate

• Reduced occurrences of obstetrical

annual report on quality in Maryland’s

for hand hygiene in 2014, up from 71

hemorrhage by over 20 percent and

hospitals details the effective strategies

percent when the program began in 2010

occurrences of obstetric lacerations by 14

hospitals are deploying to improve patient safety.Maryland sets predetermined Medicare reimbursements for hospitals and state-wide target goals for reducing unnecessary hospitalizations and preventable conditions.

• Reduced hospital readmissions by 4

percent.

percent compared to the previous year,

This report is timely as Maryland’s

faster than the national rate

hospitals have just completed a full year

• Maintained zero central line-associated bloodstream infections per month for 90 percent of the participating hospital units • Maintained zero catheter-associated urinary tract infections among 83 percent of participating hospital units • Reduced the number of ventilatorassociated complications by 55 percent

of operations under the terms of a new agreement with the federal government that allows Maryland to continue to be the only state that sets hospital payment rates. According to the agreement, hospitals must perform well on multiple tests related to quality, including significant reductions in readmissions and hospital-acquired conditions.

from the previous year (improper use of ventilators — machines that mechanically

http://www.clinical-innovation.com

Liberia succeeds in fighting Ebola with local, sector response The story of how Liberia’s most populous

results. These local sector teams involved

September and treatment centers filled

county, Montserrado, turned around an

more than 4,000 community members,

up the day they opened, started to turn

exponentially-growing Ebola outbreak

using business best practices and an

back the epidemic when it organized and

is intriguing. WHO’s team and national

incident management system to vastly

empowered local teams to handle the

officials, aided by veterans from

improve surveillance, case finding, contact

response.

WHO’s polio eradication group in India,

tracing, and overall management of key

decentralized the response, using quality

response activities.

management principles that empowered local teams and held them accountable for

Essentially the government decided to decentralize the Ebola management

Liberia, where the Ebola outbreak

system and break it down into four smaller

seeing exponential growth in cases last

systems. This allowed for better quality

SPRING 2015 | 21


MEDINFO April 2015

International Market &Trends control on surveillance, case finding,

cases and contacts. Health officials, local

experience in combating polio in that

contact tracing, and overall management

citizens and partners worked together in

country and knew the importance of good

of key response activities necessary in

each sector and made operations more

localized epidemiology and response,

tackling the Ebola outbreak.

effective, taking advantage of the strong

provided robust technical support, helping

sense of community and identity.

build strong cohesive sector teams. Thierry

A WHO analysis later found a direct link

Cordier-Lassalle, WHO, Liberia

between implementing a full package of

The objective of the Montserrado sector

control interventions, including community

approach was to “hunt the Ebola virus

This decentralized approach also

engagement, acceptance, and ownership

disease” in controlled zones of the sector,

enhanced quality management by building

of the response, and the decline and then

using timely local responses. In 2 months,

a customer service system that would work

end of new cases in Liberia.

the sector approach brought the Ebola

with potential cases in each community to

outbreak under control in Montserrado.

diagnose every patient and get them the

Sector teams coordinated with localized

care they needed quickly.

response teams, increasing outreach and handling issues locally using a ‘good neighbor’ approach and “door-to-door” engagement.

WHO /Aphaluck Bhatiasevi Sector approach In late November 2014, following the height of the Ebola outbreak in Montserrado, the largest county in Liberia, the country’s National Incident Management System began working to decentralize the Ebola response. Teams were organized and partners were integrated into a new “sector approach,” that divided the county into four sectors.

The approach introduced a performancebased management system, which outlined goals and targets for each staff member with very specific indicators.

The sector approach worked because it

Those in charge of meeting goals had to

was managed by the people of Liberia in

provide relevant data on their regions and

their own communities. Also those who

report on whether they had been met.

came from outside to help, respected local voices, laws and leadership. Customized solutions to fight Ebola Agile, customized sector solutions were encouraged, leaving sector leaders free to design localized responses around a strongly structured, technical “pillar” based organization. The Health Ministry, Incident Managers and partners agreed that these would cover case detection

P a r t n e r r e s p o n s e b y s t a ff i n e a c h sector left no doubt about strategies, objectives and responsibilities, and in many cases partners appointed people from the communities to maximize their responsibility. The resulting public accountability in terms of effectiveness and sectoral performance enriched community engagement and made it easier to mobilize responders and citizens around specific issues.

This new method worked by grouping

(investigation, tracing and active case

smaller, localized teams for a more nimble

finding), epidemiological surveillance,

The success in controlling the Ebola

and rapid response and empowering

case management, psycho-social activities

outbreak in Liberia is partially due to this

local staff for enhanced community

and community engagement. A similar

sectorial approach, which is a good model

engagement. It also introduced a new

framework was adopted at all levels of the

for work in other affected countries and for

performance-based management system,

“sectoral system” from the national level,

future outbreaks.

which made every staff member involved

to county, sector and zone levels.

accountable for their own work. The zone-level approach reflected historical community identities and ties. Instead of div iding e p i d e m i o l o g i c a l zones by purely administrative district organization, it localized the areas, so communities could track their own Ebola

22 | SPRING 2015

Enhanced management Active daily coordination of sectors and cross cutting responsibilities reduced overlapping activities, fostered improvements and supported areas where performance was lagging. A WHO expert team from India, which had vast

www.medscape.com


MEDINFO April 2015

International Market &Trends

Brunei Darussalam, Cambodia, Japan verified as achieving measles elimination MACAO SAR (CHINA), 27 MARCH

“Recent progress is impressive, but we

disease known, and it is easily prevented

2015 - Brunei Darussalam, Cambodia

must do more to ensure that immunization

with just two doses of measles vaccine,"

and Japan have been verified as

programmes reach everyone and

said Dr Sergey Diorditsa, Coordinator,

having achieved measles elimination

measles elimination continues to be a

Expanded Programme on Immunization

by the Measles Regional Verification

priority."

for the WHO Western Pacific Region.

Commission. The three countries join

While measles mortality and morbidity

Australia, Macao SAR (China), Mongolia

have decreased substantially, the Region

and the Republic of Korea as countries

faced challenges in 2014 with outbreaks

and areas in the Western Pacific Region

in several countries that had experienced

that have successfully eliminated

prolonged periods with little or no

measles.

measles transmission.

The Region has made substantial

At its sixty-first session in 2010, the

progress, with measles deaths dropping to 1500 in 2013 from 10 400 in 2000. Measles cases also dropped dramatically

WHO/B. Bayutas

to 31 706 cases in 2013 from 177 052

Measles elimination in Brunei

cases in 2000.

Darussalam, Cambodia and Japan

“Measles elimination is achievable in the Western Pacific Region. Increased commitment, funding and advocacy are all urgently required to immunize all children against measles, especially

was made possible because each of the three countries was able to achieve high coverage with two doses of measles vaccine either through routine immunization or immunization campaigns.

the most vulnerable in the hardest to

Worldwide, measles kills 400 people a

reach communities,” said Dr Shin Young-

day—or about 16 deaths every hour, most

soo, World Health Organization (WHO)

of whom are children under the age of

Regional Director for the Western Pacific.

five. “Measles is the most highly infectious

Regional Committee for the Western Pacific urged the Regional Director to establish an independent regional verification mechanisms for measles elimination. The regional verification mechanism enables acknowledgment of countries and areas that have eliminated measles. Commission members also provide guidance to countries working towards measles elimination.

www.medscape.com

Keeping Iraq polio free: New immunization campaign targets 5.8 million children A 5-day nationwide polio immunization

marked by events held on 12 April in

Health. Representatives of WHO and

campaign targeting 5.8 million children

Baghdad, organized by the Ministry of

UNICEF attended both events with Rotary

under 5 years of age began in Iraq on

Health, and on 13 April in Erbil organized

International attending the launch in Erbil.

Sunday 12 April. The campaign was

by the Kurdistan regional Ministry of

It is over a year since the last case of SPRING 2015 | 23


MEDINFO April 2015

International Market &Trends polio was reported in Iraq, and the new

“Population movement and shortfalls in

Thanking Rotary International for their

campaign aims to vaccinate every child

routine immunization pose significant

unflinching support to the Global Polio

under 5 throughout the country.

challenges for the polio eradication

Eradication Initiative (GPEI) through

programme,” Dr Hussain said. “However,

its history, WHO and UNICEF country

with the committed leadership of the

representatives have appealed for

Ministry of Health, support from donors,

continued support to the polio emergency

and through strong collaboration among

response in Iraq. To ensure prevention

our partners, we have been able to

of new importation-associated polio

consistently reach over 90% of all children

outbreaks and to save children from

for the last 9 campaigns since April 2014,”

vaccine preventable diseases, additional

he said.

campaigns must be held over the coming

Iraq is one of the highest risk countries for polio in the middle west due to vulnerable populations living in multiple governorates. These include internally displaced persons, refugees, communities dwelling in slums and vast portions of the country where insecurity hinders health outreach activities. Vaccination teams will exert extra effort to reach children within these

Dr Hussain cautioned that certain high-

populations during the April campaign,

risk governorates such as Baghdad,

with approximately 24 000 health workers

Karbala, Muthana and Babylon do not

set to conduct house-to-house visits.

have uniformly high vaccination rates at the district level and thus require particular attention during the campaign. WHO, UNICEF and nongovernmental health partners have provided a range of support functions to the Federal and Kurdistan Ministries of Health to combat polio within Iraq’s borders. While WHO provides technical support and training in communicable disease surveillance,

“Action to contain and stop polio in Iraq

case detection, and stool sampling and

has been strategic, concentrated and

testing for acute flaccid paralysis – a major

swift due to the strong commitment of

indicator for polio, UNICEF has been

the Government,” said Dr Jaffar Hussain,

instrumental in the procurement of OPV

WHO Representative to Iraq. “Keeping

and cold-chain equipment, and in helping

Iraq polio free has been a major priority

to raise community awareness of the

for WHO and its partners over the past 12

debilitating disease.

months, and we are doing everything we can to maintain this great achievement,” he said.

“The absence of wild poliovirus in Iraq for over a year, despite the complex humanitarian crisis, is testament to the

In the last year, a total of 13 subnational

efforts put into the emergency response

and national polio immunization campaigns

from the respective Ministries of Health.

have been conducted across the country

U N I C E F, a l o n g w i t h W H O , r e m a i n s

to counter gaps in routine immunization

committed to providing strong technical

services. Violence and insecurity in many

support and welcomes the visit of

parts of Iraq, damage to health facilities,

Rotary for this campaign, as one of the

and a shortage of health workers continue

spearheading partners in the Global Polio

to create hurdles in reaching every child

Eradication Initiative,” remarked Philippe

under 5 with oral polio vaccine (OPV).

Heffinck, UNICEF Iraq Representative.

24 | SPRING 2015

year. However, the Iraq Ministry of Health estimates a funding gap of US$ 45.5 million for campaigns planned in 2015 and 2016. Given the high political commitment of the Government to polio eradication and the Expanded Programme on Immunization, WHO and UNICEF have appealed to the wider international community to come forward and support efforts to ensure vaccine delivery to all children and women of Iraq to prevent significant mortality and morbidity. The UNICEF Iraq Country Representative emphasized that funding shortages in Iraq are putting all children at risk. “The scope and scale of the crisis, and the unimaginable hardships that Iraqi children have suffered stretch our ability to respond. If the immediate and longer term funding gaps are not met, millions of children will not receive the life saving interventions, including polio and routine immunization, that they need.” WHO and UNICEF continue to support both Ministries of Health in increasing vaccination coverage in Iraq. Through the GPEI, the organizations are currently supporting immunization campaigns in three countries in the Region.

www.medscape.com


MEDINFO April 2015

International Market &Trends

MIPT researchers grow cardiac tissue on 'spider silk' substrate Genetically engineered fibers of the protein

lightand durable. They're five times

For this purpose, they seeded isolated

spidroin, which is the construction material

stronger than steel, twice more elastic than

neonatal rat cardiomyocytes on fiber

for spider webs, has proven to be a perfect

nylon, and are capable of stretching a third

matrices. During the experiment, the

substrate for cultivating heart tissue cells,

of their length. The structure of spidroin

researchers monitored the growth of the

MIPT researchers found. They discuss

molecules that make up cobweb drag lines

cells and tested their contractibility and the

their findings in an article that has recently

is similar to that of the silk protein, fibroin,

ability to conduct electric impulses, which

come out in the journal PLOS ONE.

but is much more durable.

are the main features of normal cardiac tissue.

The cultivation of organs and tissues from a patient's cells is the bleeding edge of

The monitoring, carried out with the help

medical research - regenerative methods

of a microscope and fluorescent markers,

can solve the problem of transplant

showed that within three to five days a

rejection. However,it's quite a challenge to

layer of cells formed on the substrate that

find a suitable frame, or substrate, to grow

were able to contract synchronously and

cells on. The material should be non-toxic

conduct electrical impulses just like the

and elastic andshould not be rejected by

tissue of a living heart would.

the body or impede cell growth. A group of researchers led by Professor Konstantin Agladze, who heads the Laboratory of the Biophysics of Excitable Systems at MIPT, works on cardiac tissue engineering. The

These are heart tissue cells grown on a matrix, stained with fluorescent markers; Š Alexander Teplenin et al./ PLOS ONE

group has been cultivating fully functional

Researchers would normally use artificial

cardiac tissues, able to contract and

spidroin fiber matrices as a substrate to

conduct excitation waves, from cells called

grow implants like bones, tendons and

cardiomyocytes. Previously, the group

cartilages, as well as dressings. Professor

used synthetic polymeric nanofibers but

Agladze's team decided to find out

recently decided to assay another material

whether a spidroin substrate derived from

- electrospunfibers of spidroin, the cobweb

genetically modified yeast cells can serve

protein. Cobweb strands are incredibly

to grow cardiac cells.

"We can answer positively all questions we put at the beginning of this research project," Professor Agladze says. "Cardiac tissue cells successfully adhere to the substrate of recombinant spidroin; they grow forming layers and are fully functional, which means they can contract coordinately." www.medica-tradefair.com

SPRING 2015 | 25


MEDINFO April 2015

International Market &Trends

Mary-Claire King on Inherited Breast/ Ovarian Cancer May 14, 2015 by Dan Koboldt 0 Comment

It is a rare but delightful opportunity to learn about something from an acknowledged world expert. Such was the case last month when I heard MaryClaire King give the Stanley J. Korsmeyer Memorial lecture, hands-down one of the best talks I’ve ever heard. She was a wonderful public speaker: funny, charming, and straight-shooting. Her topic, of course, was inherited breast and ovarian cancer. If you don’t know the story already, Dr. King wrote a wonderful perspective in Scienceabout her role in the discovery of the BRCA1 gene and the race to clone it in the early 1990’s. Fascinatingly, she walked us through some of the pedigrees from early-onset breast cancer families described in the 1990 linkage study by her group. The women in those families got breast cancer very young (20s or 30s) and usually died from it. Male obligate carriers were generally unaffected. Even for a highly penetrant mutation like BRCA1, there were exceptions, like the carrier who lived to 81 without ever getting cancer. Of the seven early-onset breast cancer

families, six harbored mutations in BRCA1 and one had a mutation in BRCA2. That paper was the culmination of 17 years of work and mapped the BRCA1 locus to chromosome 17.

in several DNA repair genes — TP53, PALB2, CHEK2, BARD1, BRIP1, ATM, RAD51C, and RAD51D — are also known to predispose to breast and ovarian cancer.

The existence of a gene for predisposition to breast cancer triggered enormous interest in big labs in government, universities, and the private sector. It was the birth of cancer genetics.

Although BRCA1/2 carriers suffer a significantly higher risk of breast and ovarian cancer, they also tend to respond better to chemotherapy. This is not terribly surprising, because the loss of homologous DNA repair capability diminishes the ability of cancer cells to recover from DNA damage. Yet there’s also a different mechanism for DNA repair, non-homologous end joining (NHEJ), that does not involve BRCA1/2.

BRCA1, DNA Repair, and Chemotherapy At the time of its discovery, we knew nothing about the function of the BRCA1 gene. Subsequent genetics studies would reveal that it worked as a tumorsuppressor in a two-hit model of inherited cancer: the disease develops only after carriers of one loss-of-function mutation (generally a nonsense change or frameshift indel) lost the other copy to somatic mutation in a vulnerable cell type. Normally, BRCA1 forms a heterodimer with BARD1, which stabilizes the BRCA1/ BARD1/Fanconi complex. That complex repairs double-stranded DNA breaks via the homologous repair pathway. Mutations

The bad news is that this may enable tumor cells to resist chemotherapy. The good news is that we have a class of drugs, PARP inhibitors, that block the NHEJ pathway. The first clinical trial of PARP inhibitors in BRCA1/2 null cancer patients “crashed,” according to Dr. King, because the compound being used didn’t actually inhibit PARP. New clinical trials are under way. Hopefully, they’ll demonstrate that PARP inhibitors make BRCA1/2 null patients more responsive to chemotherapy, which will make genetic testing even more critical.

Genetics and Epidemiology of Familial Breast Cancer

Mapping the BRCA1 Region (Hall et al, Science 1990)

26 | SPRING 2015

The epidemiology of breast cancer is fairly well known. By rough approximation, 1 in 8 women will get breast cancer at some point in her lifetime, and 10-20% of patients will turn out to carry an inherited mutation in a known predisposition gene. Like many cancers, risk of breast or ovarian cancer is highly age-dependent. BRCA1/2 carriers not only have a higher


MEDINFO April 2015

International Market &Trends recently, was never going to work in the long term. Now, with targeted sequencing, we have the capability to detect all types of mutation (substitutions, indels, even large SVs) affecting BRCA1/2 and other susceptibility genes.

From Gene Discovery to Population Screening

BRCA1 and BRCA2 (Fackenthal & Olopade, Nat. Rev. Cancer, 2007) lifetime risk of disease, but also have a considerably higher age-dependent risk; some might even be diagnosed with disease in their 20’s or 30’s. There is also a widely accepted trend related to breast cancer incidence that’s been apparent for decades: more women are getting it, and seemingly at younger ages. Indeed, Dr. King showed some results from two large epidemiological studies of breast cancer showing that the incidence curves (incidence by age, classified by carrier/non-carrier status) are quite striking if you segregate the women into two groups: those born before 1940, and those born after 1940. There are lots of theories for why this might be, including some I might call conspiracy theories (e.g. radiation exposure, or hormones in milk). Yet Dr. King offered an explanation that I find both simple and convincing. We know that certain factors increase a woman’s risk of breast cancer. For example, the age of first menstruation (earlier = higher risk) and when she has her first child (later = higher risk). In 1950, a woman typically began menstruating at 15 and bore her first child at 21. Today, menstruation often begins sooner (say age 11, due to some complicated factors like better nutrition) and the first child often comes later (age 30, because women often pursue higher education and careers).

Nutrition and education/independence, of course, are good things. However, the side effect is that the window of time between menstruation and first child went from ~6 years in 1950 to ~19 years today. And during that window, a woman’s breast tissues are bathed in estrogen. It makes for some super-healthy cells that don’t die easily, even if they suffer mutations. That longer window simply increases the odds that a second “hit” will occur in the gene for which a woman already carries a lossof-function mutation. In support of this idea, if researchers adjust for the length of that time window, the year-of-birth effect totally goes away. I think that’s some fascinating stuff.

Genetic Structure of BRCA1/2 Interestingly, although the two most famous breast cancer susceptibility genes (BRCA1 and BRCA2) share no sequence similarity, they have a similar (and distinctive) genomic structure: many small exons and a large central exon. The central exon encodes a big portion of the protein and is surprisingly robust to amino acid substitutions, which is why most missense mutations in BRCA1and BRCA2 are non-pathogenic. Yet because these genes are so large, mutation databases have catalogued thousands of individual rare mutations that look deleterious. This is why a genotypingbased genetic test, like the one that was a cash cow for Myriad Genetics until

As the cost of sequencing-based genetic testing continues to drop, we’re in the position to screen the entire female population for cancer susceptibility genes. The World Health Organization offered guidelines for when genetic testing should be performed. In essence, four criteria must be met. 1.The disease must be an important health problem 2.Risk of disease for patients testing “positive” should be high. 3.The mutations responsible for conferring risk must be identifiable 4.Effective interventions must exist Dr. King makes a pretty compelling argument that familial breast/ovarian cancer meets these requirements. #1 and #2 are well-established. #3 is true if you know your stuff: for a while, companies like Myriad leaned heavily on the “Variant of Unknown Significance” classification when they encountered a new variant, to the point that 88% of results were reported as such. Yet an expert team, like the one at UW, can classify all but <2% of variants as either pathogenic or non-pathogenic. The PARP inhibitor clinical trials should give us the answer for #4. There are, of course, other considerations, like the cost of testing, the burden of genetic counseling, the age at which testing should be performed (Dr. King suggests 30), etc. Yet these are hurdles that can be overcome. Hurdles tha tmust be overcome, if we’re to use our growing knowledge of disease genetics to improve the state of human health.

www.massagenomics.org

SPRING 2015 | 27


MEDINFO April 2015

Hot Topic

New treatment for common digestive condition Barrett's esophagus New research from the University of Warwick and University Hospitals Coventry and Warwickshire (UHCW) NHS Trust could transform treatments and diagnosis for a common digestive condition which affects thousands of patients.

studies about this condition. Patients are currently commonly offered surgery for pre-cancerous changes in BE. However, the researchers found that in most cases, medical therapies and continuous monitoring are more effective

The esophagus or food pipe (gullet) is

to identify and prevent cancer for patients

part of the digestive system. It is the tube

than surgery.

that carries food from your mouth to your stomach. Barrett's esophagus (also known as BE) and low-grade dysplasia affects approximately 2% of the adult population, particularly those with heartburn, as acid reflux from the stomach can, over time, damage the lining of the esophagus and lead to BE. BE is seen in people undergoing endoscopy to determine the

Where patients had a more advanced form of the condition, however, the team found that endoscopic resection surgery was the best option. The team also recommended that men over 60 who had suffered gastroesophageal reflux disease (GORD) for ten years or over should be screened for

cause of their digestive problems. Barrett's

Barrett's esophagus.

esophagus can sometimes lead to cancer.

The researchers have developed a new

The team of researchers from Warwick

definition of BE to standardise diagnosis of

M e d i c a l S c h o o l , U H C W N H S Tr u s t and Coventry University's Centre for Technology Enabled Health Research

the condition for clinicians in the USA and Europe. The team has also proposed a clear plan for treating patients depending

found that invasive procedures are

on how their condition develops.

often not the best option to treat and

The world-leading study is believed to

diagnose patients suffering from Barrett's

be one of the largest reviews of this kind

esophagus.

in internal medicine. The team reviewed

Publishing their findings in the American

20,300 papers by over 100 world experts.

J o u r n a l o f G a s t r o e n t e r o l o g y, t h e

Professor Janusz Jankowski, Professor

researchers looked at a wide range of

of Acute Medicine at Warwick Medical

School and UHCW NHS Trust, said: "This paper could have huge implications for the thousands of patients diagnosed with Barrett's esophagus. We hope that our findings will transform care for patients, and also help to identify patients at risk of developing cancer at the earliest possible opportunity." Professor Cathy Bennett, Professor in Systematic Reviews, at Coventry University, said: "We created a unique opportunity for doctors and scientists from around the world to work together. We used a specially designed webbased platform to interact, discuss and summarise the vast amount of medical evidence available for the management of this condition. "As a result of our work, healthcare professionals from all parts of the world will be able to access these new key recommendations" The group now plans to look at genetic markers for BE patients, to determine the risk of patients going on to develop cancer. About Barrett's esophagus Barrett's esophagus is a common condition affecting the digestive system, which is commonly linked to long-term gastro-esophageal reflux disease (GORD). The average age at diagnosis is 62, and it is a pre-cancerous condition, meaning that a small number of patients go on to develop esophageal cancer.

www.sciencedaily.com

28 | SPRING 2015


MEDINFO April 2015

Hot Topic

How gum disease treatment can prevent heart disease New study from the Forsyth Institute is helping to shed more light on the important connection between the mouth and heart. According to research recently published online by the American Heart Association, scientists at Forsyth and Boston University have demonstrated that using an oral topical remedy to reduce inflammation associated with periodontitis, more commonly known as gum disease, also results in the prevention of vascular inflammation and can lower the risk of heart attack.

for Clinical and Translational Research. "The general public understands the connection between heart health and overall wellness, and often takes appropriate steps to prevent heart disease. More education is needed to elevate oral wellness into the same category in light of proven connections to major health conditions."

According to the CDC, heart disease

This study is the first time researchers anywhere have demonstrated the ability of an oral treatment for gum disease to also reduce inflammation in the artery wall. The active ingredient is an inflammation resolving molecule, known as Resolvin E1. This discovery further underscores the increasing body of evidence showcasing how problems in the mouth -- and how they are treated -- can have life changing influences on other key systems in the body, such as the heart in this case.

accounts for one in four deaths in the United States, and the rate continues to rise. Forsyth's findings suggest a need to expand the public's understanding of risk factors beyond cholesterol, smoking, hypertension and diabetes to include a

focus on oral health. With support from the scientific community, Forsyth aims to generate greater awareness of gum disease (affecting 64.7 million American adults according to the CDC) as a critical risk factor for heart disease, independent from diet and lifestyle. The study, titled, "Resolvin E1 Prevents Atheromatous Plaque Formation," will be published in print in the May issue of Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB), a journal of the American Heart Association. It is the first paper to show a rabbit model of accelerated heart disease, demonstrating a range of atherosclerotic plaque stages that more closely resemble those in humans without genetic modification of the animal. This research is authored by Hatice Hasturk, Rima Abdallah, Alpdogan Kantarci, Daniel Nguyen, Nicholas Giordano, James Hamilton and Thomas E. Van Dyke.

From: www.sciencedaily.com

"Our research is helping to underscore the very real link between oral health and heart disease," said Lead Investigator Hatice Hasturk, DDS, PhD, an associate member of Forsyth's Department of Applied Oral Sciences and director of Forsyth's Center

SPRING 2015 | 29


MEDINFO April 2015

Hot Topic

Genetically engineered Salmonella promising as anti-cancer therapy New study has demonstrated that

must find a balance between allowing it to

to colonize the tumors, although being

genetically modified Salmonella can be

kill the cancer and be safe for the patient.

most effective in killing tumor cells when

used to kill cancer cells. The study is

The bacteria, commonly known for causing

getting there.

published in this week's issue of mBio, an

severe food poisoning, can lead to sepsis

American Society for Microbiology online-

and death in humans.

only, open access journal.

To address this problem, the researchers then added another genetic modification, an inducible arabinose promoter. The

"There has long been interest in using

modification allowed the Salmonella to

genetically engineered microbes to target

be injected in the mouse in a form that

and destroy cells within solid tumors. I

would not harm normal, healthy cells, was

think this study goes a significant way in

effective at colonizing tumors, and after

developing some strategies that will help

entering cancer cells, would turn toxic.

in the overall means of using Salmonella

"This transition from a benign, invasive

as part of a cancer therapy," said Roy

Salmonella that doesn't hurt normal cells

Curtiss, III, PhD, who was involved with

In the new study, the researchers focused

to the toxic type occurs very rapidly (time

the research. Dr. Curtiss is University

on modifying the lipopolysaccharide

wise) in the tumor due to the very rapid

Professor of Microbiology and Director,

structure (LPS) of the Salmonella strain to

growth and cell division that occurs when

Center for Infectious Diseases and

make the bug less toxic. LPS, found in the

Salmonella enters a tumor," said Dr.

Vaccinology and Center for Microbial

outer membrane of bacteria, is one of the

Curtiss. In a normal cell, Salmonella grows

Genetic Engineering, the Biodesign

major inducers of sepsis, a life-threatening

very slowly, dividing once or twice in a 24-

Institute, Arizona State University.

infection. The researchers used genetic

hour period, but in a tumor, the bacteria

For years, researchers have known that

engineering to delete genes involved in

divide every hour.

certain strains of bacteria, including Salmonella enterica, can kill cancer cells. SpecificallySalmonella enterica Serovar Typhimurium has been shown to not only colonize solid tumors, but also to exhibit an intrinsic antitumor effect. However, in order to useSalmonella as a weapon against cancer in humans, researchers

30 | SPRING 2015

the synthesis of the LPS, and then tested various modified Salmonella strains to see how they performed in test tube studies with human cancer cells and in tumor bearing mice. They identified a particular mutant strain that was the most effective

According to Dr. Curtiss, the investigational therapy w oul d probabl y be used in conjunction with chemotherapy and radiation therapy, once it gets to human trials.

at killing cancer cells and shrinking tumors, and also unable to cause disease. However, this mutant strain was less able

www.sciencedaily.com


MEDINFO April 2015

Medical Supplies

SPRING 2015 | 31


MEDINFO April 2015

Medical Supplies

32 | SPRING 2015


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