The release of item guide is an important content of deepening the reform of medical service prices,and it is also a major measure to unify and standardize the price of medical services.Comprehensive examination items are widely grasped and applied by the majority of hospitals and medical personnel,the degree of service homogenization is relatively high,the frequency of occurrence is high,and it plays a key role in the medical service price system and service income.On the basis of the preparation ideas,framework structure design,item elements and characteristics of the comprehensive examination item initiation guide,it reviews the main changes in the establishment of the comprehensive examination item initiation guide price item,and puts forward suggestions to accelerate the implementation of the comprehensive examination item initiation guide:promoting the docking pricing and standardized implementation of the comprehensive examination item initiation guide,and starting the dynamic adjustment of the price of diagnostic items according to the trigger mechanism.

With the implementation of the medical service price item guidelines in various places,it is particularly urgent to follow up the coordinated policies of consumables that can be charged separately and their medical insurance catalog access and payment management.On the basis of reviewing the management policy of medical consumables charge and medical insurance catalogue,it introduces the practice of typical provinces,including making a catalogue list of consumables that can be charged separately to patients or forming a negative list of consumables based on basic consumption;formulating a unified payment management plan for medical consumables and a catalogue of medical consumables for medical insurance in the province;innovative medical consumables clinical application item fees and medical insurance payment policy coordination.The practice of typical provinces has implications for other regions to standardize consumables charges,medical insurance catalog access and payment:combing and screening,standardizing and integrating the content of price items in different places to form a list of consumables that can be separately charged;clearly defining the scope of access and meet the conditions,and classifying the consumables that can be charged separately into the medical insurance catalogue management according to the procedures.

The release of item guide is an important content of deepening the reform of medical service prices,and it is also a major measure to unify and standardize the price of medical services.Comprehensive examination items are widely grasped and applied by the majority of hospitals and medical personnel,the degree of service homogenization is relatively high,the frequency of occurrence is high,and it plays a key role in the medical service price system and service income.On the basis of the preparation ideas,framework structure design,item elements and characteristics of the comprehensive examination item initiation guide,it reviews the main changes in the establishment of the comprehensive examination item initiation guide price item,and puts forward suggestions to accelerate the implementation of the comprehensive examination item initiation guide:promoting the docking pricing and standardized implementation of the comprehensive examination item initiation guide,and starting the dynamic adjustment of the price of diagnostic items according to the trigger mechanism.

With the implementation of the medical service price item guidelines in various places,it is particularly urgent to follow up the coordinated policies of consumables that can be charged separately and their medical insurance catalog access and payment management.On the basis of reviewing the management policy of medical consumables charge and medical insurance catalogue,it introduces the practice of typical provinces,including making a catalogue list of consumables that can be charged separately to patients or forming a negative list of consumables based on basic consumption;formulating a unified payment management plan for medical consumables and a catalogue of medical consumables for medical insurance in the province;innovative medical consumables clinical application item fees and medical insurance payment policy coordination.The practice of typical provinces has implications for other regions to standardize consumables charges,medical insurance catalog access and payment:combing and screening,standardizing and integrating the content of price items in different places to form a list of consumables that can be separately charged;clearly defining the scope of access and meet the conditions,and classifying the consumables that can be charged separately into the medical insurance catalogue management according to the procedures.

Objective To investigate the expression and clinical significance of multiple endocrine neoplasia type 1(MEN1)gene in breast cancer.Methods The Cancer Genome Atlas(TCGA)database was used to analyze the relationship between MEN1 gene and clinicopathological characteristics of breast cancer.Kaplan-Meier method was used to observe the effect of MEN1 on survival of breast cancer patients.Gene Ontology(GO),Kyoto Encyclopedia of Genes and Genomes(KEGG),and gene set enrichment analysis(GSEA)were used to predict the function and signaling pathways of MEN1 related and interacting genes.Tumor Immune Estimation Resource(TIMER)and single sample gene set enrichment analysis(ssGSEA)were used to investigate the correlation between the level of immune infiltration and MEN1 expression in breast cancer.Results MEN1 was highly expressed in breast cancer patients,and its expression level was related to PAM50 subtype and menopause status(both P＜0.05).Kaplan-Meier survival analysis showed that high MEN1 expression was associated with poor clinical outcome(P=0.019).GO and KEGG enrichment analysis showed that MEN1 related and interacting genes were involved in biological processes(histone modification,histone-lysine methylation),cell components(methyltransferase complex and histone methyltransferase complex),molecular functions(histone-methyltransferase activity),and functional pathways(transcriptional disorders in tumors).GSEA identified that the highly expressed MEN1 phenotype was involved in vesicle-mediated transport,complement cascade,B-cell receptor signaling,lymphocyte-non-lymphocyte interaction,interleukin signaling,and cytokine signaling pathways in the immune system.CancerSEA single cell sequencing results indicated that the expression of MEN1 was positively correlated with angiogenesis in MDA-MB-231 cells(P＜0.05).TIMER analysis found that MEN1 in breast cancer was negatively correlated with the infiltration levels of macrophages and CD8+T cells,and positively correlated with the infiltration level of CD4+T cells(all P＜0.05).ssGSEA showed that the infiltration levels of 18 types of immune cells were negatively correlated with MEN1 expression(all P＜0.05).Conclusion High MEN1 level is associated with poor survival and immune infiltration in breast cancer patients.