Objective: To optimize matrix composition and technology for Jiefushuang Emulsion. Methods: Orthogonal design was used, oil phase, agitation velocity, emulsifiers and emulsify temperature were selected as variable factors. Results: The optimum matrix composition and technology were: The ratio of oil to water was 2∶3, emulsifiers: 320g(oil 500mL), HLB: 15, emulsity temperature: 70?C , agitation velocity: 800 revolutions per minute, lasting for 20 minutes. Conclusion: The emulsion prepared accords with the stipulation of the appendix of Chinese pharmacopoeia (2000).

Objective To identify snoRNA, which may be related to prognosis of gastric cancer. Methods Ninetygastric cancer patients who diagnosed at Tianjin Medical University Cancer Institute and Hospital were randomly collected in this study, and their clinical data were followed up. A total of 405 snoRNA expression profiles were analyzed in 90 gastric cancer patients. Patients were classified aslow expressiongroup orhigh expressiongroup according to the median expression of each snoRNA expression, which was calculated by univariate and multivariate survival analysis. We also screened out the snoRNAs, in which patients were survived differently. Patients were classified as high, middle, or low risk groups based on the snoRNA risk score. Values of age, gender, smoking, drinking, histological differentiation (well, moderately-differentiated and poorly differentiated), clinical stage (Ⅰ+Ⅱstage andⅢ+Ⅳstage), tumor size (<5 cm and≥5 cm), tumor location (upper 1/3 and others) and snoRNA risk score (high, middle, and low risk group) were assessed by multivariate Cox analysis. Results There were significant differences in overall survival and (or) progression-free survival rates in 19 patients with high and low snoRNAs expressions (P<0.05). Results of multivariate Cox analysis showed that patients with high expression of ACA61,ACA27 and U36A showed a higher overall survival and progression-free survival rates, while patients with high expression of ENSG00000206898 showed a lower overall survival and progression-free survival survival rates (P<0.01). SnoRNA risk score is an independent prognostic factor for patients with gastric cancer. Compared with low risk group, patients in middle risk group and in high risk group showed a shorter overall survival and progression-free survival rates (P<0.001). Conclusion The expressions of ACA61, ACA27, U36A and ENSG00000206898 are independent prognostic factors of gastric cancer. Low expressions of the first three indexes and high expressions of the last one predict a bad prognosis.

Cancer screening has been considered as double-edged sword with both advantages and disadvantages.For decades,there have been strong interests in screening strategies for the early detection of cancers to reduce the mortality,especially breast X-ray (mammography) screening.However,several evidences also suggested that the benefit of reduction of breast-cancer mortality with mammography might become a problem due to the repeat mammography,subsequent biopsies,and overdiagnosis.And different screening strategies with different models,different intervals,and different target populations also incurred debates.After systematical analysis and discussion,we suggested to focus on high-risk population,improve the accuracy of screening technique,conduct the informed consent of participants,and explore individual screening mode in the screening of breast cancer.

Objective: To investigate the potential application values of screening on breast cancer, using the single-nucleotide polymorphisms (SNPs) that were identified from the genome- wide association studies (GWASs). Methods: Two million Chinese women aged 35-69 years were simulated, based on both age distributions, age-specific incidence rates of breast cancer and the distribution of known risk factors, in 2013. Twenty-three SNPs identified from GWAS were further simulated. Both genetic-related risks explained by each SNPs and the improvement on the risks under reclassification, were used to select SNPs for the prediction on breast cancer among the targeted high-risk population. Further analyses were conducted to investigate the following items as: improvements on detection rates of breast cancer among the high-risk populations, areas under the curve (AUC) and the odds ratio (OR) among women at high risk. Results: A total of 12 SNPs were eligible for targeting the high-risk population of breast cancer. When high-risk populations were defined as women whose predicted risks were higher than the 95^th predicted risk of the whole population, the detection rate (146.99/100 000) among high-risked women predicted by 12 SNPs would be significantly lower than 177.46/100 000, which was predicted by the known risk factors (P<0.001), among the high-risked women. Among those women at high risk, the detection rate (229.00/100 000) predicted by integrating known risk factors and 12 SNPs was significantly higher than that predicted by known risk factors (P<0.001). Also, the AUC increased from 64.4% to 67.8% (P<0.001), and the OR of increased from 3.32 to 4.33, predicted by integrating known risk factors and 12 SNPs, for women at high risk on breast cancer. Conclusion Targeted SNPs that were identified from genome- wide association studies could be used to improve the detection rates as well as the overall accuracy of risk prediction so as to identify the potential high-risk women on breast cancer before carrying on the screening program.

Objective: To explore the effectiveness and cost of breast cancer screening strategy that is suitable for the current econom-ic conditions in China. Methods: We collected clinical and cost information of breast cancer screening for Chinese women based on previous screening programs conducted from February 2008 to December 2011 and collected the same information about breast can-cer cases diagnosed in hospitals at the same time. Markov models were developed to analyze the incremental cost-effectiveness ratios (ICER) for 132 breast cancer screening strategies compared to no screening for Chinese women. Results: In 2010, as compared to no screening, the most cost-effective breast cancer screening strategy was biennial screening with clinical breast examination (CBE) and breast ultrasound, in parallel, for women aged between 40 to 64. This screening strategy could save 1,394 quality-adjusted life years (QALY) per 100,000 women, and the cost of saving breast-cancer related QALY would be 91,944 RMB. Sensitivity analysis indicated that in 2016, the most cost-effective breast cancer screening strategy was biennial screening with CBE and mammography (MAM), in parallel, for women aged 40 to 64, with ICER of 159,637 RMB per QALY. Conclusions: Population-based breast cancer screening would be acceptable in the current conditions in China. As the Chinese economy and level of medical care improve, breast cancer screening would be more cost-effective.

OBJECTIVEFindings from the previous studies have suggested a relationship between ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP-1) or plasma cell membrane glycoprotein 1 (PC-1) gene single nucleotide polymorphism (K121Q, rs1044498) and genetic susceptibility to obesity. However, such relationship is not reproduced by some currently available studies. In this context, the present study is aimed to quantitatively analyze the association of K121Q variant with obesity in all published case-control studies in European adult populations.

METHODSPublished literature from PubMed, EMBASE, and ISI web of science databases were retrieved. The studies evaluating the association of ENPP1/PC1 gene K121Q polymorphism with obesity were included, in which sufficient data were presented to calculate the odds ratio (OR) with 95% confidence intervals (CIs).

RESULTSTen case-control studies meeting the inclusion criteria identified a total of 24,324 subjects including 11,372 obese and 12,952 control subjects. The meta-analysis results showed a statistically significant association of K121Q with obesity [OR (95%CI): 1.25 (1.04-1.52) P=0.021] under a recessive model of inheritance (QQ vs. KK+KQ) without heterogeneity or publication bias.

CONCLUSIONSThe results from the present study have indicated that ENPP1/PC1 Q121 variant may increase the risk of obesity and that more well-designed studies based on a larger population will be required to further evaluate the role of ENPP1/PC1 gene K121Q polymorphism in obesity and other related metabolic syndromes.

Europe ; epidemiology ; Genetic Predisposition to Disease ; Humans ; Obesity ; epidemiology ; genetics ; Odds Ratio ; Phosphoric Diester Hydrolases ; genetics ; Polymorphism, Genetic ; Pyrophosphatases ; genetics ; Risk Factors

Breast cancer is the most common cancer for Chinese women. Early screening is the best way to improve the rates of early diagnosis and early treatment of breast cancer. The peak ages of breast cancer in Chinese women are obviously different from those in the European and American countries. It is imperative to develop a guideline for breast cancer screening that is suitable for Chinese women. Based on the analysis and summary of breast cancer screening data in China, and the latest guidelines and consensus on breast cancer screening in Europe, the United States and East Asia, China Anti-Cancer Association and National Clinical Research Center for Cancer (Tianjin Medical University Cancer Institute and Hospital) has developed a population-based guideline for breast cancer screening in Chinese women. This guideline has provided detailed recommendations on the screening starting age, screening modalities, and screening interval in Chinese women with average risk and high risk of breast cancer, respectively. This article aims to interpret the above guideline, providing references for professionals in breast cancer screening.

The traditional proportional hazard model is commonly used to investigate the association between main outcome and predictor variables. However, the endpoints in medical studies are often not unique. The analyses of labeling other competing outcomes other than the main outcome as censored data will theoretically lead to a biased estimate of the risk of main outcome. Although the traditional competitive risk model can adjust the influence of other outcomes on the risk of the main outcome, it can not directly compare the differences on the risks of different outcomes. The multi-state competing risk model provides a relatively suitable solution for this problem. In this study, based on a previously published follow-up data set for prostate cancer patients, we developed traditional proportional hazard model, traditional competitive risk model, and multi-state competing risk model, respectively. By comparing the advantages and disadvantages of the three models with the same survival data, we clarified the clinical application value of the multi-state competitive risk model in survival data with multiple outcomes.

The traditional proportional hazard model is commonly used to investigate the association between main outcome and predictor variables. However, the endpoints in medical studies are often not unique. The analyses of labeling other competing outcomes other than the main outcome as censored data will theoretically lead to a biased estimate of the risk of main outcome. Although the traditional competitive risk model can adjust the influence of other outcomes on the risk of the main outcome, it can not directly compare the differences on the risks of different outcomes. The multi-state competing risk model provides a relatively suitable solution for this problem. In this study, based on a previously published follow-up data set for prostate cancer patients, we developed traditional proportional hazard model, traditional competitive risk model, and multi-state competing risk model, respectively. By comparing the advantages and disadvantages of the three models with the same survival data, we clarified the clinical application value of the multi-state competitive risk model in survival data with multiple outcomes.

Screening has been always considered as a double-edged sword. Cancer screening could save lives in some cases, however, in other cases, it might also turn people into overdiagnosis. Overdiagnosis is the diagnosis of cancer that will never cause symptoms or death during a patient's lifetime. Therefore, overdiagnosis might lead to unnecessary treatments and lifetime surveillance, and then increase economic burden and psychological burden. In this review, we focus on how to correctly evaluate the overdiagnosis rate, and how to avoid or reduce the harms caused by overdiagnosis in the future according to the reasons associated with overdiagnosis. After systematically reviewing the previous studies, we will try to identify the potential reasons associated with overdiagnosis in breast cancer screening with mammography, address how to correctly evaluate the overdiagnosis rate, and finally provide some suggestions to reduce the overdiagnosis.