Treatment Preferences of Residents Assumed to Have Severe Chronic Diseases in China: A Discrete Choice Experiment.

OBJECTIVES: This study aims to elicit the relative importance of treatment attributes that influence residents' choice, assuming they are suffering severe non-communicable diseases (NCDs), to explore how they make trade-offs between these attributes and to estimate the monetary value placed on different attributes and attribute levels. METHODS: A discrete choice experiment (DCE) was conducted with adults over 18 years old in China. Preferences were evaluated based on four treatment attributes: care provider, mode of service, distance to practice and cost. A mixed logit model was used to analyze the relative importance of the four attributes and to calculate the willingness to pay (WTP) for a changed attribute level. RESULTS: A total of 93.47% (2019 of 2160) respondents completed valid questionnaires. The WTP results suggested that participants would be willing to pay CNY 822.51 (USD 124.86), CNY 470.54 (USD 71.41) and CNY 68.20 (USD 10.35) for services provided by experts, with integrated traditional Chinese medicine (TCM) and Western medicine (WM) and with a service distance <=30 min, respectively. CONCLUSIONS: The results suggested that mode of service, care provider, distance to practice and cost should be considered in priority-setting decisions. The government should strengthen the curative service capability in primary health facilities and give full play to the role of TCM in the prevention and treatment of severe chronic diseases.

Positive expression of cyclin D1 is an indicator for the evaluation of the prognosis of breast cancer.

AIMS: The present study is to detect the expression of cyclin D1 in different clinical molecular subtypes in breast cancer, and to analyze its relationship to the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (Her-2), tumor size, clinical stages, histological grades, age of menarche, and prognosis. METHODS: In the present study, we retrospectively reviewed the clinical information of 226 patients with breast cancer who were hospitalized at The First Affiliated Hospital of Xinjiang Medical University between January 2000 and December 2012. Immunohistochemical method was used to detect the expression of cyclin D1 in breast cancer tissues. Pearson's Chi-square test was performed to compare the expression of cyclin D1 under different clinical indicators, and under different immune indexes and subtypes. Spearman rank correlation method was used to analyze the correlation between cyclin D1 expression and ER, PR, Her-2, tumor size, clinical stages, histological grades and age of menarche. Kaplan-Meier was employed to calculate the survival time of tumor-free survival time. Log-rank method was used to analyze the survival curves. RESULTS: The expression of cyclin D1 was not significantly correlated to tumor size, clinical stages, histological grades, age of menarche, or PR, but was correlated to ER. Higher cyclin D1 positive rate corresponded to higher ER positive rate. The expression of cyclin D1 was negatively correlated to Her-2 expression (P < 0.05). Higher cyclin D1 positive rate corresponded to lower Her-2 positive rate. In cyclin D1 positive group, the percentage of Luminal A type was the highest. In cyclin D1 negative group, the percentage of Luminal B type was the highest. Higher cyclin D1 positive rate led to longer tumor-free survival time. CONCLUSIONS: The expression of cyclinD1 is significantly correlated to ER and Her-2. Positive expression of cyclin D1 suggests good prognosis, and can be used as an indicator for the evaluation of the prognosis of breast cancer.