Objective:To investigate the current status of breast reconstruction after breast cancer surgery in hospitals in China.Methods:This study was a cross-sectional study using convenience sampling. A self-designed survey questionnaire was used to investigate nurses of department of breast diseases in China from May to August 2023. The content of the questionnaire included four aspects: identification information, basic hospital information, the implementation situation of breast reconstruction after breast cancer surgery, and the situation of medical and nursing human resources for breast reconstruction, with a total of 39 items. Statistical analysis was performed using SPSS 26.0 software. The non-normally distributed measurement data were expressed as M( Q1, Q3), and the Mann-Whitney U test was used for comparison between groups. Numeric data were expressed as frequency and percentage, and comparisons between groups were made using the χ2-test or Fisher’s exact probability method. P<0.05 indicated that the difference was statistically significant. Results:A total of 212 public hospitals from 31 provinces, autonomous regions and municipalities participated in the survey. Two hundred and three hospitals (95.8%) returned valid data, including 155 Grade Ⅲ Level A hospitals, 19 Grade Ⅲ Level B and C hospitals, and 29 Grade Ⅱ hospitals. There were 157 general hospitals, 32 specialized cancer hospitals, and 14 other hospitals. Thirty-nine hospitals did not perform breast reconstruction surgery. A total of 164 hospitals (80.8%) had already carried out breast reconstruction surgery, among which the proportion of breast reconstruction in Grade Ⅲ Level A hospitals [90.3% (140/155)] was significantly higher than that in Grade Ⅲ Level B and C hospitals [52.6% (10/19)] and Grade Ⅱ hospitals [48.3% (14/29)] ( P<0.01). The proportion of breast reconstruction in specialized cancer hospitals [96.9% (31/32)] was significantly higher than that in general hospitals [79.0% (124/157)] and other types of hospitals [64.3% (9/14)] ( P<0.05). Among the 164 hospitals, 310 (150, 637.5) patients underwent breast cancer surgery and 30 (10, 100) patients underwent breast reconstruction in 2022. The proportion of patients undergoing breast reconstruction surgery among breast cancer surgery patients was 13.3% (4.0%, 20.0%). The number of patients receiving immediate breast reconstruction was 11 (2.5, 46.5) cases, and the number of those receiving delayed breast reconstruction was 5 (0, 18.5) cases. Among 203 hospitals, the median proportions of breast oncoplastic surgeons and specialized nurses among healthcare providers in breast surgery departments were 28.6% (2/7) and 75.0% (12/16), respectively. In comparison of the 164 hospitals offering breast reconstruction surgery and 39 hospitals not, the median numbers of breast oncoplastic surgeons were 3 (1, 8) versus 1 (0, 3), and qualified breast reconstruction nurses were 12 (6, 16) versus 1 (0, 8), respectively. All differences were statistically significant (all P<0.01). Conclusion:About 80% of hospitals in China have offered breast reconstruction procedures after breast cancer surgery, and the proportion of Grade Ⅲ Level A hospitals and specialized cancer hospitals is higher than that of other types of hospitals. The proportion of patients undergoing breast reconstruction after breast cancer surgery is relatively low, and there is a considerable potential of improvements. Breast oncoplastic surgeons and nurses are insufficient, so it is necessary to strengthen the training of specialized medical staff and improve surgical techniques and the level of nursing services simultaneously, so as to improve the quality of life of breast cancer patients.

Objective To investigate the association between single nucleotide polymorphisms(SNP)rs57095329 and rs6864584 of miR-146a gene and cervical intraepithelial neoplasia(CIN).Methods A total of 96 patients diagnosed with CIN were randomly collected as the CIN group,and 225 healthy individuals examined during the same period were selected as the control group using SPSS software.Genotyping of the above SNP loci was performed using the TaqMan probe method,and their correlation with CIN was analyzed.Results The allele and genotype distribution of rs57095329 showed a statistically significant differences compared to the control group,with the frequency of the allele A in the CIN group significantly lower than that in the control group(P<0.001;OR=0.48,95%CI:0.32～0.70).In the dominant model,individuals carrying the G allele(A/G-G/G)had a significantly increased risk of CIN(P<0.001;OR=2.67,95%CI:1.64～4.37).In contrast,no correlation was found between the rs6864584 and the risk of CIN.Conclusion The A allele of the miR-146a gene at the rs57095329 locus may be a protective factor for CIN.

This study aims to analyze the biological characteristics such as pathogenicity,serotype,virulence genes,and drug resistance of Escherichia coli(E.coli)causing diarrhea in dairy and meat calves in different farms in the Northern Hebei.From 2022 to 2023,120 diseased tissue sam-ples(feces,anal swabs,and livers)of calves(0-2 months old)suffering from diarrhea in the north-ern Hebei region were collected.The detection of viral and parasitic pathogens was negative.Bacte-rial isolation and cultivation,morphological observation,biochemical identification,and PCR meth-ods were used to identify E.coli.Biological characteristics such as pathogenicity,serum typing,vir-ulence genes,and drug resistance were detected using mouse virulence test,glass plate agglutina-tion test,PCR method,and K-B drug sensitivity paper method,and determine the median lethal dose(LD50)of representative strains of dominant serotypes in mice respectively.The results showed that 76 strains of E.coli were isolated,and 56 strains were pathogenic E.coli that could cause varying degrees of death in mice,with mortality rates all above 40％.Among 56 pathogenic E.coli strains,O6 and O152 were the dominant pathogenic serotypes,among which 48 strains(85.7％)were enterotoxic E.coli(ETEC),6 strains(10.7％)were enteropathogenic E.coli(EPEC),and 2 strains(3.6％)were enterohemorrhagic E.coli(EHEC).The detection rates of vir-ulence genes fyuA,irp2,fliC,stx1,stx2,K88,K99,eaeA and ler were over 50％,while the de-tection rates of other types of virulence genes were 3.6％to 37.0％.The resistance rates to nine drugs such as ampicillin,neomycin,and amoxicillin were over 42.9％,and the resistance rates to other drugs were 12.5％to 32.1％,showing multiple drug resistance and at least resistance to three types of antibiotics.The LD50 values of the dominant serotype of representative strains ETO 152 strain and EPO6 were 3.16×104 and 3.22×106 CFU/mL,respectively.This study can provide ref-erence for the prevention and control of E.coli disease in dairy and meat calves in the Northern Hebei region.

Objective:To standardize perioperative nursing procedures for autologous tissue breast reconstruction and reduce perioperative complications by formulating the Expert Consensus on Perioperative Nursing Care for Autologous Tissue Breast Reconstruction ( 2024 Edition) (hereinafter referred to as the Consensus) . Methods:Relevant guidelines, systematic reviews, and randomized controlled trials were systematically reviewed and combined with expert clinical experience to draft the initial version of the Consensus. After two rounds of expert consultation, the items were revised and finalized. Results:A total of 24 questionnaires were distributed and returned in both rounds, yielding a 100% valid response rate (24/24). The authority coefficient of the 24 experts was 0.836. The Kendall's coefficient of concordance was 0.836 ( P<0.01). The finalized Consensus includes 5 key components: preoperative care, intraoperative care, postoperative care, management of complications, and discharge guidance with follow-up. Conclusions:The Consensus is scientifically sound and clinically practical. It provides a standardized, evidence-based reference for establishing national protocols for perioperative nursing care in autologous tissue breast reconstruction.

This study aims to analyze the biological characteristics such as pathogenicity,serotype,virulence genes,and drug resistance of Escherichia coli(E.coli)causing diarrhea in dairy and meat calves in different farms in the Northern Hebei.From 2022 to 2023,120 diseased tissue sam-ples(feces,anal swabs,and livers)of calves(0-2 months old)suffering from diarrhea in the north-ern Hebei region were collected.The detection of viral and parasitic pathogens was negative.Bacte-rial isolation and cultivation,morphological observation,biochemical identification,and PCR meth-ods were used to identify E.coli.Biological characteristics such as pathogenicity,serum typing,vir-ulence genes,and drug resistance were detected using mouse virulence test,glass plate agglutina-tion test,PCR method,and K-B drug sensitivity paper method,and determine the median lethal dose(LD50)of representative strains of dominant serotypes in mice respectively.The results showed that 76 strains of E.coli were isolated,and 56 strains were pathogenic E.coli that could cause varying degrees of death in mice,with mortality rates all above 40％.Among 56 pathogenic E.coli strains,O6 and O152 were the dominant pathogenic serotypes,among which 48 strains(85.7％)were enterotoxic E.coli(ETEC),6 strains(10.7％)were enteropathogenic E.coli(EPEC),and 2 strains(3.6％)were enterohemorrhagic E.coli(EHEC).The detection rates of vir-ulence genes fyuA,irp2,fliC,stx1,stx2,K88,K99,eaeA and ler were over 50％,while the de-tection rates of other types of virulence genes were 3.6％to 37.0％.The resistance rates to nine drugs such as ampicillin,neomycin,and amoxicillin were over 42.9％,and the resistance rates to other drugs were 12.5％to 32.1％,showing multiple drug resistance and at least resistance to three types of antibiotics.The LD50 values of the dominant serotype of representative strains ETO 152 strain and EPO6 were 3.16×104 and 3.22×106 CFU/mL,respectively.This study can provide ref-erence for the prevention and control of E.coli disease in dairy and meat calves in the Northern Hebei region.

Objective:To investigate the current status of breast reconstruction after breast cancer surgery in hospitals in China.Methods:This study was a cross-sectional study using convenience sampling. A self-designed survey questionnaire was used to investigate nurses of department of breast diseases in China from May to August 2023. The content of the questionnaire included four aspects: identification information, basic hospital information, the implementation situation of breast reconstruction after breast cancer surgery, and the situation of medical and nursing human resources for breast reconstruction, with a total of 39 items. Statistical analysis was performed using SPSS 26.0 software. The non-normally distributed measurement data were expressed as M( Q1, Q3), and the Mann-Whitney U test was used for comparison between groups. Numeric data were expressed as frequency and percentage, and comparisons between groups were made using the χ2-test or Fisher’s exact probability method. P<0.05 indicated that the difference was statistically significant. Results:A total of 212 public hospitals from 31 provinces, autonomous regions and municipalities participated in the survey. Two hundred and three hospitals (95.8%) returned valid data, including 155 Grade Ⅲ Level A hospitals, 19 Grade Ⅲ Level B and C hospitals, and 29 Grade Ⅱ hospitals. There were 157 general hospitals, 32 specialized cancer hospitals, and 14 other hospitals. Thirty-nine hospitals did not perform breast reconstruction surgery. A total of 164 hospitals (80.8%) had already carried out breast reconstruction surgery, among which the proportion of breast reconstruction in Grade Ⅲ Level A hospitals [90.3% (140/155)] was significantly higher than that in Grade Ⅲ Level B and C hospitals [52.6% (10/19)] and Grade Ⅱ hospitals [48.3% (14/29)] ( P<0.01). The proportion of breast reconstruction in specialized cancer hospitals [96.9% (31/32)] was significantly higher than that in general hospitals [79.0% (124/157)] and other types of hospitals [64.3% (9/14)] ( P<0.05). Among the 164 hospitals, 310 (150, 637.5) patients underwent breast cancer surgery and 30 (10, 100) patients underwent breast reconstruction in 2022. The proportion of patients undergoing breast reconstruction surgery among breast cancer surgery patients was 13.3% (4.0%, 20.0%). The number of patients receiving immediate breast reconstruction was 11 (2.5, 46.5) cases, and the number of those receiving delayed breast reconstruction was 5 (0, 18.5) cases. Among 203 hospitals, the median proportions of breast oncoplastic surgeons and specialized nurses among healthcare providers in breast surgery departments were 28.6% (2/7) and 75.0% (12/16), respectively. In comparison of the 164 hospitals offering breast reconstruction surgery and 39 hospitals not, the median numbers of breast oncoplastic surgeons were 3 (1, 8) versus 1 (0, 3), and qualified breast reconstruction nurses were 12 (6, 16) versus 1 (0, 8), respectively. All differences were statistically significant (all P<0.01). Conclusion:About 80% of hospitals in China have offered breast reconstruction procedures after breast cancer surgery, and the proportion of Grade Ⅲ Level A hospitals and specialized cancer hospitals is higher than that of other types of hospitals. The proportion of patients undergoing breast reconstruction after breast cancer surgery is relatively low, and there is a considerable potential of improvements. Breast oncoplastic surgeons and nurses are insufficient, so it is necessary to strengthen the training of specialized medical staff and improve surgical techniques and the level of nursing services simultaneously, so as to improve the quality of life of breast cancer patients.

Objective:To standardize perioperative nursing procedures for autologous tissue breast reconstruction and reduce perioperative complications by formulating the Expert Consensus on Perioperative Nursing Care for Autologous Tissue Breast Reconstruction ( 2024 Edition) (hereinafter referred to as the Consensus) . Methods:Relevant guidelines, systematic reviews, and randomized controlled trials were systematically reviewed and combined with expert clinical experience to draft the initial version of the Consensus. After two rounds of expert consultation, the items were revised and finalized. Results:A total of 24 questionnaires were distributed and returned in both rounds, yielding a 100% valid response rate (24/24). The authority coefficient of the 24 experts was 0.836. The Kendall's coefficient of concordance was 0.836 ( P<0.01). The finalized Consensus includes 5 key components: preoperative care, intraoperative care, postoperative care, management of complications, and discharge guidance with follow-up. Conclusions:The Consensus is scientifically sound and clinically practical. It provides a standardized, evidence-based reference for establishing national protocols for perioperative nursing care in autologous tissue breast reconstruction.

Objective The MMV-Net,a deep learning framework based on mammogram multiple views,was constructed to evaluate the classification performance of the model for benign and malignant masses.Methods A retrospective analysis was conduc-ted on a dataset of 1 585 breast X-ray images from Harbin Medical University Cancer Hospital from 2018 to 2020,including 806 be-nign cases and 779 malignant cases.The dataset was divided into the training set(n=1268)and the test set(n=317)according to an 8∶2 ratios,and the training set was stratified according to the 5-fold cross validation.The integrated DDSM dataset and INBreast dataset were used as external test sets(n=1645)to evaluate the model performance.Each case in the input layer contained 4 views.The MMV-Net model was constructed by removing the last two layers of the ResNet22 network structure and adding an average poo-ling layer as the feature extraction layer,as well as fully connection layer and softmax activation function as the decision layers.Bayes-ian hyperparameter optimization was used.The performance of MMV-Net,MFA Net,and ensemble inception V4 models in AUC val-ues,accuracy,precision,recall and F1 scores were compared.Results The AUC values of MMV-Net model for distinguishing benign and malignant masses on the test set were 0.913,0.882 for MFA-Net,and 0.865 for inception V4.The accuracy and precision evalu-ation metrics of the MMV-Net model were also higher than the other two models.Conclusion The deep learning MMV-Net model based on multiple views of mammogram is helpful for the classification of benign and malignant breast masses.

ObjectiveTo explore the correlation between skeletal muscle mass and metabolic syndrome （MS） disease risk among middle-aged and elderly community residents in Urumqi， and to provide a theoretical basis for understanding the relationship between skeletal muscle mass and MS among middle-aged and elderly community residents in China. MethodsA total of 1 438 community residents ≥ 50 years old were selected as the research subjects from July 2018 to January 2019 in Urumqi. They were selected from a multi-ethnic natural population cohort in Xinjiang. Data were collected through questionnaires， physical examination， bioelectrical impedance analysis （BIA）， laboratory tests， etc. Skeletal muscle mass was evaluated using the limb skeletal muscle mass index （SMI） corrected for body weight； MS was defined as it at least includes three of the following： abdominal obesity， hypertension， hyperglycemia， high triglycerides and low high-density lipoprotein cholesterol. SMI was divided into four quantile arrays of Q₁‒Q₄. Trend χ² test was applied to explore whether there was a correlation between SMI changes and MS. A multivariate logistic regression model was used to analyze whether there is a difference in the risk of MS between the higher SMI group （Q₂， Q₃， Q₄） and the reference group Q₁. ResultA total of 560 MS patients were detected in this study， with a prevalence rate of 38.94%. Among them， the prevalence rate of MS was 39.16% in males and 38.80% in females. The increase in male SMI grading level is not correlated with the prevalence of MS （trend P>0.05）； After adjusting for confounding factors （model 4）， the increase in SMI was still not related to the prevalence of MS （P_trend=0.995）. There was no statistical difference in the risk of MS between the lowest quartile group Q₁ and the highest quartile group Q₄ （OR=1.01， 95%CI： 0.69‒1.78）. The prevalence of MS in women gradually decreased with the increase of SMI grading level （P_trend<0.001）； After adjusting for confounding factors （model 4）， there was still a correlation between the increase of SMI and the prevalence of MS （P_trend=0.005）. With the lowest quartile of SMI Q₁ as the reference group， the risk of MS in Q₂ （OR=0.63， 95%CI： 0.40‒1.00）， Q₃ （OR=0.56， 95%CI： 0.34‒0.94）， Q₄ （OR=0.42， 95%CI： 0.23‒0.76） decreased. ConclusionAn increase in skeletal muscle mass may be beneficial for preventing MS， especially among middle-aged and elderly female residents. Considering the intensification of aging in China and the close relationship between MS and related comorbidities， managing skeletal muscle mass may contribute to potential MS prevention.

The prevention and control of chronic and non-communicable diseases is an important public health problem in China. The general environment in the northwestern China is unique, and the health and disease status of local population is distinctive. In order to meet the urgent need for in-depth research of the causes, mechanisms and prognosis of chronic and non-communicable diseases in this area, a general population cohort in Shaanxi Province, Gansu Province and Qinghai Province, Ningxia Hui Autonomous Region and Xinjiang Uygur Autonomous Region was established during 2017-2019. A total of 117 644 general individuals aged 35-74 years in the multi-ethnic groups (Han, Hui, Uygur, Kazak and Tibetan) were recruited according to the special ecological environment, population size and ethnic distribution. The baseline information about individual exposure, environment and society were collected. More than 900 000 biological samples, including whole blood, plasma, serum and buffy coat, were collected and stored at -80 ℃ in standardized biobank. The long-term observation has started in forms of routine monitoring and active follow-up. The average age of the cohort members was 52.43 years, and 70 391 cohort members were women (59.8%). There were some differences in socio-economic status and lifestyle among different ethnic groups. Although the cohort members in different ethnic groups had similar health status, different characteristics still existed. The cohort can serve as a platform for in-depth research of the relationship between major chronic and non-communicable diseases and environment, people's lifestyle and genetic factors, and the research results can be used as important epidemiological evidence for clarifying the causes of chronic and non-communicable diseases and long-term health hazards in different ethnic groups in this area and reference for the national chronic and non-communicable disease prevention and control. This paper briefly introduces the design and practice of general population cohort in northwestern China.