Objective To investigate the safety, economic benefits and psychological effects of day breast conserving surgery for breast cancer. Methods The demographic data and clinical data of breast cancer patients undergoing day (day surgery group) and ward (ward surgery group) breast conserving surgeries in West China Hospital of Sichuan University from March 2020 to June 2021 were retrospectively collected; the demographic data, clinical data, medical and related transportation costs, and preoperative and postoperative BREAST-Q scores of breast cancer patients undergoing day (day surgery group) and ward (ward surgery group) breast conserving surgery in West China Hospital of Sichuan University from June 2021 to June 2022 were prospectively collected. The safety, economic benefit, and psychological satisfaction of day surgery was analyzed. Results A total of 42 women with breast cancer were included in the retrospective study and 39 women with breast cancer were included in the prospective study. In both prospective and retrospective studies, the mean age of patients in both groups were <50 years. There were only statistical differences between the two groups in the aspects of hypertension (P=0.022), neoadjuvant chemotherapy (P=0.037) and postoperative pathological estrogen receptor (P=0.033) in the prospective study. In postoperative complications, there were no statistical differences in the surgical-related complications or anesthesia-related complications between the two groups in either the prospective study or the retrospective study (P>0.05). In terms of the overall cost, we found that the day surgery group was more economical than the ward surgery group in the prospective study (P=0.002). There were no statistical differences in postoperative psychosocical well-being, sexual well-being, satisfaction with breasts or chest condition between the two groups (P>0.05). Conclusion It is safe and reliable to carry out breast conserving surgery in day surgery center under strict management standards, which can save medical costs and will not cause great psychological burden to patients.

Objective To systematically analyze the medical radiation exposure levels in a district of Ningbo City and to provide a scientific basis for the reasonable and effective control of medical radiation exposure. Methods Based on the radiological diagnosis frequency and dose information system, basic medical radiation exposure data were collected, such as radiation doses received by patients in various X-ray diagnostic examinations, from all 13 public medical institutions in a district of Ningbo City from January 1 to December 31, 2020. The data were analyzed for the percentage and collective effective dose of various diagnostic examinations, the distribution of examinations by sex and age, and the number of patients undergoing two or more examinations and their cumulative doses within multiple time intervals. Results Among medical X-ray diagnostic examinations in the district, the percentages of CT examination and routine photography examination were 50.88% and 47.93%, respectively, and the collective effective dose of CT examination accounted for 97.75%. By age and sex, the frequency of examination was the highest in the age group of 45-54 years, and the frequency of examination in the male was higher than that in the female before age 55. The annual effective dose for two patients exceeded 100 mSv. Conclusion In this study, CT examination accounted for up to 50.88% of all medical X-ray diagnostic examinations, and contributed 97.75% of the collective effective dose, highlighting the need for particular attention to the justification of medical radiation exposure from CT.

Objective To understand the individual radiation dose levels and changes of occupational external exposure among radiation workers in a steel group from 2020 to 2023, and to provide a basis for strengthening radiation protection in the group. Methods According to the Specifications for individual monitoring of occupational external exposure (GBZ 128-2019), individual monitoring was conducted using a thermoluminescent dosimeter, with each monitoring cycle lasting 90 days, totaling four cycles per year. Individual monitoring data of occupational external exposure among radiation workers in the steel group from 2020 to 2023 were collected for statistical analysis. Results A total of 5889 monitoring records were collected from radiation workers across 37 affiliated units of the steel group during the period of 2020-2023. The average annual effective dose was 0.150 mSv, the maximum annual effective dose was 3.84 mSv, and 0.3% monitored workers showed annual effective doses exceeding 1 mSv. The average annual effective dose in 2023 was 0.146 mSv, which was lower than in 2020 but higher than in 2021 and 2022 (Z = −6.657 to 14.129, P < 0.001). The number of monitored workers in industrial and medical sectors accounted for 86.9% and 13.1%, respectively. Their average annual effective doses were 0.152 mSv and 0.140 mSv, respectively, and the difference was statistically significant (Z = −7.969, P < 0.001). In the industrial sector, the average annual effective dose for the monitored workers in industrial radiography was significantly higher than other occupations (Z = −8.094, P < 0.001). There was a significant difference in average annual effective dose among workers of different occupational categories in the medical sector (H = 67.040, P < 0.001). The average annual effective doses were relatively high for diagnostic radiology and nuclear medicine. Additionally, the average annual effective doses for male and female radiation workers were 0.150 mSv and 0.152 mSv, respectively (P > 0.05). Conclusion The average annual effective dose of radiation workers in the steel group was at low levels for four consecutive years, which meet the requirements of the national standard. However, to maintain the individual radiation dose levels of radiation workers as low as reasonably achievable, it remains necessary to strengthen radiation protection management in the steel group.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease with high global prevalence and long course, which affects more than 30% of the population and seriously endangers human health. Lipid metabolism plays an important role in the occurrence and development of MASLD. An increasing number of studies have shown that active ingredients in traditional Chinese medicine can regulate lipid metabolism to improve MASLD. Due to the obvious advantages of multi-target regulation and fewer side effects, the active ingredients have shown great potential and value for application. However, the pathological mechanism of MASLD is intricate and the active ingredients of traditional Chinese medicine can improve MASLD from multiple aspects, there is currently a lack of systematic discussion on lipid metabolism. Therefore, this review focuses on lipid metabolism and reviews the latest research progress of active ingredients from traditional Chinese medicine in ameliorating MASLD from the aspects of lipid uptake, lipid synthesis, lipid oxidation, lipid secretion, etc., in order to provide more theoretical references for active ingredients of traditional Chinese medicine in regulating lipid metabolism to improve MASLD.

Objective To explore whether adiponectin receptor 1/2(AdipoR1/R2)mediates berberine to alleviate renal lipid toxicity in mice with diabetic kidney disease.Methods C57BLKS/J db/db mice and db/m mice were selected and divided into 4 groups,with 8 in each group.db/db mice and db/m mice were given berberine(150 mg·kg-1·d-)or placebo by gavage for 12 weeks,respectively.After intervention,blood glucose,blood lipids,urinary microalbumin/creatinine ratio and urinary albumin excretion rate were determined.Kidney tissues were taken for pathological examination,and oil red O staining,immunohistochemistry,ELISA and Western blotting were used to examine lipid deposition,AdipoRl/R2 expression and fibrosis markers expressions,etc.,respectively.The human glomerular endothelial cell line(HGEC)was used to verify the role of AdipoR1/R2 in berberine alleviating renal lipid toxicity.Results After berberine intervention,the body weight,blood glucose,lipids,proteinuria,renal lipid deposition,and renal pathological changes decreased in db/db mice(P＜0.05);the expressions of AdipoR1 and AdipoR2 increased,expressions of TGF-β1 and Col-Ⅳ decreased,and the expressions of PPAR-α and p-AMPK increased in kidney tissue of db/db mice(P＜0.05).In high-fat cultured HGEC cells treated with berberine-treated db/db mouse serum,the expressions of TGF-β1 and Col-Ⅳ decreased,while the expressions of PPAR-α and p-AMPK increased(P＜0.05);after AdipoR1/R2 on HGEC cells were silenced,the expressions of TGF-β1 and Col-Ⅳ increased,while the expressions of PPAR-α and p-AMPK decreased(P＜0.05).Conclusions Berberine can reduce renal lipid toxicity in diabetic nephropathy mice,and adiponectin receptor may mediate this effect of berberine.

In recent years, the high temperature and heatwaves have seriously affected the health of Chinese residents, and there is an important need for public health protection guidelines for high temperature and heatwaves in China. The National Bureau of Disease Control and Prevention has organized experts to fully investigate the evidence from epidemiological research on the health of populations in high temperature and heatwaves globally and in China, analyze the health hazards and protection needs of different populations, and put forward practical and effective individual protection measures and health recommendations. For this reason, the "Guideline for Public Health Protection against High Temperature and Heatwaves" (referred to as the "Guideline") was officially issued in June 2023. This article interprets the background and significance of the Guideline, the principles of compilation, the main considerations, the main contents, the implementations and promotions and other aspects, to improve the understanding of the content of the Guideline and strengthen the publicity and implementations.

Objective·To explore the influencing factors of oral nutritional supplement compliance in postoperative patients with digestive tract cancer based on COM-B model,and to analyze the mediating role of medication belief and self-efficacy in oral nutritional supplement.Methods·A total of 300 postoperative gastrointestinal cancer patients were selected by convenience sampling method.The General Information Questionnaire,Morisky Medication Adherence Scale,Digestive Cancer Patients Nutrition Knowledge,Attitude and Practice Questionnaire,Multidimensional Scale of Perceived Social Support,Beliefs about Medicines Questionnaire and General Self-Efficacy Scale were used.A mediating effect model was used to analyze the influencing factors of compliance with oral nutritional supplements.Results·The score of Morisky Medication Adherence scale was 1.61±1.38,which was at a low level.Oral nutritional supplement compliance was significantly positively correlated with nutrition knowledge,social support,medication belief and self-efficacy(r=0.391,0.401,0.438,0.410,all P＜0.01).Medication belief had a partial mediating effect between nutrition knowledge and adherence to oral nutritional supplements(effect size=0.097,accounting for 18.00%of the total effect).Self-efficacy had a partial mediating effect between nutrition knowledge and oral nutritional supplement compliance(effect size=0.044,accounting for 8.16%of the total effect).Self-efficacy had a partial mediating effect between social support and oral nutritional supplement compliance(effect size=0.044,accounting for 16.67%of the total effect).Conclusion·The compliance of oral nutritional supplements in postoperative patients with gastrointestinal cancer is at a low level.The individualized nursing intervention can increase the nutritional knowledge of patients,improve the social support,reduce the concerns of patients about oral nutrition,and improve the self-efficacy of patients,so as to promote the compliance of patients with oral nutritional supplements.

Objective To explore the features of sleep quality and its relationship with perceived stress and occupational stress in military personnel serving in high-altitude regions.Methods Cross-sectional study design was adopted in this study.In February 2023,self-designed demographic data questionnaire,Pittsburgh sleep quality index(PSQI),perceived stress scale(PSS-10)and job content questionnaire(JCQ)were applied to survey 3 784 soldiers from a unit stationing in plateau subjected by cluster sampling.Results The total score of PSQI was 5.37±2.78 in the participants,and the total score and the scores of each dimension of PSQI were significantly higher than the national norms for Chinese(P＜0.001).There were significant differences in PSQI scores among different age,length of military service,nationality,length of stationing in plateau,education level and family structure(P＜0.001).The low perceived stress group had significantly lower PSQI scores than the high perceived stress group(t=-12.108,P＜0.001).Regulatory effect analysis showed that the length of stationing in plateau,work autonomy,work psychological requirements,and social support in the work environment could modulate the relationship between perceived stress and sleep quality(t=8.326,-3.788,-2.145,-6.656,P＜0.05),and explained 14.6％,7.6％,7.0％and 7.9％of the variance of sleep quality,respectively.Conclusion The military personnel serving in high-altitude regions have a poor sleep quality.Age,time of military service,time of stationing in plateau,nationality,family structure,education level,perceived stress,and occupational stress are important factors affecting their sleep quality.The length of stationing in plateau time and occupational stress,can modulate the relationship between perceived stress and sleep quality.

In recent years, the high temperature and heatwaves have seriously affected the health of Chinese residents, and there is an important need for public health protection guidelines for high temperature and heatwaves in China. The National Bureau of Disease Control and Prevention has organized experts to fully investigate the evidence from epidemiological research on the health of populations in high temperature and heatwaves globally and in China, analyze the health hazards and protection needs of different populations, and put forward practical and effective individual protection measures and health recommendations. For this reason, the "Guideline for Public Health Protection against High Temperature and Heatwaves" (referred to as the "Guideline") was officially issued in June 2023. This article interprets the background and significance of the Guideline, the principles of compilation, the main considerations, the main contents, the implementations and promotions and other aspects, to improve the understanding of the content of the Guideline and strengthen the publicity and implementations.

Objective To explore the relevant relationship and specificity between the implicit and explicit loyalty of military cadets in order to provide a theoretical basis and objective indicators for a more comprehensive and objective assessment for individual loyalty.Methods E-Prime 2.0,a classic implicit association paradigm was employed to construct an implicit association loyalty test for 64 military cadets.Simultaneously,an explicit loyalty measurement was conducted using the Chinese Military Personnel Loyalty Scale.Results ① Significant implicit effect was observed in the loyalty assessment of military cadets,indicating a general tendency to perceive higher levels of personal loyalty and lower levels of loyalty to external entities.② Explicit loyalty assessment revealed that the participants had the highest loyalty score towards the Party,the Nation,and the People(4.79±0.34),followed by the loyalty score to their profession(4.38±0.53),and the relatively lower loyalty score towards the unit and leaders(4.03±0.83).Among the 3 dimensions of loyalty,the normative loyalty score ranked highest,while continuance loyalty score took lower.③ There were no correlations among the scores of loyalty to the Party,the Nation,and the People(r=-0.030,P=0.823),to the profession(r=-0.047,P=0.728),to the unit(r=0.050,P=0.710),or to the leaders(r=0.043,P=0.749).Conclusion The implicit effect in the loyalty assessment is significant in military cadets,and there is no significant correlation between explicit and implicit loyalty measurements.Thus,we cannot rely solely on explicit measurements to assess their loyalty attitudes.