An analysis is made on major issues and difficulties in the application of the performance appraisal system structure,appraisal model and appraisal outcomes.It was discovered that the performance appraisal system,if used in clinical medical technology departments in the hospital,should focus on the system itself,the appraisal process and re-improvement of the system.These three factors are key to determining whether the system is effective and efficient,and key to transforming the system into departmental and hospital performance,even into overall enhancement of hospital performance in general.

Studying prognostic factors of breast cancer is a traditional subject. With new advances in detection methods applied and new prognostic factors, the clinical course and the biological behavior of breast cancer have been well understood, thus the treatment can be more rational. At present, the majority of prognostic factors related to molecular biology still need to be investigated. And although some of them have broad prospects, they are not available for routine examination currently. In this article, we reviewed some prognostic factors of breast cancer, which have been confirmed or may have potential in practical application.

d infrastructure quality.Conclusions Raising responsiveness for special medical services will be conducive for improving the quality of non-medical services for these inpatients when they are in the hospital.

With the development of breast-conserving surgery,the problem of local relapse after conservation therapy became a hot spot for discussion.There was much research done on the influential factors of recurrence after conservation therapy,however,there is little research on the strategy for salvage of relapse.This review summarizes the recent research on the diagnosis,treatment and prognosis of local recurrence of breast cancer after conservation therapy.

Pregnancy associated breast cancer(PABC) is a special kind of breast cancer,it is difficult to diagnose at early stage since the mammary epithelial cells are actively proliferative.Whether pregnancy will affect the biological behavior of breast cancer and how the treatment strategy for the patients with PABC impact on the outcome in terms of side effects,response,etc,those factors have to be taken into special consideration.The standard management of PABC still remain controversial.This article summarized the studies on PABC and discusses the advances in the management of the disease.

Background and purpose:Cyclooxysenase-2(COX-2)was first researched in colon caner,and extensively studied in breast cancer.However it was rarely reported in lymph node negative breast cancer.This study assessed the effect of expression of COX-2 in the prognosis of lymph node negative breast cancer and its use as information of COX-2 status to perfect the prognostic mathematic model.Methods:The expression of COX-2 protein was detected by IHC in 119 cases of lymph node negative breast cancer,the survival data was analyzed.Results:Elevated expression of COX-2 was associated with unfavorable distant disease-free survival(74% vs 93.86%).In subgroups by the simple prognostic model PI=size+HER2-2.5?age-CT-0.55?(ER?ET),the 5-year DFS were decreased with subgroups of low-risk,mid-risk and high-risk and the rate of elevated expression of COX-2 was increased with higher risk subgroups.Furthermore,in mid-risk group,the elevated expression of COX-2 was still able to predict poorer prognosis.Conclusion:The information of expression of COX-2 can be used to perfect the simple prognostic mathematic model,thus it would be more effective for treatment of breast cancer with auxiliary lymph nodes metastases.

Background and purpose:Exposure to estrogen is an important independent determinant of the risk of breast cancer.Moreover,chemokines and its corresponding receptors play an important role in breast cancer occurrence and development.Our study is to investigate the impact and related mechanism of estrogen on chemokines expression in breast cancer cells.Methods:Microarray was performed to analyse chemokine and corresponding receptors' mRNA expression in MCF-7 cells treated with estradiol.Real-time(RT)-PCR was applied to confirm the change of chemokine expression at different time point with different dose of estradiol in presence or absence of ICI182,780.ELISA was used to analyse the change of extracelluar secrete protein.Results:Physiological estradiol could obviously up-regulate CXCL12 mRNA expression in breast cancer cell MCF-7,which emerged from 4h after treatment and continued to 24 h.In addition,estradiol could stimulate CXCL12 protein secretion from 2h to 24h after treatment.These effects could be totally inhibited when MCF-7 was treated with ICI182,780(ER antagonist)prior to estradiol.Conclusions:Our study demonstrated that estrogen could up-regulate CXCL12 mRNA expression and its extracelluar protein secretion,which was mediated through ER signaling pathway.

STK11 gene is a recently found tumor suppressor gene. It maps 19p13.3. This gene can express a kind of serine threonine kinases. STK11 gene plays an important role in the regulation of cell cycle progression, and it may relate to cell apoptosis. However, until now the mechanisms of STK11 gene is not very clear and progress in the research of this new tumor suppressor gene is sitll needed.

We review the proceedings on the methods of how the aromatase inhibitor maintains its function, the recently developed drugs and the progress in the field of endocrine therapy for human breast cancer

Objective To analyze the flow tendency of elderly patients,create a better mechanism to help guide elderly patients to form a good order in seeking medical care,and consequently improve the resource operational efficiency in medical service.Methods Analyzing the data by the descriptive,χ2 test and logistic regression of SPSS 20.0.Results Elderly patients prefer community health service centers and tertiary hospitals;of those visiting tertiary hospitals,nearly 30% seek medical advice for common chronic diseases.Main influencing factors for patient flow are medical insurance coverage and education. They tend not to embrace the two-way referral service,due to such factors of inconvenient process and defective mechanisms.Conclusion Transition from medical demand management to medical supply management.Such factors as quality cost,expense cost,time cost,and public opinion cost should be used to replace and weaken their mindset of the medical hierarchy,and embrace the concept of “seeking medical advice by grades”,thus improving the utilization of medical resources,and optimizing medical service accesibility.