Objective To produce a plastic ampoule with an opening that fits syringe adapters to allow solutions to be drawn up without needles (to avoid needle stick and sharps injuries) and to test the effectiveness of the new design in terms of residual fluid volume and risk of microorganism contamination. Methods Evaluation study based on laboratory research was adopted. For the experimental group, 30 ampoules based on the new design were produced by 3D printing. The ampoules were sterilized and filled with 2 ml sterile water. The sterile water was drawn up without the use of needles, and the wastage fluid (i.e., 2 ml minus the quantity drawn up) was calculated. A 1 ml aliquot of sterile water from each ampoule was dropped onto a nutrient agar plate, and the number of colony-forming units was assessed after 48 h. For each ampoule, the experiment was performed twice. Sixty 2 ml glass-packaged sterile water injections constituted the control group. The fluid was drawn up with a needle, and the superfluous fluid and number of colony-forming units were assessed, as in the experimental group. Results The mean wastage fluid was 0.06 ml, 95% CI was 0.05-0.07 ml in the experimental group and the superfluous fluid was 0.06 ml, 95% CI was 0.06-0.07 ml in the control group, there was no significant difference between the two groups (Z=-1.194, P=0.233). The number of colony-forming units was 8 in the experimental group and 4 in the control group, there was no significant difference between the two groups (P=0.224). Conclusions The newly designed plastic ampoule opening could help health workers to avoid needle stick and sharps injuries when drawing up solution. The wastage fluid and microorganism contamination levels met the required standards, indicating that the new design is suitable for clinical application.

Objective To evaluate the correlation between transient elastrography (TE) and liver function Child-Pugh grade in patients with liver cirrhosis. Methods The clinical data of 120 patients with liver cirrhosis were retrospectively analyzed. Among the patients, hepatitis-B virus-related cirrhosis was in 103 cases, and 57 patients had ascites. The liver stiffness measurement (LSM) was measured by FibroScan. The liver function Child-Pugh grade was evaluated by liver function Child-Pugh system score. The LSM was compared in patients with different liver function Child-Pugh grade. Results Among the 120 patients with liver cirrhosis, Child-Pugh A grade was in 39 cases, Child-Pugh B grade in 28 cases, and Child-Pugh C grade in 53 cases. The LSM in Child-Pugh B grade patients and C grade patients were significantly higher than that in Child-Pugh A grade patients: (20.2 ± 1.1) and (30.8 ± 1.2) kPa vs. (15.7 ± 1.4) kPa, the LSM in Child-Pugh C grade patients was significantly higher than that in Child-Pugh B grade patients, and there were statistical differences (P<0.05). Among the 103 patients with hepatitis-B virus-related cirrhosis, Child-Pugh A grade was in 33 cases, Child-Pugh B grade in 24 cases, and Child-Pugh C grade in 46 cases. The LSM in Child-Pugh B grade patients and C grade patients were significantly higher than that in Child-Pugh A grade patients: (18.7 ± 0.9) and (26.9 ± 0.6) kPa vs. (12.6 ± 1.7) kPa, the LSM in Child-Pugh C grade patients was significantly higher than that in Child-Pugh B grade patients, and there were statistical difference (P<0.05). Among the 57 patients associated ascites, Child-Pugh B grade was in 11 cases, and Child-Pugh C grade in 46 cases. The LSM in Child-Pugh C grade patients was significantly higher than that in Child-Pugh B grade patients:(42.3 ± 1.4) kPa vs. (35.1 ± 1.0) kPa, and there was statistical difference (P<0.05). Among the 103 patients with hepatitis-B virus-related cirrhosis, associated ascites was in 49 cases, Child-Pugh B grade was in 10 cases, and Child-Pugh C grade in 39 cases. The LSM in Child-Pugh C grade patients was significantly higher than that in Child-Pugh B grade patients: (40.6 ± 0.9) kPa vs. (33.2 ± 1.5) kPa, and there was statistical difference (P<0.05). Conclusions The LSM values of patients with liver cirrhosis are higher with the elevation of liver function Child-Pugh grade. There is a correlation between LSM values and Child-Pugh scores. The LSM can partly evaluate the severity of liver disease in patients with liver fibrosis.

Objective To investigate the effect of MicroRNA-9 (miR-9) on cell proliferation and collagen synthesis in hepatic stellate cells (HSCs),and to explore the potential mechanism.Methods HSC-T6 cells were cultured and transfected with miR-9 mimics with lipofectamine 2000.After incubation 48 h,the cells were collected and total proteins and RNAs were extracted.The expression of miR-9 was detected by quantitative real time polymerase chain reaction (qRT-PCR).The protein expression of type Ⅰ collagen and type Ⅲ collagen were measured by Western blot.The methyl thiazolyl tetrazolium (MTT) method was used to asses the proliferation of HSC-T6 cells.The expression of transforming growth factor-β1 receptor 2 (TGFBR2) was detected by qRT-PCR and Western blot.Results Compared to the control group,miR-9 expression in HSCs was increased in the miR-9 mimics group (P ＜ 0.05),type Ⅰ and type Ⅲ collagen protein expression was reduced by (44 ± 2) ％ and (50 ± 3) ％ (P ＜ 0.01),respectively.The proliferation activity of HSCs was decreased by (48 ± 4)％ (P ＜ 0.05).The expression of TGFBR2 was inhibited in the miR-9 mimics group.Conclusions Upregulation of miR-9 plays a role on suppressing cell proliferation and collagen synthesis in HSCs.This process might be mediated by downregulation of TGFBR2.

Objective To estimate the clinical effect of fuzhenghuayu capsule in treatment of early hepatocirrhosis by liver instantaneous elastic imaging. Methods Eighty patients with early hepatocirrhosis were divided into experiment group and control group according to the treatment method with 40 cases each. All the patients in 2 groups were given the same antiviral treatment with entecavir dispersible tablets, and the patients in experiment group combined with fuzhenghuayu capsule. All treatment lasted for 6 months. The liver stiffness measurement (LSM) was measured before treatment and 1, 3 and 6 months after treatment by liver instantaneous elasticity imaging. The serum hyaluronic acid was measured, and the Child-Pugh score was evaluated at the same time. Results The LSM, hyaluronic acid and Child-Pugh scores 6 months after treatment in experiment group were significantly lower than those in control group:(19.3 ± 0.9) kPa vs. (29.6 ± 1.3) kPa, (215.6 ± 59.3)μg/L vs. (344.4 ± 39.6)μg/L and (2.1 ± 1.3) scores vs. (3.9 ± 0.9) scores, and there were statistical differences (P<0.05). No obvious adverse reactions related to the use of fuzhenghuayu capsule were found during the course of treatment. Conclusions Liver instantaneous elasticity imaging can be used to evaluate and monitor early hepatocirrhosis. Fuzhenghuayu capsule on patients with early hepatocirrhosis has a certain degree of curative effect.

OBJECTIVE:To evaluate the effect of clinical antibiotics use special rectification in our hospital. METHODS:100 discharged medical records of typeⅠincision surgery were randomly sampled from our hospital during May in 2010 to Apr. in 2011,May in 2011 to Apr. in 2012,May in 2012 to Apr. in 2013,May in 2013 to Apr. in 2014,totaling 400 records. And then evaluation indicators were analyzed statistically,such as antibiotics use intensity,perioperative DDDs of antibiotics in typeⅠinci-sion surgery,DUI,types of antibiotics during perioperative period,medication time,etc. RESULTS:Since the implementation of clinical antibiotics use special rectification in May 2011,the utilization ratio of antibiotics in typeⅠincision surgery of our hospital decreased from 96% to 33%;DUI decreased from 1.44 to 0.79;while reasonable rate of drug selection increased from 19.8% to 100%,and that of medication time increased from 43.8% to 100%. CONCLUSIONS:Rational medication evaluation indicators in typeⅠincision surgery of our hospital have been improved after the implementation of clinical antibiotics use special rectification.

Exchange proteins activated directly by cyclic adenosinemonophosphate (Epac) is one of cyclic adenosinemonophosphate (cAMP)-regulated guanine nucleotide exchange factors.When Epac closely binds with cAMP,it can activate many downstream signal molecules,such as Rap and Ras,etc.By activating several effectors,Epac regulates a multitude of important physiological and pathological processes.Ras and Rap play important effects on the differentiation and proliferation of photoreceptors.Ras may participate in the pathogenesis and development of age-related macular degeneration (AMD) and prolifereative vitreo-retinopathy (PVR) through Ras/Raf-1/MEK/ERK cascade.Therefore,further studies about the role of Epac and its downstream signals in the retina may provide numerous directions both in research and treatment of retinal diseases.The researching progress in Epac and the functions of the downstream signaling molecules of Epac in the retina were reviewed.

Objective To investigate the effect of miRNA-200b-specific inhibitor on hepatic stellate cells(HSCs) activation,proliferation,and extracellular matrix production.Methods The miRNA-200b-specific inhibitors were designed,synthesized,and transfected into HSCs with lipofectamine 2000.The supernatant and HSCs were collected after incubation for 48 h.The expression of miR-200b was detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR).The expression ofα-smooth muscle actin (oα-SMA) protein in HSCs was detected by Western blotting.The cell proliferation was assayed by methyl thiazolyl tetrazolium (MTT) method.Contents of type Ⅲ procollagen and hyaluronic acid in supernatant were determined by radioimmunoassay.Results Compared to the control group,miRNA-200b expression was decreased in the miRNA-200b inhibitor group by 82％ (P ＜ 0.01),α-SMA protein expression was reduced in the miRNA-200b inhibitor group by (19 ± 3) ％ (P ＜ 0.05),and the activity of HSCs proliferation was reduced by(33 ± 5)％ (P ＜0.01),and the contents of type Ⅲ procollagen and hyaluronic acid in supernatant were reduced in miRNA-200b inhibitor group by (35 ± 4)％ and (31 ± 2)％,respectively(P ＜0.01).Conclusions The miRNA-200b-specific inhibitor could significantly reduce the expression of miRNA-200b,and inhibit HSC proliferation,activation,and extracellular matrix production.

OBJECTIVE: To evaluate the satisfaction of service for outpatient within two weeks and for inpatient service within a year in Hunan Province in 2013 and to analyze the influential factors.
 METHODS: Using the data from the First Health Service Survey of Hunan Province, we evaluated the satisfactions for service in outpatients and inpatients based on the listed satisfaction indicators of the Fifth National Health Service Survey questionnaire. Weighted logistic regression was used to examine the influential factors for patients' satisfactions. SURVEYFREQ and SURVEYLOGISTIC procedures in SAS9.2 were used to conduct statistical analysis.
 RESULTS: The overall satisfaction proportion was 73.85% (95% CI: 68.67%-79.03%) and 66.31% (95% CI: 61.28%-71.34%) for outpatients and inpatients, respectively. After adjusting the location, gender, age and household income, high degree of satisfaction for outpatients was associated with good patience and trust in medical personnel as well as the low medical costs, with the adjusted odds ratios of 3.64, 5.38 and 3.34, respectively; high degree of satisfaction for inpatients was associated with a good attitude from medical personnel to patients' questions, high patients' trust in medical personnel and low medical costs, with the adjusted odds ratios of 2.56, 4.69 and 4.35, respectively.
 CONCLUSION Most of outpatients and inpatients were satisfied with medical services in 2013 in Hunan province. High degree of satisfaction is associated with good attitude from medical personnel to patients' questions, good patience and trust in medical personnel, and low medical costs.
China ; Health Care Surveys ; Humans ; Inpatients ; Odds Ratio ; Outpatients ; Patient Satisfaction

OBJECTIVETo predict the burden caused by fatal road traffic injuries from 2015 to 2030.

METHODSWe searched the websites of United Nations Population Division,United States Department of Agriculture, World Health Organization, China Energy Research Foundation and other agencies to obtain the predictive values of gross domestic product (GDP) per capita, urbanization, motorization and education from 2015 to 2030 in China. Predicted values were then applied to log-linear models to estimate the numbers and years of life lost due to road traffic injuries from 2015 to 2030.

RESULTSThe mortality rate caused by road traffic injury decreased slightly, from 13.7/100 000 in 2015 to 11.8/100 000 in 2030. 191, 189, 183, 169 thousand persons were estimated to die from road traffic crashes in 2015, 2020, 2025 and 2030, respectively, showing a declining trend. Years of Life Lost (YLLs) caused by road traffic deaths were predicted to be 6 918, 6 634, 6 189, 5 513 thousand years in 2015, 2020, 2025 and 2030, respectively, also showing a gradual downward trend. But the YLLs displayed an increase among people at 55 years of age or older, between 2015 and 2030. Results from the sensitivity analysis showed a stable forecasting result.

CONCLUSIONMortality, number of deaths and YLLs from road traffic crashes were predicted to decrease slightly, between 2015 and 2030 but the number of deaths and YLLs due to road traffic injuries will continue to increase from 2015 to 2030.

Accidents, Traffic ; mortality ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; epidemiology ; Cost of Illness ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Young Adult

Objective To predict the burden caused by fatal road traffic injuries from 2015 to 2030. Methods We searched the websites of United Nations Population Division,United States Department of Agriculture,World Health Organization,China Energy Research Foundation and other agencies to obtain the predictive values of gross domestic product(GDP)per capita,urbanization, motorization and education from 2015 to 2030 in China. Predicted values were then applied to log-linear models to estimate the numbers and years of life lost due to road traffic injuries from 2015 to 2030. Results The mortality rate caused by road traffic injury decreased slightly,from 13.7/100 000 in 2015 to 11.8/100 000 in 2030. 191,189,183,169 thousand persons were estimated to die from road traffic crashes in 2015,2020,2025 and 2030,respectively,showing a declining trend. Years of Life Lost(YLLs)caused by road traffic deaths were predicted to be 6 918,6 634,6 189,5 513 thousand years in 2015,2020,2025 and 2030,respectively,also showing a gradual downward trend. But the YLLs displayed an increase among people at 55 years of age or older,between 2015 and 2030. Results from the sensitivity analysis showed a stable forecasting result. Conclusion Mortality, number of deaths and YLLs from road traffic crashes were predicted to decrease slightly,between 2015 and 2030 but the number of deaths and YLLs due to road traffic injuries will continue to increase from 2015 to 2030.