强化 “全科医学”,提倡“中西合璧”-美中医学交流学会(ACMES)学术年会纪实

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2012113日,美中医学交流协会(ACMES)在位于波士顿美丽的查尔斯河畔的Hyatt Regency 酒店隆重举行了以“全科医学及整合医学”为主题的学术年会,为时一天,约200余名全国各地医生学者出席这一盛会,包括远道从中国赶来的访问医师及学者。

这次大会分设两个会场同时进行,共有28名专家精彩讲演,涉及20个不同的医学热点课题,各种常见病的最新进展,并聚焦主要的华人健康问题。两个会场分别由哈佛医学院的周捷医师及陈力超讲师主持,ACMES医务主任,Beverly医院内分泌科刘昭医师及ACMES副会长,约旦医院内科李维根医师分别在两个会场致开幕词。会场座无虚席,气氛异常活跃。

癌症专场由来自纽约州立大学病理科副教授,ACMES理事陈小槐医师主持。三位来自哈佛大学医学院以色列医院(BIDMC)的肿瘤专家Elizabeth Buchbinder医师,Anand Mahadevan医师,及王浩医师先后讲演, 分别就癌症的免疫治疗最新进展,肿瘤放疗新技术,及肺癌的筛检及治疗方案作了详尽的阐述,引发听众热烈的讨论。Buchbinder医师就肿瘤免疫特异和非特异治疗的进展进行了总结和展望,期望将来有所突破。Mahadevan医师讲述了放射治疗的基本原理,定向定位的靶向放疗可提高疗效,减少肿瘤周围正常组织损伤。王浩医师从CT扫描筛查早期诊断肺癌的价值和应用展开,通过确证强调了戒烟是预防肺癌的发生最重要的措施。另外一个会场来自德州休斯顿大学的神经科教授朱继光医师的讲演涉及恶性神经胶质瘤的最新治疗方法,是这一领域的重大突破,加之过人的演说能力,故而讲演语惊四座,催人振奋。麻省总医院疼痛研究中心主任哈佛医学院教授茅健人医师讲授阿片类镇痛药物的临床指南。他不但学识渊博而且讲演非常生动,深入简出, 给听众留下了深刻的印象。

午餐时继续医学教育课程,由加州大学肝脏中心主任,ACMES理事胡克勤教授讲授。他就慢性肝病的病因,常见并发症的机理及治疗进行了详尽讲解,对肝性脑病这一严重并发症治疗的最新进展进行了阐述。他介绍说,不仅乳果糖(Lactulose)对肝性脑病有一定的效果,利福昔明(Rifaximin)可大大降低肝性脑病的发生率,此药实为慢性肝病患者的福音。

下午会议继续进行,首先由哈佛医学院附属布莱根妇女医院内分泌科Margo Hudson医师演讲二型糖尿病血糖的最佳控制疗法。她介绍了胰岛素的应用及一批新型抗糖尿病药物的问世,给糖尿病的治疗提供了更多地选择和有效控制。Regeneron制药公司眼科部副主任曹景泰博士讲述了如何从医生到科学家及发明家的转变。他和他的团队发明的EGF-Trap治疗湿性视网膜退行性变得到了FDA的批准并得到了广泛的应用。塔夫茨大学约旦医院外科陈文亮医师就腹腔镜的应用作了一个精彩的报告。他的腹腔镜手术的录像使听众如身临其境。腹腔镜手术的应用和进展使手术创伤更少,恢复更快,费用更低。David M. Gould 律师的讲座是针对医疗纠纷医疗诉讼这一敏感的领域,他结合实例告诫医生们防微杜渐,依循临床常规,加强与患者及同行的交流,以避免不必要的悲剧。

全科医学专场之二由麻州大学医学院助理教授, ACMES副会长周人志医师主持,来自加州斯坦福大学的呼吸科教授袁南希医师首先演讲,她就睡眠呼吸暂停综合症这一常见的病症如何早期诊断及治疗入手,她的丰富经验及卓识使临床医师们受益匪浅,哈佛医学院妇产科助理教授李小玉医师对于妇女更年期的应对措施的讲演颇为生动风趣,使人们在他的谈笑风生中体味无穷,哈佛医学院内分泌学讲师闵乐医师则阐述了男性性功能低下的原因及治疗进展,也令听众耳目一新,颇受启迪,哈佛医学院消化科讲师,新英格兰Baptist医院(NEBH) 消化科主任 Tom Liu 医生则分享了他对于胃肠功能紊乱这一棘手的临床病症的治疗方案及相关进展,深得与会者好评。

自闭症专题先声发言的是学会的老朋友大平原实验室主任William Shaw 博士。作为一个自闭症儿童的家长,Shaw博士长期坚持不懈地探索研究自闭症的治疗方法,他们成功地帮助过数千自闭症儿童和家长有效地改善了他们的症状和生活。在他的主题“自闭症的新发现”中,他细致地介绍了梭形厌氧菌感染与自闭症的致病关系,其他有效的自闭症检测方法,听众很感兴趣。

麻省总医院神经专科医师、哈佛医学院助理教授Martha Herbert 这次在她题为“自闭症革命”的演讲中指出很多心理学家认为自闭症是一种心理疾病,很多医生又认为自闭症是一种生理疾病。她认为自闭症其实应该是更多的什么。它其实是基因、大脑、神经、心理、社会/文化环境、物理环境等因素的有机相互作用、平衡的结果,这一理论模式堪称是一革命模式。

另一位自闭症家长,Berg公司执行总裁栾生博士,他十岁的儿子也是一位自闭症患者。他告诉我们美国每年为每位自闭症患者花费是1.4 到2.3百万美元,解决自闭症问题的确是一个十分有意义的社会问题,而不仅仅是一个健康问题。当他介绍了理解和诊断自闭症的创新性方法后,一个女儿是自闭症的听众当即就表示愿意参加他的实验,接受他的方法。不过栾博士也指出自闭症的早期发现仍具挑战性。

Hon Ho 医师,哈佛医学院北岸医学中心小儿精神病学家在大会分享的主题是自闭症用药的临床指导。相信做临床工作的医师及自闭症家长尤其会有收获。Ho 医师还特别提醒听众在整个自闭症的诊断、鉴别、治疗、恢复工作中,第二种意见和观点非常重要和必要,因为自闭症十分复杂和具变化性。为了更正确地作出判断,仅仅只有一种声音是不够的,而且要特别小心药物的副作用。

在整合医学专场,多位演讲人都一致提到替代医学的问题。由哈佛医学院的刘树柏博士及波士顿大学附院的吴皓医师先后主持。

哈佛医学院副教授,麻省总医院精神病医师Albert Yeung指出1/3有健康问题的美国人曾经和正在寻找替代治疗。其中气功已广泛地运用于很多医学/心理疾病以及防止和恢复,并有着巨大的潜力。他并具体介绍了几个成年人和老年人气功治疗糖尿病,治疗忧郁症的临床实验。

Albert Yeung的同事,也在麻省总医院麻醉科工作的哈佛医学院助理教授林旭医师也指出美国有五百万病人用银针这种替代方法治病。她介绍讲解了各种不同种类的银针,人体上有2000 多个针灸点。据统计,在约60,000个针灸疗程中,没有一个有严重后果的,即针灸治疗是安全可靠的。观众提问了有关针灸保险的问题。

中医师刘京博士演讲的题目是“疲劳症的整合疗法”。刘博士曾在麻省总医院研究传统中医药达15年之久,对中药的认识可谓深刻透彻。慢性疲劳综合症的病因和治疗尚不明确, 也缺乏有效的治疗手段。经过长期研究,刘博士认为很多病人的疲劳症状与 荷尔蒙失调有关, 特别是肾上腺皮质和甲状腺功能减退。针对不同病人病情选用中药或营养保健品对慢性疲劳的病人有更好的疗效效。另一个值得关注的问题是肠道菌群失调或有害菌 感染例如酵母菌感染也常常导致疲劳。用中西医整合的方法对这些病人进行治疗往往会受到更好的治疗效果。

北京中医学院教授张群豪教授也身为麻州中医学会会长,他指出三千多年前“黄帝内经”就介绍过用针灸治疗肿瘤和癌症,他分享了自己作为执照针灸师对于癌症辅助治疗的经验。黄明达医师多年从事中西医结合,在波士顿行医30年之久他坚信中草药有着坚实的学术基础,有时也更有效。他对于中医与哲学作了深入的研究,立论新颖,引人深思。

律师Daniel Heffernan从法律的角度讲解介绍了麻省对自闭症和其他疾病患者的权利、权益保护、特殊教育资源、经济、医疗支持等知识和资源,补充了很多家庭在这方面知识的欠缺。另一位来自纽约保险公司的律师Alan Chew则针对医生群体就财产保护及风险管理作了详尽而生动的描述。

所有的发言都结束后,意犹未尽的听众与演讲者挪步到了美酒招待会,位于16楼可以俯瞰查尔斯河及波士顿全景的旋转大厅,继续提问、解答、商榷。然后一场丰盛的晚宴庆祝正式开始,由从德州特地赶来的学会副会长吴晓芸女士及学会市场顾问,麻州大学刘瑞明教授共同主持。席间执委会成员喻向阳博士向大家介绍了她请来的大会嘉宾Ironwood公司副总裁,消化科专家Doug Levine 医师作了精彩讲演,题为“胃肠功能紊乱IBS的新世纪”介绍了该公司新上市的治疗IBS新药及其临床试验资料,引起医生们的热切关注。

ACMES会长,哈佛医学院的孔学君医师介绍了ACMES作为非营利医学学会(www.acmes.net) 的宗旨,历史与展望,并总结了2012年所取得的成绩。该会旗下的英文期刊“NAJMS,北美医学与科学”(www.najms.net ) 第17期及中文期刊“北美医学与健康”(www.najmh.org )第27期均在上月10月份如期出版,会间作为礼品送给每位讲演者及贵宾;中英双刊稳步发展,吸引了越来越多的参与者奉献者。ACMES在2012年举办十余场学术会议及CME讲座,还有义诊,杂志俱乐部,病患培训班等社区活动,国际医师培训及交流,自闭症及乙肝普查项目始终是学会的重点项目,在2012年推向了新阶段。她并深怀感恩之心向各位来宾介绍了她的核心团队成员,观众报以了热烈的掌声,并向2012年度奖获得者陈力超博士及刘娟子女士颁发奖状,表彰他们对于社区的无私奉献精神,她并感谢所有执委会成员及志愿者的卓越功绩。她特别强调团队的精神,一个人或几个人的力量毕竟有限,大家齐心协力,才能为我们社区作出更大贡献。

著名音乐家翁慧弹奏的古筝名曲“彝族舞曲”,青年歌唱家王颖演唱的意大利歌剧选段“我亲爱的爸爸”、英文歌曲“歌声献给你”,刘瑞明教授的中文歌“我亲爱的祖国”唤起了与会者更加高涨的热情;功夫/太极表演队的真功夫吸住了人们的眼睛;由学会元老,学会自然医学部主任刘京医师创始的,由刘娟子、刘昭、刘京京以及陈玉泉展示的易筋太极功更是引起大家的喝彩,易筋太极功是以太极和易筋经为主要基础发展的一种以调气和脊柱运动为核心的健身术。至此晚会达到高潮,最后大家纷纷走下舞池,在桃李满波城的舞蹈老师吴晔的带领下,随着优美的乐曲翩翩起舞。我们所孜孜追求的正是这样一种境界:增进我们的健康水平,改善我们的生活品质。不仅活的健康,而且活的健美。

这次大会的圆满与众多组委会成员及志愿者的无私奉献密不可分,除了上面提到的各位主持,组委会成员及志愿者还包括宋一青,纪永莉,程文杰,牛江河,马以林,赵京雁,何盈盈,费喻,李勇,马剑韬,刘娟子,叶曙波,陈奋,闽乐,刘京,李雯,周宁,王晓春,王颖,刘京京,孔令荻,刘晓梅,李子达,陈玉泉,栾生,吴震,吴晔,翁慧,孔亚伟,陆平等(牛江河报道)

On November 3, 2012, ACMES held its annual conference entitled “Primary Care And Integrative Medicine” at Hyatt Regency Cambridge, along the scenic Charles River in Boston, attended by more than 200 medical professionals from all over the country, as well as international scholars and physicians from China. 

The conference has two parallel tracks. One of them is primary care, which is chaired by Dr. Weigen Li, vice president of ACMES and a hospitalist from Jordan’s hospital;   and the other is integrative medicine, which is chaired by Dr. Zhao Liu, medical director of ACMES and an endocrinologist from Beverly hospital. Dr. Jie Zhou, and Dr. Lichao Chen, both from Harvard Medical School, served as moderator for the two meeting rooms.

Primary care track started with an oncology panel and was moderated by Dr. Frank Chen, MD, Associate Professor of Pathology from State University of New York at Buffalo. Three physicians from Harvard affiliated Beth Israel Deaconess Medical Center, Dr. Elizabeth  Buchbinder, Dr. Anand Mahadevan, and Dr. Hao Wang, covered advances in immunotherapy, radiotherapy, and lung cancer screening and therapy.  Dr. Buchbinder summarized recent advances in both specific and nonspecific immunotherapy and previewed possible breakthroughs in the near future. Dr. Mahadevan demonstrated the improvement of efficacity and reduction of normal tissue injury by using stereotactic radiotherapy. Dr. Wang discussed the value of CT in screening and early diagnosis of lung cancer. He also reaffirmed that smoking cessation was the most important measure in lung cancer prevention. Their talks led to active discussions among participants and excited the audience.

In a separate talk, Dr. Jiguang Zhu, Associate professor of neurosurgery from the University of Texas Medical School at Houston, update the audience on the current and novel therapeutic modalities for malignant gliomas. Dr. Jinaren Mao, professor of anesthesia research from MGH, Harvard Medical School, provided clinical guideline of Opioid use for primary care physicians.  Both talks impressed the audience with their depth and breadth on the up to date medical information.

The topic of lunch CME lecture was “chronic liver disease and hepatic encephalopathy.” Dr. Keqin Hu, Professor of Medicine from University of California at Irvine, systemically reviewed the topic and the recent progress on hepatic encephalopathy. For example, he mentioned that Lactulose is one treatment option, and Rifaximin appears to be more effective.  These are good news for patients who suffer from hepatic encephalopathy.

In the afternoon, Dr. Margo Hudson from Brigham & Woman’s Hospital started the session on optimizing glycemic control in type 2 diabetes. She reviewed the application of insulin as well as the new generation of medication for diabetes to provide a fine tuned control for the disease. Dr. Jingtai Cao, associate director of ophthalmology from Regeneron Pharmaceuticals, described his journey from a physician to a scientist and an inventor. His company developed  VEGF-Trap-eye, which was approved by FDA last year to treat ‘wet’ or neovascular form of age-related macular degeneration (AMD).  Lastly, Dr. Wenliang Chen, staff surgeon from Jordan Hospital updated the audience on the application and advances of laparoscopy surgery. As the surgery has the benefits of smaller incision, lower cost, and quicker  recovery comparing to traditional surgical techniques, more patients could benefit from it.

The next session was led off by Dr. Nanci Yuan, Professor of Medicine from Stanford University. She imparted her rich experience and insight in the field of sleep medicine to her colleagues in primary care. Her talk on the diagnosis and treatment of sleep apnea was well received. Next, Dr. Shiaoyu Lee, assistant professor of Harvard Medical School, talked about managing menopause in women, and Dr. Min Le from the same institution reviewed male hypogonadism. There talks were interesting and informative. Finally, Dr. Thomas Liu, from Weill Medical College of Cornell University, shared his knowledge on how to treat irritable bowel syndrome.

The morning session for integrative medicine is centered on autism. The first speaker is the director of the Great Plains Laboratory, Dr. William Shaw. As a father of an autistic child himself, Dr Shaw has investigated treatment options for autism for years. He has helped improved the lives of thousands of autistic children and their parents.  His talk described newly identified links between the metabolites of gut clostridia bacteria and the pathogenies of autism. 

The next speaker, Dr.Martha Herbert, pediatric neurologist of MGH/Harvard Medical School and a well-known autism expert entitled her talk as “Autism Revolution.”  She proposed a new model on autism spectrum disorder based on her research and clinical practice. She believes that autism is not merely a mental illness or a physiological disorder, but the result of systemic interactions among genes, environment, development, as social and culture factors and a whole body disease. She signed her books with the same title after her talk to enthusiastic audience.

Another autism parent and a researcher, Dr Shen Luan, from Berg Diagnostics, offered hope that new biomarkers for autism may be on the horizon. Every autistic patient costs 1.4 to 2.3 million dollars a year. And cognitive behavior therapy is quite effective for autistic children if early diagnosis can be made. Indeed, autism disorder is becoming a potential social problem is current epidemic is not halted. Some parents of autistic children in audience expressed interest to participate experiments for early diagnosis, but Dr.Luan also pointed out that early detection of autism was still challenging.

The last speaker in the morning was Dr. Hon Ho, a pediatric psychiatrist from the North Shore Medical Center. He shared his clinical experience on using psychiatric drugs to treat autism.  He suggested that some psychiatric drugs should be prescribed with caution, starting at a low dose and adjusting the dose slowly. It is important to monitor the patients for potential side effects. He also encouraged parents of autistic children to seek second opinions when deciding to use psychiatric drug treatment.

 The theme shifted to alternative medicine in the afternoon.  Dr. Shubai Liu and Dr. Wu Hao joined to moderate the afternoon session. Dr. Albert Yeung, a psychiatrist from MGH and an associate professor of Harvard Medical School, pointed out that one-third Americans with health problems are looking for alternative treatments. Qigong has great potential and it has been widely used in the treatment and rehabilitation of many medical and psychological disorders.  He also described several clinical trials to treat derepression or diabetes mellitus in elderly patients.

 Dr. Yeung’s colleague at MGH, Dr. Lucy Chen, assistant professor of anesthesiology at Harvard Medical School, extended the topic of alternative treatment with applications of acupuncture in pain management. Dr. Chen pointed out that there are 5 million patients in the US have used acupuncture as alternative treatments. She explained that there were more than 2,000 acupuncture points on the surface of human body. In addition, acupuncture is safe. In one study, no serious complications were found among 60,000 cases of acupuncture or moxibustion treatment. She also discussed with the audience on insurance coverage of acupuncture treatment.

 Licensed acupuncturist Dr. Jing Liu gave a lecture on the topic of “fatigue and integrative approach.” Dr Liu has been studying traditional Chinese medicine at MGH for over 15 years. His deep knowledge in the field piqued the interest of the audience. After the analysis of the relationship between fatigue and hormone imbalance, especially adrenal insufficiency.  He noted that some Chinese herbs, such as ginseng, Siberian Ginseng, rhodiola rosea, glycyrrhiza, withania, are particularly effective in treating patients with chronic fatigue.

 Professor John Zhang from Beijing Traditional Chinese Medical College explored the topic of acupuncture in treating complications in cancer. He pointed out that “the Yellow Emperor’s internal classic” introduced acupuncture and moxibustion for treatment of tumors and cancer more than 3,000 years ago. He also gave multiple examples of successful treatment in his clinical experience.

 Finally, Dr. Ming Wong, who has been practicing integrative medicine for over 30 years in the greater Boston area. He overviewed philosophical approaches adopted by Western and Chinese Medicine. He quoted Erwin Schrödinger to define life as having negative entropy. And he criticized traditional western medical practice as “zombie” medicine.

 The conference also invited two attorneys from distinguished law firms to address legal issues related to medical community. Mr. David  Gould from Ficksman & Conley taught the techniques to deal with litigation and Board of Registration inquiries. He cautioned physician to carefully follow clinical procedures and enhance communication with patients to avoid unnecessary incidents. Attorney Daniel Heffernan from Kotin, Crabtree & Strong explained the rights of children with special needs, education arrangements, and arbitration process if there is a dispute. He pointed out that there are resources available for parents to protect their children’s rights in Massachusetts. The last speaker Alan Chew from Newyork Life introduced to the audience on estate planning and irrevocable living trust.

 The evening reception and banquet were held at Charles View Ball Room with a panoramic view of Charles River and Boston. A lot of people took the opportunity to network and discuss with colleagues and friends. The evening program was hosted by Xylina Wu, the vice president of ACMES, who flew in from Texas, and Raymond Liu, marketing advisor of ACMES, professor of business at  University of Massachusetts of Boston. Dr. Douglas Levine, vice president of Ironwood Pharmaceuticals, was introduced by Dr. Xiangyang Yu. Dr. Levine’s talk is “New Era of IBS treatment” and he presented a newly FDA approved drug that is developed by his company.

 Dr. June (Xuejun) Kong, the president of ACMES (www.acmes.net) reviewed the mission and achievement of this non-profit organization. In 2012, ACMES has held more than a dozen academic meetings and CME seminars as well as journal clubs, workshops, and other community programs such as free clinics. In addition, ACMES has contributed on Sino-American medical exchange, especially, training of Chinese physicians. Two focuses of ACMES is autism treatment and Hepatitis B screening. Both have made fruitful progress this year. Moreover, both English Journal NAJMS (www.najms.net) and Chinese Journal NAJMH (www.najmh.org ) have steadily increasing readerships and contributors. VIP guests are speakers of the conference received latest issues (October, 2012) from both journals as gifts.

 Dr. Kong also introduced and thanked board members and other core team members of ACMES with deep gratitude. She emphasized that one person, however capable, has limitations. On the other hand, a team, working together will make a much bigger contribution the community.  She presented community service award to Dr. Lichao Chen and Ms. Juanzi Liu.

The entertainment program included Guzheng (Chinese plucked zither) performance by master musician Ms. Hui Weng, “O mio babbino caro” and “when I have sung my song to you” by young Soprano Ms.Ying Wang, “my dear motherland” by Prof. Ramond Liu, and Kung Fu performance by children of Wah Lum Kung Fu and Tai Chi Academy. The highlight of the evening is the Yijing and Taiji Exercise, invented by the co-founder and the director of natural medicine of ACMES. The dance was performed by Juanzi Liu, Zhao Liu, Jingjing Liu, and Yuquan Chen and won accolades from the audience. Inspired by their performance, the audience went down to the dancing floor and danced together led by master Ballroom dance teacher Ms. Ye Wu, ending the evening program on a high note. At this point, the annual conference was wrapped with boundless grace, joy and beauty. Indeed, ACMES is positioned to contribute to the promotion of global health and well-being, and highest quality of life. (reported by Lichao Chen)

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