Setting up a society in harmony is one of important abilities of our Party being in power.Right health care system in rural areas is one of important contents of setting up socialist society in harmony.This article argues from three aspects that setting up a society in harmony is mankind's moral ideal,building up health care system in rural areas is to appeal to morality which sets up a society in harmony,and building up health care system must be strengthened.But the writer thinks that there are many lacks now.So we should take some steps to build and complete the health care system in rural areas,it is significant for setting up a society in harmony.

Objective To study the meaning of breast cancer staging system by AJCC eighth edition to invasive lobular carcinoma and analysis the clinical pathological characteristics.Methods According to the eighth edition of the AJCC staging to evaluate the TNM stage and prognosis evaluation of invasive lobular carcinoma cancer patient in Peking University Shenzhen Hospital from 2011 to 2016,and compared with others in clinical pathological data.Results There were 21 cases of invasive lobular carcinoma,accounting for 2.7％ of all invasive breast cancer.We found that invasive lobular carcinoma shows no significant difference (P ＞ 0.05) in ages,menstrual status,molecular features and anatomic staging and prognosis staging with others;histological grade were significantly different (P ＜ 0.05).There were significant differences in the prognosis and staging of invasive lobular carcinoma.Conclusions Eighth AJCC staging systemn provides a new reference for the clinical treatment of breast cancer,should be evaluated with anatomic stage.Histological grade is relatively good in invasive lobular carcinoma and the prognosis is good,needs more research to the individualized treatment of invasive lobular carcinoma.

STGC3, a novel tumor related gene, was cloned recently. The previous studies indicated that STGC3 can inhibit the proliferation of CNE2 cell line in vitro. To examine the effect of STGC3 on the tumorigenicity of CNE2 cell line and explore its mechanism in nude mice. The Tet/pTRE/CNE2-STGC3 cell line was planted under the front leg skin of nude mice and induced by doxycycline (Dox). The mRNA and protein level of STGC3 in transplanted tumor tissues were detected with RT-PCR and Western Blotting. The apoptosis ratio of the tumor cell was analyzed with flow cytometry. STGC3, Bcl-2 and Bax proteins were examined by immunohistochemistry method. The results indicated that high level of STGC3 expression can inhibit tumorigenicity of CNE2 cell line in nude mice. Tumor grew slowly, later and smaller. Cell apoptotic percentage increased. Bcl-2 protein expression was down-regulated and Bax protein expression was up-regulated in Tet/pTRE/CNE2-STGC3 cell line (P

Objective · To conduct a survey on the current status of professionalism and personal protection in Central Sterile Supply Department (CSSD) practitioners in Shanghai, analyze the existing problems and provide suggestions, in order to improve work quality and management level of CCSD. Methods · Cluster sampling was used to extract 23 different level hospitals with CSSDs among 4 districts in Shanghai including Jing'an, Jinshan,Qingpu and Jiading. A total of 147 participants consisted of 104 employees and 43 heads of CSSDs. Field investigation and questionnaire survey were applied into CSSD practitioners for investigating their essential information, professionalism and personal protection status. Results · Practitioners in different hospitals showed different professional knowledge, especially practitioners in private hospital performed worse than those in secondary and tertiary-level hospitals in this survey of professionalism. Daily protection measures were defective due to lacking of consciousness of personal protection.Conclusion · There was problem of personal professionalism and protection consciousness in CSSD practitioners. It is important to optimize the allocation of CSSD human resource, reinforce skill training and improve quality management.

Objective To study the clinical significance for expression of serum matrix metalloproteinase and HER-2 extracellular domain in primary breast cancer.Methods Two hundred and forty two early breast cancer patients were enrolled as research group who met the criteria in Peking University Shenzhen Hospital from May 2015 to October 2017.They were divided into HER-2 positive breast cancer group (n =53) and HER-2 negative breast cancer group (n =189) according to HER-2 status.At the came time,non breast cancer women were recruited in outpatient as control group.The concentrations of serum MMP-2,MMP-9 and HER-2 ECD were detected by ELISA,and the differences of concentration in each grup were compared.Measurement data were expressed by mean and standard deviation,t test was used between two groups of parameters.A single factor analysis of variance was used among the multiple groups of parameters,and LSD test was used in the comparison between every two groups.Results The serum levels of MMP-2,MMP-9 and HER-2 ECD were (12.07 ± 1.23) ng/ml,(25.20 ±3.53) ng/ml and (10.42 ± 6.08) ng/ml in research group,HER-2 positive group were (13.43 ± 4.63) ng/ml,(25.24 ± 2.12) ng/ml and (13.25 ± 3.42) ng/ml,HER-2 negative group were (10.55 ± 3.72) ng/ml,(23.16 ±3.21) ng/ml and (6.33 ±4.11) ng/ml.The serum levels of MMP-2,MMP-9 and HER-2 ECD in the control group were (9.03 ± 1.15) ng/ml,(21.15 ±2.12) ng/ml and (4.71 ± 1.93) ng/ml.There were significant differences in MMP-2,MMP-9 and HER-2 ECD concentration between research group and control group (all P ＜ 0.0001).There was significant difference between HER-2 positive group and HER-2 negative group,HER-2 positive group and control group in the HER-2 ECD (P ＜ 0.0001).There were significant difference between control group and HER-2 positive group,control group and HER-2 negative group in the MMP-2 and MMP-9(P ＜ 0.000 1).In the HER-2 positive group,there was significant difference between HER-2 ECD positive and HER-2 ECD negative subgroup of MMP-2 and MMP-9(P ＜ 0.000 1).Conclusions In early breast cancer,HER-2 positive is an important condition for HER-2 ECD positive,and associated with abnormal activation of MMP.Combined detection of serum HER-2 ECD,MMP-2 and MMP-9 contributes to the determination of HER-2 status in tissues.

Objective:To explore the application effect of ultrasound-guided pectoralis Ⅱ(PECS-Ⅱ)blocks anesthesia in benign tumor resection of breast.Methods:A total of 60 female patients who underwent benign tumor resection of breast were selected from Maternity and Child Care Center of Qinhuangdao from January 2021 to December 2021,and they were divided into the thoracic nerve block group(nerve block group)and local infiltration anesthesia group(local anesthesia group)according to the random number table method.The nerve block group used ultrasound-guided PECS-Ⅱ anesthesia,and the local anesthesia group used local infiltration anesthesia for tumor.The hemodynamic indicators,postoperative visual analogue score,first intervention time of postoperative analgesic drugs,and the use of sufentanil within 24 hours after surgery were compared and analyzed between the two groups of patients.Results:The average operation time of the nerve block group was(127.32±34.56)min,and the difference of that between the nerve block group and local anesthesia group(128.11±33.84)min was no statistically significant(P>0.05).The differences of the heart rate(HR)and mean arterial pressure(MAP)before anesthesia(T0)between two groups of patients were not statistically significant(P>0.05).The HR and MAP levels at the time of skin incision(T1),at the 0.5 h after the surgery was conducted(T2)and the time of completing surgery(T3)in nerve block group were significantly lower than those of the local anesthesia group,respectively.The differences were statistically significant(tHR=5.709,5.836,5.662,tMAP=3.501,3.223,3.128,P<0.05),respectively.Compared with the local anesthesia group,the pain level at the same time point in the nerve block group was significantly reduced,and the difference was statistically significant(t=4.501,6.575,8.197,8.262,P<0.05),respectively.The intervention time of analgesic medication at the first time of the nerve block group was significantly later than that of the local anesthesia group,and the consumption of sufentanil within 24 hours after surgery of the nerve block group was also significantly reduced,and the differences of them were statistically significant(t=13.741,9.482,P<0.05),respectively.Conclusion:Ultrasound-guided PECS-Ⅱ can effectively relieve postoperatively early pain in patients with benign tumors of breast,and delay the intervention time of postoperative analgesic medication,and reduce the intake amount of opioid drugs.

Objective:To explore the will of the aged to participate in long-term care insurance in Qinhuangdao and its influencing factors under the background of aging of population.Methods:From April to May 2019, we selected 450 elderly people as subjects by stratified cluster random sampling in Qinhuangdao. All elderly people were investigated with the self-designed Long-term Care Insurance Need Questionnaire for the Aged. The individual characteristics, economic state and consciousness were analyzed with the methods of descriptive analysis, chi-square test and Logistic regression analysis.Results:A total of 445 valid questionnaires were collected. There were 60.7% (270/445) of aged with the wills to participate in long-term care insurance and 57.8% (156/270) of them hope the insurance mostly in cash or nursing service. Single factor analysis showed that there were statistical differences in the wills to participate in long-term care insurance among the aged with different ages, education levels, with or without a spouse, living situation, number of children, number of sons, primary caregivers, conscious health status, number of chronic diseases, number of hospitalizations in the past year, main source of income, monthly income, type of medical security, preference for care places (χ 2=50.228, 19.662, 26.504, 36.934, 16.456, 23.963, 44.482, 27.684, 24.783, 29.278, 22.313, 14.836, 10.446, 9.087; P<0.05) . Logistic regression analysis showed that the influencing factors of the will of the aged to participate in long-term care insurance included the ages, spouses and caregivers with statistical differences ( P<0.05) . Conclusions:Elderly people in Qinhuangdao are not willing to participate in long-term care insurance, and the elderly who are low age, have no spouse and have no caregivers are more willing to participate in long-term care insurance.

Objective:To systematically review the characteristics of sleep patterns in the elderly with subjective cognitive decline (SCD) and the relationship between subjective cognitive decline and sleep disorders.Methods:Observational studies on sleep patterns in the elderly with SCD were retrieved by computer in Chinese and English databases such as PubMed, Embase, Web of Science, ScienceDirect, China National Knowledge Infrastructure (CNKI) , WanFang Data and VIP, and the retrieval time was from the establishment of the database to March 31, 2020. Two researchers independently conducted article screening, data extraction and quality evaluation according to the standard. The random-effects model was used for Meta-synthesis of studies with data that could be pooled, and descriptive analysis for studies that could not be pooled.Results:A total of 12 articles were included, with a total sample size of 67 474 cases. The prevalence of SCD in the elderly was 25.9% (95% CI: 6.4%-52.5%) . The sleep patterns of the elderly with SCD were characterized by decreased total sleep time, prolonged wake-time after sleep onset, and frequent awakenings at night. Compared with the normal elderly, the elderly with SCD had a higher risk of poor sleep quality, insomnia and excessive daytime sleepiness ( OR=2.1, 1.15, 2.6) , and excessive daytime sleepiness (ESD) increased the risk of SCD in the elderly ( OR=6.06) . Conclusions:Compared with the normal elderly, the overall sleep quality of the elderly with SCD is poor, and sleep disorders can increase the risk of SCD in the elderly. Existing studies have differences in the diagnostic criteria of SCD, and future studies need to further confirm the causal relationship between SCD and sleep disorders in the elderly.

China has entered a period of high incidence of colorectal cancer. The year of 2015 is the start of precision medicine. Colorectal cancer "precision medicine" is based on the analysis of the cancer genome sequencing and information analysis, interprets the mechanism of the occurrence, development, invasion, metastasis and recurrence of colorectal cancer, and helps to implement targeted individual treatment. The experts of the world's Colorectal Cancer Subtyping Consortium, integrated the past genetic testing based on the classification of colorectal cancer subtypes, refered to the indices of gene mutation, copy number, methylation, microRNA and proteomics, and coalesce the types of colorectal cancer into four consensus molecular subtypes(CMSs) with distinguishing features. CMSs may be the most powerful classification system of colorectal cancer because of its clear biological interpretation, and is expected to provide a reference basis for the establishment of clinical precision treatment system.
China ; Colorectal Neoplasms ; Humans ; Mutation ; Precision Medicine ; Proteomics ; Recurrence

OBJECTIVETo explored the relationship of clinicopathological classification and clinical and pathological characteristics of breast cancer and analyze the value in treatment.

METHODSThe patients with invasive breast carcinoma had been treated between January 2011 and December 2012. The breast cancer have been divided into luminal A, luminal B, HER2-positive and triple-negative subtypes according to criteria of St. Gallen International Expert Consensus report 2011. The Mann-Whitney test and Kruskal-Wallis test were used to analyze the relationships between four subtypes and TNM staging, histopathological grading.

RESULTSThe 530 cases of invasive breast cancer patients were included in this study. The luminal A was 94 cases (17.7%), the luminal B was of 285 cases (53.8%), the HER2-positive was 59 cases (11.1%), and the triple-negative subtype was 92 cases (17.4%). In luminal B subtype, the HER2-positive was 56 (19.6%) and negative was 229 (80.4%). Most of luminal B was later in grade (71.7% of cases were more than II grade) and stage (66.7% were more than stage II).

CONCLUSIONSClinical pathological classification is important in the individualized treatments of breast cancer, and the Luminal types (A+B) are more than 71.5% of all breast cancer patients, and they should be paid more attention to the endocrine therapy; Luminal B type accounted for 53.8% of all breast cancer and it needs further study to improve the precision of the diagnosis and treatment.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; classification ; pathology ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; Prognosis ; Young Adult