Objective To investigate the mechanism of metformin for regulating tumor-stromal cell cross-talk in breast cancer.Methods Tumor associated fibroblasts(CAFs)co-cultured with breast cancer cells were treated with metformin,and the changes in expressions of hypoxia-inducible factor-1α(HIF-1α),p-AMPK,stroma-derived factor-1(SDF-1)and interleukin-8(IL-8)in the CAFs were detected using ELISA,RT-qPCR or Western blotting;Transwell assay was used to evaluate the invasiveness of the tumor cells and its changes following treatment with exogenous SDF-1,IL-8 and TGF-β1.The effects of HIF-1α shRNA or overexpression plasmid,AMPK shRNA,and treatment with OG(a proline hydroxylase inhibitor)or 2-OXO(a proline hydroxylase activator)were examined on p-AMPK,HIF-1α,SDF-1 and IL-8 expressions and invasiveness of the CAFs.Results Metformin treatment significantly increased the expression levels of p-AMPK,SDF-1 and IL-8(P<0.05)and decreased HIF-1α expression(P<0.05)without affecting AMPK expression level(P>0.05)in the CAFs.The invasion ability of metformin-treated breast cancer cells was significantly decreased(P<0.05).Exogenous SDF-1 and IL-8,HIF-1α overexpression,and OG-induced upregulation of HIF-1α all significantly attenuated the inhibitory effects of metformin on breast cancer cell invasion(P<0.05)and HIF-1α,SDF-1 and IL-8 expressions in CAFs(P<0.05).Transfection with HIF-1α shRNA or treatment with 2-OXO significantly decreased the invasiveness of breast cancer cells(P<0.05).P-AMPK knockdown significantly suppressed the inhibitory effect of metformin on HIF-1α expression in CAFs and on invasion of breast cancer cells(P<0.05).Treatment with TGF-β1 partially decreased the inhibitory effect of metformin on HIF-1α expression in CAFs and invasiveness of the breast cancer cells(P<0.05).Conclusion Metformin suppresses HIF-1α expression in CAFs to block tumor-stromal cross talk in breast cancer.

Objective:Optimizing and upgrading the accounting methods and approaches for each dimension by comparing and analyzing the practical effects of the full-dimension costing path in public hospitals.Methods:List the mainstream accounting paths guided by the current cost accounting plan for public hospitals,to compare the advantages and disadvantages of the results of each type of accounting methods and their degree of difficulty,and to optimize and upgrade the details of accounting in all dimensions.Re-sults:Different accounting methods have their own advantages and disadvantages,and the path selection needs to rely on the scale of public hospitals,management needs,accounting level and information construction degree and other comprehensive factors,that is,with the selection of accounting paths in each dimension from simple to fine,the degree of data refinement and reference strength are correspondingly from weak to strong.Conclusion:Public hospitals should combine their own accounting basic conditions,choose the best accounting methods and paths,build a cost accounting control system,and continuously optimize and upgrade the ac-counting model,in order to provide strong decision-making support for hospitals to find out the asset base,strengthen resource allo-cation and improve data governance capabilities.

Objective:Optimizing and upgrading the accounting methods and approaches for each dimension by comparing and analyzing the practical effects of the full-dimension costing path in public hospitals.Methods:List the mainstream accounting paths guided by the current cost accounting plan for public hospitals,to compare the advantages and disadvantages of the results of each type of accounting methods and their degree of difficulty,and to optimize and upgrade the details of accounting in all dimensions.Re-sults:Different accounting methods have their own advantages and disadvantages,and the path selection needs to rely on the scale of public hospitals,management needs,accounting level and information construction degree and other comprehensive factors,that is,with the selection of accounting paths in each dimension from simple to fine,the degree of data refinement and reference strength are correspondingly from weak to strong.Conclusion:Public hospitals should combine their own accounting basic conditions,choose the best accounting methods and paths,build a cost accounting control system,and continuously optimize and upgrade the ac-counting model,in order to provide strong decision-making support for hospitals to find out the asset base,strengthen resource allo-cation and improve data governance capabilities.

Objective:Optimizing and upgrading the accounting methods and approaches for each dimension by comparing and analyzing the practical effects of the full-dimension costing path in public hospitals.Methods:List the mainstream accounting paths guided by the current cost accounting plan for public hospitals,to compare the advantages and disadvantages of the results of each type of accounting methods and their degree of difficulty,and to optimize and upgrade the details of accounting in all dimensions.Re-sults:Different accounting methods have their own advantages and disadvantages,and the path selection needs to rely on the scale of public hospitals,management needs,accounting level and information construction degree and other comprehensive factors,that is,with the selection of accounting paths in each dimension from simple to fine,the degree of data refinement and reference strength are correspondingly from weak to strong.Conclusion:Public hospitals should combine their own accounting basic conditions,choose the best accounting methods and paths,build a cost accounting control system,and continuously optimize and upgrade the ac-counting model,in order to provide strong decision-making support for hospitals to find out the asset base,strengthen resource allo-cation and improve data governance capabilities.

Objective:Optimizing and upgrading the accounting methods and approaches for each dimension by comparing and analyzing the practical effects of the full-dimension costing path in public hospitals.Methods:List the mainstream accounting paths guided by the current cost accounting plan for public hospitals,to compare the advantages and disadvantages of the results of each type of accounting methods and their degree of difficulty,and to optimize and upgrade the details of accounting in all dimensions.Re-sults:Different accounting methods have their own advantages and disadvantages,and the path selection needs to rely on the scale of public hospitals,management needs,accounting level and information construction degree and other comprehensive factors,that is,with the selection of accounting paths in each dimension from simple to fine,the degree of data refinement and reference strength are correspondingly from weak to strong.Conclusion:Public hospitals should combine their own accounting basic conditions,choose the best accounting methods and paths,build a cost accounting control system,and continuously optimize and upgrade the ac-counting model,in order to provide strong decision-making support for hospitals to find out the asset base,strengthen resource allo-cation and improve data governance capabilities.

[Objective] To evaluate the effects of preoperative ureteroscopy (URS) on the prognosis of patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). [Methods] Data of 712 UTUC patients who received RNU in West China Hospital during May 2003 and Jun.2019 were retrospectively analyzed. Patients were divided into URS group (n=187) and non-URS group (n=525) according to whether URS was performed before RNU. Kaplan-Meier curves were used to analyze the overall survival (OS), cancer-specific survival (CSS), and intravesical recurrence-free survival (IVRFS). Cox proportional risk model was used for risk assessment. Subgroup analysis and interaction test were used to further verify the results. [Results] Significant differences were observed between the two groups in terms of body mass index (BMI), diabetes mellitus, surgical method, hydronephrosis, tumor location, tumor grade, lymph node metastasis, lymphovascular invasion and tumor diameter (P<0.05). Kaplan-Meier survival analysis showed that IVRFS was significantly lower in the URS group than in the non-URS group (P<0.001), and the difference was more pronounced in renal pelvis carcinoma (P<0.001); there were no differences in OS and CSS between the two groups (P>0.05). Cox multivariate regression showed that URS was an independent risk factor for intravesical recurrence (HR=2.12, 95%CI: 1.34-3.36, P<0.001). [Conclusion] Preoperative URS can increase the recurrence rate of UTUC, but it has no effect on the OS and CSS.

Objective:Optimizing and upgrading the accounting methods and approaches for each dimension by comparing and analyzing the practical effects of the full-dimension costing path in public hospitals.Methods:List the mainstream accounting paths guided by the current cost accounting plan for public hospitals,to compare the advantages and disadvantages of the results of each type of accounting methods and their degree of difficulty,and to optimize and upgrade the details of accounting in all dimensions.Re-sults:Different accounting methods have their own advantages and disadvantages,and the path selection needs to rely on the scale of public hospitals,management needs,accounting level and information construction degree and other comprehensive factors,that is,with the selection of accounting paths in each dimension from simple to fine,the degree of data refinement and reference strength are correspondingly from weak to strong.Conclusion:Public hospitals should combine their own accounting basic conditions,choose the best accounting methods and paths,build a cost accounting control system,and continuously optimize and upgrade the ac-counting model,in order to provide strong decision-making support for hospitals to find out the asset base,strengthen resource allo-cation and improve data governance capabilities.

Objective:Optimizing and upgrading the accounting methods and approaches for each dimension by comparing and analyzing the practical effects of the full-dimension costing path in public hospitals.Methods:List the mainstream accounting paths guided by the current cost accounting plan for public hospitals,to compare the advantages and disadvantages of the results of each type of accounting methods and their degree of difficulty,and to optimize and upgrade the details of accounting in all dimensions.Re-sults:Different accounting methods have their own advantages and disadvantages,and the path selection needs to rely on the scale of public hospitals,management needs,accounting level and information construction degree and other comprehensive factors,that is,with the selection of accounting paths in each dimension from simple to fine,the degree of data refinement and reference strength are correspondingly from weak to strong.Conclusion:Public hospitals should combine their own accounting basic conditions,choose the best accounting methods and paths,build a cost accounting control system,and continuously optimize and upgrade the ac-counting model,in order to provide strong decision-making support for hospitals to find out the asset base,strengthen resource allo-cation and improve data governance capabilities.

Objective:Optimizing and upgrading the accounting methods and approaches for each dimension by comparing and analyzing the practical effects of the full-dimension costing path in public hospitals.Methods:List the mainstream accounting paths guided by the current cost accounting plan for public hospitals,to compare the advantages and disadvantages of the results of each type of accounting methods and their degree of difficulty,and to optimize and upgrade the details of accounting in all dimensions.Re-sults:Different accounting methods have their own advantages and disadvantages,and the path selection needs to rely on the scale of public hospitals,management needs,accounting level and information construction degree and other comprehensive factors,that is,with the selection of accounting paths in each dimension from simple to fine,the degree of data refinement and reference strength are correspondingly from weak to strong.Conclusion:Public hospitals should combine their own accounting basic conditions,choose the best accounting methods and paths,build a cost accounting control system,and continuously optimize and upgrade the ac-counting model,in order to provide strong decision-making support for hospitals to find out the asset base,strengthen resource allo-cation and improve data governance capabilities.

Objective:Optimizing and upgrading the accounting methods and approaches for each dimension by comparing and analyzing the practical effects of the full-dimension costing path in public hospitals.Methods:List the mainstream accounting paths guided by the current cost accounting plan for public hospitals,to compare the advantages and disadvantages of the results of each type of accounting methods and their degree of difficulty,and to optimize and upgrade the details of accounting in all dimensions.Re-sults:Different accounting methods have their own advantages and disadvantages,and the path selection needs to rely on the scale of public hospitals,management needs,accounting level and information construction degree and other comprehensive factors,that is,with the selection of accounting paths in each dimension from simple to fine,the degree of data refinement and reference strength are correspondingly from weak to strong.Conclusion:Public hospitals should combine their own accounting basic conditions,choose the best accounting methods and paths,build a cost accounting control system,and continuously optimize and upgrade the ac-counting model,in order to provide strong decision-making support for hospitals to find out the asset base,strengthen resource allo-cation and improve data governance capabilities.