ObjectiveTo study the relationship between EphA2 and laryngeal carcinoma angionegesis.MethodsImmunohistochemical staining was used to determine the expression of EphA2 and CD34 in 20 normal squamous epithelium tissues and 50 laryngeal carcinoma.The relationship between EphA2 expression and Microvascular density was analyzed bg Spearman correlation and linear regression.ResultsThe MVD in laryngeal carcinoma (54.89 ± 13.67) was significantly higher than that in normal squamous epithelial tissues ( 17.15 ± 5.21 ) ; The EphA2 in laryngeal carcinoma(4.56 ± 1.38) was significantly higher than that in normal squamous epithelial tissues ( 2.49 ± 1.23 ) ( t =16.721,5.847,all P ＜ 0.05 ).There was significant positive linear correlation between EphA2 and MVD in laryngeal squamous cell carcinoma(P ＜ 0.01 ).ConclusionEphA2 may correlate with angionegesis in laryngeal squamous cell carcinoma.

Objective To investigate the expression and correlation of cell cycle protein-D1 and Ki-67 in laryngeal cancer tis-sues.Methods Immunohistochemical streptavidin-perosidase ( SP) staining method was used to detect the expression of Cyclin D 1 and Ki-67 proteins in laryngeal squamous cell carcinoma tissues and their correlation between Cyclin D 1 and Ki-67 was analyzed .Re-sults Among 56 cases of Cyclin D1 positive over-expressed laryngeal squamous cell carcinoma tissues , 41 cases of Ki-67 had positive over-expression.Among 51 cases of Ki-67 low-expressed tissues, 35 cases of Cyclin D1 had low-expression.Spearman rank correlation test showed that expressions of Cyclin D 1 and Ki-67 in laryngeal squamous cell carcinoma tissues had a significant positive correlation ( rs =0.620, P <0.01).Conclusions Cyclin D1 and Ki-67 expressions in laryngeal squamous cell carcinoma have a significantly positive correlation .

The study introduced the general evaluation indicator system for community health services in Shanghai and its characteristics,analyzing the results of the comprehensive evaluation from the aspects of regions and institutions.From six aspects of financial input,human resource construction, operation mechanism,family doctor system,information system construction and the application of the comprehensive evaluation results,the paper recommended on deepening the reform of community health services.

ObjectiveTo assess the effectiveness of tele-medicine and self-management goal(SMG) setting technique used in the diabetes management in the community setting.Methods It is a control-group study.415 type 2 diabetic residents were recruited from the Shanghai Wuliqiao community based on existing medical records.The subjects were divided into two groups,the study group was cared by general practitioners (GPs) specialists cooperation through the tele-medicine mechanism,the other was a control group.For the study group,a cooperation pathway between community health care centers and general hospitals were established.Standardized training and guidelines were provided to community health workers,regarding the setting of management goals of blood glucose and blood pressure,treatment plan,patient education,and SMG techniques.Fasting blood glucose ( FBG ) and 2 h postprandial blood glucose (2hBG) in the study group were monitored,followed by community health workers visiting monthly with seminars for diabetes education.At the baseline and the 12tb month,FBG,2hBG,HbA1C,blood pressure,triglyceride,total cholesterol,body mass index,waist-hip ratio were determined in each group.A survey was conducted to evaluate the costs of diabetes treatments,the knowledge base related to their disease,lifestyle,and the awareness of the new care model.The rates of achieving the goal of blood glucose,blood pressure,and HbA1Ccontrol were calculated.Internet case discussion between GPs-Specialists and referral to certain specialists were implemented when some patients did not reach the control goal.ResultsBy the 12 month follow up,FBG,2hBG,HbAIc,blood pressure of the study group were lower than the baseline,and as well as the control group with statical significance (P＜0.05).There are other improvcments:diabetes knowledge (29.1％ vs 5.5％ ),healthy diet (9.6％ vs -10.4％ ),blood glucose monitoring (30.3％ vs 10.8％ ),support for diabetes care in community (35.7％ vs 9.4％ ),and the preference of the new model (63.8％ vs 17.9％ ) with statistical significauce (P＜0.01 ).As for the medical costs,the study group's monthly costs were consistently lower than the control's.( -3.39Yuan vs 32.26 Yuan,P＜0.05).ConclusionsThe new diabetes care model based on GPs-Specialists tele-medicine and SMG in community opens the door to the community based care model formulation in regard to the health quality and costs control.The deployment of more technologies and management techniques could be explored further to improve the outcomes of community based chronic disease care model.

OBJECTIVETo evaluate the cost-effectiveness of two breast cancer screening modalities conducted in Minhang district of Shanghai, China.

METHODSAn organized and an opportunistic breast screening programs were implemented among women aged 35-74 years in Minhang district of Shanghai between May 2008 and Oct 2010, and were compared with the results obtained without screening. Costs related to screening were obtained by access to finance data of the screening programs, and costs of first treatment were collected through patient survey and medical reimbursement system query. Information on breast cancer stage was obtained from Shanghai Cancer Registry and confirmed by medical chart review. The effectiveness of screening was evaluated by breast cancer stage improvement.Cost-effectiveness ratios (CERs) were computed as costs of gaining a stage improvement from a specified screening strategy when compared with the results obtained without screening. Incremental cost-effectiveness (ICER) which compares the two screening strategies was calculated by dividing the difference in total net costs and the difference in stages improved between the two screening strategies.

RESULTSThirty-five, one hundred and ninety-three and four hundred and seventy-nine breast cancer cases were identified in the organized screening, opportunistic screening and control groups, with an early detection rate of 46.9%, 40.7% and 38.9%, respectively. The costs of screening were 208 yuan per person or 72 453 yuan per case detected in the organized screening group and were 21 yuan per person or 11 640 yuan per case detected in the opportunistic screening group. The total cost was 103 650 yuan per case in the organized screening group, significantly higher than 50 712 yuan in the opportunistic screening group and 35 413 yuan in the control group. However, the average direct medical cost was significantly lower in the organized screening group than that in the opportunistic screening group and control group, with median costs of 11 024 yuan, 13 465 yuan and 14 243 yuan per case, respectively (P<0.001). The additional cost per case detected was 68 237 yuan for the organized screening and 15 299 yuan for opportunistic screening. The CERs were 135 291 yuan and 152 179 yuan per stage improved in the organized screening and opportunistic screening relative to the control group, with ICER of organized versus opportunistic screening being 131 086 yuan per stage improved.

CONCLUSIONSThe organized screening modality and the opportunistic one are both effective in early detecting breast cancer in Chinese women. The organized screening costs more than opportunistic screening, but with a better cost-effectiveness. It may be used as an option in economically developed areas of China.

Adult ; Aged ; Breast Neoplasms ; diagnosis ; pathology ; China ; Cost-Benefit Analysis ; Early Detection of Cancer ; economics ; Female ; Humans ; Mass Screening ; economics ; Middle Aged ; Program Development ; economics ; Surveys and Questionnaires

Objective:To explore the health economic evaluation methods of disease screening,providing insights for scholars conducting related research.Methods:By integrating relevant content from modem epidemiology,health statistics,and health economics,it investigates the differences in conducting health economic evaluations of disease screening using authenticity indicators(sensitivity,specificity)and predictive value indicators(positive predictive value,negative predictive value),and combines empirical studies with cases from the literature.Results:Authenticity indicators(sensitivity,specificity)are intrinsic measures of diagnostic tests,unaffected by the disease prevalence in the sample population,making them more suitable for conducting health economic evaluations of disease screening.Moreover,authenticity indicators are easy to obtain,and the model calculations are straightforward and convenient.Case study results demonstrate that compared to risk score screening,the Incremental Cost-Effectiveness Ratio(ICER)of fasting plasma glucose(FPG)testing for type 2 diabetes is 626,indicating that for every additional diabetic patient identified through risk score screening,an extra 626 yuan is spent.Conclusion:It is recommended to use authenticity indicators for conducting health economic evaluations of disease screening,standardize the path methods for model selection,and continuously improve the evidence quality of health economic evaluations of disease screening in China.

Objective:To explore the health economic evaluation methods of disease screening,providing insights for scholars conducting related research.Methods:By integrating relevant content from modem epidemiology,health statistics,and health economics,it investigates the differences in conducting health economic evaluations of disease screening using authenticity indicators(sensitivity,specificity)and predictive value indicators(positive predictive value,negative predictive value),and combines empirical studies with cases from the literature.Results:Authenticity indicators(sensitivity,specificity)are intrinsic measures of diagnostic tests,unaffected by the disease prevalence in the sample population,making them more suitable for conducting health economic evaluations of disease screening.Moreover,authenticity indicators are easy to obtain,and the model calculations are straightforward and convenient.Case study results demonstrate that compared to risk score screening,the Incremental Cost-Effectiveness Ratio(ICER)of fasting plasma glucose(FPG)testing for type 2 diabetes is 626,indicating that for every additional diabetic patient identified through risk score screening,an extra 626 yuan is spent.Conclusion:It is recommended to use authenticity indicators for conducting health economic evaluations of disease screening,standardize the path methods for model selection,and continuously improve the evidence quality of health economic evaluations of disease screening in China.

Objective:To explore the health economic evaluation methods of disease screening,providing insights for scholars conducting related research.Methods:By integrating relevant content from modem epidemiology,health statistics,and health economics,it investigates the differences in conducting health economic evaluations of disease screening using authenticity indicators(sensitivity,specificity)and predictive value indicators(positive predictive value,negative predictive value),and combines empirical studies with cases from the literature.Results:Authenticity indicators(sensitivity,specificity)are intrinsic measures of diagnostic tests,unaffected by the disease prevalence in the sample population,making them more suitable for conducting health economic evaluations of disease screening.Moreover,authenticity indicators are easy to obtain,and the model calculations are straightforward and convenient.Case study results demonstrate that compared to risk score screening,the Incremental Cost-Effectiveness Ratio(ICER)of fasting plasma glucose(FPG)testing for type 2 diabetes is 626,indicating that for every additional diabetic patient identified through risk score screening,an extra 626 yuan is spent.Conclusion:It is recommended to use authenticity indicators for conducting health economic evaluations of disease screening,standardize the path methods for model selection,and continuously improve the evidence quality of health economic evaluations of disease screening in China.

Objective:To explore the health economic evaluation methods of disease screening,providing insights for scholars conducting related research.Methods:By integrating relevant content from modem epidemiology,health statistics,and health economics,it investigates the differences in conducting health economic evaluations of disease screening using authenticity indicators(sensitivity,specificity)and predictive value indicators(positive predictive value,negative predictive value),and combines empirical studies with cases from the literature.Results:Authenticity indicators(sensitivity,specificity)are intrinsic measures of diagnostic tests,unaffected by the disease prevalence in the sample population,making them more suitable for conducting health economic evaluations of disease screening.Moreover,authenticity indicators are easy to obtain,and the model calculations are straightforward and convenient.Case study results demonstrate that compared to risk score screening,the Incremental Cost-Effectiveness Ratio(ICER)of fasting plasma glucose(FPG)testing for type 2 diabetes is 626,indicating that for every additional diabetic patient identified through risk score screening,an extra 626 yuan is spent.Conclusion:It is recommended to use authenticity indicators for conducting health economic evaluations of disease screening,standardize the path methods for model selection,and continuously improve the evidence quality of health economic evaluations of disease screening in China.

Objective:To explore the health economic evaluation methods of disease screening,providing insights for scholars conducting related research.Methods:By integrating relevant content from modem epidemiology,health statistics,and health economics,it investigates the differences in conducting health economic evaluations of disease screening using authenticity indicators(sensitivity,specificity)and predictive value indicators(positive predictive value,negative predictive value),and combines empirical studies with cases from the literature.Results:Authenticity indicators(sensitivity,specificity)are intrinsic measures of diagnostic tests,unaffected by the disease prevalence in the sample population,making them more suitable for conducting health economic evaluations of disease screening.Moreover,authenticity indicators are easy to obtain,and the model calculations are straightforward and convenient.Case study results demonstrate that compared to risk score screening,the Incremental Cost-Effectiveness Ratio(ICER)of fasting plasma glucose(FPG)testing for type 2 diabetes is 626,indicating that for every additional diabetic patient identified through risk score screening,an extra 626 yuan is spent.Conclusion:It is recommended to use authenticity indicators for conducting health economic evaluations of disease screening,standardize the path methods for model selection,and continuously improve the evidence quality of health economic evaluations of disease screening in China.