Objective To investigate the influence of multidisciplinary team (MDT) model on decisionmaking of adjuvant chemotherapy for breast cancer and analyze relevant influencing factors.Methods The patients with invasive breast cancer who underwent surgery and MDT discussion for adjuvant treatment in Shaoxing People's Hospital,from May 2016 to May 2018,were retrospectively analyzed.The patient's clinicopathological characteristics and postoperative adjuvant treatment and MDT records were obtained.Here the chemotherapy decision alternation was defined as disagreement in chemotherapy or not,or inconsistence in regiments between the attending doctor and multidisciplinary team.Results A total of 385 patients were enrolled in the multidisciplinary discussion and 327 patients (327/385,84.9％) were suggested to receive chemotherapy.Differences between attending doctor's recommendation and MDT panel's decision were found in 23 (23/385,6％) patients,of whom 15 patients (15/23,65.2％) were escalated adjuvant treatment and 8 patients (8/23,34.8％) were de-escalated adjuvant treatment.The relevant pathological indicators affecting the change of chemotherapy decision-making included the Ki67 expression index in the intermediate state of 15％ to 30％,the low expression of ER/PR and the small tumor of T1a.Conclusion MDT can influence the decision of adjuvant chemotherapy for breast cancer surgery,and can be promoted in grassroots hospitals at all levels.

Objective: To analyze the influencing factors for hospitalization of pneumoconiosis patients, so as to provide reference for improving the timeliness of treatment and quality of life in these patients. Methods: The pneumoconiosis patients in Changshan, Wenling and Changxing ( having mining industry ) of Zhejiang Province were selected by stratified and typical sampling methods. Their demographic features, prevalence of pneumoconiosis and hospitalization status were collected by a questionnaire survey. Logistic regression analysis was conducted to analyze the influencing factors for hospitalization. Results: Among 166 pneumoconiosis patients, 122 ( 73.49% ) chose to be hospitalized. The multivariate logistic regression analysis revealed that the patients who scored higher in ED-5Q ( OR=65.821, 95%CI: 3.831-1130.781 )and who would communicate with other pneumoconiosis patients ( OR=3.744, 95%CI: 1.261-11.115 ) were more likely to be hospitalized; the patients who were under the medical insurance for urban employees were more likely to be hospitalized than those who were under the new rural cooperative medical care system ( OR=0.033, 95%CI: 0.007-0.154 ) and others ( OR=0.038, 95%CI: 0.002-0.960 ) . Conclusion The quality of life, communication with other pneumoconiosis patients and type of medical insurance were the influencing factors for hospitalization of pneumoconiosis patients.

Pancreatic neuroendocrine neoplasms (pNENs) are highly heterogeneous, and the management of pNENs patients can be intractable. To address this challenge, an expert committee was established on behalf of the Chinese Pancreatic Surgery Association, Chinese Society of Surgery, Chinese Medical Association, which consisted of surgical oncologists, gastroenterologists, medical oncologists, endocrinologists, radiologists, pathologists, and nuclear medicine specialists. By reviewing the important issues regarding the diagnosis and treatment of pNENs, the committee concluded evidence-based statements and recommendations in this article, in order to further improve the management of pNENs patients in China.