Human epidermal growth factor receptor-2 (HER2) is regarded as an important and promising target in the treatment of HER2-positive breast cancers. However, the correlation of clinicopathological characteristics and prognostic significance of HER2 overexpression in gastric cancer patients remains unclear. Our aim was to clarify this issue. Embase, PubMed, and the Cochrane Library were searched for relevant articles published up to May 2016. Outcomes of interest contained sex, age, tumor size, tumor site, tumor node metastasis (TNM) stage, distant metastasis, lymph node metastasis, Lauren’s classification, differentiation grade, lymphovascular invasion, neural invasion, and multivariate analysis data for overall survival. A total of 41 studies of 17,494 gastric cancer patients were identified with HER2 test. HER2 positive rate was 19.07% (95% CI = 9.16, 28.98). There existed statistical significance between HER2 overexpression and patients’ prognosis (RR = 1.47, 95% CI = 1.09, 1.98). Male patients (OR = 1.48, 95% CI = 1.34, 1.65), proximal tumors (OR = 1.25, 95% CI = 1.07, 1.47), intestinal-type tumors (OR = 3.37, 95% CI = 2.54, 4.47), advanced stage cancers (OR = 1.35, 95% CI = 1.10, 1.66), lymph node metastasis (OR = 1.26, 95% CI = 1.14, 1.41), well-differentiated cancers (OR = 1.79, 95% CI = 1.15, 2.76), and distant metastasis (OR = 1.91, 95% CI = 1.08, 3.38) were correlated with higher HER2 expression rates. However, no statistical differences existed in age, tumor size, lymphovascular invasion, or neural invasion. Subgroup analysis revealed that HER2 expression rates reported in articles from Asian (19.52%) countries were quantitatively higher than those from European (16.91%) areas. Results were consistent with those reports that define HER2 status according to trastuzumab for gastric cancer (ToGA) criteria. This study showed that HER2 overexpression was associated with poor prognosis in gastric cancer patients. HER2 positive rates may be associated with sex, tumor site, TNM staging system, distant metastasis, lymph node metastasis, Lauren’s classification, and differentiation grade in gastric cancer patients. The HER2 expression rate in Asians may be higher than that in Europeans. This study offers a convenient way for doctors to select patients for relevant HER2 detection and following treatment.

Parents’ education and household wealth cannot be presumed to operate independently of each other. However, in traditional studies on the impact of social inequality on obesity, education and financial wealth tend to be viewed as separable processes. The present study examines the interaction of parents’ education and household wealth in relation to childhood obesity. Anthropometric measurement and questionnaire surveys were carried out on 3670 children (aged 9–12 years) and their parents from 26 elementary schools in northeast China. Results showed that the interaction term was significant for household wealth and father’s education (p < 0.01), while no significant interaction between household wealth and mother’s education was found. In a separate analysis, the interaction was statistically significant among girls for obesity risk based on BMI (p = 0.02), and among urban children for both obesity risk based on BMI (p = 0.01) and abdominal obesity risk based on WHR (p = 0.03). Specifically, when household wealth increased from the first quintile to the fifth quintile, OR for father’s education decreased from higher than 1 (OR = 1.95; 95% CI: 1.12–3.38) to non-significant for girl’s obesity risk, from non-significant to lower than 1 for urban children’s obesity risk (OR = 0.52; 95% CI: 0.32–0.86 for the fourth quintile; OR = 0.37; 95% CI: 0.19–0.73 for the fifth quintile) and from higher than 1 (OR = 1.61; 95% CI: 1.04–2.05) to non-significant for urban children’s abdominal obesity risk. These findings indicate that father’s education level interacts with household wealth to influence obesity among girls and urban children in northeast China.

Changes in lifestyle and food environment have created a heavy burden of obesity and chronic disease in China. However, measurements of the food environment have been rarely reported in China or other countries with similar food cultures; this measurement shortage is partially due to the lack of valid and reliable measurement tools. The aim of the present study was to adapt and validate a Chinese version of the Nutritional Environment Measurement Survey for Stores (C-NEMS-S). Categories and items of the NEMS-S were culturally adapted to fit the Chinese population and included grains, dry beans, starchy tubers, vegetables, fruits, seafood, meat and poultry, dietary oils, milk, bread, instant noodles, and beverages. A scoring sheet for each food category was created to measure availability, quality, and pricing. Then, the C-NEMS-S was validated in 10 large-sized supermarkets and 10 convenience stores in Shenyang, China. Two trained raters performed their evaluations separately at the same store. The intra-class correlation coefficient (ICC) of the availability composite score was 0.98. All food measures had a moderate or good ICC (0.41 to 1.00). The kappa for each food measure ranged from 0.52 to 1.00. C-NEMS-S was able to show the difference in healthy food availability between large-sized supermarkets and convenience stores, as well as the price differences between healthier options and regular options. Large-sized supermarkets had a significantly higher total score (p < 0.001) and healthier option availability for all food measures (all items were statistically significant (p < 0.05), except sugar-free beverages). Healthier options cost more than regular options for grains, milk, bread, and instant noodles (from 4% to 153%). The adapted C-NEMS-S can be used to measure the consumer food environment in stores in China.

There are more than 4.9 million rural health workers undertaking the health care need of rural population of over 629 million in China. The lifelong learning of physicians is vital in maintaining up-to-date and qualified health care, but rural physicians in many developing countries lack adequate medical professional developments. There has also been no empirical research focused on the lifelong learning of rural physician populations. The purpose of this study was to investigate the primary levels of lifelong learning of the rural physicians and to analyze group differences. We conducted a cross-sectional study on 1197 rural physicians using the Jefferson Scale of Physician Lifelong Learning (JSPLL). Cronbach’s α coefficient, exploratory factor analysis, independent sample t-test, and one-way ANOVA followed by Student-Newman-Keuls test were performed to analyze the data. For Chinese rural physicians, the JSPLL was reliable (Cronbach’s α coefficient = 0.872) and valid, with exploratory factor analysis fitting a 3-factor model and accounting for a total of 60.46 % of the variance. The mean lifelong learning score was 45.56. Rural physicians generally performed worse in the technical skills in seeking information domain. Rural physicians with 21-30 working years have a lower score of lifelong learning (P < 0.05) than other phases of working years. Career satisfaction and professional titles had a significantly positive influence on physicians’ orientation towards lifelong learning (P < 0.05). The overall lifelong learning scores of physicians who received more training after completion of medical school were higher than those with less additional post-medical school training (P <0.05). The JSPLL is effective for the Chinese rural physician population. In order to cope with impacting factors on rural physicians’ lifelong learning, the results of the study reinforced the importance of continuing medical education and career satisfaction for lifelong learning and the need for medical schools and hospitals to provide reasonable strategies and necessary support for rural physicians with different amounts of working years. Providing rural physicians more educational opportunities and helping them access educational resources may be an effective strategy for improving their orientation to lifelong learning.

Effects of meteorological factors on the incidence of meningococcal meningitis