Objective To investigate the current situation of community health service requirements and health-seeking behaviors of the elderly in Yuzhong District of Chongqing City and analyse its mainly influencing factors,in order to provide references for further promoting hierarchical medical pattern.Methods A total of 410 elderly persons aged 60 year old or older treated in four community health service centers in Yuzhong district of Chongqing city in June 2015 were recruited by using multi-stage random sampling technique.The basic information about demography,cognitions and requirements of community health service,cost of health service and health-seeking behaviors were surveyed via questionnaire,and were analysed.Results A total of 402 effective questionnaires were returned,and the effective response rate was 98.05％.There were 76.37％ of elderly persons firstly selected community health service centers for disease treatment.The main factors affected health-seeking behaviors of the elderly were suffering from the coronary heart disease,the waiting time in community health service centers,the medical costs per month,facilities and environment of the community health service centers and whether to pay for health insurance.Conclusion Community health centers should make full use of their own advantages and convenience.It is necessary to provide characteristic services for the corresponding elderly patients,and increase the public health input.All of these are intended to raise the synthesized level of diagnosis and treatment in community health service centers,and change health-seeking behaviors of elderly patients fundamentally.

Objective To explore the correlation between TOP2A gene expression and TCM constitutional types of patients with triple-negative breast cancer.Methods The questionnaire for constitution of Chinese medicine was used to identify the TCM constitutional types of 71 patients with triple-negative breast cancer and TOP2A gene alterations were quantified by real-time PCR. 2-ΔΔCt was used to analyze the expressions of each group. SPSS17.0 was employed to analyze the correlation between TOP2A gene amplification and TCM constitutional types.Results Totally 71 patients were divided into general type (0 case), Qi deficiency type (18 cases), Yang deficiency type (10 cases), Yin deficiency type (12 cases), Qi stagnancy type (7 cases), blood stasis type (10 cases), phlegm wet calculus type (8 cases), damp-heat type (6 cases), and special type (0 case). All of them were biased constitutional types, of which Qi deficiency constitution (25.35%), Yin deficiency constitution (16.90%), blood stasis constitution (14.08%) took the majority. TOP2A gene amplification was negative correlated with each constitutional type (P<0.05).Conclusion Biased constitutional types were the main types of TCM constitutional type of patients with triple-negative breast cancer. The main three biased constitutional types of triple-negative breast cancer were Qi deficiency constitution, Yin deficiency constitution and blood stasis constitution. TOP2A gene expression in patients with triple-negative breast cancer was normal or less expressed, which predicted low chemotherapy sensitivity and poor prognosis.

Objective To investigate the feasibility of a rat carotid atherosclerosis model induced by artery clamping with high-cholesterol diet and vitamin D3.Methods Twenty Wista rats were randomly divided into either a general diet group (n =5) or a high cholesterol diet group (n =15).After clamping the right common carotid arteries of the rats in the high cholesterol diet group,they were fed with high fat diet,and vitamin D3 (600 000 IU/kg) was injected intraperitoneally.The lipid levels of the general diet group and the high cholesterol diet group were detected at 6 and 12 weeks respectively.The bilateral cormmon carotid arteries were selected for preparing paraffin sections and were stained with HE staining.The pathological changes in blood vessels were observed.Results The levels of serum total cholesterol at 12 weeks (2.803 ± 1.307 mmol/L vs.1.513 ±0.281 mmol/L; P=0.017) and low-density lipoprotein cholesterol (0.660± 0.260 mmol/L vs.0.311 ±0.078 mmol/L; P =0.003) in the high-cholesterol diet group were significantly higher than those at 6 weeks.The histopathological examination showed that the common carotid artery intimas on the clamping sides were incomplete,the foam cell deposition was observed under intima,the atherosclerotic plaques or fibrous plaques were observed on the surface of cavity,inside the plaques contained necrotic tissue,and thrombosis was observed in the cavity.The common carotid artery intima-media thickness in the general diet group (n =5) at 12 weeks was 8.3 ± 1.1 μm.The sham-operated sides (n =20) and clamping sides (n =20) were 8.8 ± 0.7 μm and 97.4 ±25.7 μm,respectively.There were significant differences among the three groups (F =116.313,P=0.000).The clamping sides in the high-cholesterol diet group were significantly higher than the shamoperated sides in the high-cholesterol diet group (P=0.000) and the general diet group (P =0.000).Conclusions Common carotid artery clamping with high-cholesterol diet and vitamin D3 is a simple and feasible method for inducing a rat carotid atherosclerosis model.

Lung cancer has the highest morbidity and mortality among malignant tumors in our country.The treatment researches related to non-small cell lung cancer (NSCLC) such as targeted therapy and immunotherapy are the research hotspots in recent years.Nivolumab is the first programmed death-1 (PD-1)inhibitor which is allowed to enter clinical trials,and it is also the first approved drug for tumor immunotherapy in China.In June 2018,Nivolumab injection was marketed in China,and it was used in the second-line treatment for the patients with advanced NSCLC,opened up a new era of the lung cancer treatment in our country.Review the clinical research related to the Nivolumab and NSCLC,summarizing usage,dosage,adverse reactions,will provide a help for clinical application,bring more benefits for patients at the same time.

Objective To study the relationship between preoperative serum a-fetoprotein (AFP) level and early recurrence of patients with hepatocellular carcinoma (HCC) after partial hepatectomy.Methods 267 patients with hepatocellular carcinoma who underwent partial hepatectomy in Xijing Hospital,the Fourth Military Medical University from January 2011 to November 2015 were retrospectively studied.The patients were divided into the AFP-negative group (AFP ≤20 μg/L) and the AFP-positive group (AFP ＞ 20 μg/L) according to the preoperative serum AFP levels.The risk factors of early recurrence of HCC in patients after partial hepatectomy were studied by multivariate regression analysis.The recurrence-free survival rates during 24 months after surgery between the AFP-negative group and the AFP-positive group were compared.Results In 267 patients,97 patients had low or negative AFP levels (AFP≤20 μg/L) and 170 patients had high or positive AFP levels (AFP ＞ 20 μg/L).Patients in the AFP-positive group had significantly more well differentiated HCC on tumor histology when compared with patients in the AFP-negative group (x2 =17.050,P ＜ 0.05).The proportion of patients with liver cirrhosis in the AFP-positive group was significantly higher than that of the AFP-negative group (x2 =4.374,P ＜ 0.05).On the other hand,the numbers of patients with adjacent tissue invasion (x2 =4.374,P ＜ 0.05) and early HCC recurrence (x2 =7.595,P ＜ 0.05) in the AFP-positive group were significantly less than those of the AFP-negative group.Survival analysis showed that the recurrence-free survival rates in the AFP-positive and negative groups were 35.3％,52.6％,respectively.The results on univariate analysis showed that portal vein tumor thrombus,HBsAg positivity,tumor number,tumor diameter,tumor tissue differentiation,preoperative serum AFP level and adjacent tissue invasion were significantly associated with early recurrence of liver cancer (P ＜ 0.05).Cox multivariate regression analysis revealed that serum AFP positivity (HR =1.605,P ＜ 0.05),portal vein tumor thrombosis (HR =3.936,P ＜ 0.05),HBsAg positivity (HR =1.621,P ＜0.05),tumor diameter (HR =1.977,P ＜ 0.05) and tumor number (HR =1.991,P ＜ 0.05) were significantly correlated with early recurrence of liver cancer after partial hepatectomy.Conclusion The preoperative serum AFP level had an important predictive value for early recurrence of primary hepatocellular carcinoma in patients after partial hepatectomy.

Objective:To observe the toxic and side effects of TCM syndrome differentiation and treatment combined with abemaciclib and endocrine drugs in the treatment of hormone receptor ( HR ) positive and human epidermal growth factor receptor 2 ( HER2 ) negative advanced breast cancer and the dose of abemaciclib under the influence of toxic and side effects.Methods:Patients with HR+/HER2- advanced breast cancer who received TCM combined with abemaciclib and endocrine therapy in Beijing Hospital of Traditional Chinese Medicine, Capital Medical University from March 2021 to February 2023 were selected, and the relevant data of East Asian population in MONARCH 2 and MONARCH 3 of abemaciclib random phase Ⅲ clinical study were extracted for retrospective cohort study. The TCM exposure cohort was divided into 20 cases of TCM + abemaciclib + fulvestrant group (EXP 1) and 22 cases of TCM + abemaciclib + aromatase inhibitor (AI) group (EXP 2). The East Asian populations in MONARCH 2 and 3 were non-exposed cohorts, which were divided into NEXP 1 group ( 146 cases ) and NEXP 2 group (102 cases). The safety analysis of the 2 cohorts was carried out, and the reduction and termination of abemaciclib taken by patients under the influence of toxic and side effects were counted.Results:①There were significant differences in CTCAE any grade, grade 2 ( χ2 values were 8.11, 4.59, respectively ) between EXP 1 group and NEXP 1 group, as well as in CTCAE any grade ( χ2=18.57) between EXP 2 group and NEXP 2 group compare the incidence rate of diarrhoea ( P<0.05 or P<0.01). There was significant differences in CTCAE ≥ grade 2 EXP 1 group compare the incidence rate of diarrhoea ( χ2=5.56, P=0.02). The incidence of grade ≥ 3 neutropenia in EXP 1 was [ 5 cases (27.78%) ] and in EXP 2 was [ 2 cases (13.33%)]. There were 65 cases (44.52%) in NEXP 1 and 30 cases (29.41%) in NEXP 2, and the exposed cohort were lower than those in the non-exposed cohort. The increase of GPT, GOT and SCr in the exposed cohort were lower than those in the non-exposed cohort. ② Compared with the non-exposed cohort, the first occurrence time of diarrhea and neutropenia was prolonged and the duration was shortened in the exposed cohort. ③ The patients in the exposed cohort were less likely to take abemaciclib reduction and discontinuation due to diarrhea, neutropenia, impaired liver function, and elevated SCr than those in the non-exposed cohort. Conclusion:TCM syndrome differentiation and treatment combined with abemaciclib and endocrine drugs is safe in the treatment of HR+/HER2- advanced breast cancer, which can effectively prevent and treat the toxic and side effects caused by abemaciclib, and reduce the drug reduction and discontinuation.

Objective:To summarize the clinical data and experience of pure single-port lumpectomy non-lipolysis breast-conserving surgery (PSLN-BCS) in patients with early-stage breast cancer.Methods:A retrospective analysis was conducted on 400 patients who underwent breast-conserving surgery for early-stage breast cancer in the Second Department of Breast Surgery at Harbin Medical University Cancer Hospital from Jan. 2022 to Jan. 2023. Patients were divided into two groups: PSLN-BCS group ( n=200) and conventional breast-conserving surgery (C-BCS) group ( n=200). The surgical time, intraoperative blood loss, postoperative drainage within three days, and short-term (3 months to 6 months after surgery) complications, including the incidence of residual fluid after drain removal and incision infection were observed. Long-term (6 months after surgery) complications, including the incidence of skin and pectoralis major muscle adhesions in the surgical area and cosmetic results after breast-conserving surgery, were also evaluated. Statistical analysis was performed using R language, and quantitative data were expressed as mean ± standard deviation ( ± s) and analyzed using t-test, while count data were analyzed using χ2 test. A p-value less than 0.05 was considered statistically significant. Results:PSLN-BCS had a longer average surgical time than C-BCS (198.341min vs 62.961min, P<0.001, 95% CI:132.028 vs 138.732). PSLN-BCS had less intraoperative bleeding (18.824 ml vs 22.627 ml, P=0.003, 95% CI: -6.294 vs -1.311) and lower postoperative drainage volume (346.157 ml vs 406.191 ml, P<0.001, 95% CI: -70.571-a-49.496). There were no significant differences in short-term postoperative complications such as subcutaneous fluid accumulation ( χ2=2.33, P=0.127) or incisional infection ( χ2=0.14, P=0.708) between the two groups. The incidence of skin and muscle adhesions in the surgical area was lower in patients who underwent PSLN-BCS at 6 months postoperatively ( χ2=11.58, P<0.001). Patients who received PSLN-BCS achieved better cosmetic outcomes, with a statistically significant difference ( χ2=273.00, P<0.001) compared to those who received C-BCS. Conclusion:Pure single-port lumpectomy non-lipolysis breast-conserving surgery is a safe and effective treatment option for early-stage breast cancer and can be considered as a surgical option for patients with cosmetic requirements.

Objective:To observe the effect of CoCl2on the cisplatin sensitivity of human ovarian cancer SKOV3cells, and to clarify the possible mechanism.Methods:The SKOV3cells were cultured in vitro and randomly divided into control group, CoCl2 group, cisplatin (DDP) group and CoCl2 combined with DDP (combination) group.The cells in CoCl2group were cultured in normal cell medium for 20hafter cultured in 200μmol·L-1 CoCl2for 4h, the cells in DDP group were cultured in normal cell medium containing 10mg·L-1 DDP for 24h, and the cells in combination group were cultured in 10mg·L-1 DDP for 20hafter cultured in 200μmol·L-1 CoCl2for 4h.The survival rates of SKOV3cells in various groups were detected by MTT method, and the positive expression intensities of hypoxia-inducible factor-1α (HIF-1α) and inducible nitric oxide synthase (iNOS) in the cells in various groups were detected by immunofluorescence method.Rhod 2-AM fluorescence probe was used to observe the levels of Ca2+in mitochondria in the cells in various groups.Western blotting method was used to observe the expression levels of cytochrome C (cyto C) , cysteinyl aspartase 3 (caspase 3) and cleaved cysteinyl aspartase 3 (cleaved caspase 3) .Muse○R apoptosis assay kit was used to detect the apoptotic rates of cells in various groups.Results:Compared with control group, the survival rate of the cells in CoCl2group had no significant change (P＞0.05) , and the survival rates of the cells in DDP and combination groups were decreased (P＜0.05) ;the survival rate in combination group was higher than that in DDP group (P＜0.05) .Compared with control group, the positive expression intensities of HIF-1αin CoCl2and combination groups were increased (P＜0.05) .Compared with control group, the positive expressions of iNOS in DDP and combination groups were increased (P＜0.05) .The Ca2+levels in the cells in DDP group and combination groups were higher than that in control group (P＜0.05) and the Ca2+level in DDP group was higher than that in combination group (P＜0.05) .Compared with control group, the expression levels of cyto C, caspase 3and cleaved caspase 3proteins in the SKOV3cells in CoCl2group had no significant changes (P＞0.05) , and the expression levels of cyto C, caspase 3and cleaved caspase 3in DDP group were increased significantly (P＜0.05) ;compared with DDP group, they were lower than those in combination group (P＜0.05) .Compared with control group, the apoptotic rate of SKOV3cells in DDP group was increased significantly (P＜0.05) ;the apoptotic rate of SKOV3cells in combination group was lower than that in DDP group (P＜0.05) .Conclusion:CoCl2can redece the mitochondrial apoptosis of human ovarian cancer SKOV3cells by inhibiting the DDP-induced enhancement of iNOS expression and decrease the sensitivity of SKOV3cells to cisplatin.

Objective:To understand the performance of public health risk assessment in emergencies of institutions for disease control and prevention at different levels in China, and provide suggestions for the improvement of public health risk assessment.Methods:A self-administered survey was conducted in professionals involved in public health risk assessment in emergencies from national institution, provincial institutions and some prefectural institutions for disease control and prevention (1-2 prefectural institutions were selected using convenience sampling in each province) between March and April in 2021.Results:A total of 79 institutions for disease control and prevention were investigated, including 1 national institution, 32 provincial institutions and 46 prefectural institutions. By April 2021, all the 79 institutions surveyed had conducted risk assessment of public health emergencies, in which 61 (77.2%) had established departments responsible for the public health risk assessment, i.e. emergency management office or communicable disease prevention and control office (section), and regular risk assessment mechanisms. The main sources of information for public health risk assessment were public health surveillance systems, including the National Notifiable Diseases Reporting System (100.0%) and Public Health Emergencies Management Information System (97.5%). Compared with the provincial institutions, the prefectural institutions were more likely to use specific disease surveillance systems (84.8% vs. 62.5%; χ2=5.09, P=0.024). The risk management recommendations made by 43 institutions for disease control and prevention (54.4%) after the risk assessment were accepted by the superior health administrative departments and used in epidemic prevention and control. Conclusions:Public health risk assessment in emergencies has been widely carried out by national, provincial and prefectural institutions for disease control and prevention in China. Specialized departments and mechanisms have been established, but the information sources are still confined to public health surveillance systems and the application of the risk assessment results still needs to be further improved.

Objective:To investigate the occurrence of catheter fracture in totally implantable venous access ports (TIVAP) and analyze its influencing factors.Methods:A retrospective nested case-control study was used to establish a cohort of 3 517 patients with TIVAP and infusion port maintenance in Affiliated Hospital of Qingdao University from January 2012 to December 2021, and they were divided into the fracture group and the control group. The general information questionnaire, TIVAP Catheter Fracture Related Factors Questionnaire and TIVAP Catheter Fracture Clinical Characteristics Questionnaire were used to collect general and clinical data of patients in two groups. The risk factors of TIVAP catheter fracture were analyzed by Logistic regression.Results:The incidence of TIVAP catheter fracture was 0.6% (21/3 517) . Logistic regression analysis showed that the operator's experience of placing ports, whether the patient performed TIVAP maintenance regularly, time for patients carrying the infusion port and whether TIVAP were repeatedly blocked were influencing factors for the occurrence of catheter fracture in TIVAP.Conclusions:Nursing staff should fully understand the risk factors of TIVAP catheter fracture, identify high-risk groups in the early stage and carry out targeted nursing interventions to reduce the incidence of TIVAP catheter fracture.