By reviewing the latest published papers on palliative care, the article discussed the development and research progress of palliative care for people with advanced cancer, so as to provide reference for the development of palliative care specialty. According to the analysis, it suggested that by means of striving for more government support in both economic and education, raising funds through various channels, perfecting the social insurance system and volunteer′s regimen, promoting group working model, establishing standardized policies and regulations, increasing the publicity of palliative care, palliative care would move forward to a professional and normalized road, so that the people with incurable disease will receive better palliative care to improve the quality of life to the most.

Breast cancer has become the most common malignant tumor and the major cause of cancer-related death for women around the world. The number of patients shows an increasing trend recently. Breast cancer is a big threaten to wom?en’s health and quality of life. With the development of molecular biology, molecular biomarkers have been found assiciated with prognosis in patients with breast cancer, which makes it possible to predict cancer patient survival precisely and practi?cally. This review summarized those new developments of biomarkers on the prognosis of breast cancer.

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.

Objective To investigate the trends in incidence and mortality of esophageal cancer from 1981 to 2002 in Tianjin,China and to predict future trends and facilitate future prevention.Methods All new cancer cases registered in the Tianjin Cancer Registry between 1981 and 2002 were reviewed.Yearly age-specific,crude and age-adjusted incidence rates were calculated for males and females.Secular trends of incidence and mortality were indicated by the estimated annual percentage change(EAPC).Results A total of 8206 cases of esophageal cancer were reported in Tianjin form 1981 to 2002,with 5533 males and before 45 years,but increased rapidly after 45 years.The median age of esophageal cancer cases was 69 years,with quartile range from 62 to 75 years.The peak for age specific incidence in females was 75-80 years,which was earlier than that in males(aged 80-85).But recent data indicated that the peak age in females had increased and became similar to that of the males.The crude and age-standardized incidence rates(ASIR)of esophageal cancer decreased in last 22 years.For male and female,crude incidence decreased by 2.22% and 3.56% per year and ASIR decreased by 5.18% and 6.56% per year.The mortality of esophageal cancer decreased in the last 22 years.Conclusion The incidence of esophageal cancer decreased in the last 22 years in Tianjin,but there is little overall improvement in survival.

Objective To analyze the genotypes and homology of MSP?1 and CSP gene of Plasmodium vivax in Shandong Province,so as to provide the evidence for case traceability. Methods A total of 12 blood samples were collected from P. vivax?infected cases in Shandong Province in 2011. Parasite genomic DNA was extracted. Primers were designed according to MSP?1 and CSP gene sequences of P. vivax. Then Nested PCR,enzyme digestion,sequencing and sequence alignment,and homolo?gous analysis were performed. Results The MSP?1 gene of all the 12 samples from P. vivax?infected cases were detected with a 470 bp PCR amplification band,and 350 bp and 120 bp enzyme digestion fragments,which were identified as type Sal?1. An analysis of phylogenetic tree of MSP?1 gene showed that the sequences of 9 indigenous case samples in Shandong Province were located in the same branch,one case sample infected from India was located in the same branch with India strains. All the 12 P. vivax?infected samples covered GDRA(D/A)GQPA sequences in CSP gene,which were identified as type PV?Ⅰ. Of the CSP gene among 12 P. vivax?infected samples,10 samples of indigenous case in Shandong Province and one sample of the case in?fected in Guangdong Province were detected with both 560-840 bp and 150-230 bp PCR amplification bands,which were iden?tified as temperate zone family strain of type PV?Ⅰ. However,one sample from the case infected in India was detected only with a 560-840 bp band,which was identified as tropical zone family strain of PV?Ⅰ. An analysis of phylogenetic tree of CSP gene showed that the sequences of 10 samples from the indigenous cases in Shandong Province and one sample from the case infected in Guangdong Province were located in the same branch,one sample from the case infected in India was located in the same branch with India and Indonesia strains. Conclusion Of all the indigenous isolates in Shandong Province,MSP?1 gene is geno?typed type Sal?1,CSP gene is genotyped temperate zone family strain of type PV?Ⅰ,with a high homology found among the in?digenous isolates.

Objective To investigate and analyze consistency in attitudes toward advance directive and life sustaining treatments between cancer patients and their family members.Methods Totally 242 pairs of cancer patients and family members were involved in the research through convenience sampling from two tertiary hospitals.We investigated consistency in attitudes toward advance directive and life sustaining treatments between cancer patients and their family members using questionnaire of attitudes toward advance directive.Results After explanation of advance directive,51.65％ of cancer patients would like to make advance directive.Most of the family members(89.26％) said they would like to follow patients' wishes if they made advance directive.The consistency in attitudes toward advance directive between cancer patients and their family members were "willing" accounting 48.35％,and "not willing" accounting for 1.65％,with weak consistency(Kappa value was 0.05,P＞0.05).The consistency in attitudes toward life sustaining treatments between cancer patients and their family members were "willing" accounting for 16.94％～38.84％,"not willing" accounting for 1.65％～4.96％,and "never considered" accounting for 9.92％～17.77％,with weak consistency(Kappa value was 0.09-0.18,P＜0.05).Conclusion Cancer patients and their family members show positive attitudes toward advance directive without too many differences.Family members' choices on life sustaining treatments cannot fully represent patients' wishes.

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.

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.

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.