CXCL12 and its receptor CXCR4 can express in breast cancer,and are regulated by several factors in the genesis and development of breast cancer. Lots of researches have proved that CXCL12 and CXCR4 can be used as new independent prognostic makers of breast cancer.Treatment targeted for CXCR4 can be seen as a new kind of combination therapy,which may provides patients a more ideal treatment.

Objective To detect the expressions of CXCR4,Smoothened (Smo) and Patched (Ptch) in breast cancer,to analyze the clinical significance of the expression of CXCR4,and to evaluate the relationships among CXCR4,Smo and Ptch.Methods The expressions of CXCR4,Smo and Ptch from 121 cases of breast cancer specimens were detected by immunohistochemistry,and the results were analyzed.Results The positive expression rate of CXCR4 in breast cancer was 66.9％,which was positively associated with the lymph node metastasis (r =0.181,P =0.044).The positive expression rates of Smo and Ptch in breast cancer were respectively 58.9％ and 64.5％.The expressions of Smo and Ptch were positively associated with the expression of CXCR4 in breast cancer (r =0.189,P =0.036 ; r =0.230,P =0.010).Conclusion The expression of CXCR4 in breast cancer is associated with the lymph node metastasis,and it is positiviely associated with the expressions of Smo and Ptch.Patients with breast cancer who express both CXCR4 and Hedgehog signaling pathway may have a higher risk of recurrence.

Objective To investigate the change in ventricular repolarization at different altitudes and time courses among healthy young males .Methods A total of 143 healthy young men living on the plains were randomly selected as subjects.Their change in relative parameters of ventricular repolarization was measured by the same person at 500 m above sea level,24 hours their ascent to the plateau at an altitude of 3700 m was,after one week′s acclimatization on the 4400 m plateau and after 50 days acclimatization on the 4400 m plateau.Results Compared with 500 m,at 3700 m above sea level in 24 hours and after one week′s acclimatization on the 4400 m plateau,the heart rate(HR),systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate-corrected-QT (QTc)interval and heart rate-corrected T-peak to T-end (TpTec) on V3 lead were significantly increased(P<0.05).while oxygen saturation, QT interval,T-peak toT-end(TpTe)interval on V3 lead were significantly decreased ( P<0.05) .Compared with 500 m, oxygen saturation significantly decreased ( P<0.05),while SBP,DBP,QT interval,QTc interval,TpTe interval,TpTec interval did not change significantly (P>0.05) after 50 days acclimatization on the 4400 m plateau.Conclusion The ventricular repolarization duration of these young healthy men was significantly increased when they rapidly ascentded to high altitude .With prolonging residence at high alti-tude,the ventricular repolarization duration gradually returned to the level on the plains ,suggesting that the the ventricular repolarization duration will be restored to its level on the sea level by the adaptation and adjustment mechanism of the body .

Objective : To optimize the primary prevention strategies of birth defects in Zhejiang Province by Delphi method, so as to promote the capacity of birth defects prevention. Methods: The expert consultation questionnaire was developed based on the relevant policies of Zhejiang Province and literature. Ten experts from medical institutions and health administrative departments were employed for one round Delphi expert consultation. The weighted scores and priorities of ten measures for the primary prevention of birth defects in Zhejiang Province were determined, as well as the suggestions of optimizing the current policies. Results : The response rate of the experts was 90.91%; the coefficient of authority was 0.92; the coefficients of variation of ten measures were all less than 0.25; the coefficient of coordination was 0.31 ( P<0.05 ) , which indicated the opinions of the experts tended to be consistent. In the order of priority, ten primary prevention measures of birth defects were the improvement of birth defects surveillance network ( province, city and county level ) , the training of birth defects prevention talents, the construction of genetic consultation clinics, health education and publicity, the reproduction outpatient service construction for older people, free premarital medical examination, free pre-pregnancy eugenics test, the construction of drug consultation clinics, career planning and training of birth defect prevention and control consultants and free folic acid supplement to the whole population. Nine experts suggested that the following policies need to be optimized: birth defects surveillance system, free premarital medical examination, and health education and publicity. Conclusion In the primary prevention of birth defects in Zhejiang Province, the most urgent problem to be solved is the improvement of the three-level birth defects surveillance network.

ObjectiveTo investigate the current status and influencing factors of hand hygiene practices among primary healthcare workers， and to provide a reference for improving hand hygiene behavior in primary healthcare institutions. MethodsA self-designed questionnaire was used to conduct a survey among medical staff of seven community health service centers in Jiading District， Shanghai， using a cluster random sampling method. The data collected were subjected to descriptive statistics， reliability and validity tests， correlation analysis， and structural equation model fitting. ResultsA statistical difference in hand hygiene compliance was found among medical staff with varying occupational types and educational levels （P<0.05）， and medical staff in clinical departments exhibited higher levels of hand hygiene compliance （P<0.05）. In the health belief model， among the core variables， healthcare workers’ perceived benefits， perceived barriers， and self-efficacy had a direct impact on hand hygiene behavior， with direct effect values of 0.341， -0.152， and 0.234， respectively. Meanwhile， cues to action and perceived severity of COVID-19 infection indirectly affected hand hygiene behavior， with an indirect effect value of 0.066 and 0.062， respectively. ConclusionHealthcare workers generally exhibit a high degree of hand hygiene compliance， but there are variations in hand hygiene scores among healthcare workers with different characteristics. Enhancing healthcare worders’ perception of benefits， action cues， and self-efficacy while reducing perceived barriers can effectively improve their hand hygiene behavior.