With the process of rapid mobilization,China is suffering from huge road tolls.The ethical issues related to road safety are also emerging.To provide recommendations for relevant public policies,we discussed several ethical issues in this article as follows.Human lives and health may not be traded off for the benefit of mobilization.The designers,regulators of road traffic system share responsibilities for road safety with users.The principle of equity needs to be embodied in the road traffic system.Therefore,it is necessary to increase investment in underdeveloped areas and enhance the protection of vulnerable road users.

Objective To evaluate the effects of blood-lipid report's reformat on outpatients' behavior and knowledge of dyslipidemia therapy.Methods The blood-lipid report was reformatted by adding three tables from the Chinese Guideline on the Prevention and Treatment of Adult Dyslipidemia on its back.The same questionnaire was used twice to evaluate the patients' behavior and knowledge of dyslipidemia therapy before and after reformat.Results Before and after reformat,the rates of correct deterination of their own risk stratification were 26.0％ ( 112/430 ) and 26.3％ ( 115/438 ) respectively.The awareness rates of Different LDL-C goals among different persons wcre 37.0％ (159/430) and 35.8％ (157/438).Only 0.7％ (2/306) and 1.0％ (3/299) of patients knew their blood lipid goals (P =0.557).When the report showed normal blood lipid levels,the percentages of taking lipid-lowering drug were 47.6％ ( 230/483 ) and 46.6％ ( 216/464 ),20.5％ ( 99/483 ) and 19.0％ ( 88/464 ) of patients questioned the prescription.Non-medication rates were 31.9％ ( 154/483 ) and 34.5％ ( 160/464 ) respectively before and after reformat ( P ＞ 0.05 ).For patients requiting lipid-lowering drug therapy by the guideline,treatment rate improved significantly in the low-risk group (13.3％ vs.75.0％,P =0.002).Treatment rate slightly increased in the high-risk and very high-risk groups after reformat (54.0％ vs.56.8％,62.4％ vs.69.0％,P ＞ 0.05 ).Rates of achieving lipid goal showed no change [ 41.5％ ( 102/ 245 ) vs.44.5％ ( 114/256 ),P ＞ 0.05 ] after reformat,especially among the very high-risk patients [17.9％(12/68) vs.21.6％(11/52),P＞0.05].Conclusions The blood-lipid report reformat did not improve the patient behaviors and knowledge of the prevention and treatment of dyslipidemia because of poor treatment rate and medication compliance.The combination of patient education and thorough blood-lipid report reformat may help to increase the attainment rate of dyslipidemia therapy.

Purpose To investigate the value of three-dimensional quantitative measurement of spiral CT in evaluating tumor size and preoperative T stage in stage I non-small cell lung cancer (NSCLC). Materials and Methods The complete data of 125 patients with stage I NSCLC confirmed surgically and pathologically were compared in terms of maximum tumor diameter and T stage analysis by means of three-dimensional quantitative CT measurement, two-dimensional measurement and general pathology measurement. Results The mean maximum tumor diameter of these 125 patients measured by quantitative three-dimensional CT measurement, two-dimensional measurement and general pathology measurement were (26.21±8.14) mm, (27.03±9.90) mm and (25.60±9.31) mm, respectively. The difference in mean maximum tumor diameter by two-dimensional measurement and three-dimensional quantitative measurement was significant, and remained so when two-dimensional measurement and pathology measurement was compared (t=2.377, P<0.05;t=2.961, P<0.01), but that between three-dimensional quantitative measurement and pathology measurement was not significant (t=1.281, P>0.05). Bland-Altman analysis showed that three-dimensional quantitative measurement had higher consistency than two-dimensional measurement when compared with the gold standard pathology measurement. When three-dimensional quantitative measurement was taken to be the staging criterion, 20% results (25 cases) obtained by two-dimensional measurement proved to be inconsistent. Conclusion Compared with two-dimensional measurement, quantitative three-dimensional CT measurement can provide more accurate information in maximum tumor diameter and T stage for patients with stage I NSCLC, therefore can be applied as a more accurate criterion in preoperative staging and prognosis of stage I NSCLC.

Objective To investigate the mechanism of venous reverse-flow flap in the differentperiod after operation.Methods The rabbits wero randomly allocated into 3 groups.In group A,including saphenous artery and venae commutante.In group B,saphenous artery without venae commutante.In group C,surface seeping and saphenous artery and venae commutante.Flap appearance,intravenous pressure,vessel diameter,mierocircular and histological examination were mea8ured.Results The difference of introvenous pressure between group A.B and C was obvious.Reverse flow WaS found in group A and C group through microcirculation observation 2 hours post-operation.Venous valve lose efficacy while the vessel diameter wes at maximum just after the pressure peak.Conclusion Venous retrograde return in reverse-flow island flaps can be achieved more easily through"incompetent valves route"than through "communicating and collaterall by pass route".By pass route is a supplementary way.Surface seeping Can slighfly relieve the venous pressure but can cause infection.

Objective: To analyze the current status of anticoagulant therapy for in-hospital patients with acute coronary syndromes (ACS) at county hospitals of China and to explore the relationship between anticoagulant therapy and clinical outcomes in real medical environment. Methods: 99 county hospitals from15 provinces of China were selected for this prospective registry study and 12373 eligible ACS patients without interventional therapy admitted from 2011-09 to 2014-06 were enrolled. The basic condition, previous history, initial assessment, anticoagulants (unfractionated heparin/low molecular weight heparin) application, severe bleeding events and in-hospital mortality were collected in all patients. Multiple logistic regression analysis was conducted to explore the relationship between anticoagulant therapy and clinical outcomes including in-hospital mortality, severe bleeding events and combined endpoints; meanwhile, possible confounders were adjusted. Results: A total of 9985/12373 ACS patients received anticoagulant therapy and 2388 did not. Anticoagulant therapy was conducted in 92.7% (4237/4570) patients with ST-segment elevation myocardial infarction (STEMI), 90.8% (1639/1805) with non-ST-segment elevation myocardial infarction (NSTEMI) and 68.5% (4109/5998) with unstable angina (UA); there were differences by regions and genders,P<0.01and no difference by age. Multivariable analysis indicated that anticoagulant therapy decreased the risk of in-hospital mortality in ACS patients at 53% (OR= 0.47, 95% CI 0.36-0.62), such reduction in STEMI patients was at 55% (OR=0.45, 95% CI 0.32-0.64), in NSTEMI patients was at 58% (OR=0.42, 95% CI 0.24-0.75); while it had no real effect in UA patients,P>0.05. Meanwhile, it did not increase the risk of severe bleeding events in ACS patients,P>0.05. Conclusion: Anticoagulant therapy has been widely used in STEMI and NSTEMI patients at county hospitals of China and obviously decreased the in-hospital mortality; while the application rate was relatively low in UA patients. The general safety of anticoagulant therapy has been good in ACS patients.

Objective: To understand the gender disparity and influencing factors for in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) at secondary hospitals in China. Methods: A total of 5525 in-hospital STEMI patients from 99 secondary hospitals of 15 provinces or autonomous regions between 2011-09 to 2014-06 were recruited including 1649 female and 3876 male. The in-hospital mortalities were compared between 2 genders and the relevant inlfuencing factors were studied by multiple Logistic regression analysis. Results: There were about 29.8% female and 70.2% male STEMI patients were studied. The in-hospital mortalities in female and male were 13.2% and 5.9%,P<0.01; gender disparity was obviously existing regardless of age, history of MI, hypertension and diabetes mellitus. The mortality in female was higher than male even without diseases history and cardiovascular risk factors. Compared with male gender, female patients were usually having elder age and likely complicated with cardiovascular risk factors; they were with lower incidence to receive ECG, drug therapy and thrombolysis within 10 minutes of admission. With adjusted confounding factors, multiple regression analysis presented that female STEMI patients had the higher mortality than male (OR:1.7, 95% CI:1.4-2.0). Conclusion: The in-hospital mortality for STEMI patients was higher in female than male at secondary hospitals in China. Female patients were usually having elder age, complicated with more cardiovascular risk factors, while with less chances to receive ECG, drug therapy and thrombolysis within 10 minutes of admission.

Objective To introduce the method of using hollow pull screw insertion for the suprapubic fracture with 3D printing navigation template and to evaluate its clinical effect.Methods From March 2016 to August 2017,eighteen cases of suprapubic ramus fractures treated with hollow lag screw fixation in the Department of Orthopedics of Yanan University Affiliated Hospital were retrospectively collected was collected.Before operation,the thin slice CT scan of pelvis was used to get raw data,and the mimics17.0 software was used to reconstruction the model,to design and make the personalized navigation template assisting the suprapubic fractures surgery.The navigation template was printed out pre-operatively,and the nail was inserted via the assisted by the template intra-operatively.After the operation,the fracture reduction was evaluated by Matta imaging scores and the pelvis function was evaluated by Majeed scores.Results All the operations were successfully completed.The Matta scores were excellent in 11 cases,good in 6 cases,and fair in 1 case.The Majeed scores were excellent in 13 cases,good in 3 cases,and fair in 2 cases.Conclusion 3D Printing navigation template assisted the placement of the hollow screw on the suprapubic fracture could provide personalized treatment,reduce the difficulty of operation and satisfy the clinical effect.

Cases of 2019-nCoV nucleic acid and antibody (IgM and IgG total antibody) after discharge from a hospital in Chongqing were continuously monitored. It was found that 5 cases of "re-positive" phenomenon, 5 cases of antibody were positive, and there was a trend of increasing with time. "Re-Positive" may be related to the following three factors. Children with asymptomatic infection had a long time of fecal detoxification.There were two consecutive nucleic acid tests "false negative" caused by various reasons.The virus clearance in patients was not complete, and the discharge standard was not conservative enough. The analysis of the causes of "Re-Positive" patients and the discussion of its infection will help us reveal more characteristics of this virus, and to provide a new basis for the discharge standard in the constantly updated diagnosis and treatment programme.

Objective To compare the clinical effects of G-arm X-ray machine and C-arm X-ray machine in percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture (OVCF) of thoracolumbar spine.Methods The clinical data of ninety-five patients with thoracolumbar OVCF treated with PKP from May 2016 to August 2017 in Yanan University Affiliated Hospital were retrospectively analyzed.They were divided into two groups according to the different guiding fluoroscopy methods used during the operation.Forty-six cases in G arm group completed PKP under the guidance of G arm X-ray machine,Forty-nine cases in C arm group completed PKP under the guidance of C arm X-ray machine.The operation time,fluoroscopy times,cement leakage cases,the height of injured vertebral leading edge,Cobb angle of kyphosis,visual analogue score and Oswestry dysfunction index were recorded before and after operation,and the related indexes were analyzed and compared.Results Two groups of patients were successfully completed surgery,no complications of vascular and nerve injury.The operation time and fluoroscopy times in G arm group were less than those in C arm group (operation time:(29.6±4.5) min vs.(42.5±5.3) min,and fluoroscopy times in G arm group:(9.1±2.0) vs.(16.9±3.2));the difference was statistically significant (t =-12.747,12.870,P＜ 0.01).Postoperative height of injured vertebral leading edge(G arm group (22.3±5.3) mm),C arm group (22.4±5.1) mm),kyphosis Cobb angle (G arm group (9.2±3.8)°,C arm group (9.3±3.7) o),visual analogue score (G arm group (2.1±0.7)points,C arm group (2.2±0.9) points),Oswestry dysfunction index (G arm group (21.3±8.5) points,C arm group(21.5 ± 8.3)points),compared with preoperative(the hight of injured vertebral leading edge of G arm group (18.2 ±5.3) mm,C arm group (18.4±5.2) mm,Cobb angle of injured vertebra G arm group (15.7±4.4) °,C arm group (15.9±4.3) °,visual analogue score of G arm group (7.8± 1.2) points,C arm group (7.7± 1.1) points,Oswestry dysfunction index score of G arm group(41.2±8.3)points,C arm group (41.5±8.2) points),the difference was statistically significant (t =-3.709,-3.844,-7.582,-8.144,27.827,27.088,11.360,11.999,P＜0.01),but there was no significant difference between the two groups (P ＞0.05).Conclusion Using G-arm X-ray machine to assist PKP in the treatment of thoracolumbar spine OVCF can effectively shorten the operation time,reduce the intraoperative fluoroscopy time,and the clinical effect is satisfactory.

Objective To get the situation with the Uygur students of hepatitis B virus marker in south Xinjiang , provide basis for physical examination system.Methods 398 blood samples of pupils in the southern region of Xinjiang were collected , 5 serological markers of hepatitis were detected with ELISA. Results The HBsAg positive rate was 1.26% ( 5/398 ) of the samples from the pupils in the southern region of Xinjiang, HBsAb positive rate was 50.47% ( 201/398 ) .There was no significance difference between male and female for the HBsAg and HBsAb positive rate (P>0.05).Conclusions The infection rate of HBV is relatively low among pupils in the southern region of Xinjiang, HBsAg positive rate is lower than the national average level, so the prevention of HBV infection should be enhanced there.