The Year In Medicine

《Nature Medicine》在最近一期（ December 2004, Volume. 10. No. 12 ）发布了名为《The Year that was -- 2004 wrap up》的医学2004年大事记略 - - 从新闻、人物、科技进展等多方面对2004年的医学进行了一个总结。 CMBI以此报道为蓝本，搜集了相关的资源和文献，总结如下，供大家参考。


The swift spread across Asia this year of the deadly H5N1 strain of avian influenza served as a grave warning of a possible flu pandemic like the one in 1918, which killed more than 20 million people. The virus infected wild birds, cats, tigers, ducks and pigs and drove governments to cull more than 200 million domestic fowl, wreaking economic havoc in the region. It also claimed 32 human lives as of 17 November. H5N1 transmission between people appears to be rare thus far, but its presence in pigs?awhich also harbor human flu viruses?asparked fears that the virus could mutate into a strain against which humans have no immunity. Although last year's epidemic of severe acute respiratory syndrome boosted infectious disease surveillance, there are still significant gaps. Reports of H5N1 infection in pigs languished undiscovered in Chinese language journals for seven months ( Nature 430.955;2004). Meanwhile, the US was left 48 million doses short of its flu vaccine need when one of the country's two major suppliers was closed down as a result of lab contamination. The shortage highlighted problems in flu preparedness and vaccine production. The World Health Organization in November held a summit of health agencies and vaccine manufacturers to speed up vaccine development for pandemic flu strains. Meanwhile, the US National Institutes of Health announced a multicenter scheme to sequence thousands of strains of human and avian influenza viruses. The debate on open access to scientific literature intensified this year, as governments and influential scientific organizations increasingly took sides on the movement's significance. In Britain, an inquiry by the House of Commons Science and Technology Committee concluded in July that open access seems viable but requires further experimentation. The committee advised the government to require UK-based authors to publish articles on their institutions' websites, but the government largely rejected the advice on 8 November. In August, 25 Nobel laureates signed a letter calling on the US government to provide public access to government-funded research. As a result, the US National Institutes of Health in September invited comments on a proposal to make the results of all federally funded research freely available shortly after publication. And in October, the German government gave 6.1 million to the Max Planck Society to develop an open-access system for publications from the society's institutes. Meanwhile, 48 biomedical societies united to oppose open access. On 16 March, they launched a series of Principles for Free Access to Science, which backs open access but reserves the right of publishers to charge for several months after publication. Society editors argued that it would be impossible to generate income for other society activities if they only raised money through payments from authors.	Reproductive biology took a few promising, and rather bizarre, turns this year. Succeeding where many others had failed, Korean scientists revealed in February that they had created the first cloned human embryo. In March, another team announced the birth of a monkey from frozen ovarian tissue transplanted under the abdomen. Just months later, a cancer survivor gave birth to the first baby girl born from an ovarian transplant ( Lancet 364 , 1405–1410; 2004). The ovary had been frozen before the woman had received chemotherapy for an advanced case of Hodgkin lymphoma; the baby was conceived naturally ( Nature 428 , 137–138; 2004). Researchers have also successfully transplanted ovaries into the arm. In many ways, this was the year for female fertility. The popular media particularly loved the story of fatherless mice ( Nature , 428 , 860–864; 2004), born through parthenogenesis, a process more familiar to other species such as lizards, in which the embryo develops directly from an egg. A separate study also overturned the dogma that female mammals are born with all the eggs they will ever have. Mice were found to keep pumping out new eggs from stem cells well after birth ( Nature 428 , 145–150; 2004). Compounded by controversy over pharmaceutical company practices, regulating and registering clinical trials this year took on an added urgency. On 1 May, the European Union launched its clinical trials directive to normalize and improve trials. The new regulations are intended to establish the legal obligations of trial sponsors and ensure greater patient protection. But some academic researchers have protested the directive since its announcement in 2001, saying it will be difficult for them to meet the regulatory requirements and cost. In March, the UK unveiled the National Clinical Research Network to centralize funding and regulation of clinical trials. And in April, the World Health Organization, in conjunction with Current Controlled Trials, part of an independent publishing group, announced an online registry to improve tracking and comparison of randomized trials worldwide. The issue intensified when, responding to concerns about the selective reporting of trial data, the editors of 11 leading medical journals announced in September that registering trials in a free, searchable public database would be a prerequisite for considering manuscripts for publication in their journals. In October, the US Senate and Congress introduced legislation seeking mandatory registration of clinical trials. RNA interference - which uses short fragments of RNA to block the production of specific proteins—this year cleared several hurdles in its path to becoming an approved therapy for human diseases. Two companies - Acuity Pharmaceuticals in August and Sirna Therapeutics in September - filed applications with the US Food and Drug Administration to begin testing the technique's ability to treat age-related macular degeneration by interfering with the growth of new blood vessels. This year also saw several reports documenting the method's effectiveness in silencing gene expression in animal models of disease. One notable report showed that, delivered intravenously, short interfering RNAs targeted to an apolipoprotein can lower serum cholesterol in mice ( Nature 432 , 173; 2004). Whether the technique can treat diseases in people remains to be seen. Researchers are still investigating whether the RNA fragments can be delivered in sufficient quantities to relevant tissues, how specific they are for their intended targets and what sorts of toxicities they might produce.

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