可不可以，你也剛好喜歡我？glucosamine & 我被遺棄了QQ

今天本來要七點起床
但還是失敗了....8:07爬起來（比起星期一是１１點這進步真顯著）
一天一天像蝸牛一樣努力
明天一定可以早起的（要早睡吶！小姐）




然後宅女的一天，早上打暗黑
下午去開心農場收成茄子
我媽種的茄子我今天收成有３斤ㄟ
根本我媽就吃不完吶.....

悲慘的是小黃瓜先生得了白粉病
已經sign DNR了

希望能夠一直吃到健康的小黃瓜
小黃瓜最近也有蜜蜂的蟲害
有一種蜜蜂會把卵產在小黃瓜裡面
最後就會爛掉....

上禮拜開始10條小黃瓜挑一挑大概只剩下3條的量可以吃
(嗚嗚 這是大自然的威力嗎....)
我想吃健康的小黃瓜Q___Q




上個月投履歷到台南某私人醫學中心
結果落榜了.......連面試都沒機會就掛了  XDDDD


今天跟一位資深的學姐討論以後才曉得
原來履歷裡面是不能寫太多做過的事情以求注意力
因為工作的時間不夠長，寫做過很多事情
反而只會給人一種很不穩定的感覺
因此他強烈建議我下次要投前高雄縣某私人接近醫學中心的醫院的時候
資料寫一半就好！(我在想是不是乾脆不要寫，假裝自己是一張白紙)


是說，昨天知道消息以後是沒甚麼感覺
但今天又再找目標的時候
失落感跟失敗感就有一點點漸漸地浮現
是說世界上比我優秀的人一定很多沒錯
但....就是標題...可不可以，你也剛好喜歡我 XDDD


如果要去山裡面的醫院工作
應該就是定位成好好的學一下
而且還得買車....就要還完貸款才可以跑路XD

最後用一張圖來回應給台南某私人醫學中心
多安慰啊！阿門！

本日文章...
Glucosamine Drink Flops in Knee Osteoarthritis Trial
我覺得動詞用很好，Flop是翻牌的意思
glucosamine 在骨關節炎的試驗中翻牌了XDD

Glucosamine就是維骨力的成分名稱
說到這個維骨力，外行人在看的時候千萬不要因為他這裡說維骨力沒效
就打跑一大堆維骨力....連健保都不給付那樣

目前被認為具有療效的是 Glucosamine sulfate 是硫酸基的
但這篇講的都是Glucosamine HCl，藥局賣的健康食品大多都是 HCl的
硫酸基就是義大利原裝進口的...(廣告那個)


單字

• lemonade (n.) 檸檬水 ...念起來怎麼很像像台語
• cartilage (n.) 軟骨
• deterioration (n.) 退化、惡化
• notable (adj.) 顯著
• derive (v.) 獲得
• cluster (v.) 聚集
• demonstrate (v.) 指明、示範

摘要

• 1500 mg glucosamine HCl 每天喝，喝6個月對骨關節炎的效果，喝了跟沒喝一樣
• 報告指出不管是影像學上的軟骨退化、鼓瘀傷的改善、CTX-II(一種看軟骨損傷的尿中成分)、疼痛感、功能都沒有差別。
• 然後各段都在講他的研究方法、研究結果沒有差異這樣
• 最後一段研究的博士Dr. Kwoh說：我們本來假設glucosamine有一點點效果，令我驚訝想不到的是竟然完全沒有
• 然後另一個博士Dr. Matteson說：這真是個好研究，以後患者問的時候就跟他說沒效！
• Glucosamine是非維他命、非礦物質銷售最好的成分！2010年曾經創下21億美金的銷售量

Glucosamine Drink Flops in Knee Osteoarthritis Trial

Patients with mild to moderate knee osteoarthritis (OA) who drank 1500 mg glucosamine hydrochloride dissolved in lemonade each day for 6 months had just as much pain and knee cartilage deterioration as similar patients who drank only lemonade, according to a randomized, placebo-controlled trial by C. Kent Kwoh, MD, and colleagues, published online March 10 in Arthritis & Rheumatism.

Glucosamine Not Associated With Less Cartilage Damage

Results of the study, which is notable for using 3T magnetic resonance imaging rather than plain X-ray imaging to assess worsening of cartilage damage (the primary outcome), "suggest that administration of glucosamine hydrochloride in a beverage for 24 weeks is not associated with less deterioration in knee cartilage damage, less worsening of [bone marrow lesions (BMLs), also known as "bone bruises"], improvement of BMLs in the knee, decreased urinary excretion of CTX-II [C-terminal cross-linking telopeptide of type 2 collagen, a marker of cartilage damage], and/or decreased pain and functioning in individuals from the community with chronic knee pain," the authors conclude.

"It is difficult to recommend glucosamine for patents with knee pain based on the results of our study. If a patient with knee pain asks whether glucosamine may be helpful, they may need to take it more than 6 months to derive any potential benefit more than a placebo," Dr. Kwoh, professor of medicine and medical imaging, The Charles A.L. and Suzanne M. Stephens Chair of Rheumatology, and director, University of Arizona Arthritis Center, Tucson, told Medscape Medical News.

First Study to Use MRI to Measure Glucosamine Cartilage, BML Effects

For this double-blind, placebo-controlled trial, the researchers enrolled 201 participants with mild to moderate pain in 1 or both knees, defined as a Western Ontario and McMaster Universities pain score between 25 and 100. Two thirds of patients had a Kellgren-Lawrence grade of 2 or higher in at least 1 knee on baseline radiography.

Participants were randomly assigned to receive either 24 weeks of daily treatment with 1500 mg glucosamine hydrochloride in a 16-ounce bottle of diet lemonade (n = 98) or diet lemonade placebo in an identical bottle (n = 103). The treatment drinks were prepared at the clinic using Regenasure glucosamine hydrochloride (Cargill).

The primary outcome was worsening of cartilage damage in all knees assessed using 3T magnetic resonance imaging, according to the validated Whole Organ Magnetic Resonance Imaging Score system. Secondary outcomes were change in BMLs in all knees and urinary CTX-II, which the author notes has been associated with both prevalence and progression of radiograph osteoarthritis of the knee and hip.

Glucosamine Did Not Protect Cartilage or Reduce Osteoarthritis Pain

After 24 weeks of treatment, the researchers found no difference in cartilage worsening between the 2 groups (odds ratio, 0.85; confidence interval, 0.47 - 1.54). Analysis using an adjusted logistic regression model that controlled for clustering by subregions within knees and between knees within an individual likewise showed no association between cartilage deterioration and treatment group (adjusted odds ratio, 0.938; 95% confidence interval, 0.53 - 1.67).

"We also were unable to demonstrate a benefit of glucosamine over placebo with regard to improvement in BMLs. We chose BMLs as a secondary outcome since they have been shown to be associated with subregional cartilage loss. There have been no prior studies that have examined the benefit of glucosamine on changes in BMLs," the authors add.

The researchers also found no benefit of glucosamine over placebo with regard to decreased excretion of urine CTX-II or to Western Ontario and McMaster Universities pain scores at 12 or 24 weeks.

Researchers Surprised at Glucosamine Lack of Effect in Knee OA

"Our initial hypothesis was that glucosamine would show some effectiveness. I was surprised that none of the measure indicated an effect better than placebo," Dr. Kwoh said.

Eric Matteson, MD, chair of the Division of Rheumatology at the Mayo Clinic, Rochester, Minnesota, told Medscape Medical News that the researchers adequately addressed the structural questions regarding the possible benefit of glucosamine supplementation in this form.

Dr. Matteson, who was not involved in the study, said, "I think this is an excellent study which demonstrates that oral glucosamine has no efficacy with respect to knee joint morphology. When asked, clinicians may counsel that there is no evidence that these products restore joint integrity."

Dr. Kwoh suggested that different formulations such as glucosamine sulfate or a longer treatment period might be worth further study.

According to the authors, glucosamine is the second most commonly used nonvitamin, nonmineral natural product. It is used as alternative therapy for osteoarthritis. Global sales of glucosamine supplements were more than $2.1 billion in 2010.

This trial was sponsored in part by the Beverage Institute for Health & Wellness, a project of the Coca-Cola Company, which for a time marketed Minute Maid Active orange juice containing Regenasure glucosamine HCl, and by the National Institute of Arthritis, Musculoskeletal and Skin Diseases. Dr. Kwoh has received consulting fees from Pfizer and Novartis. The other authors have disclosed no relevant financial relationships. Dr. Matteson has disclosed no relevant financial relationships.

Arthritis Rheum. Published online March 10, 2014. Abstract