The United States is the first country that has introduced legislation designed to stimulate orphan drug research and development .In this paper , we analyze three major amendments of the Orphan Drug Act ( ODA) since 1983 and its incentive system .We then discuss the success of the ODA in encouraging orphan drug research and development and boosting the biopharmaceutical industry .Following that , we investigate the high price of orphan drugs caused by market exclusivity and drug repositioning .Finally, we draw experience from the ODA to make some suggestions on how orphan drug legislation can be devised in China with the aim of improving the health of rare -dis-ease patients and facilitating the development of Chinese biopharmaceutical industry .

Objective To investigate the relationship between cerebrovascular accident and abnormal electrocardiogram. Methods The ECG abnormalities and clinical data of 314 patients with cerebrovascular accident were analyzed. Results 56.7% patients developed arrhythmia. Among them, the morbility of arrhythmia in patients with cerebral hemorrhage was higher than that of cerebral infarction ( P

OBJECTIVETo investigate the effects of recombinant human growth hormone on serum lipid in aged male patients with chronic heart failure (CHF).

METHODSEighty seven patients with chronic heart failure(> or = 60 years old) were randomly divided into 2 groups: the CHF control group (n = 46) who received regular therapy and the CHF experimental group (n = 41) who received regular therapy and recombinant human growth hormone. The treatment would be continued for 3 months. Another group was normal control group (n = 10). The detection of serum growth hormone (GH), insulin-like growth factor (IGF-1), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) was carried out before and after treatment in the participants.

RESULTSBefore treatment, the levels of GH and IGF-1 were not significantly different among groups. After treatment, the levels of GH (0.71 +/- 0.34 vs 0.96 +/- 0.48) and IGF-1 (95.64 +/- 21.11 vs 111.64 +/- 23.14)in CHF experimental group were higher than those before the treatment. In CHF control group, the levels of GH(0.81 +/- 0.32 vs 0.79 +/- 0.29) and IGF-1 (97.82 +/- 19.74 vs 99.65 +/- 20.11) had no significant change after the treatment. After treatment, the levels of GH (0.96 +/- 0.48 vs 0.79 +/- 0.29) and IGF-1 (111.64 +/- 23.14 vs 99.65 +/- 20.11) in CHF experimental group were higher compared with that of CHF control group. Before treatment, the serum levels of LDL-C, HDL-C, TC and TG had no significant difference among groups. After treatment,the levels of LDL-C (2.11 +/- 0.82 vs 1.76 +/- 0.51) and TC (3.78 +/- 1.34 vs 3.21 +/- 1.17) in CHF experimental group were lower than those before the treatment. However, the levels of HDL-C (1.10 +/- 0.31 vs 0.99 +/- 0.28)and TG (1. 89 +/- 1.07 vs 1.66 +/- 0.95) had no significant change after the treatment compared with before treatment. In CHF control group, the serum lipid levels had no significant change after the treatment.

CONCLUSIONAs the treatment of rhGH for aged male patients with chronic heart failure, GH influences lipid metabolism, which reduces the level of LDL-C, TC. However GH has no effects on the serum HDL-C and TG level. With the treatment of rhGH for long-term, lipid metabolism should be paid attention,and the treatment for blood lipid reduction should be adjusted in time.

Aged ; Chronic Disease ; Heart Failure ; blood ; therapy ; Human Growth Hormone ; pharmacology ; Humans ; Lipids ; blood ; Male ; Recombinant Proteins ; pharmacology

Objective To investigate the clinical features and therapy of fournier's gangrene.Methods The clinical data of 12 patients with fournier's gangrene who were treated at the Third Affiliated Hospital of Nanjing University of Chinese Medicine from January 2010 to February 2012 were retrospectively analyzed.Eleven patients had perianal abscess and 1 patient had perianal foreign body,most of the patients were presented with perianal pain,fever (＞ 38.5 ℃) and tachycardia.The mean interval between the onset of symptoms and admission to the hospital was 8 days (range,3-20 dyas).Seven patients were complicated with diabetes.Only 2 patients were administered hypoglycemic agents,but the effects were poor.Six patients were complicated with hypertension.One patient had the history of resection of sigmoid colon cancer 2 months before operation.Debridement and drainage were applied to all the patients after examination.Antimicrobial therapy applied to all the patients according to the results of drug sensitivity test.The incisions were washed by hydrogen peroxide solution postoperatively.Redebridement was applied if the disease was progressed.All patients were followed up via out-patient examination and phone call till June 2012.Results Results of clinical features:Perianal tissues necrotized,with the color of black.The scrotum or labia majora of 8 patients were invaded by the necrotic tissues.Results of laboratory test:the white blood cell count was (3.8-27.6) × 109/L,the white blood cell count of 6 patients was above 10 × 109/L,3 was above 20 × 109/L.The ratio of neutrophil granulocytes was 0.61-0.93.Four patients received single debridement,5 received redebridement,and 3 patients received debridement for more than 2 times.Two patients had sapremia and infectious shock,and they received treatment for 3 days and 4 days at the intensive care unit.Results of bacterial culture:6 patients were infected by the escherichia coli,4 by klebsiella pnenmoniae,and 1 by pseudomonas aeruginosa.The mean duration of hospital stay was (25± 14)days (range,1-49 days).All patients were followed up for 4-29 months,1 patient was discharged at postoperative day 2,and the prognosis of the 11 patients was good,no mortality was observed.Conclusions The clinical features of fournier's gangrene include severe pain and rapid spread of infections caused by necrosis of perianal subcutaneous tissues.Diabetes might be the risk factor of fournier's gangrene.Early diagnosis and prompt and aggressive surgical debridement are critical for improving survival.

Objective: To observe the changes of hippocampus in the rats of depression model and study the protective effects of EGb (extracts of gingkobiloba) and Venlafaxine on brain injury. Methods: Rats were divided into 6 groups. Groups A served as normal control. Group B?C?D?E?F received 21 days chronic stress. Group C?D?E?F were fed with normal food, EGb, Venlafaxine and EGb+Venlafaxine respectively for 28 days after enduring 21 days chronic stress. Every rat had been observed open-field behavior before decapitated.One side of the hippocampus were measured the expression of nNOS by immunohistochemistry method, the other side hippocampus and the serum were measured the concentrations of NO.Results:The expression of protein nNOS in hippocampus of group B was increased compared with group A (P

OBJECTIVE To investigate antimicrobial resistance of Enterobacter cloacae in our hospital,for guiding the treatment of these infections in clinical practice.METHODS Bacterial susceptibility testing was done by Kirby-Bauer method and bacteria were identified by VITEK-32.Retrospective analysis of the drug resistance was done to the E.cloacae isolated from our hospital in the recent 3 years.RESULTS A total of 364 E.cloacae strains were isolated,which mainly isolated from sputum.They were resistant to 13 types of antibacterial agents but the resistance rate to imipenem was 3.30%.The resistant rate to third and fourth generation cepholosporins(excepting cefoperazone/sulbactam) and quinolones was more than 30% and to ampicillin and cefazolin was more than 94.00%.CONCLUSIONS E.cloacae is severely resistant to cepholosporins and quinolones.More attention should be paid to the surveillance of such strains.Imipenem may be considered for use in critical patients.

Objective To evaluate the efficacy and safety of etoricoxib and meloxicam in the treatment of patients with acute gout. Methods A randomized,active comparator study was conducted at outpatients and inpatients in our hospital from January 2009 to July 2010.A total of 84patients aged (63.7± 11.0) years with an acute attack of gout were treated with etoricoxib 120 mg/d (n =48),or meloxicam 15 mg/d (n =36) for 7 d.The patient's assessment of joint pain (0- 4 point Likert scale) at drug treatment for 2-5 d was considered as the primary efficacy end point,4 h after firstly takiug the drug and 2-8 d after treatment as the secondary efficacy end point.The starting efficacy was determined until pain relieved by patient himself. The safety was assessed by adverse experiences and indexes including leucocyte, platelet,crcatinine, uric acid,alanine transaminase (ALT),aspartate transaminase (AST) and mean artery pressure(MAP). Results In 84 patients,3cases (8.3％) in meloxicam treatment and 15 cases (31.2％) in etoricoxib treatment (among which 13 cases finished treatment) discontinued therapy.The improvement scores of joint pain were (-0.41 ±0.35 vs.-0.19±0.30,P=0.005) at4 h after firstly taking the drug,(-1.66±0.58 vs. 1.38±0.44,P=0.018)at drug treatment for 2 -5 d,( - 1.83 ± 0.60 vs.- 1.85 ± 0.53,P=0.9) at 2 8 d after treatment,and (-2.64±0.45 vs. - 2.38±0.37,P=0.000) post-treatment higher than pre treatment.The starting time of pain relieving were (4.0 ± 4.6) h in etoricoxib treatment and (12.1±5.7) h in meloxicam treatment. The levels of leucocyte were decreased after treatment as compared with before treatment in both two drug treatments(P＜0.05),while no differences were found in platelet.creatinine,uric acid,ALT and AST.MAP after etoricoxib treatment was increased compared with pretreatment ( P ＜ 0.05 ). Drug related adverse experiences appeared in 15 cases (31.2 ％ ) in etoricoxib treatment and 12 cases(33.3 ％ ) in meloxicam treatment(P=1.000).The ratio of gastrointestinal tract-related adverse effects in meloxicam treatment was higher than in etoricoxib (22.2％ vs.6.2％,P＜ 0.05),while adverse effects on cardiovascular in etoricoxib treatment were comparable to that of meloxicam (16.7 ％ and 11.1 ％,P＞0.05). Conclusions Etoricoxib at a dose of 120 mg once daily may be more effective than meloxicam for acute gout in aspects of safety and tolerance.

Objective To study the relationship between urinary laminin(LN) and diabetic nephropathy.Methods Using the method for concentrating urinary laminin based on precipitation with PEG-4 000 and γ-globulin.The concentration of LN in the urine of 83 diabetics was measured by RIA.The concentration of micro-albumin and Ccr in the urine and the levels of plasma glucose and HbA1c were also measured.Results The choice of 150g/L of PEG-4 000 and 0.5 g/L of γ-globulin was the best method for concentrating urinary LN.The urinary LN in all groups was significantly higher than that in control group.Conclusion Urinary LN is an indicator in the diagnosis of the early diabetic nephropathy.

Objective To systematic review the efficacy of Bifidobacterium preparation in Helicobacter pylori ( HP ) eradication therapy. Methods We systematically reviewed clinical research about the efficacy of probiotics in Helicobacter pylori eradication in multiple data-base( PubMed, EMBASE, Medline, OVID, Web of Science); After screening and assessing the quality of the data, we used RevMan 5.3.5 software and Stata 12.0 software for data analysis, then we used GRADE pro3.6.1 software assessing the quality of results.Results Six studies were included with 1396 patients,there were 690 patients in experimental group and 706 patients in control group.Compared with control group, the eradication rates calculated by per-protocol analysis [RR=1.19,95%CI(1.12,1.26),Z=5.87 (P<0.00001)]and intention-to-treat analysis[RR=1.18,95%CI(1.07,1.31),Z=3.33(P=0.0009)]in experimental group was higher,the number of diarrhea[RR=0.43,95%CI(0.23,0.79),Z=2.73(P=0.006)]/the number of nausea[RR=0.67,95%CI(0.56,0.81),Z=4.19 (P<0.0001)]/the number of taste disorders[RR=0.61,95%CI(0.32,1.13),Z=1.57(P=0.12)]in experimental group was lower.The quality of results:the eradication rates calculated by per-protocol analysis was high quality, intention-to-treat analysis and the number of nausea and the number of diarrhea was moderate quality,the number of taste disorders was low quality.Egger’s test showed there was no evidence of substantial publication bias.Conclusion Bifidobacterium preparations during standard triple HP therapy may improve the eradication rate and reduce adverse reactions.

AIM: To investigate the expression of c-fos in the neonatal rats' brains following hypoxia-ischemia.METHODS: RT-PCR and immunohistochemistry were used to detect the transcription and translation of c-fos gene in the cortex and hippocampus following hypoxia-ischemia.RESULTS: The expression of c-fos mRNA and protein were induced in the cortex and hippocampus at the early stage following hypoxia-ischemia(P