Objective To assess the efficacy of early detection of breast cancer and the prognostic value of breast self-examination(BSE).Methods Randomized controlled trials(RCTs)involving BSE were included the present meta-analysis based on their qualities.The pooled analysis was performed with RevMany 4.2.8.Results Three RCTs were identified and then they were included the present metaanalysis.In women who conducted a BSE.the rate of biopsy fora lump in breast was 1.27%in the first 5 years,2.47%in more than 5 years but less than or equal to 10 years,and 2.50%in more than 10 years, respectively,all of which were significantly higher than in those who could not conduct a BSE(P<0.05) There was no significant difierence in the rate of final diagnosis and the mortality for breast cancer between the two populations in any follow-up time(P>0.05).Conclusion The rate of biopsy for a lump in breast in women could be increased by a BSE.which should not have been discarded from the early detection of breast cancer completely despite it is not helpful in increasing the rate of final diagnosis and decreasing the mortality for breast cancer.

AIM: To explore the ex vivo expansion characteristics of the endothelial progenitor cells (EPCs). METHODS: CD34+ cells were selected from umbilical cord blood mononuclear cells (MNC) by MiniMACS system, expanded at the same conditions as that for total MNC, coincubation of CD34+ and CD34- from the same donation for EPCs. In addition, we tested the effect of vessel endothelial growth factor (VEGF) and passage on cell differentiation, expansion kinetics and apoptosis. EPCs were determined and quantified by immunocytochemistry and flow cytometry. RESULTS: Coculture of CD34+ and CD34-,total MNC led to a significant increase in the expansion of CD34+ cells compared with CD34 enrichment (P0.05). These differentiated EPCs were stained positive for CD34+, von Willebrand factor (vWF), KDR, CD31 and incorporate acetylated low-density lipoprotein (LDL). CD34+ and AC133+cells accounted for 68.2%?6.3% (n=6) and 57.2%?9.8% (n=6) of attaching (AT) cells at day 7 of culture, respectively. CONCLUSIONS: Coculture of CD34+ and CD34- or culture of MNC enhances ex vivo expansion of EPCs. Early passage decreases apoptosis rate, VEGF has no significant effect on ex vivo expansion of EPCs.

The characteristics for the ex vivo expansion of the endothelial progenitor cells (EPCs) were explored. CD34+ cells were selected from umbilical cord blood mononuclear cells (MNC) by MiniMACS system, expanded under the same conditions as those for total MNC, coincubation of CD34+ and CD34- from the same donor for EPCs. In addition, the effects of vessel endothelial growth factor (VEGF) and passage on cell differentiation, expansion kinetics and apoptosis were examined. EPCs were determined and quantified by immunocytochemistry and flow cytometry. The results showed that both coculture of CD34+ and CD34- and total MNC led to a significant increase in the expansion of CD34+ cells as compared with CD34 enrichment (P < 0.05). There was a tendency toward decreased apoptosis in cultures when early passage was performed immediately after cord like structures appeared. VEGF had no significant effect on apoptosis (P > 0.05). These differentiated EPCs were positive for CD34+, von Willebrand factor (vWF), KDR, CD31 staining and phagocytized acetylated low-density lipoprotein (LDL). CD34+ cells accounted for (68.2 +/- 6.3)% of attaching (AT) cells at day 7 of culture. It was suggested the most efficient method to ex vivo expansion of EPCs was coculture of CD34+ and CD34- or total MNC. Early passage makes cell apoptosis rate decrease. VEGF had no significant effect on ex vivo expansion of EPCs.

In this paper , we discussed the financing mechanisms of premarital healthcare services from their properties combined with the status quo financing in our country .We then provided the scientific basis and decision-making reference for improving financing mechanism to improve the premarital healthcare system .A literature or doc-umentary and field researches have combed the present situation of the premarital healthcare services financing mech -anisms at home and abroad .Related data were collected in eight research areas , namely Fujian, Guangxi, Yunnan, Hubei, Jiangsu, Heilongjiang, Beijing and Tianjin and the related personnel from health administrative department , civil affairs departments , maternal and child healthcare institutions were interviewed in terms of Field Research .From the main content at present , premarital healthcare services belong to the category of quasi-public goods .We dis-cussed the financing mechanisms from the financing levels , sources of funds , fund allocation , payment and financial regulatory and other aspects .Finally, some policy recommendations were put forward including making clear the na-ture of premarital healthcare service property , establishment of a special financial investment mechanism , unify the basic financing service standard after scientific feasibility studies , timely and fully allocate special premarital health-care service funds to strengthen the fund supervision policy recommendations .

Objective:This article uses the Mitt-Horn Model to analyze the premarital healthcare policies imple-mentation, in order to seek viable path for the effective implementation .Methods: Eight provinces, namely Guangxi, Fujian, Yunnan, Jiangsu, Hubei, Heilongjiang, Tianjin and Beijing were chosen to carry out the field research .Relevant information and data were collected through interviews , questionnaires, site visits, etc., and all relate to the implementa-tion of a qualitative premarital analysis policy .Results:The research areas have refined the local premarital policy targets under the relevant legal framework , and have improved the policy implementation resources and execution environment . Conclusion:The premarital healthcare effects of measures implemented in the country based on the actual situation is good, but there are still some problems such as poor policy implementation with no in-depth sector, resource investment deficit in the policy , insufficient inter-department coordination and other issues affecting the policy implementation results .

Objective To investigate the efficacy of absorbable screw rod system in the treatment of posterior hip dislocation complicated with femoral head fracture.Methods Between February 2009 and June 2014,20 patients were treated at our department for posterior hip dislocation complicated with femoral head fracture.They were 14 males and 6 females,with an average age of 38.2 years (range,from 27 to 60 years).Eight left hips and 12 right hips were affected.By the Pipkin classification,15 cases were type Ⅰ and 5 type Ⅱ.The time from injury to surgery ranged from 3 to 14 days (average,6 days).All of them were treated with absorbable screw rod system after Allis manual reduction.Results The operation time in this group ranged from 1 to 6 hours (average,1.8 hours).The intraoperative blood loss ranged from 70 to 400 mL (average,160 mL).They were followed up for 18 to 48 months (average,32 months).All the fractures united after an average time of 3.4 months (range,from 2.5 to 5.0 months).According to the Harris scores at 6 months postoperation,10 cases were rated as excellent,7 as good,2 as fair and one as poor,with a good to excellent rate of 85.0％.Total hip replacement was performed for 2 fair and one poor cases because their postoperative pain was not relieved and femoral avascular necrosis developed.Conclusion Absorbable screw rod system is an effective treatment of posterior dislocation with femoral head fracture,because it can simplify operative procedures,reduce trauma,fixate the fracture firmly,avoid secondary operation,and reduce postoperative complications.

Objective:To determine children ’ s health status and influential factors in Nujiang prefecture , Yun-nan.Methods:Rickets morbidity rate , growth retardation rate , and low-weight rate were selected as the key indica-tors to calculate the sample size by using four-stage-sampling procedure .The data was collected through questionnaire survey, in-depth interviews, and focus-group discussions .χ2 test and qualitative analysis were used to analyze the quantitative and qualitative data .Results:The infant mortality rate was 13.14 %in 2011, which was 1.1 and 1.15 times more than the national and provincial average .The mortality rate of children under five was 16.35%in 2011, which was 1.05 and 1.13 times more than the national and provincial average .It was also 2.19 times more than the average in developed countries .The prevalence of medium and severe malnutrition in children under five was 2 .32%, which was 1 .54 times more than the national average .The incidence of low birth weight was 1 .41%.The research shows that the rates of rickets , growth retardation , and low-weight were 36.13%, 25.81%and 20.98%,and nutritional diseases are more serious .Conclusion:There are serious health problems for children in Nujiang pre-fecture, especially nutritional diseases .Influential factors include health policy and system , economic development, customs, geography, health service capacity , and parental health knowledge Suggestion:The government should im-prove top-level design , strengthen policy support , and develop the local economy in order to solve the social and poli-cy environment factors .Institutions and human capacity should be strengthened , access and quality of services should be improved , health education should be popularized , and health awareness and behaviors should be improved .

In this paper , we summarize the theoretical models and research progress about program evaluation and practical situation of children ’ s health in Nujiang prefecture .We then develop a framework for comprehensively evaluating the intervention for children ’ s health based on program theory .This framework comprises the outside pro-gram environment , intervention action modules and change modules , and assessment techniques environment .The e-valuation mainly includes leading agencies , implementing agencies , coordinating agencies , coordination/implementa-tion personnel , intervention and service standards , the environment and atmosphere , target populations , interven-tions, determinants, outcome and effect .

Objective: On the basis of typical cases, the objective of this study is to assess the service quality of primary healthcare institutions under the vertically integrated model from the perspective of demanding side.Methods: The vertical model between Renhe Hospital and Lixian Township Health Center was selected as the case study.Quantitative data were collected by exit review using Primary health-Care quality service Assessment Tool (PCAT)-Chinese version from the patients seeking services in Lixian.Quantitative data were analyzed by descriptive statistics and multiple linear regression equations while qualitative data were analyzed by thematic framework analysis.Results: Under the vertical model, the PCAT total score was 20.09.The scores on the first diagnosis, continuity of care, and comprehensiveness of care and coordination of care were 6.59, 3.27, 4.58 and 5.62 respectively.The scores on the three dimensional extensions, family-centered, community-oriented, medical culture were 3.07, 1.86 and 2.67 respectively.The difference was significant for the PCAT total score between a number of visits and the length of waiting time for services in Lixian.Conclusions: Under the vertical model, primary healthcare institutions did better in the first diagnosis while weaker in continuity and the three dimensional extensions.With the development of the integration, the primary healthcare institutions need to strengthen the continuity and downward referral in the future.Future researches and follow-up, analysis is needed to track the impact of the vertically integrated model.

Objective:To investigate the correlations between CO-029 expression and cholangiocarcinoma invasion and metastasis, and the further explore the potential mechanism involved.Methods:The constructed lentiviral vector of vshRNA-CO-029 (LV/GFP/CO-029) was used to transfect and screen the stable transfected cholangiocarcinoma cell line HCCC-9810-vshRNA-CO-029 as the silence group, HCCC-9810 cells transfected with the mock plasmid were used as the mock group, and the untransfected cells were used as the control group. Cell scratch assay, Transwell assay and in vivo implantation assay were used to detect the migration, invasion and metastasis of the three groups of cells. Immunoprecipitation and tumor necrosis factor (TNF)-α stimulation assay were used to detect the effect of CO-029 on the expression of EMT-related genes.Results:The scratch healing rate of the silence group was (27.11±4.58)%, which was lower than that in mock group (92.84±6.24)%, the number of cells passing through Matrigel in silence group was (57.15±6.10), which was significantly lower than that in mock group (108.20±9.21) and control group (112.00±10.45), the differences were statistically significant ( all P<0.01). The volume of liver tumors in the silence group of orthotopic xenograft mouse model was (2.17±0.54) cm 3, while the volume of liver tumors in the transplanted simulation group was (0.74±0.15) cm 3, the differences were statistically significant ( P<0.05). The incidence of lung metastasis and the number of lung metastases in the simulated group was 100%(6/6) and (214.17±35.64), respectively, while that in the silence group was 16.7% (1/6) and (41.56±14.15), respectively, the differences were statistically significant (all P<0.05). Co-immunoprecipitation showed that CO-029 can form a complex with TNF-αR1. TNF-α induced the down-regulation of E-cadherin and up-regulation of vimentin and N-cadherin in the mock group, but no significant changes were observed in the silence group. Conclusion:CO-029 expression is positively correlated with tumor invasion and metastasis of cholangiocarcinoma, and could couple with TNF-α to induce EMT, which is a novel well-established potential prognostic and therapeutic target for cholangiocarcinoma metastasis and prognosis intervention.