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Health Policy Of Last Resort - Blame The Doctors, Australia

Health Policy Of Last Resort - Blame The Doctors, AustraliaAMA President, Dr Rosanna Capolingua, said she was shocked by Health Minister Tony Abbott's extraordinary attack on doctors over three matters for which he has had the total cooperation of the AMA and the medical profession.Dr Capolingua said the Minister's unprovoked criticism of doctors' performance in informed financial consent (IFC), the Medicare safety net, and medical advertising appears to be a case of political point scoring by blaming doctors for policy failure on the eve of an election."The Minister's speech last night was a classic case of using a sledgehammer to crack a walnut," Dr Capolingua said."We are in agreement and working with him in all three areas, the only point of difference being the Minister's unreasonable expectation that the IFC rate should be 100 per cent of private hospital procedures."It would appear that the Minister is setting the scene for the Government to legislate to compel doctors to provide (IFC) to all patients in every situation, even when it is impossible for them to position to do so."Doctors are not in a position to discuss fees with patients who are unconscious, in pain, or in distress in accident or emergency, or when complications occur during surgery."The doctors are busy saving lives."Well over 85 per cent (and rising) of patients receive full IFC for their private hospital procedures."The small number of cases where IFC is not provided have been addressed by a joint AMA/Government education campaign over the last twelve months, and which the Government has funded for another year."You would think the Minister would be applauding the improved IFC rates, not recklessly exploiting an already identified area of non-compliance."To threaten compulsion through legislation at this stage smacks of pre-election populist politics with the old 'greedy doctors' line about gap payments."I remind the Minister that doctors charge fees. Gap payments are the domain of the private health funds and the Government."

FIP Honours Outstanding Pharmacists And Pharmaceutical Scientists

FIP Honours Outstanding Pharmacists And Pharmaceutical ScientistsDuring the Opening Ceremony of the 67th FIP Congress in Beijing, China, the Federation honoured some of the world's leading pharmacists and pharmaceutical scientists with the 2007 FIP Awards. This year, the Board of Pharmaceutical Sciences awarded FIP's highest scientific honour, the Høst-Madsen Medal, to Dr Patrick Couvreur (France). The medal is given every two years to an outstanding pharmaceutical scientist, and is offered by the Danish Pharmaceutical Association to honour the memory of former FIP President Dr Høst-Madsen. Complementing this prestigious accolade within the pharmaceutical sciences were two awards recognizing outstanding achievement in Pharmacy Practice. The Distinguished Practice Award went to Ms Jane Nicholson (UK), for her longstanding contribution to and enthusiasm for many branches of pharmacy practice both in and outside of the United Kingdom. Joining her was Prof. Dr Zoltán Vincze (Hungary), the recipient of the Lifetime Achievement Award for Pharmaceutical Practice for his dedication to the advancement and improvement of Pharmaceutical Practice and recognition of pharmacists in Hungary and on a global level. In addition, the following individuals were acknowledged and will hereby by recognized as FIP Fellows, for consistently upholding the qualities and professional characteristics deemed by FIP to deserve this special recognition.

Apple Q4 profits boosted by iPhone and Mac sales

Apple Q4 profits boosted by iPhone and Mac sales Apple Inc. on Monday reported strong earnings for its fourth quarter, boosted by record Macintosh computer sales and the shipment of 1.12 million iPhones.The company beat analyst estimates with net income of US$904 million, or $1.01 per share, compared with $542 million, or $0.62 per share, in net income reported in last year's fourth quarter. Analysts polled by Thomson Financial estimated a consensus of $760.45 million in net income and earnings of $0.84 per share for the quarter ended Sept. 29. The company reported $6.22 billion in revenue, up from $4.84 billion in the fourth quarter last year. The revenue consensus from analysts polled by Thomson was for $6.07 billion.For fiscal 2007, Apple reported net revenue of $24 billion and net income of $3.5 billion, said Peter Oppenheimer [CQ], Apple's chief financial officer, in a conference call with financial analysts. Looking ahead, the company estimates that revenue will hit $9.2 billion, with earnings per share of $1.42 for the first fiscal quarter of 2008, Oppenheimer said.The company shipped 2.16 million Macs during the quarter, a 34 percent growth over the year-ago period, Apple said in a news release. Mac sales increased worldwide, spurred by back-to-school promotions, said Tim Cook, Apple's chief operating officer, on the call. In addition to rapid growth in the U.S. and Europe, Mac unit shipments also increased in Japan, a major market where Apple has traditionally struggled to grow, Cook said. Shipment of Mac notebooks, including MacBook and MacBook Pro, grew 31 percent year-over-year and accounted for 62 percent of all Macs sold, Oppenheimer said.Given the success of this back-to-school period, Mac sales could be flat in the upcoming quarter, Cook warned.Sales of the iPhone are outpacing those of the iPod during the first few months after its 2001 introduction, Cook said. The company shipped 1.39 million iPhones during the year, and saw a spike in sales after a $200 price drop of the 8G-byte iPhone from $599 to $399 in September.Apple is confident it will sell 10 million iPhones in the next calendar year, Cook said.Apple sold 10.2 million iPods during the quarter, a 17 percent year-over-year growth. iPod has sold 120 million units to date, Oppenheimer said. The upcoming holiday shopping season will be a big quarter for iPod sales, Oppenheimer said.Apple had a busy quarter with multiple product announcements.Last month, it unveiled the iPod Touch, a portable multimedia player with a touchscreen user interface and Wi-Fi capabilities. It also announced availability of the iPhone in Europe, with U.K. network operator O2 (UK) Ltd. slated to start shipping the device in November. The company is excited about entering the Europe market, and plans to enter the Asia-Pacific market in 2008, Cook said. On the software front, Apple announced iWork '08, its office applications suite, in August. Mac OS X Leopard, Apple's latest operating system, will begin shipping later this week.

Plague Suspected In Death Of Man In Arizona

Eric York, a 37 year old wildlife biologist who worked at the Grand Canyon National Park who was found dead at his home on the South Rim of the Canyon in Arizona on November 2nd, probably died of the plague caught while carrying out an autopsy on a mountain lion that had probably died of the disease a week earlier.Plague, due to the bacterium Yersinia pestis, was confirmed as the likely cause of death following preliminary laboratory tests at the Arizona Department of Health Services (ADHS) and the Centers for Disease Control and Prevention (CDC).York had been treated at a local clinic for flu like symptoms that started three days after he did the autopsy, but nothing more serious than that was diagnosed at the time. When he was found dead health officials suspected either plague or hantavirus that causes a type of hemorrhagic fever, and immediately tracked down 49 people who had been in recent contact with him so they could have aggressive antibiotic treatment. None of them has become ill.Plague is primarily a disease of animals and rarely infects humans, who can catch it from being bitten by rodent fleas or, as is suspected in the case of York, from direct contact with infected animals. York' symptoms were similar to those of pneumonic plague, the most serious, but least common form of plague.Plague can be passed on from one human to another, and from animals to humans, through coughing and sneezing, which thrusts infected droplets into the air that is then breathed in by others. However, according to the CDC, human to human infection is rare, and their records show the last time this happened in the US was in 1924.Symptoms of pneumonic plague include: high fever, chills, nausea, chest pain, cough, headache, and blood in the saliva. Symptoms are often accompanied by a painful, enlarged lymph node in the groin or armpit. If treated early with antibiotics, the chances of survival are very high.Anyone who has these symptoms, particularly if they have been exposed to fleas, sick cats, rodents or rabbits in areas where plague may be active, should seek medical attention immediately. Plague is considered endemic high in the mountains of northern Arizona (above 4,500 feet). 48 cases of plague have been reported in the state since 1977, eight of which were fatal. Not one was reported between 2001 and 2007, which officials put down to drought conditions and high summer temperatures.In September 2007, Arizona health officials released news of the state's first human infection since 2000, a woman in Apache County, who became ill following a flea bite at her home in the northern part of the state. She was given antibiotics and is now recovering, they said.Craig Levy, head of Arizona's Vector Borne and Zoonotic Disease Program, said at the time that:"The recent appearance of plague activity in two northern counties has us concerned that we may see plague in other areas as well." Animal cases of plague in Arizona in 2007 include prairie dog colony die-offs in two separate neighbourhoods in Flagstaff in Coconino County, and a pet cat in Prescott in Yavapai County.Arizona state health officials warned campers, hunters, hikers and others who live at 4,500 feet or higher or are visiting the area, to take the following precautions to avoid being exposed to the plague: Do not handle sick or dead animals.Don't go near rodent burrows. Avoid exposure to fleas. Stop your dog or cat from roaming as they can bring home plague infected fleas. Use flea control products on your dog or cat, ask your veterinarian about the best ones. Wear protective gloves when cleaining or skinning wild animals, for instance for cooking. If cooking game meat, do so at 180 degrees, until the juices run clear. If you get start getting symptoms like those listed above, within 6 days of a potential exposure, seek medical help at once. If your cat falls ill, get it checked by a veterinarian. For more information call the Grand Canyon National Park Incident Information Center at (928) 638-7922 or (928) 638-7688.

New ESC ESH Guidelines On Arterial Hypertension

In 2000, 26% (972million) of the adult population worldwide had hypertension and this figure is estimated to rise by 2025 to 1.56billion. Such individuals have an increased risk of stroke or heart disease and the detection and effective management of such patients presents an enormous challenge to healthcare systems. Identifying specific patients at risk of developing organ damage will allow better deployment of preventative healthcare resources.Against this background, the European Society of Cardiology and the European Society of Hypertension have revised their 2003 guidelines based upon the publication of new evidence. The cornerstone of treatment remains the introduction of lifestyle measures such as increasing exercise, reducing body weight and other environmental factors such as reducing the intake of alcohol and salt before embarking on a treatment programme involving drugs.Three issues then follow: First, identifying the high-risk patient. The new guidelines continue to stratify patients according to level of presenting blood pressure and the detection of other risk factors -- metabolic syndrome, sub-clinical organ damage or diabetes or finally, established cardiovascular or renal disease. The two latter categories place patients at moderate to very high risk and of course, treatment should be very aggressive.The second issue is the class of drugs to be used. The ESC and ESH agree that the most important factor in reducing an individual's cardiovascular risk is lowering blood pressure. Against this background, there is some evidence emerging that particular classes of drugs may have the ability to protect against specific organ damage. Although this is intriguing further investigation is needed to verify the evidence. Newer classes of drug, for example, may be able to prevent the development of Type 2 diabetes or at least delay the onset of this problem, which inevitably rapidly increases an individual's cardiovascular risk.Another interesting area is the detection of sub-clinical organ damage. Initially this was largely confined to the detection of albuminuria or elevated creatinine, which is not only important parameters for defining renal function and progressive renal failure, but also for delineating increased cardiovascular risk. However, as methodology has improved the measurement of intimal medial thickness and pulse wave velocity have become more generally acceptable and with these the possibility of again defining cardiovascular risk at an earlier time-point and with more accuracy. Similarly, microcalcification of medium sized blood vessels using high resolution CT scanning has been demonstrated to be important although of course the technology necessary to measure this is much more limited. However, the concept of earlier detection of vascular damage and the recognition that it is extremely prognostically important means that we have new ways of characterising the risk associated with patients and a fresh impetus to interfere with blood pressure levels at a much earlier point to prevent irreversible end-organ damage.The third issue is the target level to be achieved. This has largely remained unchanged from 2003 with the target for the majority of patients being 140/90mmHg or less. In patients at higher risk with Type 2 diabetes and hypertension, this level is 130/80, which is now extended to patients with previous history of stroke or evidence of renal dysfunction. The importance of detecting and treating hypertension cannot be overestimated -- effective treatment of hypertension reduces the risk of developing stroke by more than 40% with almost immediate impact and on coronary artery disease, over a period of several years the risk will be reduced by more than 20%. This increasing healthcare problem needs to be tackled promptly and efficiently in an ever enlarging cohort of asymptomatic patients.

Effect Of Miglustat On Bone Disease In Adult Type 1 Gaucher Disease (GD1): Results Of Apooleda Pooled Analysis

Effect Of Miglustat On Bone Disease In Adult Type 1 Gaucher Disease (GD1): Results Of Apooleda Pooled AnalysisActelion Ltd (SWX: ATLN) announced the publication of "Effect of miglustat on bone disease in adult type 1 Gaucher disease: a pooled analysis of three multinational open label studies" (Pastores et Al) in Clinical Therapeutics, vol 29, number 8, 2007. This pooled analysis investigates the efficacy of Zavesca® (miglustat) in controlling bone manifestations, such as bone pain, osteopenia and osteoporosis, bone crisis and fractures, in Gaucher Disease type 1 patients. The data in this analysis is drawn from the Zavesca pivotal studies OGT 918 - 001, 004, 005. Bone manifestations are considered among the most painful and debilitating components of Gaucher Disease type 1 highly impacting on patients' quality of life. It has been estimated that bone pain occurs in more than half of GD1 patients and that 26% will develop bone crisis (1); in addition GD1 has been shown to effect affect bone metabolism leading to an increase in bone resorption, which causes a decrease in bone mineral density (BMD), osteopenia and osteoporosis in the majority of the GD patients. Furthermore, the current standard treatment, enzyme replacement therapy (ERT), has shown only limited efficacy in GD1 related bone disease (2) (3) (4). The analysis involved 72 patients, including 41 (57%) who had received previous ERT and 20 (28%) who had undergone splenectomy. Patients' mean (SD) age was 41.2 (13.1) years. The most frequent bone related manifestations at study entry were osteoporosis (43/63 [68%] patients) and bone pain (41/65 [63%] patients). This paper, led by Dr. Gregory Pastores, associate professor of neurology and pediatrics at the New York University School of Medicine, has shown that at two years 83% (54/65) of the patients reported no bone pain compared to baseline data. The reductions in bone pain were comparable among all subgroups, including high-risk patients (i.e. splenectomized). Moreover, there were no new cases of "bone crisis", osteonecrosis or fracture; BMD Z-scores were improved from baseline at both the lumbar spine and femoral neck at each time point (months 6, 12, and 24) (P < 0.001). As early as 6 months after the initiation of miglustat monotherapy, significant increases from baseline in the BMD Z-score were observed at both the lumbar spine (mean, 0.15; P = 0.022) and femoral neck (0.23; P < 0.001); the increases remained significant at 12 months (0.19 [P = 0.012] and 0.21 [P = 0.017], respectively) and 24 months (0.21 [P = 0.015] and 0.18 [P = 0.039]). Significant increases in BMD Z-scores were observed at the femoral neck in splenectomized patients (P < 0.001) and at both sites in osteoporotic patients (lumbar spine: P < 0.001; femoral neck: P = 0.006). Lead investigator Dr Gregory Pastores commented: "Bone disease in patients with Gaucher Disease can be a source of severe debilitation and remains a major management issue. The beneficial effect of miglustat on bone manifestations and especially on bone pain in these patients might be explained by its wide tissue distribution even in deep organs such as bone and by a direct effect on bone cells." Zavesca is currently not approved for the treatment of bone manifestations in Gaucher disease type 1. About Gaucher's diseaseGaucher's disease is a rare genetic disorder, which results from reduced activity of glucocerebrosidase, a key enzyme responsible for the metabolism of glycosphingolipids (GSL - a subclass of fats). Symptoms include enlargement of spleen and liver, bone disease, anaemia, intense fatigue, and in some cases lung involvement. About Zavesca® in type 1 Gaucher DiseaseZavesca® (Miglustat) is the only oral treatment option approved for adults with type 1 Gaucher disease for whom enzyme replacement therapy is not a therapeutic option. It is the first in a class of drugs known as substrate reduction therapy. Zavesca® reduces the rate of formation of glucosylceramide, a glycosphingolipid that accumulates in Gaucher disease, to a level that can be cleared by the remaining enzyme, thus preventing the build up of excess glucosylceramide in the macrophage cells. Zavesca® is approved and available in the European Union, United States, Canada, Switzerland, Brazil, Australia and Israel. Zavesca is currently not approved for the treatment of bone manifestations in Gaucher disease type 1. Zavesca® safety informationMild-to-moderate tremor was reported in approximately 30% of patients in all Zavesca trials combined. Many cases were resolved spontaneously within 1 to 3 months; dose reduction may ameliorate tremor within days;3 patients claimed tremor as one of the reasons for withdrawal from the clinical trials although 1 of these was considered unrelated to Zavesca. The most common adverse reactions in all Zavesca trials combined were diarrhoea and weight loss. Gastrointestinal events, mainly diarrhoea, have been observed in more than 80% of patients treated with Zavesca®, either at the outset of treatment or intermittently during treatment. The majority of cases are mild and are expected to resolve spontaneously on therapy. In clinical practice, diarrhoea has been observed to respond to diet modification (reduction of lactose and other carbohydrate intake), to taking Zavesca® away from meals, and/or to anti-diarrhoeal medication such as loperamide. In some patients, temporary dose reduction may be necessary. Patients with chronic diarrhoea or other persistent gastrointestinal events that do not respond to these interventions should be investigated according to clinical practice. Zavesca® has not been evaluated in patients with a history of significant gastrointestinal disease, including inflammatory bowel disease. Weight loss was mild (6% - 7% of total body weight); most prevalent in the first year of treatment and stabilized thereafter; no patients claimed weight loss as a reason for withdrawal from the clinical trials.Peripheral neuropathy has been reported in type 1 Gaucher patients treated with Zavesca®. Patients should undergo a neurological exam at the start of treatment and regularly thereafter. Zavesca® should be reassessed in patients who develop symptoms of peripheral neuropathy. Zavesca® may cause fetal harm if administered to a pregnant woman and is contraindicated in women who are or who may become pregnant; patients should be apprised of the potential hazard to the foetus. There is a risk of impaired fertility in men. Men should maintain reliable contraceptive methods and not plan to conceive while taking Zavesca® and for three months thereafter. References- Mankin et al. Clin Genet 2006- Charrow et Al, 2007. - Mankin et al. Clin Genet 2006 - Pastores et al. Semin Hematol 2004Actelion Ltd Actelion Ltd is a biopharmaceutical company with its corporate headquarter in Allschwil/Basel, Switzerland. Actelion's first drug, Tracleer®, an orally available dual endothelin receptor antagonist, has been approved as a therapy for pulmonary arterial hypertension. Actelion markets Tracleer® through its own subsidiaries in key markets worldwide, including the United States (based in South San Francisco), the European Union, Japan as well as Canada, Australia and Switzerland. Actelion, founded in late 1997, is a leading player in innovative science related to the endothelium - the single layer of cells separating every blood vessel from the blood stream. Actelion focuses on the discovery, development and marketing of innovative drugs for significant unmet medical needs. Actelion shares are traded on the SWX Swiss Exchange (ticker symbol: ATLN).

GetABI Study Finds That Even Mild Atherosclerosis In The Legs Increases Mortality Substantially

GetABI Study Finds That Even Mild Atherosclerosis In The Legs Increases Mortality SubstantiallyPatients with atherosclerosis in the leg arteries face a substantially increased all cause and cardiovascular mortality risk, according to a large study presented at the European Society of Cardiology Congress in Vienna.Heart attacks and strokes as a result of atherosclerosis have been ranked for years among the most common causes of deaths in Europe. Another previously underestimated manifestation of atherosclerosis is peripheral arterial disease (PAD), which is closely associated with heart attack or a stroke.The German epidemiological study on Ankle Brachial Index (getABI) was initiated in 2001 to answer questions about whether a simple screening test on atherosclerosis can be applied to identify it at an early stage, and if so, what risk such patients carry in the future. Professor Curt Diehm from the Clinic Karlsbad-Langensteinbach, an affiliated teaching hospital of the University in Heidelberg, and his co workers from various renowned medical institutions in Germany presented a 5 year study follow-up.Professor Diehm explained: "We used the ankle brachial-index (ABI), which is simple to understand and to apply by physicians and nurses. In an individual in the supine position, the blood pressure in the leg arteries is equal to or a little higher than in the arm arteries. If atherosclerotic stenoses in the legs manifests (termed PAD), blood flow after the obstruction decreases, and the pressure in the leg artery is lower than in the arm. This sign is almost and reliable as angiography to identify your atherosclerotic risk patient."The study included a total of 6,880 unselected patients in primary care, which underwent ABI testing by their primary care physician. Mean age of the patients was 72.5 years, 58% were females, 46% were past or current smokers, 74% had hypertension, 24% diabetes mellitus and 52% lipid disorders. Of all patients, 18.0% in the total cohort had a pathological ABI test, but the majority of these patients had no clinical signs or complaints.After a 5 year observation period, all cause mortality was 24% in patients with symptomatic PAD, 19% with asymptomatic PAD (i.e., pathological ABI but no complaints), and 9% in patients without PAD. Even when all other known risk factors for cardiovascular death were accounted for by statistical means, PAD had the best ability to predict future death, stroke or myocardial infarction.Professor Diehm said, "The bad news is: we showed that in primary care every fifth patient aged 65 years or older has atherosclerosis in the leg arteries. Because atherosclerosis is not a local process but at the same time progresses in the heart and brain vessels, such patients usually die from heart attacks or stroke. The good news is that the ABI test is not limited to expert use but can be performed in general practice. Thus, family physicians can identify high risk patients and initiate and maintain effective treatment in this large group."The study also showed that the extent of the blood pressure difference between legs and arms matters: the higher the spread between both pressures is (in other words: the lower the ABI), the higher is the mortality of patients.Professsor Diehm said that every effort should be made to implement the ABI screening in standard programs for elderly patients and patients with cardiac risk factors such as diabetes or hypertension. "A huge number of lives could be saved if patients with atherosclerosis would be identified with the ABI, and treated timely."

The Goals Of Platelet Inhibition In Acute Coronary Syndromes

The Goals Of Platelet Inhibition In Acute Coronary SyndromesPlatelet activation and aggregation play important roles in the pathogenesis of cardiac ischemic events after either spontaneous plaque disruption in acute coronary syndromes or mechanical disruption of coronary artery plaques caused by percutaneous coronary intervention (PCI), which could be considered an artificially induced acute coronary syndrome.Standard therapy for the prevention of thrombotic events after acute coronary syndromes and coronary stenting involves dual antiplatelet therapy with aspirin plus a thienopyridine, already established in European and American guidelines years ago. Thienopyridines, like clopidogrel and prasugrel, block platelet activation and aggregation by inhibiting the P2Y12 ADP receptor. Most clinical trials supporting the use of thienopyridines plus aspirin in PCI compared with aspirin alone were originally conducted with ticlopidine. However, clopidogrel has largely replaced ticlopidine for use in PCI because of better tolerability and a lower risk of hematologic abnormalities compared with ticlopidine.Despite the widespread use of clopidogrel in patients undergoing PCI with currently available thienopyridines, several important issues remain. Data from the Clopidogrel to Reduce Events During Observation (CREDO) trial suggest that most of the acute effect seen in reducing periprocedural events with clopidogrel was limited to patients who received the drug at least 6 hours, and perhaps as many as 15 hours, before the procedure.As irreversible inhibitors of platelet function, the effects of thienopyridines are long-lasting, and therefore seem to carry a more or less inherent risk of bleeding complications, also resulting in a reluctance in current clinical practice to give these agents before determining whether a patient is likely to need coronary bypass surgery or using it over very long periods. This balance in efficacy/side-effects may be especially important for patients that receive a drug-eluting stent, which may require prolonged powerful antiplateletherapy to avoid the recently reported very late (>1 year after drug eluting stent implantation) stent thrombosis, a serious an possibly life threatening conditition.Finally, a significant variability in the response to clopidogrel among healthy subjects and patients undergoing PCI or suffering from ACS has been observed, with some individuals having minimal inhibition of ADP-induced platelet aggregation.This concept of clopidogrel resistance led to the concern that some patients may not be adequately protected from the intense platelet activation and aggregation that occur after ACS with or without PCI and are therefore at increased risk for thrombotic events. Because of all of these issues, an improved antiplatelet regimen for the treatment of ACS and to support PCI still seems desirable.Promising results with Prasugrel (CS-747, LY640315) a novel thienopyridine antiplatelet agent that has been shown in preclinical studies and in the JUMBO TIMI 26 trial to be possibly more potent and to have a more rapid onset of action than clopidogrel.ConclusionsThe currently most used thienopyridine antiplatelet agent clopidogrel is an important component of the adjunctive therapy in ACS and PCI with (drug eluting) stenting. However since on one hand not all thrombotic complications are avoided and on the other hand still bleeding complications do occur, there seems to be room for improvement with new and hopefully better (thienopyridine) antiplatelet agents, especially since patients with drug eluting stents implanted may require prolonged treatment with this class of drugs.

Imaging And Percutaneous Valve Therapy

Imaging And Percutaneous Valve TherapyThe scope of percutaneous cardiac therapy has expanded from percutaneous coronary and peripheral intervention to percutaneous valve intervention, first used in the mid eighties. Today mitral regurgitation represents the second most important native valve disease in Europe (30%) as shown by the Euro Heart Survey.When patients present with symptoms, or when there are objective signs of poor tolerance in patients without symptoms, surgery should be performed using as often as possible surgical mitral valve repair, as this treatment has shown safety, efficacy and good long-term results.However, real life observation, once again from the Euro Heart Survey, has shown that mitral valve repair is performed only 50% of the time. This shortfall is mostly due to a lack of expertise in performing the procedure. Finally, observations from the Euro Heart Survey also stress the fact that half of the patients, despite the presence of severe symptoms and severe mitral regurgitation, are not considered for surgery by their practising physicians. Thus, there is a need for treatment, other than surgery, for high-risk patients or those denied surgery.Percutaneous mitral valve repair was introduced only a few years ago. There are two different approaches to percutaneous mitral valve repair.The first approach is the edge to edge technique, which creates a double mitral valve orifice replicating the surgical intervention pioneered by Professor Alfieri. This technique is very demanding since it requires transseptal catheterisation and sophisticated collaboration between the echocardiographist and interventionist to catch the valve at the appropriate moment and location. Preliminary clinical results obtained in over 100 patients suggest that in expert hands the feasibility of the technique is high (80-90%) and the degree of mitral regurgitation can be reduced to mild in two-thirds of cases. In addition, the risk is low, once again, in experienced centres. In patients where the procedure was successful, two-thirds of the cases remained event free after three years. Thus these data, even if only preliminary, are encouraging.The second possible approach is mitral annuloplasty, which is achieved by introducing a constraining device in the coronary sinus located in the vicinity of the mitral annulus. The rationale here is that ring annuloplasty is almost always combined with other procedures during surgical interventions on the mitral valve. More than ten devices have been designed and three are currently being studied. They share common technical features: distal fixation and proximal fixation in the coronary sinus and a bridge between these two fixating elements. Here the procedure is easier since it only requires a catheterisation of the coronary sinus. Preliminary results from the EVOLUTION study in 60 patients show here again high feasibility (90%) and good safety profiles since almost 80% of the patients experienced no complications within 90 days. Very preliminary efficacy data suggest a reduction in the degree of regurgitation.Clearly at the present stage these two approaches do not yet reach the standard of the multiple surgical techniques that make the success of surgical mitral valve repair.The annuloplasty technique could be potentially used in patients with functional mitral regurgitation, while the edge to edge technique could be used in selected patients with degenerative mitral regurgitation.The potential clinical indications of the new percutaneous techniques are represented by the vast group of patients with contraindications or judged to be at very high risk for surgery. Before considering extending the application of these techniques to other patients, trials should be performed in order to answer 3 major questions: how much are we ready to lose in terms of efficacy by going percutaneously as opposed to surgically? Secondly, how much are we ready to risk in patients who have not yet reached surgical indication? And finally, will the performance of this percutaneous intervention compromise subsequent treatment possibilities?Many devices are currently being studied or are at the experimental stage: suture based direct annuloplasty, percutaneous mitral valve replacement, or transpericardial left ventricular remodelling.In conclusion, the first steps of percutaneous mitral valve repair have been taken in almost 300 patients and show the feasibility of this technique suggesting also a reduction in the degree of mitral regurgitation.Today, we are at the stage of evaluation and the research should be carefully evaluated in comparison with surgery and standard contemporary medical treatment including cardiac resynchronisation. Trials such as EVEREST II, EVOLUTION II, and AMADEUS are underway.The development of these new techniques will require close collaboration between engineers, interventionalists, imaging specialists, and surgeons.

Plague Suspected In Death Of Man In Arizona

Eric York, a 37 year old wildlife biologist who worked at the Grand Canyon National Park who was found dead at his home on the South Rim of the Canyon in Arizona on November 2nd, probably died of the plague caught while carrying out an autopsy on a mountain lion that had probably died of the disease a week earlier.Plague, due to the bacterium Yersinia pestis, was confirmed as the likely cause of death following preliminary laboratory tests at the Arizona Department of Health Services (ADHS) and the Centers for Disease Control and Prevention (CDC).York had been treated at a local clinic for flu like symptoms that started three days after he did the autopsy, but nothing more serious than that was diagnosed at the time. When he was found dead health officials suspected either plague or hantavirus that causes a type of hemorrhagic fever, and immediately tracked down 49 people who had been in recent contact with him so they could have aggressive antibiotic treatment. None of them has become ill.Plague is primarily a disease of animals and rarely infects humans, who can catch it from being bitten by rodent fleas or, as is suspected in the case of York, from direct contact with infected animals. York' symptoms were similar to those of pneumonic plague, the most serious, but least common form of plague.Plague can be passed on from one human to another, and from animals to humans, through coughing and sneezing, which thrusts infected droplets into the air that is then breathed in by others. However, according to the CDC, human to human infection is rare, and their records show the last time this happened in the US was in 1924.Symptoms of pneumonic plague include: high fever, chills, nausea, chest pain, cough, headache, and blood in the saliva. Symptoms are often accompanied by a painful, enlarged lymph node in the groin or armpit. If treated early with antibiotics, the chances of survival are very high.Anyone who has these symptoms, particularly if they have been exposed to fleas, sick cats, rodents or rabbits in areas where plague may be active, should seek medical attention immediately. Plague is considered endemic high in the mountains of northern Arizona (above 4,500 feet). 48 cases of plague have been reported in the state since 1977, eight of which were fatal. Not one was reported between 2001 and 2007, which officials put down to drought conditions and high summer temperatures.In September 2007, Arizona health officials released news of the state's first human infection since 2000, a woman in Apache County, who became ill following a flea bite at her home in the northern part of the state. She was given antibiotics and is now recovering, they said.Craig Levy, head of Arizona's Vector Borne and Zoonotic Disease Program, said at the time that:"The recent appearance of plague activity in two northern counties has us concerned that we may see plague in other areas as well." Animal cases of plague in Arizona in 2007 include prairie dog colony die-offs in two separate neighbourhoods in Flagstaff in Coconino County, and a pet cat in Prescott in Yavapai County.Arizona state health officials warned campers, hunters, hikers and others who live at 4,500 feet or higher or are visiting the area, to take the following precautions to avoid being exposed to the plague: Do not handle sick or dead animals.Don't go near rodent burrows. Avoid exposure to fleas. Stop your dog or cat from roaming as they can bring home plague infected fleas. Use flea control products on your dog or cat, ask your veterinarian about the best ones. Wear protective gloves when cleaining or skinning wild animals, for instance for cooking. If cooking game meat, do so at 180 degrees, until the juices run clear. If you get start getting symptoms like those listed above, within 6 days of a potential exposure, seek medical help at once. If your cat falls ill, get it checked by a veterinarian. For more information call the Grand Canyon National Park Incident Information Center at (928) 638-7922 or (928) 638-7688.

CDC: New respiratory bug has killed 10

ATLANTA - A mutated version of a common cold virus has caused 10 deaths in the last 18 months, U.S. health officials said Thursday. Adenoviruses usually cause respiratory infections that aren't considered lethal. But a new variant has caused at least 140 illnesses in New York, Oregon, Washington and Texas, according to a report issued Thursday by the U.S. Centers for Disease Control and Prevention.
CDC officials don't consider the mutation to be a cause for alarm for most people, and they're not recommending any new precautions for the general public.
"It's an uncommon infection," said Dr. Larry Anderson, a CDC epidemiologist.
The illness made headlines in Texas earlier this year, when a so-called boot camp flu sickened hundreds at Lackland Air Force Base in San Antonio. The most serious cases were blamed on the emerging virus and one 19-year-old trainee died.
"What really got people's attention is these are healthy young adults landing in the hospital and, in some cases, the ICU," said Dr. John Su, an infectious diseases investigator with the CDC.
There are more than 50 distinct types of adenoviruses tied to human illnesses. They are one cause of the common cold, and also trigger pneumonia and bronchitis. Severe illnesses are more likely in people with weaker immune systems.
Some adenoviruses have also been blamed for gastroenteritis, conjunctivitis and cystitis.
There are no good antiviral medications for adenoviruses. Patients usually are treated with aspirin, liquids and bed rest.
Some people who get infected by the new bug probably would not suffer symptoms, and some may just feel a common cold. Sick people should see a doctor if they suffer a high fever or have trouble breathing, Anderson said.
In the CDC report, the earliest case of the mutated virus was found in an infant girl in New York City, who died last year. The child seemed healthy right after birth, but then became dehydrated and lost appetite. She died 12 days after she was born.
Tests found that she been infected with a form of adenovirus, called Ad14, but with some little differences, Su said.
It's not clear how the changes made it more lethal, said Linda Gooding, an Emory University researcher who specializes in adenoviruses.
Earlier this year, hundreds of trainees at Lackland became ill with respiratory infections. Tests showed a variety of adenoviruses in the trainees, but at least 106 — and probably more — had the mutated form of Ad14, including five who ended up in an intensive care unit
In April, Oregon health officials learned of a cluster of cases at a Portland-area hospital. They ultimately counted 31 cases, including seven who died with severe pneumonia. The next month, Washington state officials reported four hospitalized patients had the same mutated virus. One, who also had AIDS, died.
The Ad14 form of adenovirus was first identified in 1955. In 1969, it was blamed for a rash of illnesses in military recruits stationed in Europe, but it's been detected rarely since then. But it seems to growing more common.
The strain accounted for 6 percent of adenovirus samples collected in 22 medical facilities in 2006, while none was seen the previous two years, according to a study published this month in the medical journal Clinical Infectious Diseases.
The new bug could have implications for the military. Other forms of adenoviruses have been a common cause of illness in recruits. Military officials are bringing back an adenovirus vaccine — administered as a pill — that was given to recruits from 1971 to 1999, CDC officials said.
A Barr Pharmaceuticals vaccine for the military, currently being tested, is expected to be licensed in 2009. Like the old pill, it focuses on adenovirus serotypes 4 and 7, because those bugs have been persistent problems, said Col. Art Brown, an Army physician involved in the product's development.
Some CDC officials said a vaccination against the mutant Ad14 might be needed. Brown said it isn't clear if the mutant Ad14 will be an enduring threat, but the military will monitor illness reports.
"If it persists, then we'd consider if the vaccine needs to be modified further," said Brown, of the U.S. Army Medical Materiel Development Activity.

Musculoskeletal Regeneration Research Receives First-Of-A Knd ' Emerging Frontiers' NSF Grant

Musculoskeletal Regeneration Research Receives First-Of-A Knd ' Emerging Frontiers' NSF GrantA research group led by Dr. Cato T. Laurencin, with faculty representing five departments at the University of Virginia, will work on a first-of-its kind, $2 million grant project as they explore novel methods for the regeneration of musculoskeletal tissues. The grant from the National Science Foundation is known as an EFRI grant -- Emerging Frontiers in Research and Innovation. The group, led by Dr. Laurencin, with faculty in orthopaedic surgery, chemical engineering, biomedical engineering, electrical engineering and materials science, will investigate several innovative ways to engineer new material surfaces that will allow a range of musculoskeletal tissues to grow. "These studies should give us important fundamental information that will be broadly applicable in tissue engineering and regenerative medicine," said Dr. Laurencin, principal investigator (PI) for the studies and Professor of Orthopaedic Surgery, Biomedical Engineering and Chemical Engineering at the University of Virginia. "This grant complements my recently awarded Department of Defense grant aimed at exploring new strategies for limb regeneration." Laurencin said that a team approach is needed to tackle such a great problem. "The National Science Foundation Grant allows for a broad team that will explore important material surface cues to permit optimum cellular interactions. Learning how best to design materials, create artificial tissues and understand their healing abilities -- ultimately, for the successful treatment of our patients -- is what this translational research program aims to do," Laurencin said.

Musculoskeletal Regeneration Research Receives First-Of-A Knd ' Emerging Frontiers' NSF Grant

Musculoskeletal Regeneration Research Receives First-Of-A Knd ' Emerging Frontiers' NSF GrantA research group led by Dr. Cato T. Laurencin, with faculty representing five departments at the University of Virginia, will work on a first-of-its kind, $2 million grant project as they explore novel methods for the regeneration of musculoskeletal tissues. The grant from the National Science Foundation is known as an EFRI grant -- Emerging Frontiers in Research and Innovation. The group, led by Dr. Laurencin, with faculty in orthopaedic surgery, chemical engineering, biomedical engineering, electrical engineering and materials science, will investigate several innovative ways to engineer new material surfaces that will allow a range of musculoskeletal tissues to grow. "These studies should give us important fundamental information that will be broadly applicable in tissue engineering and regenerative medicine," said Dr. Laurencin, principal investigator (PI) for the studies and Professor of Orthopaedic Surgery, Biomedical Engineering and Chemical Engineering at the University of Virginia. "This grant complements my recently awarded Department of Defense grant aimed at exploring new strategies for limb regeneration." Laurencin said that a team approach is needed to tackle such a great problem. "The National Science Foundation Grant allows for a broad team that will explore important material surface cues to permit optimum cellular interactions. Learning how best to design materials, create artificial tissues and understand their healing abilities -- ultimately, for the successful treatment of our patients -- is what this translational research program aims to do," Laurencin said.

Diesel Air Pollution Linked To Heart Attack And Stroke In Healthy Men

Diesel Air Pollution Linked To Heart Attack And Stroke In Healthy MenUK and Swedish researchers found that diesel fumes from road vehicles increased blood clots and platelets in healthy volunteers. These are symptoms closely linked to increased risk of heart attack and stroke.The researchers reported the results of a small study to a meeting of the American Heart Association's Scientific Sessions 2007 held in Orlando, Florida, earlier this week.Previous observational and epidemiological studies have also shown a close link between exposure to traffic pollution and heart attack, said study lead author Dr Andrew Lucking, who is a cardiology fellow at the University of Edinburgh in Scotland, UK."This study shows that when a person is exposed to relatively high levels of diesel exhaust for a short time, the blood is more likely to clot. This could lead to a blocked vessel resulting in heart attack or stroke," said Lucking.Lucking and colleague carried out a double blind, randomized cross-over study on 20 healthy male participatns aged from 21 to 44. Using a specially designed exposure chamber, the men were separately exposed to filtered air (this was the control) and then to 300 mg per cubic metre (mcg/m3) of diesel exhaust fumes, which is roughly the concentration you breathe in while standing by a busy street.The researchers measured clot formation, blood coagulation, platelet activity and markers of inflammation by attaching each participant to a perfusion chamber and allowing a small amount of blood to pass through it. This was done 2 hours after exposure and then again 6 hours after exposure.Clot formation was assessed by passing the blood through a special shear chamber that simulates the types of pressure the blood would be under in blood vessels. The researchers tested the blood at high shear and low shear.Platelet activation was assessed by measuring the number of platelets associated with white blood cells. When platelets are activated they stick to white blood cells like neutrophils and monocytes and form clumps, thereby playing a key role in the formation of blood clots.The results showed that: Breathing diesel fumes increased clot formation in the low shear chamber by 24.2 per cent compared to breathing filtered air.In the high shear chamber the increase in clot formation from diesel fumes was 19.1 per cent.These effects were observed at both 2 and 6 hours after exposure to diesel fumes.Breathing diesel fumes increased platelet-neutrophil aggregates from 6.5 to 9.2 per cent 2 hours after exposure.It also increased platelet-monocyte aggregates from 21 per cent to 25 per cent 2 hours after exposure.But at 6 hours after exposure the platelet activation increases due to diesel fumes were not statistically significant.Lucking said: "High levels of traffic pollution are known to increase the risk of heart attack in the immediate hours or days after exposure."He said this study showed a "potential mechanism that could link exposure to traffic-derived air pollution with acute heart attack."Although these results apply to diesel engine fumes, it's not clear whether gasoline powered engines would have the same effect, said the researchers. Diesel fumes contain a much higher concentration of very fine particles, they said.Diesel engines are on the rise because they offer superior fuel economy, but, as Lucking explained:"While diesel engines burn more efficiently, they also put more fine particulate matter into the air."The researchers said while exercise was good for people with cardiovascular disease, they would not recommend they exercise near traffic congestion.The UK and Swedish team will be working together on the next step, which is to test the effectiveness of the particle traps fitted to diesel engines to reduce exhaust particles."Exposure to air pollution clearly is detrimental and we must look at ways to reduce pollution in the environment," said Lucking.An earlier study published in the 13th September issue of the NEJM , also by UK and Swedish researchers, showed that men with coronary heart disease who inhaled diesel fumes experienced a three fold increase in stress on the heart.

工作

昨天上班的时候有两间事,都是属于口误造成的.
第一件是一个学生寄信,就问同事(杀鸟那个),请问信交在哪里?结果他回了一句,交信在类边,啥子信交哦,表乱说.第二件是外面的人用特快专递寄了一个篮球到学校,一起上班的阿姨说了一句话，把我恩笑到了住,拉说:硬是钱多了索,寄个球!

诡异的电影<不能说的秘密>

今天没事又看了两部电影,你现在听到的歌就是电影<十面埋妇>里的插曲,是不是有点搞笑的感觉。 《不能说的秘密》没看前，据了解是爱情片吧，前三分之二的情节也是按这个思路走的。后三分之一，难道是鬼片？人鬼情未了。除了周杰伦外，任何人都不知道女主角的存在。随剧情发展原来是科幻片，女主角穿越时空，来到20年后。期间还有一点惊险片的情节，就是学校拆毁琴房那里。 简直可以用峰回路转来形容，呵呵。

Results Of Dental Health Study Of Minority New York City Youth

Results Of Dental Health Study Of Minority New York City YouthHispanic youth report better dental health habits than their non-Hispanic peers, according to a study of northern Manhattan adolescents by researchers at Columbia University Mailman School of Public Health. The study, which is published in the November issue of the Journal of Health Care for the Poor and Underserved, provides insight into the oral health of the diverse Hispanic community in America. The study, a snapshot of more than 3,200 children ages 12 to 16, who live in the northern Manhattan communities of Central Harlem and Washington Heights/Inwood, found that 94 percent of the youth responding to the study were Hispanic or black. More then 2,300 of the respondents identified themselves as Hispanic, and the greatest number of the Hispanic adolescents was of Dominican descent. In most national studies of children's oral health, the data on Hispanics largely reflects Mexican-American youth. "The study provides important information on the oral health for a Hispanic subgroup other than Mexican Americans, said Luisa N. Borrell, DDS, MPH, assistant professor of Epidemiology at the Mailman School of Public Health, and at Columbia University College of Dental Medicine, and co-author of the study. "Studies focusing on other Hispanic subgroups will help us understand the difference within the Hispanic population and underscore the need to examine health outcomes for each Hispanic subgroup whenever data is available," Dr. Borrell noted. The study relied on questionnaires filled out by the youth and clinical exams performed during each child's visit to a school-based dental clinic. Researchers found cavities in 52 percent of the Hispanic participants and 54 percent of the black youth. "This study may help us define the oral health status of Hispanic subgroups other than Mexican Americans. We still have a lot to learn about what factors are protective for the oral health of these kids, and what will work to improve that health," observed Dr. Borrell. Overall, dental health and health promoting habits of the Hispanic children were better than the other participants in the study. Ninety-four percent of Hispanic youths reported that they brush daily compared with 83 percent of blacks and 85 percent of the other children in the study. Hispanic youths were also more likely to floss. Many more Hispanic youths reported having had a dental visit sometime in their lifetime. Researchers noted moderate-to-abundant plaque in 27 percent of the Hispanic adolescents, compared with 36 percent of blacks and other children in the study. "The study's findings need to be interpreted with caution as we did not have information on the education and income of the adolescent participants' families. Also, we didn't know what proportion of these children were foreign born, which can be a protective effect for health," Dr. Borrell said.

罪过,罪过!

昨天要下班的时候,上班的地方居然飞了一只类似鸽子又不是鸽子的鸟进来,被我同事逮斗了,结果他马上就把它杀来打整出来拿回家炖汤了,汗啊.

Lowering Homocysteine With B Vitamins Does Not Reduce Cardiovascular Risk

GetABI Study Finds That Even Mild Atherosclerosis In The Legs Increases Mortality SubstantiallyPatients with atherosclerosis in the leg arteries face a substantially increased all cause and cardiovascular mortality risk, according to a large study presented at the European Society of Cardiology Congress in Vienna.Heart attacks and strokes as a result of atherosclerosis have been ranked for years among the most common causes of deaths in Europe. Another previously underestimated manifestation of atherosclerosis is peripheral arterial disease (PAD), which is closely associated with heart attack or a stroke.The German epidemiological study on Ankle Brachial Index (getABI) was initiated in 2001 to answer questions about whether a simple screening test on atherosclerosis can be applied to identify it at an early stage, and if so, what risk such patients carry in the future. Professor Curt Diehm from the Clinic Karlsbad-Langensteinbach, an affiliated teaching hospital of the University in Heidelberg, and his co workers from various renowned medical institutions in Germany presented a 5 year study follow-up.Professor Diehm explained: "We used the ankle brachial-index (ABI), which is simple to understand and to apply by physicians and nurses. In an individual in the supine position, the blood pressure in the leg arteries is equal to or a little higher than in the arm arteries. If atherosclerotic stenoses in the legs manifests (termed PAD), blood flow after the obstruction decreases, and the pressure in the leg artery is lower than in the arm. This sign is almost and reliable as angiography to identify your atherosclerotic risk patient."The study included a total of 6,880 unselected patients in primary care, which underwent ABI testing by their primary care physician. Mean age of the patients was 72.5 years, 58% were females, 46% were past or current smokers, 74% had hypertension, 24% diabetes mellitus and 52% lipid disorders. Of all patients, 18.0% in the total cohort had a pathological ABI test, but the majority of these patients had no clinical signs or complaints.After a 5 year observation period, all cause mortality was 24% in patients with symptomatic PAD, 19% with asymptomatic PAD (i.e., pathological ABI but no complaints), and 9% in patients without PAD. Even when all other known risk factors for cardiovascular death were accounted for by statistical means, PAD had the best ability to predict future death, stroke or myocardial infarction.Professor Diehm said, "The bad news is: we showed that in primary care every fifth patient aged 65 years or older has atherosclerosis in the leg arteries. Because atherosclerosis is not a local process but at the same time progresses in the heart and brain vessels, such patients usually die from heart attacks or stroke. The good news is that the ABI test is not limited to expert use but can be performed in general practice. Thus, family physicians can identify high risk patients and initiate and maintain effective treatment in this large group."The study also showed that the extent of the blood pressure difference between legs and arms matters: the higher the spread between both pressures is (in other words: the lower the ABI), the higher is the mortality of patients.Professsor Diehm said that every effort should be made to implement the ABI screening in standard programs for elderly patients and patients with cardiac risk factors such as diabetes or hypertension. "A huge number of lives could be saved if patients with atherosclerosis would be identified with the ABI, and treated timely."

峨眉山3日详细流水

本来是去年国庆计划去的，结果后来放弃了，这次除了张磊两口子没去，基本上都是五一去草海的原班人马，只是多了两个罗琳叫上的她的两个朋友。 成员有：周云、李姐、涵涵（8岁）、罗琳、陈婷、钟声、赖科、我。共8人。 原订计划：3号星期五坐6点10分自贡-峨眉的车出发，大概12点钟左右到峨眉，吃午饭后大概2点钟左右开始进山，从前山往上爬。晚上住宿前必须到达洪椿坪，如果时间允许可以去仙峰寺，住宿在仙峰寺是最理想的，基本可以保证第二天晚上抵达金顶，而住宿在洪椿坪第二天登顶就要吃力多了。4号星期六要到达金顶。5号一早起来看日出，在下午2点半以前坐最后一班车回自贡。计划是完美的，但是实际执行起来，就完全乱了，完全没有预计的那么容易，下面就把详细的行程整成流水帐，看看我们的旅途是如何的坎坷地，惨啊。。。。呵呵！ 2号我从下午开始收拾东西，反正想啊想的就 要装点东西进背包里，或者从里面拿出来！一直整到3号凌晨2点过才睡。我背包里的东西有：旅游鞋一双、毛绒外套一件、望远镜、薄的牛仔裤一条、体恤两件、雨伞、饭盒、筷子、牙刷、手机充电器、针线、扑克、扇子。估计重量在15斤左右，到第二天早上出发一背才发觉好重哦，但是已经来不及了清理了，估计也清理不出什么名堂，都是觉得应该带上的物品。 5：30的闹铃，然后挨个打骚扰电话，但估计他们比我还起的早。5点50坐两轮到了客运站。一看除了罗琳外，都到了。等了5分钟，罗琳到了。我、小周、罗琳三人都是背的大背包，估计重量都在15到20斤左右。爬山都背这么重，汗啊。 6：14 大巴车出站。 6：33 到达长土。 6：50 到达白房。 7：11 到达一个不晓得名字的小镇。 7：50 到达鼎新。 9：00 到荣县。自贡到荣县的路修了几年，仍然还在修，路太烂了，完全就是条4车道的机耕道。这一段路坐车很刺激，下坡的时候就象坐海盗船失重的感觉差不多。罗琳、陈婷、涵涵、李姐都有不同程度的晕车。李姐最惨，先是一个人霸占了一根板凳，睡在上面。后来来了一个婆婆要说要坐前面免得晕车，李姐只好起来，结果晕车反应就更大了，吐了。反正车上的人很多都吐了，车的后面一股怪味，幸好我坐在前面味道不是很重。车过了荣县路况好了很多，大家晕车的感觉减轻了许多。 9：45 到达长山已经到了自贡的边界了。 11：20到达乐山。这里有个地名叫沙湾。我们都说，要到自贡了，喊师傅在十字口刹一脚，呵呵。更搞笑的是，钟声不知是看到了嘉陵江还是岷江，就问卖票的大姐，这是大渡河吧，把我们笑到了住（我刚看查了下地图，好象是岷江和大渡河，汗啊）。同时司机告诉我们离峨眉只有10多分钟了，大家都期待着。。。。。。。 11：45终于抵达目的地-峨眉山长途车站。到候车室看了回自贡的车的时刻。每天直达市区的最晚一班车是下午2点半，不过有到其他市的车要走自贡过，比如到宜宾的可以在板桥高速路口下，还有到富顺的，到卢洲的可以在邓关下车等等。 12：15进入背对车站的右手边的一条岔路里的饭馆吃饭。只记得其中一个是回锅肉。吃完饭，我们又走到车站，短了两个的士，一个15元，到报国寺。在景区门口的广场照了几张相，去报国寺。结果走错了路，从一座小山上走下来，结果报国寺在山的另一边，还好路程不远，我又返回去。从报国寺左边的上山公路走到伏虎寺这段路程是1公里。路过伏虎寺没进去，因为要赶路。过了伏虎寺，路过善觉寺也没上去，因为上面是条死路，难得跑上跑下的。 13：55到了卖门票的地方，我们几个有学生证，结果都没通过验证。要求是：不能是成教的学生，所以你的学生证只要显示有成教几个字，就不行。还要求每学期都要注册盖章，不然不行。还有就是入学时间，超过了3年或者4年应该属于已经毕业的也不行。反正她们会一丝不苟的找你的证件所有的漏洞，尽最大努力让你买不到学生票。小孩子1米1以下不买票，以上买半票，1米4买全票。拿到票后，就去照相，他们会把照片直接打印到门票上面，门票是两日有效，可以进出。由于拐杖太贵了，他们一人买了一根枯竹杆，一元一根。我没买，觉得没必要。 14：40到达雷音寺，这里有很多蜜蜂乱飞。也是这一段路检测出了我们的体能。由于这一段上路比较陡，体能比较差的小周同志，已经感到力不从心了，而且还带了个8岁的孩子，加上十多斤的背包，再加这里还不算是真正的上山，万里长征第一步还没踏出来。我们当初对体能的估计过于乐观，对物品的准备也太过于细致。同志们切记啊，爬山千万别带太多东西啊，真的背起老火啊！ 15：45到达纯阳殿，好象是这一段路找到一个挑夫，因为大家的背包太重了，前面又还有很多路要走，因为计划是今天要走到洪春坪的。而有几个人的体能又支持不住，所以只好出钱叫他把我们4个人的背包挑到清音阁再说，说好是50元。 16：10到达神水阁，在这里小周、李姐、陈婷和罗琳、钟声、赖科对行走的线路产生了分歧（后面简称为1队和2队）。1队因为对自己的体能产生严重怀疑，理由如前所述：都是上山爬坡，东西又重，还有个小孩，体能根本就支持不住，速度慢了，2天根本没有从前山爬到金顶的可能。要求改变线路：马上去五显岗坐车上金顶住一晚，第二天看日出，然后走路下山。2队的意图我不清楚，但估计和我当时的想法（注意：这只是当时的想法）是一样的：既然来峨眉山，就是要爬上去，才有意义。最后2队只好把辎重扔给1队，带了些必要的东西，轻装上山。1队去五显岗坐车先上金顶。我先是打算去爬山，但是李姐劝我跟他们一路，我考虑了下，同意了（事后证明，酱紫做是完全正确地，节约了钱，沿途的重要景点也看了）。 17：15我们1队走到五显岗，结果没有上金顶的车了。而且第二天最早的车6：20发车，而金顶日出是6点10分出来，看来日出也没法看了。只好去找住宿的地方，在 峨眉山讲解投诉管理中心 旁边的小巷里有家私人旅店还不错，2人间住5个人总共才84元，还有电视、空调、单独的厕所洗澡间、女厕所有个甩干机，老板的服务态度还多好，还可以在楼下吃饭（不免费）。离五显岗车站也很近，出门不到50米远。 17：45我们收拾停当，吃了点零食，出发去清音阁游玩，路程大概是1.5公里，离的不远。路边很多买纪念品的小摊。看到有卖乌木的生肖牌，价格也不贵，结果因为不知道朋友的生肖只好作罢，打算买点蝴蝶标本做的书签带回去送，嘿嘿，价格便宜嘛。途中路过一个人工修成的大水塘，居然有一棵树长在水里，很奇特，不过没什么树叶，不晓得是不是因为被水泡了才这样地。塘边还有索道我们上去照了几张相。再望前走，看到一个景点叫 唐老鸭树，我们看了半天，都没看明白对面的树哪里象唐老鸭。有走了10多分钟，来到牛心亭下面类似一个水坝的地方，正好水坝正在放水，那里有几个学生在耍，我们也跑过去跑到坝上去走。我还跑到坝下面去淌水，水冰凉的，我下去的时候没踩斗刹车，结果把短裤都打湿了。还抓到一个小蝌蚪。这里的蝌蚪最大的有摄象头那么大，小周说是弹琴蛙的蝌蚪，有点恐怖哦。玩完水，我们来到牛心亭，照了几张相，觉得这里很凉快，我还抱着牛心石照了相。又到庙里看了看，又慢慢往回走。来到峨眉山讲解投诉管理中心，我们就进去借用电脑把小周一天照的相片打成包传到我的口口网络硬盘里，因为他的相机内存比较小。回到旅店，点了2碗豆花和一个酸菜粉丝汤，再拿出自带的抽了真空的冷吃肉吃饭，没想到饭有点馊，只好吃稀饭。自带冷吃肉很必要，尤其是上山后，可以节约点菜钱。吃着吃着还停了10分钟的电。吃完，回房间，洗澡，洗衣服，浪衣服，一天的消费情况盘存一气呵成。发短信得知2队爬到晚上9点过才找到住的地方，而且是走的后山。我们还拿出在管理中心拿的免费资料研究起路线来，发现一下午的行程都是围着报国寺绕圈，绕了一大圈没走多远，如果走五显岗直插清音阁、一线天，估计晚上可以到洪椿坪，不过也幸好转这一圈，不然一上去就没退路了，只有硬往上爬，体能影响速度，1天半是肯定无法到达金顶的。其结果是超出3天的时间才能回自贡或者是从山上退下去再想办法，那样的话行程就彻底乱了。一看时间，都11点过了，赶快开空调睡了。 〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓〓

8月4日星期六 5：20 起床，一看昨晚浪在门口的衣服，没干。OS、ON、刷牙、洗脸，整理装备，把不要的东西都寄存在旅店，我的东西基本上都要用的，所以我背上了我沉重的背包上路了。 6：05 出门。 6：10 买好了6：20发车去金顶的车票。 6：45 晚点35分钟后，中巴车终于到了。go go go .... 7：40 到达公路 零公里 车场。 8：55 车子通过剪票口，终于又上路了。因为车里大部分人都没票或者有票没去照相，所以要下车去排队买票照相才能进山。结果害我们等了一个多小时。 9：45 离雷洞坪还有一里路的地方因为堵车，只好下来步行了。 10：15经过短暂的休整，开始踏上最后的登顶行程。因为听说前面有猴子，所有暴露在外的口袋，都放进包里了。结果这里的猴子相当的规矩还有人看守。 10：55到达接引殿，考虑到后面还有6公里上山的路程，把我的包寄存在了接引殿，只带了必要的物品，提了一个塑料的袋子继续往上冲刺。这里终于体会到了爬山的痛苦，累啊，提着个口袋都很累，就不提如果是背那个背包了。 12：40到达太子坪。 13：10终于到了金顶大酒店，并和1队顺利会师，历史性的一刻。此刻大家都先到了井冈山。2队昨天和我们分手后的线路为：中峰寺-广福寺-清音阁-白龙洞-万年寺-息心所-长老坪-初殿，这么长的线路从16：30爬到21：30。第二天12：45到达金顶。金顶修建的东西太新了，没的历史沧桑的感觉。只是十面佛有点巨大，我还跑到里面去看了看。上次来，还看到了日出和贡嘎山，并且可以看到山底的风光。这次日出、云海、佛光什么都没捞到，雾气又大，山下什么都看不到，就更不提看什么贡嘎山了。不过看到周围的雾气随风而动，翻滚腾挪，还是蛮壮观的。雾气会瞬间飘来，把周围的一切都遮的严严实实，雾气转瞬过去后，一切又显现出来，而且雾气很凉爽，被太要晒久了用雾气降降温还不错。只要不在金顶住宿，根本不用带厚衣服或者租大衣，一件长袖体恤足以。 14：45坐上缆车，用了10分钟不到就到了接引殿。休息15分钟再接着走。这里我把旅游孩换了，再穿旅游鞋走下去，我的脚指头肯定着不猪，还是穿凉鞋舒服点。 15：10又要开始征程了，加油先到雷洞坪再说，只有1.5公里，又是下山，应该要不倒好多时间。 15：20我就说吧，要不了多少时间的，到了三。上去用了40分钟，下来才10分钟，不会吧。 15：35经过1队与2队的紧急磋商最后1队和2队从新组合。1队：周云、李姐、涵涵、陈婷、赖科、我，线路为雷洞坪经前山走下山去；2队：罗琳、钟声，因爬山上来，体能消耗过大，无法再继续走下山去，所以坐车下去再找地方住宿。一出发，陈婷和赖科就冲到前面去了，毕竟是年轻人啊，有活力，再加上他们星期一要赶回去上班不能耽搁，最迟必须坐明天下午2点半的最后一班车回自贡，不然打地都要回去。剩下我、小周、李姐、涵涵慢慢往下撤，本来小周是计划他和涵涵先撤下山的，但是李姐认为时间够用，坚持要他们一家人都走下山去，免得留下遗憾。小周一路上都在说，是被李姐诓来的，他和涵涵的体能哪里能爬山嘛。特别是涵涵一个8岁的小朋友，头天走了起码有10多公里路，早上又从雷洞坪爬上金顶，又是个9公里。对一个8岁的小孩子来说，真是不容易啊，而且一路上经管脚痛，但是没有主动的叫她爹妈背过，都是她爹地主动的去背她，她还不情愿。也没吵着要吃这样吃那样。浪乖的娃儿很少见哈。也幸好她这么乖，不然后面的路可咋走哦。估计她妈老汉弄她来爬山，就是知道她不会耍赖不走的。 17：00越往下走，雾气越大。我们一瘸一拐的下到洗象池，这里正在维修，洗象池的是水也脏的不得了，不过这里有很多猴子，幸好这里的猴子还比较文明，看来是学习过三个代表，是一个合格的和谐猴子。我们没敢招惹他们，他们也没理我们，就这样走过去了。而且我们的饼干和火腿肠就提在手里，它们也没抢，这一点迷惑了我们，以为峨眉山的猴子都是和谐猴，为后面的危险埋下了伏笔。 17：15我们在洗象池照了几张相后，继续往下赶路。 18：20走下钻天坡，来到九岭岗。从钻天坡上已经可以望见遇先寺了。但那里还不是我们的目的地，主要是那里没有住宿的地方。这个钻天坡真是陡啊，几乎是40度的梯子扶摇直上，幸好我们是往下走，不然要耗费很大的体能才能上去。现在回想起来，估计这里算是整个峨眉山最险要也最考验体能的地段，99道拐根本不算什么。在坡上我们遇到几个虔诚的朝圣者，三步一扣首，一步三个台阶。九领岗是前山和后山步行道的交汇合点。过了九岭岗，又是一个下山的道路，在路过一个路边店时，我们发现店子的前面有只猴子，李姐赶快拿出饼干来喂，没想到店子的下面路上还有两只猴子，这两只猴子一看就是路霸，因为一只老青猴就直接坐在路的中央，一副收过路费的样子。我们想把装饼干和火腿肠的袋子藏起来，已经来不及了。李姐抓了一把饼干，扔到路边，乘两只猴子争抢时，溜了过去。但类2个猴子明显是长期在这一带打劫路人的专业户，职业素质那是相当的高，把饼干塞到嘴里装起，又来抢李姐手里的饼干。它们龇牙咧嘴的，嘴里还怪叫，李姐怕它们扑到她身上来抢，吓的她尖叫一声把手的口袋和拐杖就扔地上了。猴子拖着袋子往旁边的悬崖跑去，幸好我的一双旅游鞋没和装食品的袋子拴一起，不然也一并拖去了，呵呵。反正就是吃的东西一定要放在背包里，遇到这种半路杀出来的猴子，就要小心了。或者准备点饼干装成小袋，递给它们当过路费，估计它们看你手里没东西了，就会放行的。 18：50到达遇仙寺。这里我在一个宜宾人发在论坛里的照片看到过，因为这里在搞维修，有一个小的搅拌机，他奇怪的是遇仙寺在山的半中腰，两边都是台阶路，这个搅拌机是怎么运到这里的。我也纳闷，所以问了那里的民工，原来是先把搅拌机通过公路运到五显岗，再从洗象池、九岭岗人工抬到这里的，无法想象他们当时是怎么抬到这里的，修缮用的石子是用附近的石头在现场打的。收到赖科发的消息，说他们两人已经到了仙峰寺，并且已经订了房间。 19：10下到遇仙寺所在山谷的谷底，这里有个路边店，我们点了一个汤，一份素菜，然后拿出冷吃肉开始用餐，因为天色越来越暗，怕前面没吃的地方了，还有就是也实在饿了，吃的东西又被猴子抢了。现在冷吃肉的作用发挥出来了，吃了13块钱，还吃的比较满意。 19：35出发往今晚的住宿地仙峰寺进发。听店老板说，还有半个小时的路程就到仙峰寺，我们想他们要半个小时，我们应该一个小时可以到，毕竟我们的速度要慢点，这样算来8点半左右可以到，因为一般是9点钟完全天黑。不过经过一天的跋涉，涵涵的脚已经受不了了，一直嚷脚痛，但是仍然坚持着和大人走。走到离仙峰寺还有大概一公里路时，居然哭了，毕竟走了一天，而且天色又晚了，对小孩子来说，基本达到了体能的极限了。正好这时抬滑竿的师傅下班回家，路过，就讲好价钱，一个小孩20元，抬到仙峰寺，先涵涵还不愿意，说要自己走，我们古斗她坐上去，这也是她全程唯一一次坐滑竿。我把背包也给滑竿师傅背了，大家都轻装继续最后的冲刺，在滑竿的带领下，小周的速度也提了起来，很快就到了仙峰寺，发了消息叫赖科和陈婷出来接我们，幸好他们抢先到达订好了房间，不然我们后来的话，就只能分开到各个房间去住了，而不能住在一间房间里面。6个人住了个7人间175元。赖科和陈婷他们冲到洗象池子，本来说要等我们的，但是看到很多人都往仙峰寺赶，他们也慌了，怕到时没的住处，连忙星也往仙峰寺冲，路上还听说有猴子拦路抢劫，劫食不劫色，已经有十多个人被抢了，陈婷吓惨了，怕被猴子抢去当压寨猴子，帽子也不敢戴了，拼命抓住赖科的胳膊才冲过那一段猴子出没的地带。休息了一会儿，我们听说仙峰寺有洗脚房，于是周云、赖科、我便下楼一路寻去，终于在女厕所旁边找到了洗脚房，这个洗脚房居然还有提供免费洗浴中心，只不过当我们进去刚说脱衣服时，才知道这里只提供冷水。因为仙峰寺地段的气候比较低大概22度左右，我们没敢洗冷水。出来到大厅的洗脚房，找了两个盆子，一人放了一盆热水泡脚，走了一天，脚都要冒烟了，当时的感觉就是人生最大的幸福莫过于洗脚（洗脚、洗澡免费）。洗完脚，又是商量明天的线路，及一天消费的盘存。商量的结果为：陈婷、赖科因为后天星期一要上班，最晚必须坐明天下午2点半的最后一班车回自贡。所以明天中午以前他们要冲下山去，不能等我们一路。而剩下的人，小周虽然星期一也要上班，但是体能有限，对剩下的路程估计半天是走不下去了，只能走多少算多少，尽力往下赶，预计是下午3点左右才能下山，但已经无法坐到2点半的车了，所以只能在山下住一晚，星期一早上再坐车回自贡。我由于星期二才上班，所以可以跟小周一家人一起慢慢往下走。一看时间10点过了累了一整天，赶快睡了。

五一再游草海之流水帐

回望2006年五一期间的那次草海游，感叹时光飞逝，咋一年的时间，眼睛一眨就过去了呢。这次活动早在去年就开始策划了，当时并未确定是什么地方，大概是3月份开始确定是贵州的草海，虽然我去过一次，但是感觉那里的消费水平比较低，花费比较少，又比较远，可以坐7个小时的火车，所以我们选定了草海，并订了票。 5月2日晚上8点，我们在帝豪门口集合，在门口放眼一望，没发现小周两口子，一转身发现小周就在对门，背个背包，跟拉个高中生样，还没把拉认出来，最扯的是，他背个多大的背包，李姐却背个逛街的小挎包，就象是去逛街一样，清点人数：张磊和她爱人平平、周云和爱人李姐、罗琳、陈婷。转身到超市买了水和吃的东西，小周他们带了一大口袋的卤鸭、卤翅膀等卤制品，当时还说吃不了这么多，结果最后还是吃完了，不得不佩服他们的高瞻远瞩，呵呵。买完东西，直接坐9路车到火车站，当时才8点半的样子，我们在车站门口照了几张相，然后打算去找个茶楼，喝茶等车，因为车是10点13分才到。但是想到茶是3块钱一杯，还不如去上网，反正最后人心不齐，我们一行人最后统一思想，达成一致，去候车大厅坐下来等车。火车准点到达，我们凭票上了14号车厢，软座，1-7号，但是却分为了5个座位在过道的左边，2个座位在右边。火车开动，一个半小时就到了宜宾，看来，火车果然提速了，后面的站就不知道了，因为天黑，只有当列车员报站时，才知道是什么站到了。我们把那5个位子占住，用来睡觉，一次可以睡两个人，另外再找了5个位子坐下打牌聊天。但是到了彝良还是大关，车上一下上了很多人，好象大部分都是当地出去打工的，一下，车上的味道就变了，贵州缺水，所以当地人，一般都很少洗澡的。我睡在坐位上，结果被一个估计是少数民族的mm喊醒，喊我们让她们坐一下，我起先不想让的，但她一直叫，没办法，只好起来了，结果发现车上已经人山人海了，我和陈婷一起来，就让了3个位子出来。反正晚上坐车，车外的风景是完全没法看到了，这也蛮遗憾的，上次去，又是站着去的，没位子，也无法完全领略铁轨旁的景致。 火车3号早上7点过到威宁站，我们一下车，就遇到一个当地的一个回族大姐，说可以送我们进县城，我们去看了一下回去的车次，然后跟随她上了面包车，一人3元，先找了几家旅馆都客满了，最后还是选了邮政宾馆，就住去年我们住的房间的旁边，开了一个3人间和4人间，一人10元，虽然条件不怎么好，但是有电视，电热毯，厕所用水是用一个桶来装的水，只有走廊的末端有公用自来水，而且还常常停水。但价格便宜，我们还算满意。对了，那里的气候依然和去年一样冷，今年我带了厚一点的衣服，但是还是感觉有些冷。大家收拾好后，把所有贵重的和实用的东西带上，其他东西都扔在旅馆里，然后到旅馆对门的一个卖早餐的小店里吃米线，吃完后顶着旅途的疲倦，赶赴草海游玩。我们没在正规码头上船，那里的船都很贵，步行到距离正规码头大概一里路的另一个码头，讲好7个人160元在中游耍一个半小时，从一条窄窄的水道往前进发，越走湖面越宽，视野越来越开阔，直到一眼望不到边际。今年的飞禽很少，我们只看到一只小鸭子在远处游动，听女船老大说，还有7对鸳鸯，但不知在什么地方，还见到一只白鹭。去年我们见到的野鸭、大雁等飞禽，现在不知所踪。船到中游，船老大诱惑我们，说下游的水草多，风景更好。我们说加50元去下游，但她不同意，非要加100才去，我们没同意。但过了一会，她又说50元，可以去下游，但我们又觉得在湖里飘来飘去，一点不自由，放弃了去下游，事后证明此举完全英明神武，呵呵。因为就在抵达中游边界的时候，天色已经开始变了，先前一直都红火大太阳，后来就来了几片云，最后是一大片乌云压了过来，瞬间笼罩在湖面上空，风也越来越猛，隆隆的雷声也开始响了起来，船老大还说不会下雨。等船离岸还有100米时，雨开始飘了下来，如果我们去了下游，后果是严重的，估计我们不仅要淋个落汤鸡还要不停的往船外舀雨水，避免发生沉船事件了。我们冒雨登陆，冲到码头边的一个类似农家乐的店里躲雨，里面全是躲雨的人。给朋友发了个消息，知道了自贡在早上也下了雨，还说我们自己不带伞。其实我们都带了伞的，只是当时天气好，都放在旅馆了。因为码头距旅馆很远，而且要先到马路才可以坐车到旅馆，所以我们乘雨稍小一些，马上冒雨冲了出去，他们在前面跑，我就在后面用手机摄象，很有点记录片的味道，大家一起跑，好象一群难民在逃难，尤其是张磊和小周，他们一人带着个斗笠，一个带一个帽子，很象是一个村民在跑，另一个象是伤员，事后我们看这段录象当场笑翻。我们分乘两辆的士回到旅馆，裤脚完全湿透了，又冷，我和平平去买了7包方便面，拿回来，泡着吃了，赶快睡觉，睡到5点半起床，一摸裤子，干了。开机，罗琳5点过就醒了发了消息来了。6点起床，过去一看，除了罗琳其他人都没起床，把她们闹醒，然后出去吃饭，找了一个 凉山风味 的馆子吃饭，只有那个老腊肉还不错，其他的一般，吃完饭，又回旅馆，然后大家团在一起听小周讲鬼故事，听的大家汗毛倒竖，罗琳当场被吓哭，其中一个据说是他亲身经历，说的是他以前值夜班的地方经常闹鬼，有三个房间，他在最里面一间，但是经常听见有人穿着拖鞋进房间的声音，但是问是谁，又没人答应。期间，我还一个人到隔壁的房间去提开水，反正过去都背心发凉。最后，聊到12点过，大家都睡了，第二天8点过起床，出去找了一个小店吃了早饭，7个人居然吃了30多块钱，那边的早餐也忒贵了点吧。随后包了一辆车150元，送我们到凤山和百草坪去，从凤山下来，上车的时候，我手没放对位置，结果罗琳关车门，砰一声把我的手也压到车门里了，扯都扯不出来，只有把车门打开才把手抽出来，幸好只是压破了皮，如果手是在车锁部位就惨了，菩萨保佑。车刚过凤山收费站，就被51期间检查道路安全的路政人员拦了下来，因为车老板的车没有营运执照，车也被扣了，不过路政的工作人员服务态度还不错，为我们另外找了车去百草坪，我还发现他们的车上有一把仿AK45的冲锋抢。车开了半个多小时，到了百草坪，后半段路仍然很颠簸。在这里可以骑马，但是要出钱，最后谈好的价格是5元一人，兜一圈，除了我和罗琳，其他人都坐了一圈。骑完马，除了周云和张磊，我们都去攀登那座高山，去年我们爬了3分之二就退了下来，这次我们都攀了上去，还在上面大声的呐喊。登上顶峰，休息了一会，他们几个女士就象山下的一号大本营下撤了，我和平平看到山的另一侧有一片石林，又听放牧的小孩说那里还有巷道，于是，我们两人摸了过去，还在哪里照了几张相。随后我们也开始下撤，在山脚和大家汇合，结果他们结果女的又去骑了一圈马。回来后，她们和一个当地大概8-9岁的小姑娘聊了起来，了解到她每天去学校读书，要走20里山路，中午吃的就是荞麦做成的馍，李姐问她要了一点来尝，开始有些微甜，最后却是苦涩的。他们和小女孩及几个牧童合影后，我们开始爆走，因为到百草坪又一段路是土石路面，面包车不愿进来。一路上我们有说有笑，到也不觉得累。走到一半，突然发现除了我，其他人的脸都变红了，原来是紫外线照射的杰作，他们太大意了，只戴了墨镜，而我因为只要晒着太阳就把帽子戴着，所以脸上没事（回家洗澡觉得颈子有点痛，估计是也被晒伤了），张磊就更搞笑了，她还闭着眼睛躺在草地上接受阳光的照射，当时大家都耍高兴了，没怎么去考虑紫外线的问题。回到威宁县城已经是5点半了，大家本来计划去吃当地风味的荞饭，但是考虑味道肯定不合我们四川人的口味，放弃了，另找了一家门上写有富顺豆花的馆子吃，一问，老板居然是自贡人，顿时倍感亲切，因为中午没吃饭，只吃了些零食的关系（我只喝了点可乐，奇怪，都不感觉饿），菜一端上来，大家风卷残云，吃饭只用了十多分钟的时间，肥锅肉、荤豆花等几个很合大家的口味。吃完，赶紧去买水找车去火车站，因为是要坐7点半的火车。在途中遇到一个车老板，说带我们去买水，然后坐车去车站，买了一件说，说分给我们14瓶，加车费收我们40元，当真以为我们不识数，一件水24瓶才20元，车费21元，最后谈好14元加21元车费。但是我们发现她车上还有2个人，但一个面包车最多只能坐7个人，不然就太拥挤了，她叫车上的人下来，但是我们发现，居然没司机，司机还要她打电话叫过来，我们冒火了，因为要赶时间去坐火车，当时已经6点40了，就上了另外的车，结果她不依不饶，挡在车前，不要我们的车走，罗琳还下车去拦了辆警车，结果那车是出来逛街的，那女的看到我们去叫警察，也有点怕了，就从车前闪开了，我们的车终于可以上路了，当时大家都有点后怕，怕把她惹急了，她叫上人找我们闹事。车到火车站，发现售票大厅，已经排起了长队，最后还是买到了票，虽然都是站票。火车早了10分钟进站，我们跑着跑着就跑散了，周云、平平、张磊在列车的中段上了车，其他人跟随罗琳往前跑，开始我还觉得前面不大可能有位子，结果上车在3号和2号车厢都找到了位子，然后又开始了漫漫的8个小时之旅，车到宜宾，罗琳因要参加宜宾举办的募捐仪式，下车了。到自贡已经3点半了，大家去吃了消夜，一盘存，包括消夜的费用一共用了238元。回到家已经5点过，洗了澡，看 猜猜猜，看着看着就睡戳了。。。。。。。。。

Study Shows Plasma Derived Human Thrombin Equivalent To Bovine Thrombin In Achieving Hemostasis In Surgery

Study Shows Plasma Derived Human Thrombin Equivalent To Bovine Thrombin In Achieving Hemostasis In SurgeryA randomized study comparing treatment with plasma-derived human thrombin and thrombin derived from bovine sources shows that human thrombin is as effective as bovine thrombin in achieving hemostasis in patients at three-, six- and 10-minute intervals. The study of 305 patients with mild or moderate bleeding during elective cardiovascular, neurological or general surgical procedures also showed that human thrombin was less likely to result in an immune response in patients as compared to bovine thrombin. Study results were presented Friday at the Society for the Advancement of Blood Management meeting in Los Angeles. The study was supported by ETHICON, Inc.In the study, the proportion of patients achieving hemostasis at 10 minutes (primary outcome) was 97.4% following treatment with human thrombin and also following treatment with bovine-derived thrombin. The percentages of patients achieving hemostasis at six minutes and three minutes were also equivalent. There were no statistically significant differences in several other variables including laboratory assessments, vital signs, blood loss, blood transfusions, time in specialty-care unit, procedure duration, and length of hospital stay.On August 27, the U.S. FDA approved EVITHROM Thrombin, Topical (Human) for use in cardiovascular, neurological and general surgery. EVITHROM was developed in collaboration with OMRIX Biopharmaceuticals, Inc. ETHICON plans to make the product commercially available in the United States in Q4 2007."With EVITHROM, the first plasma-derived human thrombin, surgeons have a new option for hemostasis that is as effective as bovine-derived thrombin but that also reduces the risks of antibody formation associated with the use of thrombin derived from bovine sources," said Cataldo Doria, M.D., Thomas Jefferson University Hospital. Dr. Doria was lead author of the study.According to the study results, plasma-derived human thrombin and bovine thrombin have similar adverse event profiles. However, more patients who received bovine thrombin demonstrated seroconversion for at least one of the four antibodies assayed than did patients who received human thrombin (12.7% versus 3.3%, respectively).Results from a separate second study were also presented at the SABM meeting. This study compared the safety and effectiveness of EVICEL Fibrin Sealant (Human), which contains the same human thrombin as in EVITHROM, to manual compression (MC) in achieving hemostasis in vascular surgery. In the study, a higher percentage of patients who received EVICEL achieved hemostasis at four-, seven- and 10-minute time points than patients who received MC. In addition, a lower incidence of treatment failures was observed in the fibrin sealant group. The results of this study suggest that EVICEL is useful for achieving rapid hemostasis for indicated procedures while introducing no new safety concerns. EVICEL consists of human plasma-derived thrombin and fibrinogen and is currently the only aprotinin-free fibrin sealant commercially available in the U.S.EVITHROM and EVICEL are contraindicated in individuals known to have anaphylactic or severe systemic reaction to human blood products. As with all plasma-derived products, the risk of transmitting infectious agents cannot be completely eliminated. EVITHROM and EVICEL should not be injected directly into the circulatory system or used for the treatment of severe or brisk arterial bleeding. There is a potential risk of thrombosis if EVITHROM is absorbed systemically. About ETHICON, Inc.ETHICON, Inc., a Johnson & Johnson company, is a global medical device company that develops and markets surgical products for use in general surgery, wound management and women's health & urology. Johnson & Johnson Wound Management, a division of ETHICON, offers a complete portfolio of topical and advanced hemostatic products including SURGICEL Absorbable Hemostat, SURGIFOAM Absorbable Gelatin Sponge, EVICEL Fibrin Sealant (Human), and SURGIFLO Hemostatic Matrix with FlexTip. For more information about ETHICON.

Stay Lean, Active And Watch What You Eat To Avoid Cancer, New Report

Stay Lean, Active And Watch What You Eat To Avoid Cancer, New ReportA report issued by an international panel of experts says that the best way to significantly reduce the risk of getting cancer is to be lean, exercise vigorously every day, avoid fast food, eat less red meat, and avoid preserved meat such as ham and bacon, eat more plant-based foods and cut down on alcohol.The panel said that diet and lack of exercise cause one third of all cancers which could be prevented by changes in lifestyle. However, the overriding message from the detailed 537-page report titled "Food, Nutrition, Physical Activity, and the Prevention of Cancer", issued by the World Cancer Research Fund, is the strong link between obesity and cancer risk.Sir Michael Marmot, who is professor of epidemiology and public health at University College London, chaired the expert panel that reviewed 7,000 papers on the causes of cancer and consulted 200 experts worldwide. He said "the most striking thing to emerge from the report is the importance of overweight and obesity".Another panel member who chairs the International Obesity Task Force based in the UK, Dr W Philip T James, said the report had one message that was "as clear as a bell". The link between cancer and obesity is "so robust, it is going to rank close to the smoking problem in America pretty soon".The panel comprised 21 internationally renowned experts in cancer, epidemiology, obesity, nutrition, and public health, backed by teams of observers.However, the message does not stop with obesity. Every extra pound brings greater cancer risk says the report. Even if you are in the normal range of weight for your height, there is a significant difference between being in the lower weight region and being in the higher weight region.In terms of BMI (Body Mass Index), the panel recommends people stay within 18.5 and 25, which is the lower part of the "healthy" zone. BMI is a measure of obesity that divides the person's weight in kilograms by the square of the height in metres. Thus a person who weighs 150 pounds (68 kilograms) and stand 5 feet 9 inches tall (1.8 metres) has a BMI of 22.1, which is in the lower half of the healthy zone, as recommended by the panel.Too much body fat is a risk factor for oesophagal, pancreatic, endometrial, bowel, kidney and post-menopausal breast cancers said the report. And excess abdominal fat also increases risk of bowel cancer.The panel concluded that people should stay lean throughout their lives, young people should avoid piling on the pounds and stay slim. One panel member said he was "shocked" when he realised this.