RNA-based gene therapy has been widely used for various diseases, and extensive studies have proved that suitable delivery routes greatly help the development of RNA therapeutics. Identifying a safe and effective delivery system is key to realizing RNA therapeutics' clinical translation. Inhalation is a non-invasive pulmonary delivery modality that can enhance the retention of therapeutic agents in the lungs with negligible toxicity, thereby improving patient compliance. Inhaled RNA therapeutics are increasingly becoming an area of focus for researchers; however, only several clinical trials have explored inhaled delivery of RNA for pulmonary diseases. This review presents an overview of recent advances in inhaled delivery systems for RNA therapeutics, including viral and nonviral systems, highlighting state of the art regarding inhalation in the messenger RNA (mRNA) field. We also summarize the applications of mRNA inhalants in infectious and other lung diseases. Simultaneously, the research progresses on small interfering RNAs (siRNAs), antisense oligonucleotides (ASOs), and different types of RNA are also discussed to provide new strategies for developing RNA inhalation therapy. Finally, we clarify the challenges inhaled RNA-based therapeutics face before their widespread adoption and provide insights to help advance this exciting field to the bedside.

【Objective】 To explore the relationship between the storage time of leukodepleted red blood cells and transfusion adverse reactions by analyzing the occurrence of transfusion adverse reactions of patients after leukodepleted red blood cells transfusion from four hospitals. 【Methods】 By using the electronic medical record management system, the collection and transfusion dates of leukodepleted red blood cells from four hospitals in Enshi Prefecture from 2018 to 2022, as well as the information on transfusion adverse reactions, were retrieved. 【Results】 From 2018 to 2022, a total of 697 61 bags of leukodepleted red blood cells were transfused in four hospitals, resulting in 166 cases of transfusion adverse reactions, among which 93 were allergic reactions, 63 were non hemolytic febrile reactions, and 10 were others, with a total incidence rate of transfusion adverse reactions at 0.24%. The average storage time of leukodepleted red blood cells with and without transfusion adverse reactions was (20.25±6.31) and (19.88±5.50) days, respectively. With a storage time of 7 days as the threshold, the incidence of transfusion adverse reactions was the lowest for a storage time of 15~21 days. The incidence of transfusion adverse reactions of leukodepleted red blood cells in two groups (with storage days ≤21 days and >21 days) was not statistically significant(P>0.05). 【Conclusion】 Allergic reactions were the main type of transfusion adverse reaction caused by leukodepleted red blood cells, and the incidence of transfusion adverse reactions decreased and then increased with the prolongation of the storage time of leukodepleted red blood cells. There was no significant difference in the incidence of transfusion adverse reactions with leukodepleted red blood cells stored for ≤ 21 days and >21 days.

Objective: To investigate the clinical value of plasma presepsin level in early severity evaluation for acute pancreatitis (AP) patients. Methods: The clinical data of 67 patients with AP admitted in Second Affiliated Hospital of Wenzhou Medical University from December 2016 to January 2019 were prospectively selected. The patients were divided into mild AP group (MAP, n=36) and moderately severe and severe AP group (MSAP+ SAP, n=31) according to CTSI and with or without organ dysfunction and local or systemic complications on admission. Another 20 healthy normal subjects were selected as the control group. Plasma presepsin, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), serum amylase and calcium levels were measured within 2 hours, and the APACHEⅡ score was calculated within 24 hours of admission. Receiver operating characteristic curves(ROC) were plotted and the area under the curve (AUC) was calculated to assess the clinical value of presepsin, CRP, PCT, WBC, serum amylase and calcium for predicting the severity of AP patients, respectively. Results: The plasma presepsin level in MAP, MSAP+ SAP and control group was (439.59±74.23)ng/L, (1097.82±93.15)ng/L and (97.31±21.57)ng/L, respectively. Plasma presepsin level in MAP and MSAP+ SAP patients with biliary pancreatitis were obviously higher than those patients with other etiological factors, and plasma presepsin level in MSAP+ SAP patients with hyperlipidemia-associated pancreatitis was significantly higher than those in the MAP group, and the difference was statistically significant (P<0.05). The AUC of plasma presepsin in the diagnosis of MSAP+ SAP was 0.873(95% CI 0.734-0.922), which was greater than the AUC values of CRP, PCT, WBC and serum calcium; the optimal cut-off value was 951.94 ng/L; the diagnostic sensitivity was 85.6%, which was superior to CRP, PCT, WBC and serum calcium; and the specificity was 76.2%, which was second to 78.9% of serum calcium. Conclusions Plasma presepsin level can be used as a sensitive indicator for early severity evaluation of AP patients, with a specificity only second to serum calcium.

Objective To evaluate whether an intervention with a health promotion program can reduce prevalence of the health risk factors of non-communicable chronic diseases (NCD) and improve the knowledge awareness of NCD prevention of employees from a security corporation in Beijing selected by the study team. Methods A cross-sectional study was conducted by selecting 157 employees of a security corporation in Beijing, and a quasi-experiment method and a self-developed Questionnaire of Intervention for Health Risk Factors were used. Based on the results of the distribution of risk factors for NCD and the focus-group discussion, one year health promotion program intervention was performed. According to the comparison of prevalence of risk factors between baselines and after intervention of the studied employees, the intervention effectiveness was evaluated. Results After the health intervention, rate of reported unhealthy diet reduced from 75.0%to 56.8%, which showed statistically significant (?2=8.53, P<0.05);rate of reported less physical activity reduced from 35.5%to 17.4%, with statistical significance (?2=19.60, P<0.05);rate of reported cigarette smoking reduced from 16.8%to 11.6%with statistically significance. There was no statistically significant reduction in the rate of the other health risk factors (P>0.05). The median value of health knowledge awareness of the studied employees was significantly improved from 10.20 to 11.33(S=-2 545, P<0.05) and awareness of recommended daily intake of dietary salt increased significantly from 46.20%to 67.09%after intervention (χ2=17.85, P<0.05). Conclusion The non-communicable chronic diseases intervention program can reduce the health risk factors and improve health knowledge awareness of the studied population.

Objective To understand the affecting factors of health and health promotion needs of one company staff so as to provide evidence for effective health intervention.Methods A convenience sampling method was used to enroll subjects in this cross-sectional study.All the participants were required to fill in a questionnaire to learn their demographics,health related factors and health promotion needs in the 2 work days of June 2012 had been studied.Chi-square test and unconditional logistic regression were used for data analysis.Results More males showed higher risk of disease than females (x2 =5.394,P ＜ 0.05).In conditional logistic regression,age was the main factor affecting health (odds ratio (OR) =3.127,95％ (confidence interval) CI 1.020-9.591,P ＜ 0.05) when gender,marital status,educational level and occupation were adjusted.Dietary nutritional knowledge (69.6％) and physical check-up (64.6％) were urgent needs among those surveyed.Conclusion Staff with varied demographic characteristics have different health related factors and physical check-up may provide a tool to meet their urgent needs of health promotion.

Objective To probe into the effect of systematic nursing model on treatment compliance and clinical efficacy of elderly patients with diabetes. Methods 100 elderly patients with diabetes in our hospital were selected from January 2008 to December 2010.The patients were divided into the study group and the control group randomly,50 cases in each group.The patients in the control group were treated with conventional care model,while the patients in the study group were treated with systematic nursing model.The compliance,clinical treatment effect,and improvement of clinical indicators were compared and ana lyzed in two groups respectively. Results Compared with the control group,treatment compliance indexes such as self-monitoring,diet control,medication compliance,exercise therapy in the study group were significantly improved,the difference was statistically significant.Compared with the control group,the clinical efficacy of patients in the study group was significantly improved.Compared with the control group,the FBG,PBG and HbAlc were improved significantly,the difference was statistically significant. Conclusions Systematic nursing model plays a positive role in promoting treatment compliance and clinical effects of elderly patients with diabetes mellitus.The interventions need to be further enriched and perfected.

ObjectiveThe study was designed to understand the education training situation and demand of rural doctors,identify problems in training and provide theoretical basis for the relevant government departments to further the development of rural doctors education,explore the pattem of ru ral health education and improve the effectiveness of training.MethodsThe participants were a sample of rural doctors among the east and center-west region in China (Beijing Municipality,Jiangsu,Zhejiang,Hainan,Shanxi,Guangxi Zhuang Autonomous Region,Guizhou,Yunan and Gansu).20 288questionnaires were issued,18 259 of them were taken back,which occupied 90.1％ recovery rate.Group interview method and stratification-cluster sample method were conducted in the Cross-sectional study.Results70.2％ were male doctors,with an average age of 44.3 ±10.9 years,63.0％ of whom received technical school education and technical secondary school Training time was mainly less than 12 days per year (48.8％),training content was mainly about clinical skills(80.6％),and traning mode was mainly conference traning (56.6％).There was a certain gap between training status and demand.ConclusionThe on-site clinically guide-based,comprehensive and short-term non-job training should be demand-orientedly carried out aiming at young doctors in rural areas.

With the method of non-experimental assessment research of epidemiology,by viewing the reformation as the intervention and dividing observation group and control group,the study makes some statistics about the variables related to the quality of applicants for a medical college after and before the reformation.The conclusion is:the reformation may be one of the causes that appeals to applicants from reformed class to the non-reformed class ; the reformation is a risk factor to the non-reformed class ( may cause the quality of applccants down ) while the reformation is a protective factor to the reformed class ( help raise the quality of applicants or avoid slipping down too fast ).

Objective To evaluate the effectiveness of intervention for health risk factor in hospital employees. Methods This study was carried out among 339 employees of a hospital in Jinan, Shandong Province. Based on the results of Health Risk Appraisal for 14 health risk factors, we designed a 6-months intervention program for the most widely distributed and intervenable health risk factors; and then evaluated the changes of health risk factors after 6 months. Results After 6-month intervention the prevalence of 3 health risk factors decreased (P ＜ 0.05 ): physical inactivity decreased from 57.8% to 38.6%,hyperlipidemia from 9.4% to 5.3%, and unhealthy dietary from 28.9% to 14.8%. Compared with the baseline data, the average number of health risk factors were reduced from 3.10 to 2. 71 ( P ＜ 0. 01 ).Conclusion The intervention can reduce health risk factors effectively.

Objective To evaluate the effectiveness of health management on quality of life of hypertensive patients living in underdeveloped rural regions. Methods Minqin County of Gansu Province was taken as research field, and health education covered all the population. Individual follow-up was adopted by quasi-experiment,and SF-8 scale was used to evaluate the change of scores of quality of life at baseline and the end of the study. Results The score of various dimension of quality life of interventive group showed a significant decrease at the end of follow-up ( P < 0. 05) , and the net score of general health status was 10. 92,the net score of impact to social role exerted by physical function was 9. 59,and the net score of social function was 4.61. Moreover, there was statistical difference between the intervention group and the control group for their quality of life(P <0. 05) , which showed in detail that each dimension of quality of life of the intervention group had higher score than that of the control group, after adjusting baseline difference by analysis of covariance. Conclusions All these results suggest that the active screening, following up and health education, conducted by the primary health care staff of township hospitals, under the idea of health management, can improve the quality of life of hypertension patients effectively in the rural area of underdeveloped region.