History of Medicine

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(1 A Brief History of Medicine OO wae | 

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Why should we learn history The longer you look back, the farther you can look forward --Winston Churchill 1944 QOUOO00000 -oo Taking history as a mirror, one can draw ۱ lessons from raises and falls of powers 5 - Li Shimin pFirst Emperohot Tat fe Dynasty) ‏رتم‎ oo = 

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What is History of Medicine QO0000 ٠ History of Medicine is an interdisciplinary study leading toward an understanding of the origination and development of medicine and influencing factors; and its impact on society ‏تاد‎ ys human being. dus 

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About the course Elective [] 32 teaching hours [2 credit points * Schedule [] Lectures + discussion History of human diseases 4h Origin and history of medicine 22h Student presentation & discussion 6h * Test () Essay writing 

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Time Schedule انع لاس اس ال ‎ie a‏ Mar 03 pm Introduction, History of Mon Disease (1) = Mar 07 am History of Human Disease (2) Fri 3 Mar 10 pm Origin of Medicine Mon 3 Mar14 am Medicine in ancient times Fri 4 Mar17 pm Medicine in ancient times Mon 4 Mar 21 am Student presentation (1) Fri 5 Mar 24 pm Student presentation (2) Mon Mar 28 am Student presentation (3) Gr 

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Time Schedule (cont.) اس سل اس Apr 11 Fri am History of infectious diseases (2) 8 Apr 14 pm Development of diagnostic Mon techniques 8 Apr 18 Fri am Development of therapeutic Techniques 

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Reference Books Roy Porter [|)The Cambridge History of Medicine Cambridge University Press 1996 [] 2006 revised Kenneth F. Kiple: The Cambridge World History of Human Disease The Press Syndicate of the University of Cambridge 2003 Arturo Castiglioni{] A History of Medicine (English translation), New York, J.Aronson 1975 11" Editions Frederick Cartwright & Michael Biddiss: Disease & History Sutton Publishing 2000 Internet www.nlm.nih.gov/hmd, www.historylearningsite.co.uk, en.wikipedia.org/wiki/History_of medicine ۷ 4 

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Information for Slides down-load * Visit website: http://m-learning.zju.edu.cn ۰ ۱۱۱ 000100 ][ Digital Learning Platform) * QO00 (Course List)_ * P4(jHistory of Medicine * “TjOO000” (Enter Course Website) * Lecture Slides * If any problems contact Mr Ye Zhiguo,. » softlab@ziju.edu.cn, Tel. 88206726 

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0 اليا ۳ ای یت لت باوج سم روج ری برد اود جر تمه جوم كوه دعم ‎exons‏ ‏نت ‎am‏ = Radon ‏در‎ ‎ess ‎aver ‏جنر‎ ‏معاد‎ ‏و‎ ‘orate ana nis 0 53 SHORE TROE ‏هر‎ 36 a-wans ‏و‎ 9 80 ار 0 nt 

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هه هو ارات انم و ۱ 

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هه هه os asscess Baan 6) 2) SBI ‏وتو‎ تست ‎RENE‏ 6( له بزموطی RIAYRTEN=S 60 ‏مومم‎ waar] arn] see] aan] are liecwesies 9 art] sane 

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History of Human Disease 

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ton coo Evolut Preset (088 S194 Jo SHON 

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Human Evolution Since the first man emerges on the Earth [J] the man and its disease have been bonded inseparably. 

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OOUUU History of Human Diseases The history of mankind is the history of its diseases - Folke Henschen Since the first man emerges on the Earth Jj mankind and its disease have been bonded inseparably. 

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What is disease ٠ 00 Disease (dis-ease) an impairment of the normal state of an organism that interrupts or modifies its vital functions. - To cure sometimes, to relieve often, to comfort always Trudeau 

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History of human disease studies: The natural history of disease (emerge, develop, outbreak, attenuate, eliminate) and the intervention of human activities The geographical and historical distribution of human diseases The impact of human society on the development of disease, and in turns the impact of disease on the development of human society and human being itself ۱ 

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Prehistorical Diseases Homo erectus “Turkana boy” of Kenya 1.65 M yrs “ows, Treproewo 

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Prehistorical Diseases Related to gathering and hunting (hunter- gatherers): * malnutrition * parasitosis 

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Disease in agricultural society * Zoonosis (disease transmitted from animals to humans or from humans to animals) Epidemic of infectious disease Digestive air Insects Domestication of animals 2 نگ و 

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‎Zoonosis‏ تا ‎ 

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Paleopathology Ancient Egypt Mummy Pyramid 

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تست Pharaoh Ramses V died in 1157 B.C from smallpox A louse found in a mummy of 3000 EO 

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[J Schistosomiasis 8 Schistosoma heamatobium in Africa [] Mideast S. Japonicum in China [] Phillipines S.mansoni in Africa J Latin America 

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Infective Stage 9 Cercariae released by snail A Diagnostic Stage Sporocysts in snait @ eee A Cer lose tails dt 5 ‏نی‎ @ venetiaton and become “A, “6 ‘schistosomulae TO xi — ALA 24 a — snail issue 2 ‏مام الات‎ a Migrate to portal bl. ‏أ‎ ct _inliver and mature = ‏زر هت نی‎ into aduts ©) ‏ميت‎ eS ٠ infeces Ad inurine 6 9 Eggs hatch = releasing miracidia 35 ‏ممم‎ ih Paired adult worms migrate to: 23 Simesenteric venules of bowel/rectum 27 He (laying eggs that circulate to the liver and shed in stools) A C venous plexus of bladder 

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[DL ۷ Examining mummy with CT scanner 5 Calcification in bladder caused by a, schistaggmiasis 

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Paleopathology Schistosoma eggs discovered ina body of preserved ancient lady’s body (in Changsha Mawangdui of Hunan Province, 165 BC) Autopsy also discovered coronary heart disease, biliary stones and eggs of other intestinal parasites. نگ و 

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Paleopathology Schistosoma eggs were also found in another well- preserved body (167 BC) in Jiangling of Hubei . He also suffered from cholecystitis, cholelithiasis, pleuritis, and eggs of whipworm, tape worm, and Clonorchis sinensis etc. 

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Congestion of population, war and travelling result in outbreak and epidemics of infectious diseases 

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Black death (plague) in 14th century Outbreak of plague epidemic in Europe 1346- 1353 0000, black § death], more than 25 million people died and the population of Europe reduced by one third 

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لالالانا The outbreak of influenza in 1918 Starting from Camp Funston, Kansas USA in spring of 1918 then spread worldwide, during 1918-1919 1 billion people (world population 1.7 b) infected and 25-40 million died, much more than killed in the 1st World War, incorrectly called “Spanish flu” (Triple Alliance, Triple Entente) 

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Modern society : globalization leads to the speed of virus transmission spread as quick as that of the modern transportation (SARS 2003, N1H1 Flu 2009) ‘OO Epidemics outbreak of infectious disease ‘000 Pandemics Epidemic\spreading across a large ‏دس‎ | | 

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Disease in modern society 8 ساپس (oh Cs Epidemilogical 0 probe oF expan, ‏واه‎ transition ملس << ۹ 5ك 

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Influencing factors to modern diseases * Demographic [] degeneration disease, chronic non- communicable diseases * Ecological and environmental [j pollution and occupational diseases * Dietary and life style smoking, obesity, accident * Stress and social pressure [] depression and suicide * Progress of medical technology: ‏ابید‎ disease, brain death, vegetative state ~ 

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Life Expectancy at Birth نآ عن 33 20 18 20-0 20-30 25-35 35+ 20-30 30-40 66.7 80.07 74.830) Zhejiang 77.290 Hanazhoy 8067(M78 62. FR? 29 == Upper Paleolithic Neolithic Bronze Age Classical Greece Classical Rome Pre-Columbian North America Medieval Islamic Caliphate Medieval Britain Early 20" Century Current World Average(2008) Japan China (2010) 

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Ageing of population 1981 1990 1996 200 200120024 ۳ لا (6000) 26,05 سس .60۵ مسج [] 600000 0] 00 ی 

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58 ane سمل سوت Life Expectancy at Bith Ageing of population World Life Expectancy 3 

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Ageing of population Leading causes of death in US: comparison of 1990 and 1997 Leading Causes of Death, 1900 Leading Causes of Death, 1997 عه = 

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World causes of death in 2000 ,99,096 وی و سل )59.0%( 

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Deaths by Broad Cause Group Developed Regions Developing Regions | Communicable di Sa = 

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Cuuses oP dedk to dPReret OO reqgouw: COOO % ‎Suv‏ سوه 0 و۵04 و0۵ م۳ وه 

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Deaths, by broad group, 2000 World China mmunicable ions (7 million) 1 5 Injuries (1 millio diseases 3 Communicable diseases) (18 million) (a millon) > 5 ae mmunicable ‘ions (33 million \ ae S unicable’ Injuries (5 million) Communical 

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The greenhouse effect The Greenhouse effect Greenhouse gases: CO, carbon dioxide CH, methane 0 ozone N,O nitrous oxide H,O 

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]1]1]1]1 - 0۲ Energy ‏سس‎ ‎|___ Consumption | | ‏جك‎ | CO, Emissionj ‎Greenhouse‏ سم ‎effect‏ ‎ ‎ ‎ ‎ ‎ ‎ ‎Global Warming ‎1 ‎Ecological Damage | => Disease ‎ ‎ ‎ ‎ ‎ ‎ ‎ ‎ ‎ ‏وروی سا خن باه ‎Decker = Oued‏ ‎weaker *> do‏ د سل( ‎ ‎ ‎ ‎ ‎ ‎ ‎ ‎ ‎ ‎ 

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Countries /areas at risk of dengue transmission, 2006 هجوت 

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Impact of climate changes on health 4 uy 17 Temperature (Degree Casts) x 

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Covlovicd dacvage-ozonosphere hole Ozowsphere obser ‏جنا اعاصوسهك:‎ >) Prow svkr radaiva proteviy Iitagy oryeisws to the cart Prow OO. doce. OlforePuorocerbous (OP Or [] widely ‏دصحت برد مه حدصي تادر سرون لوص‎ vepletiva oP the ukerspheric care hye by releostay Prev radi . Over expose tp OO way case shit power, otra [] ei. 

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Environmental Pollutior 

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Environmental Pollution Minamata Disease (Mercury poisoning) ‎Chemical Furtory but t®IOCS used to‏ 0000 بان ‎produce Perilizer [] stated to wacuPuctune chorvethplede tt‏ ‎votdpzer [] wet‏ موم سوه موه مورا 1989 ‎waste woter droced iaiz the boy.‏ وا (تحوه. ‎9S9 vot chores (0000 cocured tt Oicavata Bap aed (“suivide vat”). @Pterwards hucwad puiecs preseuted the soe ‏جذاا نز وی ,موه مرو‎ hoods ood Pert, ‏له موه لا ‎oF the‏ رس ‎yeverd wusdle weubuess,‏ و و ‎speek.‏ جه لوصا صا ص وول ‎uses, iusuciy, pordesis, ‏مدوم‎ ood deci ‎Polow witha weeks of the coset oP syxpiows. C ‘Dor COSS subPered the dsruse ond POP ded. ‎ ‎ 

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Environmental Pollution - Minamata Disease 

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Environmental Pollution - Minamata Disease 

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Life style related disease [] smoking (0 Cokucobus discovered the ‏ام له مه بر‎ ‏ذا مه بل و‎ 4899) SOO pea ‏رام‎ has ‏عم‎ the forgest state risk Pastor thredtediag the health oP ‏الوم نموم‎ ۱ 1004, EARLIEST TOBACCO SHIPMENT from the New Iniorld was in 9B, when one cf Columous’ ships, 

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Life style related disease [| smoking Every year 3.5 million people die from smoking related disease in the world, the figure will reach to 10 million by 2030(Jif no effective actions are taken [ithe economy loses will be $200 billion , half in the low income countries. * In China, 350m smokers, 1m died from smoking-related diseases 

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Life style related disease ll smoking by disease group Figure 31: Proportion of deaths hi Occupation Famiy history BE Raciason Risk Factors 

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The Long Term Health Effects OF Sting Tobacco Smoking- = related ۱ diseases Respratory \ 0۸6۶۲ 0۷ ۲ Syste Hout, Lp, بت 1 

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Life style related disease obesity and metabolic syndrome Causes: Inheritance dietary habit y reduced physica 

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Life style related disease obesity and metabolic ure * Body mass inde BMI [] Kg/M? O1LO standard chassPivaicd DP vbesiy Ovrend 0106.06 Ovenvenht: CS.0-C9.9 Obesity ches 1 30.0- 59 Obesiy ches 11 9S.0- 99.9 Obesiy class 111 > Ne 

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Obesity Trends* Among U.S. Adults BRFSS, 1985 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 

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Obesity Trends* Among U.S. Adults BRFSS, 1986 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 14%-10% ۶۵ [ أده ملم GLE — NO oy Vip .. Hy Ss 

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Obesity Trends* Among U.S. Adults BRFSS, 1987 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) ۶۵ [ أده ملم 

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Obesity Trends* Among U.S. Adults BRFSS, 1988 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 

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Obesity Trends* Among U.S. Adults BRFSS, 1989 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) ۳ No Dal 10% 10%-14% one > 0 

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Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 14%-10% ۶۵ [ أده ملم نگ و 

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Obesity Trends* Among U.S. Adults BRFSS, 1991 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 15%-19% 

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Obesity Trends* Among U.S. Adults BRFSS, 1992 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 15%-19% 

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Obesity Trends* Among U.S. Adults BRFSS, 1993 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 15%-19% 

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Obesity Trends* Among U.S. Adults BRFSS, 1994 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 10%-14% | 15%-19% 

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Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 10%-14% | 15%-19% 

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Obesity Trends* Among U.S. Adults BRFSS, 1996 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) No Dal 10% 10%-14% | 15%-19% 

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Obesity Trends* Among U.S. Adults BRFSS, 1997 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) No Dal 221096 100-1 10 1590-60 

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Obesity Trends* Among U.S. Adults BRFSS, 1998 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) No Dal 221096 100-1 10 1590-60 

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Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) No Dal 221096 100-1 10 1590-60 220% 

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Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) No Dal 221096 100-1 10 1590-60 220% 

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Obesity Trends* Among U.S. Adults BRFSS, 2001 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 

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Obesity Trends* Among U.S. Adults BRFSS, 2002 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 12521006 

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Obesity Trends* Among U.S. Adults BRFSS, 2003 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 

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Obesity Trends* Among U.S. Adults BRFSS, 2004 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 71100 6 107-1 1 0 

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Obesity Trends* Among U.S. Adults BRFSS, 2005 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 

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Obesity Trends* Among U.S. Adults BRFSS, 2006 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 

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Obesity Trends* Among U.S. Adults BRFSS, 2007 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) ۱۱ 1 ‏لس‎ oO ‏مت‎ ‎oe 

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Obesity Trends* Among U.S. Adults BRFSS, 2008 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) 

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Obesity Trends* Among U.S. Adults BRFSS, 2009 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) No Di 10% 1096 24 = A a ‏لت مت‎ و 

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Obesity Trends* Among U.S. Adults BRFSS, 2010 (*BMI 230, or ~ 30 Ibs. overweight for 5’ 4” person) وه 60 

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State % Rhode 25.5 Island South 31.5 Carolina South 27.3 Dakota Tennessee 30.8 Texas 31.0 Utah 22.5 Vermont — 23.2 Virginia 26.0 Washington 25.5 West 32.5 Virginia Wisconsin 26.3 Wyoming 25.1 Pennsylvania 6 2010 State Obesity Rates State % Montana 23.0 Nebraska 26.9 Nevada 22.4 New 25.0 Hampshire New Jersey 23.8 New Mexico 25.1 New York 23.9 North Carolina 27.8 North Dakota 27.2 Ohio 29.2 Oklahoma 4 Oregon 26.8 State % Illinois 28.2 Indiana 29.6 lowa 28.4 Kansas 29.4 Kentucky 31.3 31.0 26.8 ۱۸۵7۷۱۵۸۵ 1 Massachusetts 0 Michigan ‏ومد‎ Minnesota 24.8 Mississippi 34.0 Missouri 30.5 % 32.2 24.5 24.3 30.1 24.0 21.0 22.5 28.0 22.2 26.6 29.6 22.7 26.5 State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii \daho 

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Obesity- Heavy burden for the society HEAVY BURDEN Estimates of what various conditions add to 27 health-care service costs over a 12-month Period, based on a survey of 10,000 people. Obesity TES 2 smoking (IN 20 1۷ | 20years' acing (NNN $225 ‏پات‎ ‎Problem drinking [INN 0 ‏با ۱۱ ر‎ Overweight [NN 5125 ۲ y ‘Source: Rand 

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The Medical hazards of ‘ouy maze Index Cag.) مام عمسم ماه م و موه 00 ‎nia‏ ©2028 0 2009 

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11۱۱ ۳: 777 WMetabslic Syndrome: The Role of Obesity (Obesity) 3 ‏لادان‎ ‎3 نا 7 ۱ ع ‎Triglycerides‏ ‏00000 0 لل 1 ی ات۲ 1 a rar eee 

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‎D Myes, MD. be‏ ساره ‎ 

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Life style related disease ‏ال تاه‎ 25million people died from traffic accidents since Karl Benz vented the first car in * About 500,000 people die from road accident every year in the world Death from road accident ranks 7 in China, 10 for.the world, but it may bec ie ek 4% by 2030 

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Life style related disease accident Accident is the number one cause of death for children under 14 in China accounting for 26.1% of all death. * It is estimated 40million children suffer from accident and 3.35 m hospitalized 0.4m disabled “Five leading causes: drowning, traffic accident, 

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Stress from modern society - depression ۱ WHO estimates: there are 120- 200m people suffer from depression in the world, it would become the second leading cause of death or disability by 2020 is 6.1% ] 9.5% for life time J about 13% [] 20% has one or more depressive episodes or experiences in one’s life time * The prevalence rate of depression 

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Stress from modern society - depression آی ییون ۰ ‎domed ins‏ سرون اسيم رجا چرس ‎eee teeters eet‏ رزوی راجت و محارم حصي اعبت بريه ‎Op» OO% of dl peop why‏ باتوی تسج ‎wher wood dsvrder.‏ 

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Stress from modern society - de n Suicide rate in severe depression reaches 150], writers or poets are a high-risk 

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Stress from modern society - depression 

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Development of medical technology iatrogenic disease QQ000 Deaf induced by toxicity of aminoglycoside antibiotic (streptomicine, neomycine Kanamycine, ¢ 1 ¢ 

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Development of medical technology iatrogenic disease QU000 Thalisomide, a sedative produced by ChemieGruenenthal, Germany in 1957 for sick of pregnant women. Up to 1959 more than 1m took the drug, in 1960 phocomelia (birth defect) increased which was related to the drug use during the pregnancy of the mother ۰ The drug was banned in Nov 1961 but already 10000- 12000 malformed infants born, 4000 died before ly. 

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Descriptive study Ory Gokt Thokdowtde(hu) Cases of Phocomelia ‏حك‎ Sor 6 ‏ماوت‎ ese ‏وه‎ ‎۳0 999 oro ‘Wolke ako es aaa 90 aq 7 9 9 ا ‎ado 8 ky‏ اسر ‎Cerony 980099 SOOO —‏ 

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Eco- «epidemiological study fy 160 Ha aS i it (RESSRSREH RASS AA 3 1960 1989 

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Case-control study ae) en ae ‏لت‎ ‎Yes |OR(CO.0| 506.10( | 90 %) Ov 6 ee dor 5 ||x2=69.40, P<0.001, OR=93.5 ho ES 

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(20)ص 9 09 Cohort study Tord oe 909 Outer ‏لاب‎ ‏امد‎ ‏عم‎ ae 0 لاب ای مخ ۳ do 60 RR=175, AR=41.76% Ose t O10 

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Animal experiments and intervention * Thalidomide induced limb defects in Rhesus monkey Thalidomide induced limb defects in thesus monkey, micrognathia is also present (Schardein 1333). 

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سلطا نما 198 و لو عمب > وا دا موه ای سا تخورطاه ‎cod thew Pouce tiie ch Reva‏ سبح یا سره سم | اس ‎ereuntoss (OLE),‏ ‎surcowa (110 iPevtion)‏ (anther researched reveded: the ePPet oP thakdowtde ts assvctated uit ‏وصناطاكاك‎ ‎۳0/۵۵ ‏هس ی‎ oe No weal without woe. (Luck and Misfortune comes in turn.) O0000 , OOO00. ona 5 

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Chinese Aphorism * QOOOUOCO0U00000 + Dhe Peer thot you spout tare to pare Por does ot grow, white the ‏ام ره بر ما نوت‎ > Otered Pewers sever blo, but جات ی © Pollow fove ocd it wil Pee; Pee love * O0000 , OOOO -f0 Lao Tse * DisPortuce, thot is where 

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Summary Dke vrigt oF wookied ced its disease coe together Phe develppwed, spread cod epidewic ure the results oF ‏نم‎ PPR evs oP coturd exvircovedt ond soci eovircovet, sv there ure unique diseuse profiles ‏موه و‎ historicd! era. Do study the history oP ‏موی روت حول‎ ur ‏موه رولیت‎ the cotucd how oP disease ‏لمم مجو وصاصيصك‎ fs OF vohue to heath policy ‏یه‎ 

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THANK YOU FOR YOUR ATTENTION ۱