Rare diseases still lack effective treatments, and the development of drugs for rare diseases (known as orphan drugs) is an urgent medical problem. As natural active ingredients in living organisms, some biomacromolecule drugs have good biocompatibility, low immunogenicity, and high targeting. They have become one of the most promising fields in drug research and development in the 21st century. However, there are still many obstacles in terms of in vivo delivery. In view of the unique advantages of nanocarriers prepared from polymers, lipids, organic biomimetic and inorganic materials in drug delivery, researchers are committed to building an efficient delivery system with versatility and synergy to solve the bottleneck issues in treating rare diseases with biomacromolecule drugs. Therefore, this article reviews the research progress of nanocarrier delivering proteins, peptides and nucleic acids in the field of rare disease treatment in the past ten years, which provides ideas for researches on biomacromolecule drug nanosystems in the field of treatment of rare diseases.

Objective: To investigate the current situation of drug supply and determinants of drug shortage in primary health institutions in Anhui province. Methods:Primary health institutions in Anhui province were selected as the main research subjects. One hundred and six (106) primary health institutions from three areas/districts in Anhui province namely northern Anhui,Central Anhui,and Southern Anhui were selected with stratified random sampling as the first sample,and 54 pharmaceutical producing enterprises and 62 pharmaceutical trading enterprises were selected with convenience sampling method as the second sample. The survey was conducted by issuing questionnaires to record views of the respondents to help understand the current situation of drug supply from the first sample and the main de-terminants and solutions of drug shortage from two samples. Results:13% of the primary health institutions still suffer from serious shortage of drug supply; the drug distribution rate varies greatly between units, and 19% of the primary health institutions have a drug distribution rate below 70%,and all primary health institution within the scope of inves-tigation experienced drug shortages. The frequency of choices of determinants of drug shortage were in sequence of or-der:drug demand instability (19.20%), drugs have a new and higher profit alternative (15.94%), etc.; The fre-quency of choices of solutions of drug shortage of primary health institution were in sequence of order:to improve the national list of essential medicines(12.78%),appropriate improvement in efficacy the low-priced varieties(with cura-tive effect) (12.03%),etc. Conclusions:Primary health institutions suffer from drug shortage issue widely,and the reasons for the shortage of drugs are more complicated;the government should continue to implement relevant policies, comprehensively improving the primary health institution drug supply mechanisms in all to prevent drug shortages.

OBJECTIVETo investigate the effect of premature rupture of the membrane (PROM) on neonatal complications in premature infants.

METHODSThe registration information of 7684 preterm infants with gestational age <37 weeks were collected from the cooperative units in the task group between January 1, 2014 to December 31, 2014. Specially trained personnel from each cooperative units filled in the unified form in a standardized format to record the gender, gestational age, birth weight, PROM, placental abruption, antenatal corticosteroid, Apgar score, amniotic fluid pollution, and complications of the infants. The data were analyzed comparatively between the cases with PROM and those without (control).

RESULTSThe preterm mortality rate was significantly lower but the incidences of ICH, NEC, ROP and BPD were significantly higher in PROM group than in the control group (P<0.05). The 95% confidence interval of the OR value was <1 for mortality, and was >1 for ICH, NEC, ROP and BPD. After adjustment for gestational age, birth weight, gender, mode of delivery, placental abruption, placenta previa, prenatal hormones, gestational diabetes mellitus (GDM), gestational period hypertension and 5-min Apgar score <7, the incidences of NEC, ROP and BPD were significantly different between the two groups (P<0.05) with 95% confidence interval of OR value >1, but the mortality rate and incidence of ICH were not significantly different between the two groups (P>0.05).

CONCLUSIONPROM is a risk factor for NEC, ROP and BPD in preterm infants, and adequate intervention of PROM can reduce the incidences of such complications as NEC, ROP and BPD in the infants.

Apgar Score ; Birth Weight ; Female ; Fetal Membranes, Premature Rupture ; pathology ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Infant, Newborn, Diseases ; etiology ; Infant, Premature ; Pregnancy ; Risk Factors

OBJECTIVETo study the changes of adenosine diphosphate (ADP)-induced platelet aggregation rate, and evaluate the effects of Maixuekang Capsule (, MKC) on platelet aggregation rate and long-term prognosis of patients with acute coronary syndrome after percutaneous coronary intervention (PCI).

METHODSA total of 236 patients with acute coronary syndrome, who received successful PCI, were randomly assigned to a trial group (116 cases) and a control group (120 cases) according to random numbers; treatment allocation occurred when the participants met the inclusion criteria and signed the informed consent forms. In the trial group, the patients were treated with MKC combined with routine medication, and in the control group the patients were treated with routine medication. The therapeutic course for the two groups was 12 months and the follow-up was 12 months. The levels of ADP-induced platelet aggregation rate and serum high-sensitive C-reactive protein (hs-CRP) were determined before PCI, 12 h and 30 days after PCI. In the meantime, the incidence of cardio-/cerebrovascular events was recorded during the 12-month follow-up.

RESULTSCompared with before PCI, the levels of ADP-induced platelet aggregation rate and serum hs-CRP were significantly higher at 12 h after PCI (P<0.05). They were significantly reduced after 30-day-treatment of MKC, showing statistical differences when compared with those in the control group (P<0.05). During the 12-month follow-up, the incidence of cardio-/cerebrovascular events was significantly lower in the trial group than in the control group (6.9% vs. 12.5%, P<0.01).

CONCLUSIONSADP-induced platelet aggregation function was significantly elevated after PCI. MKC improved the prognosis of patients with acute coronary syndrome, possibly through inhibiting the platelet aggregation, fighting against inflammation, and protecting the vascular endothelial function.

Acute Coronary Syndrome ; drug therapy ; surgery ; Adenosine Diphosphate ; pharmacology ; Aged ; C-Reactive Protein ; metabolism ; Capsules ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Male ; Percutaneous Coronary Intervention ; Platelet Aggregation ; drug effects ; Prognosis

OBJECTIVETo determine serum levels of resistin and visfatin in the patients with acute Kawasaki disease before and after intravenous immune globulin (IVIG) treatment.

METHODSA total of 50 children with acute Kawasaki disease were treated with IVIG for 48 hours between January 2011 and January 2013. As controls, 30 healthy children and 30 children with acute infectious diseases were included. Serum levels of resistin and visfatin were measured by ELISA both before and after the treatment.

RESULTSThe baseline serum levels of resistin and visfatin were significantly higher in patients with acute Kawasaki disease than in the two control groups of subjects (i.e., healthy children and patients with acute infectious diseases; P<0.05). In the 50 patients with Kawasaki disease, 38 were not responding and 12 were responding. Serum resistin levels before treatment were significantly higher in non-responders than those in responders (P<0.05). A significant decrease in serum levels of resistin after treatment was observed in IVIG responders (P<0.05). Serum visfatin levels were not significantly different between IVIG responders and non-responders (P>0.05). Additionally, serum resistin and visfatin levels were not significantly different between acute Kawasaki disease patients with and without coronary artery lesions.

CONCLUSIONSResistin and visfatin may play important roles in the development of Kawasaki disease and serum resistin may be used as a novel outcome indicator of the IVIG treatment.

Acute Disease ; Child, Preschool ; Cytokines ; blood ; Female ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; blood ; drug therapy ; Nicotinamide Phosphoribosyltransferase ; blood ; Resistin ; blood

Nowadays, there is a trend of HIV prevalence transmitting from high-risk group to average-risk group in China. Rural China is the weak link of HIV prevention, and rural areas of Henan province which is one of the most high-risk regions in China have more than 60% of the AIDS patients in the province. Thus, improving the HIV awareness and implementing health education become the top-priority of HIV/AIDS control and prevention. A multistage sampling was designed to draw 1129 people living with HIV/AIDS (PLWHAs) and 1168 non-PLWHAs in 4 prevalence counties of Henan province. A health promoting and social-psychological support model was constructed to improve the health knowledge of participants. Chi-square tests and unconditional logistic regression were performed to determine the intervention effect and influencing factors. All groups had misunderstandings towards the basic medical knowledge and the AIDS transmission mode. Before the intervention, 59.3% of the HIV/AIDS patients and 74.6% of the healthy people had negative attitudes towards the disease. There was statistically significant difference in the improvement of knowledge, attitude and action with regards to HIV prevention before and after intervention (P<0.05). PLWHAs who were males (OR=1.731) and had higher education level (OR=1.910) were found to have better HIV/AIDS health knowledge, whereas older PLWHAs (OR=0.961) were less likely to have better HIV/AIDS health knowledge. However, the intervention effect was associated with the expertise of doctors and supervisors, the content and methods of education, and participants' education level. It was concluded that health education of HIV/AIDS which positively influences the awareness and attitude of HIV prevention is popular in rural areas, therefore, a systematic and long-term program of HIV control and prevention is urgently needed in rural areas.
Acquired Immunodeficiency Syndrome ; prevention & control ; Adult ; Aged ; China ; Female ; Humans ; Male ; Middle Aged ; Outcome and Process Assessment (Health Care) ; Patient Education as Topic ; methods ; standards ; Rural Population

Objective To study the mechanisms of vertebrae semi-dislocation of Tuina manipulation for treating patients with lumbar intervertebral disc protrusion (LIDP) by observing the three-dimensional (3D) displacement of lumbar before and after Tuina manipulation. Methods Ten LIDP patients were selected and evenly divided into two groups: Group 1 as tendon-smoothing manipulation group (relaxing group), Group 2 as tendon-smoothing plus adjusting manipulation group (adjusting group). Besides, Group 3 as control group was established by 5 healthy volunteers treated with tendon-smoothing manipulation. Before and after manipulation intervention, all subjects were scanned from L1 to L5 segment by using Philips 64 spiral CT under equal conditions for accessing the volume data. ITK reconstruction software was used to reconstruct each lumbar skeleton for finite element analysis. The 3D displacements and angular displacements among three groups were compared. Results 3D displacement from L1 to L5 segment all changed in three groups. For adjusting group, the angular displacements at X-axis in L3 segment was (1.77±0.46)°, and that in L4 segment at X-axis and Y-axis was (1.78±0.53)° and (1.89±0.75)°, respectively, which was significantly larger than relaxing group and control group (P<0.05); the angular displacements at X-axis from L1 to L5 segment were (1.50±0.47)°, (1.55±0.57)°, (1.77±0.46)°, (1.78±0.53)°, (1.61±0.39)°, respectively, which were significantly larger than control group (P<0.05); displacement at Y-axis in L3 segment was (2.87±0.74) mm, and that at X-axis in L4 segment was (1.68±0.64) mm, which were significantly larger than relaxing group and control group (P<0.05); displacement at X-axis in L1, L4 and L5 segment was (1.28±0.21),（1.68±0.64）, (1.30±0.51） mm, and that at Y-axis in L1 to L3 segment was (1.92±0.42), (2.25±0.61), (2.87±0.74) mm, which was significantly larger than control group (P<0.05). The angular displacements and displacements of L1 to L5 segment in relaxing group were larger than those in control group, but without any significant differences. Conclusions Compared with relaxing manipulation, adjusting manipulation played a more obvious adjusting role in instability and degenerative lumbar vertebra, especially for angular displacements in X-axis, and displacements in X-axis and Y-axis. Namely, the mechanisms of vertebrae semi-dislocation of adjusting manipulation were to make horizontal and rotational displacements at lumbar vertebra other than upper and lower displacement. The effect of relaxing manipulation was not so obvious on lumbar structure of LIDP patients.

OBJECTIVETo investigate the effect of aging on the expressions of monocyte chemoattractant protein 1 (MCP-1) and intercellular adhesion molecule 1 (ICAM-1) in the lung tissue of rats with lipopolysaccharide (LPS)-induced acute lung injury (ALI).

METHODSBoth young (3 months old) and aged (27 months old) female Wistar rats were randomly divided into two groups (n=8), namely the normal control and LPS-induced ALI groups. Immunohistochemistry for of ED-1 was used to detect the infiltrating inflammatory cells. Western blot and Northern blot analyses were employed for evaluating the expressions of MCP-1 and ICAM-1 at the protein and mRNA levels.

RESULTSVirtually no ED-1-positive cells were found in the lung tissue of the control rats in the young and aged groups. After LPS-induced ALI, ED-1-positive cells in the lung tissues increased significantly in both young and aged groups (P<0.05), and the increment was more obviously in the aged group (P<0.05). In the two normal control groups, the aged rats showed significantly higher expressions of MCP-1 and ICAM-1 than the young rats (P<0.05); LPS significantly up-regulated their expression in the young and aged groups (P<0.05), but the latter showed greater increments (P<0.05). The aged rats with ALI also showed significantly greater MCP-1 and ICAM-1 increments than those of the young rats (P<0.05).

CONCLUSIONSAging may upregulate lung MCP-1 and ICAM-1 expressions and enhance LPS-induced increments of MCP-1 and ICAM-1 expressions to exacerbate the pulmonary inflammation in rats.

Acute Lung Injury ; chemically induced ; metabolism ; Aging ; Animals ; Chemokine CCL2 ; genetics ; metabolism ; Female ; Intercellular Adhesion Molecule-1 ; genetics ; metabolism ; Lipopolysaccharides ; Lung ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Up-Regulation

OBJECTIVEIn mid-July 2005, five patients presented with septic shock to a hospital in Ziyang city in Sichuan, China, to identify the etiology of the unknown reason disease, an epidemiological, clinical, and laboratory study were conducted.

METHODSAn enhanced surveillance program were established in Sichuan, the following activities were introduced: active case finding in Sichuan of (a) laboratory diagnosed Streptococcus suis infection and (b) clinically diagnosed probable cases with exposure history; supplemented by (c) monitoring reports on meningococcal meningitis. Streptococcus suis serotype 2 infection was confirmed by culture and biochemical reactions, followed by sequencing for specific genes for serotype and virulence factors.

RESULTSFrom June 10 to August 21, 2005, 68 laboratory confirmed cases of human Streptococcus suis infections were reported. All were villagers who gave a history of direct exposure to deceased or sick pigs in their backyards where slaughtering was performed. Twenty six (38%) presented with toxic shock syndrome of which 15 (58%) died. Other presentations were septicaemia or meningitis. All isolates were tested positive for genes for tuf, species-specific 16S rRNA, cps2J, mrp, ef and sly. There were 136 clinically diagnosed probable cases with similar exposure history but incomplete laboratory investigations.

CONCLUSIONAn outbreak of human Streptococcus suis serotype 2 infections occurred in villagers after direct exposure to deceased or sick pigs in Sichuan. Prohibition of slaughtering in backyards brought the outbreak to a halt. A virulent strain of the bacteria is speculated to be in circulation, and is responsible for the unusual presentation of toxic shock syndrome with high case fatality.

Animals ; Bacteremia ; epidemiology ; microbiology ; China ; epidemiology ; Disease Outbreaks ; Humans ; Meningitis, Bacterial ; epidemiology ; microbiology ; Shock, Septic ; epidemiology ; microbiology ; Streptococcal Infections ; epidemiology ; microbiology ; veterinary ; Streptococcus suis ; isolation & purification ; Swine ; Swine Diseases ; microbiology

OBJECTIVE To investigate the HIV infections states in tumor patients for clinical diagnosis,treatment and to prevent HIV infection in the tumor hospital.METHODS The result of HIV detection in tumor patients from Dec 2000 to Aug 2006 was analyzed by the review statistics analysis.RESULTS Totally 48 101 tumor paients were detected,and the number of tumor patients with positive HIV antibody result was 51(0.106%).Among the positive patients there were 21 cases with blood transfusion history,14 cases with blood donating experience,2 cases with both these two kinds of experiences and 14 cases without the two kinds of experiences.Their rate was separately 41.0%,27.5%,4.0% and 27.5%.Most of the HIV positive patients had no clinical synptoms.CONCLUSIONS The HIV positive rate of patients with blood transfusion or blood donating is significantly higher than the patients without these experiences.The routine detection for the HIV before the operation,blood transfusion or other traumatic detection is very necessary.