Patient′s expectation has been defined as the anticipation that given events were likely to occur during, or as an outcome of, health care. What people expect from their health care are potentially important in predicting patient satisfaction and dissatisfaction with their care, treatment and health outcomes. There was widespread recognition of the importance of evaluating services from consumer perspectives. In this article, domestic and foreign research in recent years, expectations status, significance and various influencing factors in relation to the expectations in processes of health care were summarized. Consumer evaluations of their health care are now an established component of quality assessment, planners need to understand the expectations underlying patients′views in order to interpret their feedback. Thus leading to improve patient satisfaction and the social evaluation of medical units.

Objective To analyze the current situation and influence factors of ordinary medical college undergraduates' contact with scientific research at early stage in order to provide references for scientific research.Methods Totally 1940 students majoring in clinical medicine,imaging,traditional Chinese medicine and nursing (2008 -2010 grade) in China Three Gorges University were enrolled to do questionnaine and SPSS 17.0 was used to do statistical analysis.Results Totally 1653copies of questionnaires were collected from 1940 students,the recovery rate was 85.21％.Two hundred and nineteen students ( 13.25％ ) participated in scientific research,65.28％ students thought college propaganda to be ordinary,95.43％ students got benefits from scientific research.The main influence factors of scientific research were lack of time (23.73％),insufficient knowledge reserves (22.03％) and researchers' own problems (39.73％).Conclusions Medical school should expand the range of scientific research and strengthen propaganda.Medical students should arrange research time and constantly improve their comprehensive ability so as to achieve good results.

Objective To evaluate the effects of age factors on the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block in patients.Methods Twenty patients of both sexes,aged ≥ 18 yr,weighing 50-75 kg,of American Society of Anesthesiology physical status Ⅰ or Ⅱ,scheduled for elective lower extremity surgery,were divided into 2 groups (n=10 each) according to age:young and middle-aged group (18-59 yr) and elderly group (≥ 60 yr).Combined lumbar plexus-sciatic never block was performed using an ultrasonic instrument and a nerve stimulator.Lumbar plexus block was performed with 0.5％ ropivacaine 30 ml.Sciatic never block was performed with 2％ lidocaine 10 ml plus 0.75％ ropivacaine 10 ml.Before administration and at 5,10,15,20,30,45,60,120,180 and 360 min after administration,blood samples were collected from the radial artery for determination of the blood concentration of ropivacaine by high-performance liquid chromatography.The area under the concentrationtime curve,maximum concentration (Cmax),time to C terminal elimination half-life and clearance were calculated.Results Compared with young and middle-aged group,the blood concentration of ropivacaine was significantly decreased at 5-45 min after administration,the Cmax was significantly decreased,terminal elimination half-life was significantly prolonged (P＜0.05),and no significant change was found in area under the concentration-time curve,the time to C and clearance in elderly group (P＞ 0.05).Conclusion Age factors can affect the pharmacokinetics of ropivacaine during combined lumbar plexus-sciatic nerve block,and both absorption and metabolism of ropivacaine are slower in elderly patients than in young and middle-aged patients.

Objective To investigate the applicability of zebra fish thrombosis model in antithrombotic activity screening of Chinese materia medica.Methods The living zebra fish thrombosis model was induced by adrenaline hydrochloride. Zebra fish were randomly divided into blank control group, model group, positive medicine group and medication group. Each group was given the corresponding medicine or embryo culture water. O-anisidine staining solution was used to stain and calculate the staining intensity of erythrocytes in zebra fish heart, and quantitative analysis was carried out. The platelet aggregation of transgenic zebra fish was observed and under qualitative analysis. Results Compared with the model group, 100μg/mL salvianolic acid B, 300, 900μg/mL aqueous extract of Salvia miltiorrhiza, 45μg/mL 95% ethanol extract and 400, 1200μg/mL hypothalamus could significantly inhibited the formation of zebra fish thrombosis (P<0.01).ConclusionZebra fish thrombosis model has good applicability in antithrombotic activity screening of Chinese materia medica.

Objective To explore the application of submental ultrasonongraphy (SUS) in the assessment of oropharyngeal swallowing disorders in children with cerebral palsy.Methods Seventeen children with cerebral palsy and oropharyngeal swallowing difficulties (7 on nasal feeding,10 on oral feeding) constituted the treatment group while 20 normal counterparts formed the control group.SUS was applied to measure any changes in the thickness of the tongue muscle and the range of hyoid bone displacement when they swallowed 5 ml of water.The results were compared with those assessed using the functional oral intake scale to decide the best cut-off point for detecting tube-feeding-dependent dysphagia.The intraclass correlation coefficient (ICC) of the 20 children in the control group was calculated to evaluate the intra-rater and inter-rater reliability of SUS.Results The average tongue muscle thickness change and hyoid bone displacement amplitude of the children on nasal feeding were significantly smaller than those of the children without nasal feeding and the normal children.The best cut-off point for the tongue muscle thickness change data was 1.0 cm,and that of the hyoid bone displacement amplitude was 1.5 cm.All of the ICCs were above 0.4,indicating good intra-rater and inter-rater reliability for the SUS examination.Conclusion Submental ultrasonongraphy can help assess the swallowing function of children with oropharyngeal swallowing disorders.

AIM: To investigate the effects of sodium hydrosulfide ( NaHS ) , a donor of hydrogen sulfide ( H2 S) , on the membrane permeability , intracellular Ca 2+concentration ( [ Ca2+] i ) and the release of IL-1βinduced by a-denosine triphosphate (ATP) in rat microglia, and to explore the effect of H2S on ATP-P2X purinergic signaling pathway and the molecular mechanism of its neuroprotective effect .METHODS: Rat microglia in logarithmic growth phase were used in the study.The [Ca2+]i was detected by Fura-2/AM staining.Fluorescent dye YO-PRO-1 was used to observe the membrane permeability.Interleukin-1β(IL-1β) was measured by rat IL-1βELISA kits.RESULTS:The YO-PRO-1 flu-orescence intensity was obviously elevated by ATP induction in a dose -dependent manner in the rat microglia , but this effect was counteracted by NaHS pretreatment (P<0.05).[Ca2+]i rapidly increased and then decreased slowly , forming a sta-ble platform for a long time when rat microglia were treated with ATP .Ca2+spike activity induced by ATP had no change , but the platform disappeared (P<0.05) after NaHS pretreatment.The ATP and LPS together facilitated the release of IL-1β, but the phenomenon was inhibited by NaHS (P<0.05).CONCLUSION:Hydrogen sulfide may decrease the mem-brane permeability , calcium inflow and IL-1βrelease in rat microglia activated by high dose of ATP .The cytoprotection of hydrogen sulfide may be mediated by purinergic signaling pathway .

Objective To study the distribution characteristics of deposited eggs and pathological changes in the viscera of animal infected with Schistosoma japonicum at different time. Methods New Zealand white rabbits were infected artificially with quantitative S. japonicum miracidia,then the distribution characteristics and the hatchability of schistosome eggs as well as the pathological changes of the corresponding viscera of the rabbits 42 and 60 d post?infection were observed and compared. Re?sults On the 42nd day post?infection,among all the viscera observed,the percentage of eggs deposited,the number of eggs per gram and the hatchability were the highest in the liver,while on the 60th day post?infection,the tissues and organs with the highest values of the above 3 indexes were the liver,rectum and upper section of the small intestine,respectively. From 42 day to 60 day post?infection,the liver of infected rabbits became swelling,hardening and lost elasticity,the color changed from black to dark grey,and egg nodules gradually appeared in the different sections of the small intestine,and also the mucosal hy?peremia,edema and egg nodules were seen in the colon,cecum and rectum. The lesion levels tended to be correlated with the deposition of eggs. Conclusion The amount and the density as well as the hatching rate of deposited eggs of S. japonicum in the viscera of infected rabbits at different time are different,and the lesion level in the host is correlated with the deposition of eggs.

Objective:To investigate the effects of hematopoietic progenitor kinase 1 (HPK1) overexpression by construction of lentiviral vector on the proliferation and apoptosis of breast cancer MCF-7 and MDA-MB-231 cells,and to elucidate its possible mechanism.Methods:The cells were infected with the lentivirus overxpressing HPK1,and the MCF-7-HPK1 and MDA-MB-231-HPK1 cell lines were stably expressed HPK1;each cell line was divided into three experimental groups:blank group (untreated),control group (empty vector) and HPK1-overexpression group.The expression levels of HPK1 mRNA and protein in breast cancer cells in each group were detected by RTPCR and Western blotting methods,respectively.The cell proliferation rate was detected by MTT assay.The cell cycle and apoptotic rate were detected by flow cytometry.Transwell assay was used to analyze the cell migration ability.Western blotting method was used to measure the expression levels of caspase 3,PTEN,MMP-9,MMP-2,Ki-67and HPK1 proteins.Results:Compared with blank groups and control groups,the expression levels of HPK1 mRNA and protein in the both cell lines in HPK1 overexpression groups were significantly up-regulated (P＜0.05),the proliferation rates were significantly decreased (P＜0.05) and the apoptotic rates were significantly increased (P＜0.05),the number of cells crossing matrigel was significantly reduced (P＜0.05),the cell cycle of MCF-7 was blocked in G1 phase (P＜0.05),the expression levels of caspase 3 and PTEN proteins in HPK1 overexpression group were significantly increased (P＜0.05),and the expression levels of MMP-2 and MMP-9 proteins were significantly decreased (P＜0.05).Conclusion:HPK1 overexpression can inhibit the proliferation and migration of MCF-7 and MDA-MB-231 cells and induce apoptosis,which may be related to the up-regulation of caspase 3 and PTEN and down-regulation of MMP-9,MMP-2 and Ki-67.

Objective: To establish the mouse aorta dissection (AD) model through drinking water containing β-aminopropionitrile (BAPN). Methods: Forty 3-week-old C57B1/6J male mice were divided into four groups according to randomized block design: control, 0.2, 0.4 and 0.8 g·kg^-1·d^-1 BAPN groups (dissolving respective dose of BAPN in the drinking water, n=10 each group). Arterial systolic blood pressure and heart rate were measured weekly in conscious, restrained mice using a noninvasive computerized tail-cuff system. Mice those died of rupture of aortic dissecting aneurysm during the study were autopsied and the aorta was examined. After 4 weeks, survived mice were sacrificed by an overdose of sodium pentobarbital and the whole aorta was harvested and analyzed. Results: The incidence of AD and the mortality of ruptured AD was 0 and 0 in control group, 30% (3/10) and 20% (2/10) in 0.2 g·kg^-1·d^-1 BAPN group, 50% (5/10) and 40% (4/10) in 0.4 g·kg^-1·d^-1 BAPN group, 90% (9/10) and 70% (7/10) in 0.8 g·kg^-1·d^-1 BAPN group (both P<0.05 vs. control group). The incidence of AD and the mortality of ruptured AD increased in proportion to BAPN concentration increase. In 0.8 g·kg^-1·d^-1 BAPN group, 7 mice died of dissecting aneurysm rupture during the experiment, among which 5 dissecting aneurysms were mainly located in the thoracic aorta and 2 dissecting aneurysms in abdominal aorta. The diameters of thoracic aorta and abdominal aorta were (1.38±0.19) and (1.23±0.13) mm in control group, (2.43±1.56) and (1.30±0.26) mm in 0.2 g·kg^-1·d^-1 BAPN group, (2.45±1.28) and (1.30±0.31) mm in 0.4 g·kg^-1·d^-1 BAPN group, (2.87±0.57) and (1.95±0.81) mm in 0.8 g·kg^-1·d^-1 BAPN group (both P<0.05 vs. control group). The diameters of thoracic aorta and abdominal aorta in mice also increased in proportion with BAPN concentration increase. Furthermore, blood-filled false lumen formation and elastic fibers fragmentation were evidenced in hematoxylin-eosin stained and Vitoria blue-Sirius red stained aortic cross-sections of mice in the 0.8 g·kg^-1·d^-1 BAPN group. Conclusion BAPN treatment induced aortic dissection model in C57Bl/6J mice can serve as a useful wild-type mouse model for the mechanism and pharmaceutical studies of AD.

Objective To evaluate the diagnostic value of ultrasound image features combined with cesarean section scores for placenta accreta . Methods A total of 151 pregnant women in the later trimester of pregnancy underwent two-dimensional and color Doppler ultrasonography . According to the results of the operation ,they were divided into the accreta group and the non-accreta group . The number of cesarean section and placental thickness in the two groups were recorded . The ultrasound image characteristics of the placenta previa ,the placenta posterior gap disappeared ,the placental lacuna in the placenta ,the muscle layer becoming thin or disappeared after the placenta ,the anatomical region of the uterus-bladder junction line and the abundant blood flow signal behind the placenta were compared between the two groups . Logistic regression analysis was performed according to the results of single factor analysis . After assigning the characteristics of the regression model ,the ROC curve was drawn to determine the best diagnostic intercept point . Results The presence of placenta previa ,placental lacuna and placental enriched blood flow signals combined with cesarean section scores were used to diagnose placenta accreta ,the area under the ROC curve was 0 .991 ,based the best cut-off point with 4 .5 ,the corresponding diagnostic sensitivity and specificity were 91 .1% and 100% ,respectively . Conclusions Ultrasound image features combined with cesarean section history scores have a high practical value in the diagnosis of placental accreta .