Objective: To analyze the causes of death in Keqiao District, Shaoxing City in 2020, so as to provide the evidence for formulating the disease control strategy. Methods: The dead cases' gender, age and causes of death in Keqiao District, 2020, were collected from Shaoxing Municipal Public Health Information System, and the mortality was estimated and standardized by the 2020 Chinese standard population. The gender- and age-specific mortality and distribution of causes of death were analyzed, and the years of potential life lost (YPLL), average years of potential life lost per death (AYLL) and YPLL rate (YPLLR) were calculated to evaluate the life lost. Results: The crude and standardized mortality rates of registered residents in Keqiao District were 636.97/105 and 494.72/105, respectively. The crude and standardized mortality rates were 712.67/105 and 512.23/105 in men and 564.75/105 and 473.25/105 in women, and a higher mortality rate was seen in men than in women (χ2=59.628, P<0.001). The mortality reduced and then increased with age, and peaked among residents at ages of 85 years and older (13 910.90/105). Chronic disease was the main cause of death, accounting for 85.60% of all causes of death and showing a mortality rate of 545.27/105. Cancer, cardiopathy, cerebrovascular disease, injury and poisoning, and respiratory diseases were the five leading causes of death, and lung cancer, gastric cancer, colorectal cancer, liver cancer and pancreatic cancer were the five leading causes of cancer-related mortality. The highest YPLL was caused by cancers (13 015.00 person-years), with a YPLLR of 1.88%, and the highest AYLL was caused by injury and poisoning (10.37 years). Conclusion Chronic non-communicable diseases, such as cancer and cardio-cerebrovascular diseases, were main causes of death among residents in Keqiao District in 2020. The management of chronic diseases requires to be reinforced to improve the quality of life.

Objective:To investigate the application effect of high-altitude field-based teaching in acute mountain sickness.Methods:The medical students of the classes 2018 and 2019 majoring in clinical medicine were selected as subjects, and they were divided into conventional teaching group and field-based teaching group, with 20 students in each group. The students in the conventional teaching group received classroom teaching alone, and those in the field-based teaching group received high-altitude field-based teaching after theoretical lectures. The two groups were compared in terms of the theoretical knowledge of acute mountain sickness, the quality score of internship, and rescue operation score of acute mountain sickness, and questionnaire feedback and post-class discussion were performed among trainees and teachers to evaluate the high-altitude field-based teaching model. SPSS 19.0 was used for statistical analysis.Results:Compared with the conventional teaching group, the field-based teaching group had significantly higher scores of the theoretical knowledge of acute mountain sickness (91.72±4.34 vs. 86.10±5.15, P<0.001), the quality score of internship (89.64±5.21 vs. 83.51±2.38, P<0.001), and the rescue operation of acute mountain sickness [94.05 (89.54, 94.87) vs. 87.01 (84.33, 90.82), P<0.001]. Conclusions:High-altitude field-based teaching can improve the teaching effect of acute mountain sickness and cultivate the interest and learning enthusiasm of students, and therefore, it holds promise for wide application.

The Continuity Assessment Record and Evaluation (CARE) in America is a comprehensive tool for continuously and consistently evaluating and recording patients' care needs. CARE can objectively reflect care level, build payment basis, monitor service quality and support the exchange and sharing of health data striding across different service organizations. Its ultimate objective is to establish a continuous service system taking the single assessment instrument as integration mechanism, based on needs, connecting acute medical care, post-acute care and long-term care. This paper introduced the development background and process of CARE as well as its composition and application, and this paper also explored its reference for establishing an assessment system which adapted to the situation of our country so as to promote the establishment of "people-centered" medical service and elder care service integration system.

Objective:To identify important prognostic molecular markers of triple negative breast cancer (TNBC) using high throughput sequencing technology and to explore the correlation of spindle checkpoint protein BUB1B and clinicopathological features with patients′ prognosis.Methods:The clinicopathological data and prognostic information of TNBC diagnosed at the West China Hospital of Sichuan University from 2009 to 2017 were collected. Forty-seven fresh tumor samples and 139 formalin fixed paraffin-embedded samples were selected. The fresh tumor samples were subject to RNA sequencing (RNA-seq). The enrichment analysis and protein-protein interaction (PPI) analysis were performed after intersection of difference analysis between RNAseq and GEO (Gene Expression Omnibus) datasets GSE38959 and GSE65194. Kaplan-Meier plotter database was used to analyze the relationship between expression of BUB1B and prognosis. Immunohistochemical staining was used to verify its expression in TNBC and correlation with clinicopathological features and prognosis.Results:Using edgeR to perform differential expression analysis between 47 TNBC tumor tissues and 12 normal tissues, 1 559 up-regulated genes and 1 376 down-regulated genes were identified, while only 131 differentially expressed genes were overlapping with those in GSE38959 and GSE65194. Enrichment analysis was mainly enriched in cell cycle, JAK-STAT signaling pathway and p53 signaling pathway. The top 10 genes ranked by degree of association were TOP2A, BUB1B, MKI67, PLK1, RRM2, PCNA, KPNA2, SMC4, PBK and IGF1. Kaplan-Meier plotter database analysis showed that the expression of BUB1B was significantly correlated with the prognosis of TNBC [overall survival, hazard ratio (HR)=0.52, 95% CI (0.35-0.77), P=0.001; distant metastasis-free, HR=0.72, 95% CI (0.52-0.98), P=0.038]. The immunohistochemical analyses of 139 formalin fixed paraffin-embedded samples showed that the low expression of BUB1B was correlated with poor prognosis in TNBC [HR=0.41, 95% CI (0.18-0.95), P=0.024]. Conclusions:The low expression of BUB1B protein is associated with poor prognosis in TNBC patients, and the molecular mechanism related with prognosis and potential therapeutic targets need to be further studied.

Objective:To study the trinucleotide repeats of GCN (GCA, GCT, GCC, GCG) encoding Alanine in exon 3 of the PHOX2B gene among healthy individuals from southwest China and two patients with Congenital central hypoventilation syndrome (CCHS). Methods:The number and sequence of the GCN repeats of the PHOX2B gene were analyzed by capillary electrophoresis, Sanger sequencing and cloning sequencing of 518 healthy individuals and two newborns with CCHS, respectively. Results:Among the 1036 alleles of the 518 healthy individuals, five alleles were identified, including (GCN) 7, (GCN) 13, (GCN) 14, (GCN) 15 and (GCN) 20. The frequency of the (GCN) 20 allele was the highest (94.79%). And five genotypes were identified, which included (GCN) 7/(GCN) 20, (GCN) 13/(GCN) 20, (GCN) 14/(GCN) 20, (GCN) 15/(GCN) 20, (GCN) 20/(GCN) 20. The homozygous genotypes were all (GCN) 20/(GCN) 20, and the carrier rate was 89.58%. Four GCN sequences of the (GCN) 20 homozygous genotypes were identified among the 464 healthy individuals. The GCN repeat numbers in the exon 3 of the PHOX2B gene showed no significant difference between the expected and observed values, and had fulfilled the, Hardy-Weinberg equilibrium. The genotypes of the two CCHS patients were (GCN) 20/(GCN) 25 and (GCN) 20/(GCN) 30, respectively. Conclusion:It is important to determine the GCN repeats and genotypic data of the exon 3 of the PHOX2B gene among the healthy individuals. The number of GCN repeats in 518 healthy individuals was all below 20. The selection of appropriate methods can accurately detect the polyalanine repeat mutations (PARMs) of the PHOX2B gene, which is conducive to the early diagnosis, intervention and treatment of CCHS.