Global biodiversity conservation requires traditional Chinese medicine trade to be sustainable and well regulated.

Traditional Chinese medicine (TCM) is highlighted by conservation practitioners as an ongoing threat to many overharvested plant and animal species, including several charismatic threatened vertebrates. However, studies that provide evidence-based and practical recommendations on how to better regulate the TCM trade for sustainability and biodiversity conservation remain limited. China is the biggest promotor of and market for TCM and understanding the TCM trade in China is important for global biodiversity conservation. In particular, conservation researchers need to better understand how the TCM trade and its regulations interact with China's development needs and should collaborate with TCM communities to propose locally adapted suggestions to decision makers. However, progress in these areas has been restricted by language, cultural, and knowledge barriers. In this paper, we provide an overview of the current status of TCM-related regulations in China, identify weaknesses in regulation frameworks, and highlight issues that currently limit our understanding of the magnitude, dynamics, and impact of the trade. We propose changes in trade regulations, actions to enhance law enforcement, and future research directions to encourage a more sustainable TCM trade that benefits both global biodiversity conservation and TCM development.

Gulf braced for the big clean-up.

Earlier oil spills suggest the Gulf may be in for the long haul to recover from this year's disaster.

Perry syndrome due to the DCTN1 G71R mutation: a distinctive levodopa responsive disorder with behavioral syndrome, vertical gaze palsy, and respiratory failure.

Perry syndrome is a rare form of autosomal dominant Parkinsonism with respiratory failure recently defined as being due to mutations in the DCTN1 gene. We describe a new family carrying a G71R mutation in the DCTN1 gene. The proband displayed a series of distinctive features not previously described in Perry syndrome: a disorder of vertical downward saccades accompanied by progressive midbrain atrophy, predominant nonmotor symptoms responsive to levodopa, distinctive craniocervical levodopa induced dyskinesias, and a good response to high-dose levodopa therapy and respiratory support. The family was initially thought to have autosomal dominant behavioral variant frontotemporal dementia with Parkinsonism. This report expands the clinical definition of this distinctive syndrome.

Malignant colo-duodenal fistula; case report and review of the literature.

BACKGROUND: Colo-duodenal fistula is a rare complication of malignant and inflammatory bowel disease. Cases with malignant colo-duodenal fistulae can present with symptoms from the primary, from the fistula or from metastatic disease. The fistula often results in diarrhoea and vomiting with dramatic weight loss. Upper abdominal pain is usually present as is general malaise both from the presence of the disease and from the metabolic sequelae it causes. The diarrhoea relates to colonic bacterial contamination of the upper intestines rather than to a pure mechanical effect. Vomiting may be faeculant or truly faecal and eructation foul smelling but in the case reports this 'classic' symptomatology was often absent despite a fistula being present and patent enough to allow barium through it. Occasionally patients will present with a gastro-intestinal bleed. CASE PRESENTATION: We present an unusual case of colorectal carcinoma, where a 65 year old male patient presented with diarrhoea and vomiting secondary to a malignant colo-duodenal fistula near the hepatic flexure. Adenocarcinoma was confirmed on histology from a biopsy obtained during the patient's oesophageogastroduodenoscopy, and the fistula was demonstrated in his barium enema. Staging computed tomography showed a locally advanced carcinoma of the proximal transverse colon, with a fistula to the duodenum and regional lymphadenopathy. The patient was also found to have subcutaneous metastasis. Following discussions at the multidisciplinary meeting, this patient was referred for palliation, and died within 4 months after discharge from hospital. CONCLUSION: We present the case, discuss the management and review the literature. Colo-duodenal fistulae from colonic primaries are rare but early diagnosis may allow curative surgery. This case emphasises the importance of accurate staging and repeated clinical examination.

Welsh I am.

With developments in genetics, researchers are increasingly able to address historical issues surrounding human migration and provenance by studying present populations. Nigel Williams reports on one of the latest studies looking at a crucial period of British history.