Objective:Until recently, no consensus has been reached about the treatment of primary tumor in patients with meta-static breast cancer, and whether or not to excise it has not yet reached agreement. This study aimed to evaluate the value of surgical and nonsurgical treatment of primary tumor by analyzing the clinical data of patients with metastatic breast cancer. Methods:This re-view includes the data of 120 metastatic breast cancer patients. Their clinical data in Xiangyang Central Hospital (Hubei province) from January 2005 to December 2012 were collected. All cases were divided into surgical and nonsurgical groups, and the overall survival and symptomatic local progression rates were analyzed. Results:The 120 patients had a median follow-up of 52 months (range=10-92 months). A total of 55 cases were in the surgical group, 30 of whom had surgery before the metastatic diagnosis, and 65 cases were in the nonsurgical group. No significant differences were observed regarding the tumor classification, lymph-node classification, and meta-static site of the tumor in the two groups. Patients in the surgical group experienced longer overall survival (49 months vs. 33 months, P=0.016) and lower rates of symptomatic local progression (14.5%vs. 46.2%, P<0.001). Conclusion:This study demonstrated that the overall survival and symptomatic local control in the surgical group were better than those in the nonsurgical group. However, this hy-pothesis remains to be proved by multicenter clinical trials.

Objective:To understand the overall satisfaction rate with vaccination services in parents of children, and the impact of additional time consumed for vaccination service on overall satisfaction rate.Methods:From December 2019 to January 2020, a total of 3 178 parents of 0-3 years old children were investigated to collect the information about their basic characteristics, additional time spent for vaccination service and overall satisfaction through questionnaires. Binary logistic regression model and restricted cubic spline model were used to evaluate the impact of additional time spend on the overall satisfaction rate.Results:The overall satisfaction rate of parents with vaccination services was 92.32%. The median time for parents to move from home to vaccination clinic was 10.00 (10.00, 20.00) minutes, the median waiting time to make an appointment was 10.00 (5.00, 15.00) minutes, the median waiting time for vaccination was 5.00 (3.00, 10.00) minutes, and the median total additional time spent was 30.00 (20.00, 45.00) minutes. The binary logistic regression analysis showed that after adjusting the relevant factors, the main factors affecting the overall satisfaction rate were the waiting time for making an appointment (the 4- minutes group vs. 8- minutes group: OR=1.863, 95% CI: 1.307-2.657), waiting time for vaccination (the <4 minutes group vs. 8- minutes group: OR=1.529, 95% CI: 1.102-2.120; the 4- minutes group vs. 8- minutes group: OR=1.534, 95% CI: 1.104-2.130), total additional time spent (the 15- minutes group vs. 30- minutes group: OR=1.470, 95% CI: 1.094-1.976). Restricted cubic spline analysis showed that the waiting time for making an appointment (non-linear: χ2=13.18, P=0.001), the waiting time for vaccination (non-linear: χ2=13.50, P=0.001), and the total additional time consumed (non-linear: χ2=9.38, P=0.009) showed a non-linear inverted "V" dose response relationship to the overall satisfaction of vaccination services. Conclusions:The waiting time for parents to make an appointment, the waiting time for vaccination and the total additional time spent for receiving vaccination services affected the overall satisfaction rate of the vaccination services. And the waiting time for making an appointment was the most important factor, and it is necessary to shorten the waiting time for appointment. It is suggested that the vaccination clinic should make use of information technology (such as WeChat public account, APP) to make accurate appointments, make appointments to the time period to control the number of people within time period.