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.
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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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