Recent research from the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO) indicates that breast cancer is the most prevalent malignant tumor among women, posing a significant threat to women's health. Surgery remains the primary therapeutic modality for breast cancer. Recently, endoscopic and robotic breast surgical techniques have gained acceptance among both surgeons and patients. However, considerable variation exists in surgical approaches and outcomes. To standardize these techniques, facilitate their broader clinical adoption, and ultimately improve patient care, the Endoscopic-robotic Breast Surgery Clinical Trials Consortium (ErBSCTC) of China has developed this guideline. This document encompasses the technologies and instrumentation utilized in endoscopic and robotic breast surgery, surgical techniques, perioperative management, complication handling, long-term follow-up, and oncologic outcomes, aiming to provide evidence-based guidance for healthcare professionals involved in the prevention, diagnosis, and treatment of breast diseases.

Breast cancer is the most common malignant tumor among women in China, with surgery being one of the primary treatment modalities. Endoscopic/robotic breast surgery (ErBS) is gaining widespread acceptance among patients and surgeons alike due to its advantages of minimal invasiveness, superior cosmetic outcomes, and accelerated recovery. However, substantial heterogeneity currently exists across China regarding patient selection, standardized operative techniques, perioperative management, and complication handling, underscoring the urgent need for evidence-based consensus guidelines. To promote standardization and ensure consistent quality of ErBS, the Chinese Endoscopic-Robotic Breast Surgery Clinical Trials Consortium (CErBSCTC) has systematically reviewed the latest high-quality evidence and formulated the "Protocol for China Endoscopic and Robotic Breast Surgery Guidelines (2026 edition)", which outlines a comprehensive methodology for guideline development.

This guideline, presented in three parts, details the core aspects of endoscopic/robotic breast surgery, including its techniques, equipment, surgical procedures, perioperative management, complication treatment, long-term follow-up, and outcomes. Part one offered a comprehensive overview of indications for endoscopic and robotic breast surgery, intraoperative techniques, surgical instrument choices, and common endoscopic and robotic breast reconstruction procedures. This part will cover other endoscopic breast procedures beyond immediate breast reconstruction and include perioperative management strategies, to provide healthcare professionals involved in endoscopic and robotic breast surgery with systematic operational guidelines and clinical decision-making references.

ObjectiveTo investigate the chemical hazards in the production line of lithium batteries, so as to provide a scientific basis for the management of occupational-health risk and to promote the healthy and sustainable development of the lithium battery industry. MethodsAn on-site survey on the process flow of the production of lithium battery was conducted in an enterprise. Volatile organic compounds (VOCs) in the occupational environment were collected by Summa canisters, carbonates and N-methyl pyrrolidone (NMP) were collected using activated carbon tubes, and airborne metals were collected using filter membranes. VOCs, carbonates and NMP were detected by gas chromatography-mass spectrometry (GC-MS), and airborne metal elements in the dust samples were analyzed by inductively coupled plasma mass spectrometry (ICP-MS). ResultsNon-targeted environmental monitoring results indicated that NMP was detected in the negative /positive electrode coating, assembly and drying filling workstations, dimethyl carbonate (DMC) was detected in the assembly, drying and electrolyte injection workstations, and ethyl methyl carbonate (EMC) was detected solely in the electrolyte injection workstation. Semi-quantitative analyses of VOCs identified 136 pollutants, including acrylonitrile and halohydrocarbons. Quantitative targeted environmental monitoring results revealed the highest geometric mean (GM) concentration of EMC (31.450 mg·m^-3) was found in the assembly and drying workstations, diethyl carbonate (DEC) was detected in all workstations. While vinylene carbonate (VC) and ethylene carbonate (EC) were detected only in electrolyte injection, assembly and drying workstations. NMP was detected in all positive electrode coating samples, with a GM concentration of 5.68 mg·m^-3 (concentration range: 4.0‒ 7.4 mg·m^-³). Lithium was exclusively detected in dust samples from the liquid injection workstation (GM: 0.014 μg·m^-³). ConclusionNMP, EMC, DEC, and other chemicals are identified at the key workstations such as the positive electrode coating, electrolyte injection, assembly and drying in the lithium production line. Furthermore, semi-quantitative VOCs analyses identified 136 pollutants, demonstrating a characteristic of multicomponent chemical exposure.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective To investigate the clinical efficacy and safety of two thrombus thrombectomy devices,AcoStream and AngioJet,in the treatment of acute iliofemoral vein thrombosis(AIFVT).Methods A total of 97 AIFVT patients were treated with different thrombus clearing devices according to their states of illness,and patients were divided into the AcoStream group(41 cases)and the AngioJet group(56 cases).The thrombus clearing status,degree of swelling reduction in affected limb,surgical time and intraoperative blood loss were compared between the two groups,and the need for assisted catheter contact thrombolysis(CDT)treatment,urokinase dosage,iliac vein stent placement,incidence of complications,length of hospital stay and hospitalization costs were also compared between the two groups.Regular follow-up was conducted to record for recurrence of thrombosis,the patency of the stent,deep vein thrombosis syndrome(PTS)and PTS degree were evaluated in lower limbs.Results There were no significant differences in age,gender,affected limb,time of illness,site of illness and causes of illness between the two groups(P＞0.05).The operation was successful in both groups and the thrombus removal effect was satisfactory.There were no significant differences in terms of thrombus clearance rate,the degree of swelling reduction in the limb 48 hours after surgery and assisted CDT rate between the two groups(P＞0.05).Compared with the AcoStream group,the AngioJet group had a longer surgical time,reduced intraoperative blood loss,increased hospitalization costs and higher rates of complications(P＜0.05).There was no significant difference in the recurrence rate of thrombosis between the two groups(P＞0.05),and there was no occurrence of iliac vein stent occlusion or PTS in either patients.Conclusion Two mechanical thrombus clearing devices of AcoStream and AngioJet are safe and effective for treating AIFVT.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective To investigate the clinical efficacy and safety of two thrombus thrombectomy devices,AcoStream and AngioJet,in the treatment of acute iliofemoral vein thrombosis(AIFVT).Methods A total of 97 AIFVT patients were treated with different thrombus clearing devices according to their states of illness,and patients were divided into the AcoStream group(41 cases)and the AngioJet group(56 cases).The thrombus clearing status,degree of swelling reduction in affected limb,surgical time and intraoperative blood loss were compared between the two groups,and the need for assisted catheter contact thrombolysis(CDT)treatment,urokinase dosage,iliac vein stent placement,incidence of complications,length of hospital stay and hospitalization costs were also compared between the two groups.Regular follow-up was conducted to record for recurrence of thrombosis,the patency of the stent,deep vein thrombosis syndrome(PTS)and PTS degree were evaluated in lower limbs.Results There were no significant differences in age,gender,affected limb,time of illness,site of illness and causes of illness between the two groups(P＞0.05).The operation was successful in both groups and the thrombus removal effect was satisfactory.There were no significant differences in terms of thrombus clearance rate,the degree of swelling reduction in the limb 48 hours after surgery and assisted CDT rate between the two groups(P＞0.05).Compared with the AcoStream group,the AngioJet group had a longer surgical time,reduced intraoperative blood loss,increased hospitalization costs and higher rates of complications(P＜0.05).There was no significant difference in the recurrence rate of thrombosis between the two groups(P＞0.05),and there was no occurrence of iliac vein stent occlusion or PTS in either patients.Conclusion Two mechanical thrombus clearing devices of AcoStream and AngioJet are safe and effective for treating AIFVT.

Objective:To evaluate the therapeutic efficacy of modified Ω nail braces and traditional Winograd surgery.Methods:A retrospective analysis was conducted on the medical records of patients with ingrown toenails treated at the Department of Orthopedics of Beijing Tongren Hospital Affiliated to Capital Medical University and the Department of Hand and Foot Surgery, the Fourth People’s Hospital of Langfang City from November 2018 to November 2020. The subjects were divided into two groups: Winograd technique group (WTG) and modified Ω nail braces group (NBG). The basic information of the patients included gender, age, body mass index (BMI), affected side, stage of condition, combined deformity, water exposure, and foot sweating. The occurrence of complications, rate of patient satisfaction, duration of recovery, recurrence rate (the number of recurrences of ingrown nails / the total number of feet), and interval between recurrences were followed up after surgery. The statistical methods employed in this study included two-group t-test and Chi-square test. A significance level of 0.05 was adopted to determine statistical significance. Results:A total of 98 patients with 116 feet were enrolled in the study, comprising 47 cases with 55 feet in the WTG group [33 males and 14 females, age: (31.5±10.8) years] and 51 cases with 61 feet in the NBG group [29 males and 22 females, age: (33.3±13.4) years]. The average duration of nail brace usage in the WBG was (2.7±0.8) months, and the mean follow-up period was (12.3±1.1) months after dismantling. No complications were observed during the follow-up. The mean follow-up duration in the WBG was (12.5±0.9) months. Two patients experienced post-operative infection one week after the surgery, but recovered completely within 60 days through regular dressing changes. In 3 cases, wound exudation occurred following suture removal. However, normal wound healing was achieved with rest and local application of mupirocin ointment. After foot surgery, 2 cases presented with nail spines at a later stage of 2 months, without significant pain or need for further intervention. The two groups did not exhibit any significant differences in terms of gender, age, BMI, affected side, and stage (all P>0.05). The NBG group exhibited a significantly shorter average time of return to work compared to the WTG group [(0.5±0.4) d vs. (13.9±7.3) d], along with a higher patient satisfaction rate (95.1% vs. 83.6% ), both of which showed statistical significance ( P<0.05). No significant differences were observed between WTG and NBG regarding recurrence interval and recurrence rate ( P>0.05). Conclusion:The modified Ω nail brace is equally effective in the treatment of ingrown nails compared to Winograd surgery, but it offers a simpler, more convenient and noninvasive approach. Moreover, patients in the nail brace group exhibited higher satisfaction rates, faster recovery times, and no risk of surgical complications. Therefore, this method can be considered a viable option for treating ingrown nails.

Objective:To evaluate the therapeutic efficacy of modified Ω nail braces and traditional Winograd surgery.Methods:A retrospective analysis was conducted on the medical records of patients with ingrown toenails treated at the Department of Orthopedics of Beijing Tongren Hospital Affiliated to Capital Medical University and the Department of Hand and Foot Surgery, the Fourth People’s Hospital of Langfang City from November 2018 to November 2020. The subjects were divided into two groups: Winograd technique group (WTG) and modified Ω nail braces group (NBG). The basic information of the patients included gender, age, body mass index (BMI), affected side, stage of condition, combined deformity, water exposure, and foot sweating. The occurrence of complications, rate of patient satisfaction, duration of recovery, recurrence rate (the number of recurrences of ingrown nails / the total number of feet), and interval between recurrences were followed up after surgery. The statistical methods employed in this study included two-group t-test and Chi-square test. A significance level of 0.05 was adopted to determine statistical significance. Results:A total of 98 patients with 116 feet were enrolled in the study, comprising 47 cases with 55 feet in the WTG group [33 males and 14 females, age: (31.5±10.8) years] and 51 cases with 61 feet in the NBG group [29 males and 22 females, age: (33.3±13.4) years]. The average duration of nail brace usage in the WBG was (2.7±0.8) months, and the mean follow-up period was (12.3±1.1) months after dismantling. No complications were observed during the follow-up. The mean follow-up duration in the WBG was (12.5±0.9) months. Two patients experienced post-operative infection one week after the surgery, but recovered completely within 60 days through regular dressing changes. In 3 cases, wound exudation occurred following suture removal. However, normal wound healing was achieved with rest and local application of mupirocin ointment. After foot surgery, 2 cases presented with nail spines at a later stage of 2 months, without significant pain or need for further intervention. The two groups did not exhibit any significant differences in terms of gender, age, BMI, affected side, and stage (all P>0.05). The NBG group exhibited a significantly shorter average time of return to work compared to the WTG group [(0.5±0.4) d vs. (13.9±7.3) d], along with a higher patient satisfaction rate (95.1% vs. 83.6% ), both of which showed statistical significance ( P<0.05). No significant differences were observed between WTG and NBG regarding recurrence interval and recurrence rate ( P>0.05). Conclusion:The modified Ω nail brace is equally effective in the treatment of ingrown nails compared to Winograd surgery, but it offers a simpler, more convenient and noninvasive approach. Moreover, patients in the nail brace group exhibited higher satisfaction rates, faster recovery times, and no risk of surgical complications. Therefore, this method can be considered a viable option for treating ingrown nails.