BackgroundUltrasound-guided cannulation of deep mid-arm veins by a modified Seldinger (US-Seldinger) technique has been demonstrated to yield better puncture success rates and lower postoperative complication rates than direct cannulation of superficial veins near the elbow with a short peripheral cannula and peripherally inserted central catheter (PICC) insertion through the cannula (non-US conventional method). Economic factors have been evaluated across different operators (i.e. nurses, radiologists, and general practitioners) and different venous catheter types (i.e. PICCs vs. central venous catheters). However, to our knowledge, data describing the economic evaluation on the aforementioned modified Seldinger technique are lacking. Hence, the aim of this study was to evaluate the cost-effectiveness of US-Seldinger technique (experimental group) compared with that of the non-US conventional method based on direct vein visualization (control group).ResultsA cohort of 360 subjects were assigned randomly to the experimental and control groups. Cost-effectiveness ratio (CER) analyses indicated that the effectiveness index (EI) for the experimental group was 89.29% (final CER = 3732.75), whereas that for the control group was 59.18% (final CER = 2492.98).ConclusionThe US-Seldinger technique was found to be more cost-effective than the non-US conventional method. These findings support the use of the former in place of the traditional latter technique as a routine puncture technique and suggest that the update would improve intravenous therapy treatment for patients needing PICCs. This study should serve as a reference for national healthcare policy. Trial registration ChiCTR-TRC-14004993Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-016-3698-8) contains supplementary material, which is available to authorized users.

Background and Aim Rifampicin is the most common pathogenic factor in anti‐tuberculosis drug‐induced liver injury (AT‐DILI), the mechanisms that it promotes hepatocyte damage in AT‐DILI are not yet to be thoroughly elucidated. In this study, we investigated the potential molecular mechanisms for ferroptosis involving rifampicin hepatotoxicity. Methods Animal and cell injury models of rifampicin were constructed, and the toxicity of rifampicin was assessed by physicochemical staining and cell viability assay. Next, flow cytometry was employed to detect changes in ferroptosis‐related markers, and Western blotting was used to detect protein expression. Then, the important role of autophagy and ferroptosis was verified with small molecule compound intervention. Results We found that ferritinophagy‐induced ferroptosis participates in the toxicity of rifampicin, and the mechanism is that rifampicin precisely activates high‐throughput autophagy, which leads to the massive degradation of ferritin and the increase of free iron. Moreover, rifampicin exhibited conspicuous inhibition of Human 71 kDa heat shock cognate protein (HSPA8) that is intimately associated with Microtubule‐associated protein light chain 3 isoform B (LC3B) expression, in turn, HSPA8 inducer attenuated intracellular autophagy flux. Of note, inducing HSPA8 or inhibition of autophagy and ferroptosis considerably relieved the hepatotoxicity of rifampicin in mouse model. Conclusions The present study highlights the crucial roles of the HSPA8 and autophagy in ferroptotic cell death driving by rifampicin, particularly illumines multiple promising regulatory nodes for therapeutic interventions in diseases involving AT‐DILI.

A kinky breather-soliton solution and kinky periodic-soliton solution are obtained using Hirota’s bilinear method and homoclinic test approach for the (3+1)-dimensional Jimbo-Miwa equation. Based on these two exact solutions, some lump-type solutions are emerged by limit behaviour. Meanwhile, two kinds of new dynamical phenomena, kinky breather degeneracy and kinky periodic degeneracy, are discussed and presented. Finally, the interaction between a stripe soliton and a lump-type soliton is discussed by the standardisation of the lump-type solution; the fusion and fission phenomena of soliton solutions are investigated and simulated by three-dimensional plots.