Objective To analyze the risk factors for non-sentinel lymph node (NSLN) metastasis in patients with sentinel lymph node (SLN)-negative breast cancer. Methods Patients with breast cancer who underwent mastectomy and SLN biopsy at our center between January 2009 and August 2024 were retrospectively included. Univariate and multivariate analyses were performed in SLN-negative populations underwent low axillary lymph node dissection to identify risk factors for NSLN metastasis. Results A total of 2 387 SLN-negative patients were included, including 2 288 (95.9%) without NSLN metastasis and 99 (4.1%) with NSLN metastasis. Univariate and multivariate analyses showed that lymphovascular invasion (LVI) was an independent risk factor for NSLN metastasis in SLN-negative patients (13.5% versus 3.5%; OR=4.14，95% CI: 2.27-7.56，P<0.001). Patients with multicentric breast cancer showed a trend towards higher risk of NSLN metastasis compared to other types of breast cancer (9.5% versus 4.1%; OR=2.08，95% CI： 0.90-4.81，P=0.089). Conclusions Patients with SLN-negative biopsy who have LVI or multicentric breast cancer are at higher risk for NSLN metastasis.

The paper summarized the literature in recent 5 years about the researches on the metabolic syndrome (MS) in traditional Chinese medicine. The paper discussed the etiology and pathogenesis, summarized the clinical research and experiment of traditional Chinese medicine for MS.

Objective To measure the present situation of medical students' learning adaptability and find the influencing factors in order to revise Learning Adaptability Scale for medical students.Methods A stratified sampling method was used to collect 1 180 medical students from Harbin Medical University.Using the internal consistency reliability test,the reliability of the revised student learning adaptability scale was verified.Five common factors were extracted by the exploratory factor analysis of the principal analysis method,and Logistic regression was used to analyze the influencing factors of medical student learning adaptability.Results The revised Student Learning Adaptability Scale (Cronbach's Alpha=0.914) consists of 27 measurement items.It includes five dimensions,namely self-directed learning,information utilization,environment choice,stresses response and goal orientation.The results showed that the adaptability of medical students was moderate (3.28 ± 0.52),and the influencing factors included job position (OR =1.496,95％ CI=1.114-2.009),academic achievement (OR =1.638,95 ％ CI=1.386-1.936),satisfaction with learning (OR=2.160,95％CI=1.745-2.673),professional satisfaction (OR=1.369,95％CI=1.092-1.718),professional interest (OR =1.426,95％ CI=1.186-1.715) and employment prospects (OR =1.526,95％ CI=1.251-1.862).Conclusion The reliability and validity of the Student Learning Adaptability Scale is appropriate.Medical students' learning adaptability is influenced by many factors.

Objective To preliminarily develop a scale to measure the proactive socialization behavior of new nurses and test validity and reliability of the scale, to explore the impact of proactive socialization behavior on turnover intention. Methods Using a questionnaire survey method to investigate 696 new nurses who had worked within three years in nursing organization, structural equation model and hierarchical line regression methods were performed to analyze the data. Results Proactive socialization behavior scale included eight items under one dimension;the consistency coefficient of scale was 0.858;new scale had a good convergent and predictive validity;the proactive socialization behavior of new nurses was significantly negative related to turnover intention (β=-0.236,P<0.01). Conclusions The proactive socialization behavior scale has a good reliability, convergent and predictive validity. Meanwhile, new nurses with higher level of proactive socialization behavior have lower turnover intention. Because they can quickly fit the new environment, role definition and organizational culture, which in turn organization embeddedness is promoted.

Objective To build a multi‐level hierarchical structure model of the influencing factors for hierarchical medical system ,to identify the role relationship between all the factors and transmission pathways ,and to recommend on developing China′s hierarchical medical system . Methods Thirty influencing factors were identified in a screening based on literature review for the hierarchical medical system .On such basis ,16 influencing factors were identified by three health policy experts ,which affect operations of the current system .Interpretative structural modeling was called into play in the end to analyze the hierarchy relationship between various influencing factors and the conduction loops .Results There exist among the 16 factors a 3‐level hierarchical structureand two conduction loops .The factor directly limiting the hierarchical medical system is two‐way referral,and most internal core drivers arehuman resources development and governance mechanism.By means of self‐growth and external constraints ,they exert their influence on the operation of hierarchical medical system .Conclusions There are interactive hierarchical effects among the factors ,merging into three node elements of functional role,inter‐entity relationshipand patient participation.

BACKGROUND:Meniscal root damage is an important reason for meniscus extrusion. In recent years, there are many reports on the relationship between meniscus root injury and meniscus extrusion at abroad, but it is rare at home. OBJECTIVE:To investigate the correlation between knee medial meniscus extrusion and the medial meniscus posterior root tears. METHODS:A retrospective analysis of the MRI and arthroscopic findings of 84 patients with knee medial meniscus extrusion signs was conducted. Medial meniscus extrusion≥ 3 mm or length of medial meniscus extrusion/maximum diameter of meniscus extrusion ≥10%was defined as serious extrusion. The chi-square test analysis was used to analyze the correlation between posterior root tears and the medial meniscus extrusion. RESULTS AND CONCLUSION:MRI measurement results of medial meniscus extrusion (length of medial meniscus extrusion ≥ 3 mm or length of medial meniscus extrusion/maximum diameter of meniscus extrusion≥ 10%) was significantly related with the arthroscopic findings of posterior root tears (P<0.05) with the odds ratio and 95%confidence intervals of 25.04 (3.07-204.44) and 6.96 (1.38-35.19) respectively. The medial meniscus serious extrusion is closely related to posterior root tears of the medial meniscus, which is a significant feature of the meniscus posterior root tears.

Objective To evaluate the value of ice-compression therapy in mice skeletal muscle after acute crush injuries and correlate treatment effect with different compression time by MR DTI. Methods Forty Weistar mice were randomly divided into 4 groups by random number table method: control group (A), 5 min compression time group( B), 15 min compression time group(C) and 30 min compression time group(D). Diffusion tensor imaging examinations were performed before, immediately after, 24, 48 and 72 hours after injuries. ADC and FA values were calculated by fiber tracking tool. The morphological changes were confirmed by histopathology, and immunohistochemical methods were used for the assessment of Desmin expression with mean of A value. Statistical analysis by LSD-t test and Spearman rank correlation.Results (1) For every group before injuries, ADC valueswere (1.38±0.04) ×10-3,(1.38±0.08) ×10-3, ( 1.34 ± 0. 05 ) × 10 -3, ( 1.36 ± 0. 09 ) × 10 -3 mm2/s respectively, FA value were 0. 46 ± 0. 05,0. 45 ±0. 03,0. 45 ± 0. 05,0. 48 ± 0. 04 respectively. ADC values increased significantly and FA values reduced in each group immediately after injuries compared with pre-injury values. ADC values were ( 1.84 ±0. 10) × 10-3, ( 1.79 ±0. 09) × 10-3, ( 1.55 ±0. 07) × 10-3, ( 1.57 ±0. 04) × 10 -3mm2/s respectively,FA value were 0. 21 ±0. 04, 0. 26 ±0. 03, 0. 31 ±0. 02, 0. 30 ±0. 04 respectively. ADC values were still higher and FA values lower than pre-injury values at 24 hours after injury in A, B groups. ADC values were (1.54±0.13) ×10-3, (1.57±0.13) × 10-3mm2/s, FA value were 0.25 ±0.03, 0.26±0.02. (2)DTT showed fibers distorted and the number of fiber bundles reduced, some separation and displacement in each group immediately after injury. C, D groups improved more than A, B groups over time. (3) The disorder arrangement of skeletal muscle cells with edema and filaments separation were found in HE staining after injury, but the degree mitigated in C, D groups. Desmin staining became lighter with fuzzy edge immediately and 24 hours after injury, and changed more than 72 hours after injury. (4) The correlation coefficients of ADC, FA values and A value were respectively - 0. 789 and 0. 763 ( P ＜ 0. 05 ). Conclusions DTI can non-invasively reflect the pathological changes after acute crush injuries of muscles of mice and ice compression therapy. It is a useful method to guide ice compression treatment after acute crush injuries.