Potential use of exenatide for the treatment of obesity

Introduction: Obesity is a major health threat in the Western world because of its high incidence and prevalence, and its association with metabolic and cardiovascular disease as well as cancer. The reduction of food intake in obese patients can be achieved only transiently (generally for no longer than 6 months), in the absence of concomitant pharmacological therapy. Only bariatric surgery provides a means to increase satiety and/or decrease nutrient absorption in obese patients, in the long term.

Areas covered: This article reviews the available pharmacological treatments for obesity as well as the pharmacology and mechanism of action of exenatide in obese type 2 diabetic patients.

Expert opinion: Exenatide is a potential new candidate treatment for obesity, possibly in combination with other hormones that increase satiety (leptin) and slow gastric emptying (amylin).     

Making choices about medical interventions: the experience of disabled young people with degenerative conditions

Background Current western policy, including the UK, advocates choice for service users and their families, taking greater control and being more involved in decision making. However, children’s role in health decision making, especially from their own perspective, has received less research attention compared to doctors and parents’ perspectives. Objective To explore the perspective and experiences of disabled young people with degenerative conditions as they face significant medical interventions and engage in decision‐making processes. Design and methods Findings from a longitudinal qualitative study of 10 young people (13–22 years) with degenerative conditions are reported. Individual semi‐structured interviews were conducted with participants over 3 years (2007–2010); the paper reports data from all three interview rounds. Interviews focused on medical intervention choices the young people identified as significant. Results Although the young people in this study felt involved in the medical intervention choices discussed, findings demonstrate a complex and diverse picture of decision making. Results highlighted different decisional roles adopted by the young people, the importance of information heuristics and working with other people whilst engaging in complex processes weighing up different decisional factors. Discussion Young people’s experiences demonstrate the importance of moving beyond viewing health choices as technical or rational decisions. How each young person framed their decision was important. Recognizing this diversity and the importance of emerging themes, such as living a normal life, independence, fear of decisions viewed as ‘irreversible’ and the role of parents and peers in decision making highlights that, there are clear practice implications including, active practitioner listening, sensitivity and continued holistic family working.     

浅析敦煌地区粟特人的医药史

从粟特人的医药观、医药职业及就医环境3方面探讨敦煌地区粟特人的医药史,指出粟特人沿着丝绸之路东行,经商贸易,敦煌地区有很多粟特人聚集生活,在医药史方面,敦煌出土文书、吐鲁番出土文书、粟特人墓志铭以及唐代医事制度典籍均有零星记载,总体特征是在粟特人聚落没有专门的粟特人医药机构,粟特人医家也记载较少,这与当地官办、寺院医坊已相当完备有关,粟特人除在疾病方面注重医药治疗外,还注重神灵庇佑,加之因其经济相对宽裕而形成的养生保养习惯,使得粟特人中不乏长寿之人。     

A short history of portal hypertension and of its management

The aim of our study was to review the changing trends in the treatment of complications from portal hypertension. A short history of portal hypertension and of the treatment of its complications is reported, underlying the most important achievements and changes.     

复用器械使用后保存方式与时间对清洗效果的影响

目的探讨复用医疗器械使用后安全有效的保存和清洗方法,保证复用医疗器械清洗灭菌质量,降低由这一途径引起的医院感染。方法采用人工污染方法,将新鲜血液污染后的复用医疗器械随机分为A1、A2、B1、B2、C1、C2、D1、D2、E1、E2共10组,每组污染器械又分为6个小组,分别放置1h、2 h、3 h、4 h、12 h、16 h后再采用不同清洗方法对污染的医疗器械进行清洗,对清洗后的医疗器械进行潜血阳性检查,以检验清洗效果.该实验重复3次,合计4500件实验器械。结果对不同保存方法,不同的放置时间段,不同的清洗方法清洗后的复用医疗器械,潜血阳性率差异有统计学意义（P〈0.01）,其中放置16 h,不加任何处理开放保存的器械采用多酶机清洗[1]潜血阳性率最高,为66.67%。5种保存方法在1 h内2种清洗方法清洗,潜血阳性率差异无统计学意义（P〉0.01）。浸清水或多酶洗液浸泡组的器械在16 h内2种清洗方法清洗,其潜血阳性率在各自组内比较,差异无统计学意义（P〉O.01）。开放保存组、干密闭组和喷酶保存组2种清洗方法清洗,潜血阳性率在各自组内比较,差异有极显著的统计学意义（P〈0.01）。结论污染的医疗器因存放方式、存放时间及清洗方法的不同,清洗效果有明显差异。     

Evaluation of Different Laboratory Tests and Activity Indices Reflecting the Inflammatory Activity of Crohn's Disease

In a prospective study we compared the usefulness of various laboratory tests (albumin, alpha-1-proteinase inhibitor (A1PI), cholinesterase (CHE), C-reactive protein, erythrocyte sedimentation rate, hematocrit) and activity indices (CDAI, VHAI) in relation to the disease activity by endoscopic criteria. Except for hematocrit highly significant differences (p < 0.0005) of the mean values of all test results were found for patients without or with slight mucosal lesions compared with patients with severe inflammation of the mucosa. Further analysis of the data indicates the highest test efficiency (84%), sensitivity (80%), and specificity (88.6%) for CHE. CHE showed good correlations to all other tests; the highest correlation was found between CHE and VHAI (r = -0.78). We suggest that a suppression of CHE synthesis mediated by endotoxins and cytokines rather than an increased intestinal loss explains the decreased CHE in severe Crohn's disease. It is concluded from the data that CHE is a useful test to assess the inflammatory activity of Crohn's disease.