The Younger You Look, the Longer You'll Live

http://www.drweil.com/drw/u/WBL02174/Womens-Heart-Attacks-Just-Like-Mens.html#2

"The only biological explanation ... was that the individuals who looked younger also tended to have longer telomeres (repeating DNA sequences at the ends of chromosomes) that are linked to aging." Telomeres are the main research subject for the 2009 Nobel Medical Science medalists.

The Dec 14 2009 article in BMJ is at
http://www.bmj.com/cgi/content/full/339/dec11_2/b5262
which concludes "Perceived age—which is widely used by clinicians as a general indication of a patient’s health—is a robust biomarker of ageing that predicts survival among those aged ≥70 and correlates with important functional and molecular ageing phenotypes."

Are Plastic Containers Unhealthy?

Dr. Weil's Q&A at
http://www.drweil.com/drw/ecs/forums/thread.html?docid=THR52089&page=1
advised that "polycarbonate plastic containers may not be safe for storage and transport of food and beverages. Better choices are polypropylene (#5 pp), high-density polyethylene (#2 hdpe), and low-density polyethylene (#4 LDPE)." The answer particularly highlights the risk of insulin resistance i.e. risk of type-2 diabetes associated with using the unsafe plastic bottles. It prompted me to check a government site for more info. And here it is:
http://www.ct.gov/dph/lib/dph/environmental_health/eoha/pdf/plastics_primer0714.pdf
Indeed, only the bottles labeled with #2, #4, or #5 recycling number seem to be relatively safe, if you have to use plastic instead of glass or ceramic containers.

More Chocolate, Less Stress

http://www.drweil.com/drw/u/WBL02167/Pollution-and-Migraine.html#1

"The researchers reported that eating the chocolate appeared to reduce levels of stress hormones in these volunteers. "

Original article at
http://pubs.acs.org/doi/abs/10.1021/pr900607v
Journal of Proteome Research, October 7, 2009
"The study provides strong evidence that a daily consumption of 40 g of dark chocolate during a period of 2 weeks is sufficient to modify the metabolism of free living and healthy human subjects, as per variation of both host and gut microbial metabolism."

阿胶 to Cure Arrhythmia and Bradycardia

Not all arrhythmia is created equal. But my 80-year-old father had it cured, at least for a month now, by 阿胶 (E1 jiao1), Donkey-Hide Gelatin. He had arrhythmia and bradycardia (very low heart beat, 40 per minute in his case) about a year ago after he practiced Taichi sword for too long with other old men and women in the morning, as they would do every day. Since then, the doctor told him to exercise for a shorter time each day, in addition to advising him to stay in hospital with a possible price tag of a few thousand RMB. There just happened to be another old man living in the same community that had exactly the same symptoms, and was successfully treated with 阿胶, taken with 西洋参 (Xi1 Yang2 Shen1) American Ginseng. So my mother did exactly the same for my father. It's been a month now. The result is amazing!

阿胶 is to bu3 xue3 (replenish blood, literally), and 西洋参 to bu3 qi4 (replenish qi). But the concept of xue3 in TCM is not to be confused with just blood; it includes all kinds of fluid plus nutrient. 阿胶 is also often used with 当归, (Dang1 Gui1, Chinese Angelica Root), another strong agent to bu3 xue3, particularly for women. But keep in mind that 阿胶 is warm in nature. My mother also took the "concoction" she made and got ichy, so she had to stop.

西洋参 is a strong bu3 qi4 medicine, like 人参 (Ren2 Shen1, Chinese ginseng), except that 西洋参 is cool in nature whereas 人参 is warm.

Standard Boring Disclaimer: In case you're not used to reading about alternative medicine, let me warn that always consult your doctor before you try anything.

Vocabulary of Medicine

A doctor posted a blog Reflections on the Vocabulary of Medicine. I've always wondered how much time a medical science student has to spend memorizing all those long and eccentric words while studying medical science per se at the same time. Could it be 20% or 1/3 or more of his study time he has to dedicate to this tangentially relevant skill or knowledge? I bet no other division of science has so many words you must learn by heart to be proficient in doing your job. I have a Ph.D in Chemistry. Although tens of thousands of chemical compound names sound mind-boggling, they're way much easier than you would think, because names of chemicals have strict rules in nomenclature. It's true that lots of medical terms are methodically structured. But too many are not. This is even a bigger problem for non-English speakers because they have to learn English as a regular language. Speaking of this, I wonder why medical terms in English started with these weird origins, Greek, Latin, etc. Why can't they use the same words as plumber Joe's words, heart, not cardia, infection, not -itis, etc. Afraid of ambiguity? Combine a few common words in a strict order and then give a clear definition. Instead of, say, "pulmonary hypertension", why not "lung high blood pressure"? There's no loss of precision in semantics. In fact, that's exactly how the medical terms in Chinese are like, and Chinese doctors are not complaining about ambiguity of technical terms because they use plumber Joe's words as building blocks.

Nanotechnology and cancer risk

My neighbor is a pharmacist, and likes to research various topics of medical science and latest findings. When it comes to cosmetics, she told me that nanotechnology works because the superfine particles can easily get into the skin and remove dark spots, among other things. On the other hand, there may be risk in cancer for the same reason that the particles are too small to be fought against by the body. I searched on Google for "nanotechnology cancer" (without quotes). 99% of the links are about how the technology is used as a tool to diagnose or treat cancer. But one article is an exception:

http://articles.latimes.com/2008/may/21/science/sci-nano21
Nanotechnology cancer risk found

It was written in May 2008 for ordinary readers with no pointers to professional publications.

A reader in a newsgroup posting asked: "Should this be verified, will we take a lesson from asbestos and start regulating/limiting production and use of these types of tubes?" There's no response.

I'll keep an eye on this topic. There must be scientific research on it. I just didn't find it online.

Drink alcohol to lower dementia risk

http://www.medscape.com/viewarticle/706325

Moderate Alcohol Consumption May Lower Dementia Risk in Cognitively Normal Elderly

"Moderate alcohol consumption may lower dementia risk in cognitively normal older subjects, but any level of alcohol consumption in individuals with mild cognitive impairment (MCI) appears to be detrimental."

Pay attention to the "but" part. If there's already sign of cognitive impairment, drinking alcohol is even worse than not doing it.

论吐痰

"痰"字国人都认识，属常用字，常见于媒体和街头。但英文的phlegm却是非常医学的，只出现在医院或医学健康文章里。[注1] 原因很简单，吐痰的动作和吐出的痰在中国随处可见，自然增加了印象。这在其他国家，甚至台湾，都是罕见的；电影《泰坦尼克》有男女主人公吐唾沫比赛的镜 头,我在韩国旅游时见到一次一男子往地上吐口水,在美国有时也见到,总的次数屈指可数,而且都不含痰,没有倒吸气、清喉咙的声音。可见吐痰真是中国的国 粹，而且是中国大陆的国粹。

其实中华民族是一个爱美恶丑的民族，比如中国街头和媒体的许多赏心悦目的照片，鳞次栉比，目不暇接，超过日本，更胜欧美。痰虽是人体排泄物，但排泄 物不都是让人恶心的，有些甚至是优雅的。按优雅度下降排序，大致有泪、汗、...、鼻涕、痰、二便。汗，尤其是泪，常为文人骚客咏叹,但越往后越不为人所 挂齿,以至到最龌龊的只有陈独秀这种流氓才会大言不惭[注2]。本人熟读唐诗几十首，隐约记得几百首，但不记得痰字曾出现在任何文学作品中,可见其不雅。 几年前的一天我在江苏同里欣赏千年民居，路过水边，见一清秀男子吟唱小调，其声柔婉，其境恬适，慨叹江南水乡之美莫过于此。他唱完了，以大约40度仰角朝 小运河吐出一口痰落入水里，好像以此展示他的潇洒，给他的美锦上添花。

为什么中国人经常吐痰呢？一说中国人痰多。那为什么痰多？是猪肉吃得多吗？《本草纲目》豕条引朱丹溪（震亨）语，“盖肉性入胃便作湿热，热生痰“。 [注3] 可我在上海一外企工作一年多，没有见到或听到同事吐痰。生活在海外的华人也没有吐痰的，甚至在厕所也不。如果有些中国人确实痰多，那必定与肺有关。多年前 一国内朋友来美国，体检时一位亚裔护士不讳种族歧视之嫌，说“你们中国大陆来的很多都有潜在的肺结核”。如果这是真的，而不是由于早年种牛痘所致，我们应 该好心规劝吐痰的国人上医院看看。街头的标语不妨换成更有趣的，比如

“您吐痰了吗？结核医院牵挂您的健康！”
“不要随地吐痰，请把它留给您的肺病医生！”
“宽容吐痰的人吧，他们虽有痨病却还坚定地活着！”

这种宣传暨张显人性，又能鞭策屡教不改者，让我不禁想起戒烟广告词“万宝路男人需要伟哥”[注4] 打击献丑者的尊严，把他们与病夫联系起来，再自称大度无所谓的人也会被刺激的。

但刺激一定要讲策略，否则不但事倍功半，而且可能招致那些uncivilized people（未开化的人）的暴力伤害。中国禁痰网创始人王涛[注5]“身”有体会。有一次我在上海的家乐福斜坡电梯上，紧跟我前面的年轻女士剥开糖果然 后把糖纸很快地扔到电梯外的货架上。我等电梯到下一层楼结束时，凑上去轻声对她说“你不应该把纸扔在货架上”，她吃了一惊马上说一句“哦，对不起！”然后 我们各走各的路，这事没有他人注意到。后来我跟我的朋友说起，他说我给了别人一个比较好下的台阶。假如我当时大声吆喝“不许乱扔垃圾”，那不仅是她，连我 也得承受一点尴尬的压力，何苦呢？

中国需要至少一千万王涛，才能保证一人教育一百人。但这没有大规模宣传谈何容易。新华网报导王涛时根本不给出中国禁痰网的网址（这是中国记者的通 病！），即便让人知道了，又会好到哪里去呢？吐痰是多数国人的习惯，恐怕只能在与给老人让座的宣传一样深入人心的宣传后才能彻底改正；给老人或有需要的乘 客让座，中国就比别的国家做得好。[注6] 假如我们到处都贴上禁止吐痰的标语，小学课堂经常性而不是一次性地讲吐痰的坏话，并敦促谈们监督他们的父母，让大人小孩都把吐痰与肮脏、恶心、有病、乡巴 佬在心理上联系起来，估计不出五年，我们就可以达到目标，然后停止给小学生灌输，撕下这些让中华民族丢脸的标语了。

需要强调的是，禁痰是grassroot的基层群众性运动。虽然我们不能绝对地说吐痰者不上网、上网者不吐痰，但这个说法大致正确。因此禁痰网站这 种精英策略不是办法，只可用于组织自愿者和报告工作进展。吐痰者多半没受过太多教育，言粗行陋，智商平平，最有效的、最不引起反抗的劝介可能来自他们的宝 贝儿子或女儿，其次是铺天盖地的宣传，最次是网上文章，假设他们能上网的话。不要悲观，我们一定能做到，只是需要全社会的大运动。“天下无痰”岂止是王涛 的理想，是中国大陆全中华民族的理想。

黄勇
2009年6月于休斯敦
欢迎转载．转载时请保留“欢迎转载”一语

_______________________
[注1] 在本人的Yahoo搜索汉字字频统计中，"痰"字在2000常用字中大约在1600位，在Google搜索字频统计中，更是上升到大约900位。英语phlegm的词频在18000位，参见Wiktionary。

[注2] 见《实庵自传》,杨光编《最后的名士》,79-80页。

[注3] 又见网上诸文,如胡延滨猪肉入药之宜与忌。

[注4] 这则把抽烟跟阳萎联系起来的广告在美国或中国都不流行，可Google搜索"The Marlboro man needs Viagra"（包括括号）。相关医学报道见２００７年２月美国卫生系统药师协会杂志Tobacco Education: Emphasizing Impotence as a Consequence of Smoking（烟草教育：强调阳萎作为吸烟的后果）。

[注5] 志愿者王涛：“天下无痰”是我的理想

[注6] 一次我在法国的地铁里，没有看到请让座的公益提示，没有人给一位刚上车的怀孕晚期的孕妇让座（不过她一直在跟她一起上车的朋友聊天）。　２００９年６月纽约甚至颁布法令杜绝这种不道德行为，参见MTA Won't Stand for Seat Hogs（大都会运输署不容忍占座的猪）。

Badminton and anti-depression

While playing badminton with kids today, I came up with an idea about depression or treatment of it. If you're an artist, how would you draw a picture of a very depressed person, or as an actor, act as a poor depressed fellow? He must be drooping his head, closing or barely opening his mouth, with a sad expression. If you want to cheer him up, what would you like to see him behave? Just the opposite, raising his head, opening mouth, smiling. Well, the three elements representing the opposite of depression are naturally satisfied with some entertaining sports such as badminton and kite flying. Think about it. You must look up to play (which, incidentally, also benefits your neck), and open your mouth to relax the skin and muscle under the chin. If the mouth is open like that, it's hard to have a sad facial expression even if you want to. Needless to say, any sport for entertainment (as opposed to competition) is generally good to mental health.

In psychology, the term suggestion means "the process of inducing a thought, sensation, or action in a receptive person without using persuasion and without giving rise to reflection in the recipient". I think the upward head direction and open mouth serve as perfect psychological suggestion to move away from depression. Badminton, as well as flying kites, should be an ideal sport for those suffering from this mental ailment.

Disclaimer: This is only my hypothesis. Its efficacy or lack of can only be ascertained by good control studies.

Omega-3 or fish oil and arthritis

A newsletter from Walgreens points out the benefit of fish oil to rheumatoid arthritis. I searched on Google for '"omega-3" arthritis' (double quotes included):
http://www.google.com/search?q=%22omega-3%22+arthritis
and got 1.15 million hits. There's no point in repeating the published research here. But I want to point out that I've had pain on my right wrist once in a while in the past, oh, perhaps ten years. I've never figured out the cause. The first doctor used a term tendinitis to describe it. Ever since my Mom suspected it was gout, I relayed that suspicion to subsequent doctors and they always gave me I think prednisone, an anti-inflammation drug, which seems to kill the pain fine, and I was told to avoid mushrooms, some fish, animal organs, etc. Nevertheless, wrist pain still comes and goes a few times a year. Oddly, a detailed blood test did not reveal any sign of gout (e.g. high uric acid) and eating mushrooms didn't correlate with flare-up. In fact, the year while I lived in China, mostly 2007, was actually worse when I had better discipline on diet. Now when I come to think of it, that was also the year I had not taken any fish oil. Back in the US, I started to take Omega-3 fish oil again and had much less frequent pain. I have to say this anecdotal evidence is quite consistent with the theory that fish oil goes against arthritis.

Government Push for Electronic Medical Records

http://www.medscape.com/viewarticle/588354

"The economic stimulus plan currently being considered by Congress allocates $20 billion to health information technology such as electronic medical records (EMRs)...mixed opinions"..."'EMR is the worst thing that has happened to me professionally in over 25 years of practice' says ..."..."'I absolutely love our EMR,' says a nephrologist"

I work at a big hospital as an IT professional. Having gone through a few projects responsible for data model design, I know exactly what a good model and hard work mean. A few years ago a gynecological cancer project was handed to me. The data analyst, representing the users, already did excellent work in gathering requirement and use cases. But to implement that correctly in my Oracle database still took a lot of thinking. For instance, there're more than a hundred input fields that are like:

* Option1
* Option2
...
* Other
If other, specify details _____________.

Programmers and DBAs always love fixed fields and hate free text because free text is hard to program and difficult to search. But users are our God's and we have no choice. The above example must be implemented as multiple fixed choices using a reference table *plus a free text field* in the data table! When there're 100 of them, you get tired quickly.

The quoted Medscape article says primary care physicians tend to hate EMR and specialists generally embrace it. The former has to face a more undetermined situation when patients first come in. No doubt there's tension between their needs and programmers' pitiful preference.

We all know the IT in healthcare is the servant for doctors and nurses. If we don't constantly remind ourselves of this role, we're not living up to tax payers' high expectations and their precious contributions to keep us employed.

Outdoor time may protect kids from nearsightedness

Original research journal summary at Optometry and Vision Science Volume 86(1), January 2009, pp 2-3
Reuters' summary (Note this summary probably stretched by adding "exposure to sunlight may play a role")

Highlights
* Having myopic parents is a very minor risk factor
* So are near [distance] work, schooling, watching TV, working on computer screens
* Ethnicity plays no role
* Reasons for protection of outdoor time may be "lesser accommodative demands in outdoor environments (despite the considerable evidence that accommodation is not important), pupil constriction in the brighter light typical of outdoor environments resulting in greater depth of focus, or a direct effect of light exposure, perhaps mediated by release of a retinal transmitter such as dopamine, which is known to inhibit eye growth in certain circumstances."
* Outdoor time matters, regardless activity or inactivity; even reading outdoors is good
* "around 2 to 3 hours a day outside of school hours seems to be sufficient to markedly lower the risk of myopia"

My comments:

The sunlight comment is probably added by the Reuters summary. If sunlight exposure is not the key, then the researchers' speculation all come down to one factor: brighter white light. If that's the case, we may just need to make sure that the brightness of indoor environment matches that of outdoor and that indoor light covers the entire visible light spectrum. On the other hand, if sunlight is essential, then the UV component of the sunlight may be a critical factor and therefore Vitamin D may play an important role in protecting eyesight. Unfortunately we don't know if the summary author or the original researchers suggested the role of natural sunlight.

Having read that, I recollect my teenage years when my eye sight degraded at a typical alarming rate from about 10 years to 15 years of age, while I was strict in following all eye usage hygiene rules (no reading in dim areas or in supine position, etc.), perhaps except one, not stopping to rest when the eyes are tired in reading. At the same time, other children, including one habitually reading inside the quilt with a flashlight, were fine with their eyesight. We all spent a great deal of time outdoors, probably three hours a day. And in the southern city we lived (with about the same latitude as Houston, Texas) there's no shortage of sunlight, although it's almost always cloudy in winter.

(If a summary in Chinese is needed, search for "孩子在室外度过的时间长就不容易近视" on baidu.com, or click here. But note this summary probably stretched by adding "晒太阳促使体内分泌更多多巴胺")

(Update 2024-09) Is it possible that the AC (alternating current) of the indoor light plays a role? In the US and Canada, the AC has a frequency of 60 Hz, and in most other areas of the world, it is 50 Hz. Regardless the actual frequency, as long as the electricity current fluctuates, it may cause frustration to eyes. This hypothesis can explain why reading inside a quilt as I mentioned above did not lead to near-sightedness for that boy. I personally feel that outdoor light gives me less eye strain, and interestingly, even the outdoor light that comes indoors through glass windows does so, too. To test the hypothesis that AC light causes more eye strain, all we need is a light source powered by DC (direct current). Cell phone light is fine but may be too narrow or too focused.

Americans are not eating enough fruits and vegetables

http://www.medscape.com/viewarticle/586492

"Fewer than 1 in 10 Americans meet their calorie-specific MyPyramid fruit or vegetable recommendations. ... The primary contributors to total fruit intake were whole fruits among adults and fruit juices among adolescents. The largest single contributor to overall fruit intake was orange juice. Potatoes dominated vegetable consumption, particularly among adolescents, in whom fried potatoes increased the median vegetable intake from 0.72 cup to 1.21 cups per day. Dark green and orange vegetables and legumes accounted for a small portion of vegetable intake,"

Italics are mine.

Calcium supplementation is as important for men as for women

Calcium Supplementation in Healthy Nonosteoporotic Men

"One quarter of all hip fractures occur in men, and 30% of older men experience fragility fractures."..."The results suggest that calcium supplementation is as important for men as it is for women. Additional studies will be required to determine precise dosing regimens (calcium 600 mg daily vs. 600 mg twice daily), the role of vitamin D supplementation in men, and supplementation's effect on fracture risk."

Risky to be part of clinical trial?

Black Parents May Be More Likely to Distrust Medical Research

--- BEGIN QUOTE

February 3, 2009 ... February issue of the Archives of Pediatric and Adolescent Medicine.

"Among minority groups, African Americans are frequently underrepresented in clinical research," ... African Americans' distrust of medical research has been suggested to be an important reason for their lack of participation. ... "African American parents were significantly more likely than white parents to believe that medical research involved too much risk to the participant;

--- END QUOTE

A friend of mine was a doctor when he was in China and is not working at a hospital but not as a doctor any more. Once I asked him if he would be interested in being recruited to any clinical trial. He said Definitely not! The reason? Pretty much the same as those "black parents", in believing medical research involves too much risk to the participant: What if you get seriously sick by trying those not fully tested drugs? You don't want to be a guinea pig, said my friend.

Smoking Still Takes a Heavy Toll in China

The Medscape report, Smoking Still Takes a Heavy Toll in China, based an article in the January 8, 2009 issue of the New England Journal of Medicine, is no surprising. Too many stupid Chinese men still believe smoking paints for them an image of maturity and masculinity, while ignoring the great health risk, and oblivious to the fact that smoking actually is linked to impotence. Smokers are costly. Indeed they're mostly using their own money, but all. For those heavily using tax payers' money to treat their smoking related diseases, they'd better die sooner to relieve the society of unnecessary financial burden and create cleaner air to others.

Some quotes of the article:

"They estimate that in 2005, 673 000 deaths were attributable to smoking in China..., the majority of which (538,200) were among men." "The prevalence of tobacco smoking has been continuously high in adult men (around 60%)." "[S]ome of those in government are beginning to understand that revenue gained from tobacco taxation is far less than the healthcare costs associated with smoking."