Objective This study evaluated the diagnostic value of adding magnetic resonance imaging (MRI) to multimodal ultrasound for breast cancer, where multimodal ultrasound consisted of two-dimensional imaging and the strain ratio (SR) from elastography. Methods We enrolled 180 patients with breast lesions who were admitted to our hospital between August 2023 and August 2025. All patients underwent multimodal ultrasound and MRI examinations. Multimodal ultrasound included two-dimensional imaging and ultrasound elastography with strain ratio measurement. Breast cancer detection rates were assessed for each imaging method. The diagnostic performance of multimodal ultrasound alone, MRI alone, and the two methods combined was compared. Results Among the 180 patients, 82 (45.56%) had benign lesions and 98 (54.44%) had malignant lesions. The numbers of cases consistent with pathological diagnosis were 152 for multimodal ultrasound, 145 for MRI, and 160 for their combination. The sensitivity of the combined diagnosis was 95.92%, which exceeded that of multimodal ultrasound alone (84.69%) and MRI alone (79.59%). The negative predictive value of the combined diagnosis was 94.29%, which was significantly higher than that of MRI alone (77.01%, P<0.05). Conclusion Combining MRI with multimodal ultrasound based on SR and two-dimensional ultrasound significantly improves the differential diagnosis of breast cancer. This strategy compensates for the limitations of using a single modality and provides a more reliable imaging basis for clinical diagnosis and treatment decisions.

Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute（CLSI）. Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus（ n=1 544，35.2%），coagulase-negative Staphylococci（ n=1 441，32.9%）， Enterococcus faecium（ n=574，13.1%）， Enterococcus faecalis（ n=385，8.8%），and α-hemolytic Streptococci（ n=187，4.3%）. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）was 26.2%（405/1 544）and 69.8%（1 006/1 441），respectively. Notably，all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility（>97.0%）to cephalobiol，rifampicin，trimethoprim-sulfamethoxazole，linezolid，minocycline，tigecycline，and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium（resistance to vancomycin and teicoplanin：both 1.7%）compared to Enterococcus faecalis（both 0.3%）. The detection rates of MRSA and MRCNS exhibited significant regional variations across the country（ χ2=17.674 and 148.650，respectively，both P<0.001）. No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA（ χ2=14.111， P<0.001）and MRCNS（ χ2=4.828， P=0.028）in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA（ χ2=18.986， P<0.001）and MRCNS（ χ2=4.477， P=0.034）in less developed regions（per capita GDP

Objective:To report the results of bacterial resistant investigation collaborative system（BRICS）on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2023，and provide reference for clinical tretment of bloodstream infections and prevention and control of bacterial resistance.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of BRICS were collected during January 2023 to December 2023. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 were used to analyze the data.Results:During the study period，11 492 strains of Gram-negative bacteria were collected from 60 hospitals，of which 10 098（87.9%）were Enterobacterales and 1 394（12.1%）were non-fermentative bacteria. The top 5 bacterial species were Escherichia coli（50.0%）， Klebsiella pneumoniae（26.1%）， Pseudomonas aeruginosa（5.1%）， Acinetobacter baumannii complex（5.0%）and Enterobacter cloacae complex（4.1%）. The ESBL-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus mirablilis were 46.8%（2 685/5 741），18.3%（549/2 999）and 44.0%（77/175），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（76/5 741）and 15.0%（450/2 999）；32.9%（25/76）and 78.0%（351/450）of CREC and CRKP were sensitive to ceftazidime/avibactam combination，respectively. 94.7%（72/76）and 90.2%（406/450）of CREC and CRKP were sensitive to aztreonam/avibactam combination. Furthermore，57.9%（44/76）and 79.1%（356/450）were sensitive to imipenem/relebactam combination. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 64.6%（370/573），while more than 80.0% of CRAB complex was sensitive to tigecycline，eravacycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 17.0%（99/581）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of important Gram-negative bacteria resistance among different regions in China，with statistically significant differences in the prevalence of CREC，CRKP，CRPA and CRAB complex（ χ2=10.6，28.6，10.8 and 19.3， P<0.05）. The prevalence of ESBL-producing Escherichia coli， CREC，CRAB complex and CRKP were higher in provincial hospitals than those in municipal hospitals（ χ2=12.5，9.8，12.7 and 57.8，all P<0.01）. Conclusions:Gram-negative bacteria are the main pathogens causing bloodstream infections in China，and Escherichia coli is ranked in the top，while the trend of Klebsiella pneumoniae increases continuously with time. CRKP infection shows a slow upward trend，CREC infecton maintains a low prevalence level，and CRAB complex infection continues to exhibit a high prevalence rate. The composition and resistance patterns of pathogens causing bloodstream infections vary to some extent across different regions and levels of hospitals in China.

Sessile serrated lesion(SSL)is a major precancerous lesion type of colorectal cancer and one of the main causes of colorectal cancer.SSL has unique tissue structures and morphological features,with low detection rate under endoscopy and high variability in histopathological diagnosis,making it one of the most easily missed lesions in colorectal cancer screening.In recent years,the application of artificial intelligence(AI)in the diagnosis of colorectal cancer has been rapidly increasing.Previous studies have found that AI-assisted endoscopic technology can improve the detection rate and diagnostic accuracy of colorectal SSL,and AI-assisted pathological diagnosis can improve diagnostic efficiency and consistency.This article aims to provide a review of current research on AI technology in colorectal SSL.

Colorectal cancer(CRC)is one of the most common malignant tumors worldwide,and its incidence has been increasing in recent years,especially among young adults.Non-genetic factors,such as dietary habits,lifestyle and intestinal flora,play an important role in the development of CRC.Dietary factors have a close relationship with CRC development.Insufficient fiber intake and excessive consumption of red and processed meat are generally considered major high-risk factors for CRC,while vegetables and fruits are considered as beneficial factors.The roles of calcium supplements,vitamin D,dairy products,and different dietary patterns in the development of CRC are still controversial.Furthermore,obesity,smoking,alcohol consumption,and lack of physical exercise are also associated with the risk of CRC.The imbalance of intestinal flora is also believed to be associated with the development of CRC.Optimizing dietary habits and maintaining a healthy lifestyle can significantly reduce the risk of CRC.Non-steroidal anti-inflammatory drugs and estrogen supplementation may have beneficial effects in reducing the risk of CRC.For certain individuals at high risk,pharmacological intervention may serve as an effective preventive measure.

Objective:To explore the prominent manifestations and internal associations of the overuse of short-form videos,inattention,and school refusal behavior in junior high school students.Methods:A survey was conducted among 1 106 junior high school students,utilizing the Short-form Video APP Overuse Scale,the Inatten-tion subscale of the Swanson,Nolan,and Pelham Rating Scale(SNAP-Ⅳ),and the School Refusal Behavior Ques-tionnaire to assess the extent of short-form video overuse,inattention,and school refusal behavior.By using the R language for network analysis,the core nodes of individual networks and the bridge nodes connecting the combined networks were analyzed,and the structural differences in networks across genders and grades were compared.Re-sults:The core nodes of the network pertaining to overuse of short-form video,inattention,and school refusal behav-ior were"Using short videos enhances connection with others"(expected influence value=1.03),"easily distract-ed"(expected influence value=1.99),and"school alienation"(expected influence value=0.83).The bridge nodes in the combined network were"defiant behavior"(bridge expected influence value=0.69)and"difficulty sustaining mental activities"(bridge expected influence value=0.47).Analysis of network structure differences i-dentified that the core nodes within the combined networks of the first,second,and third grades of junior high school students were respectively"prioritizing short videos over other activities","defiant behavior",and"academic aptitude".Conclusion:Junior high school students exhibiting overuse of short videos,inattention,or school refusal behavior are characterized by enhanced social connectivity through platforms such as short video apps,a propensity for distraction,and feelings of school alienation,respectively.When these three behaviors coexist,the most salient related factor is oppositional behavior,coupled with difficulties in sustaining cognitive tasks and maintaining con-centration.

Objective:To explore the prominent manifestations and internal associations of the overuse of short-form videos,inattention,and school refusal behavior in junior high school students.Methods:A survey was conducted among 1 106 junior high school students,utilizing the Short-form Video APP Overuse Scale,the Inatten-tion subscale of the Swanson,Nolan,and Pelham Rating Scale(SNAP-Ⅳ),and the School Refusal Behavior Ques-tionnaire to assess the extent of short-form video overuse,inattention,and school refusal behavior.By using the R language for network analysis,the core nodes of individual networks and the bridge nodes connecting the combined networks were analyzed,and the structural differences in networks across genders and grades were compared.Re-sults:The core nodes of the network pertaining to overuse of short-form video,inattention,and school refusal behav-ior were"Using short videos enhances connection with others"(expected influence value=1.03),"easily distract-ed"(expected influence value=1.99),and"school alienation"(expected influence value=0.83).The bridge nodes in the combined network were"defiant behavior"(bridge expected influence value=0.69)and"difficulty sustaining mental activities"(bridge expected influence value=0.47).Analysis of network structure differences i-dentified that the core nodes within the combined networks of the first,second,and third grades of junior high school students were respectively"prioritizing short videos over other activities","defiant behavior",and"academic aptitude".Conclusion:Junior high school students exhibiting overuse of short videos,inattention,or school refusal behavior are characterized by enhanced social connectivity through platforms such as short video apps,a propensity for distraction,and feelings of school alienation,respectively.When these three behaviors coexist,the most salient related factor is oppositional behavior,coupled with difficulties in sustaining cognitive tasks and maintaining con-centration.

Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute（CLSI）. Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus（ n=1 544，35.2%），coagulase-negative Staphylococci（ n=1 441，32.9%）， Enterococcus faecium（ n=574，13.1%）， Enterococcus faecalis（ n=385，8.8%），and α-hemolytic Streptococci（ n=187，4.3%）. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）was 26.2%（405/1 544）and 69.8%（1 006/1 441），respectively. Notably，all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility（>97.0%）to cephalobiol，rifampicin，trimethoprim-sulfamethoxazole，linezolid，minocycline，tigecycline，and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium（resistance to vancomycin and teicoplanin：both 1.7%）compared to Enterococcus faecalis（both 0.3%）. The detection rates of MRSA and MRCNS exhibited significant regional variations across the country（ χ2=17.674 and 148.650，respectively，both P<0.001）. No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA（ χ2=14.111， P<0.001）and MRCNS（ χ2=4.828， P=0.028）in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA（ χ2=18.986， P<0.001）and MRCNS（ χ2=4.477， P=0.034）in less developed regions（per capita GDP

Objective:To report the results of bacterial resistant investigation collaborative system（BRICS）on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2023，and provide reference for clinical tretment of bloodstream infections and prevention and control of bacterial resistance.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of BRICS were collected during January 2023 to December 2023. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 were used to analyze the data.Results:During the study period，11 492 strains of Gram-negative bacteria were collected from 60 hospitals，of which 10 098（87.9%）were Enterobacterales and 1 394（12.1%）were non-fermentative bacteria. The top 5 bacterial species were Escherichia coli（50.0%）， Klebsiella pneumoniae（26.1%）， Pseudomonas aeruginosa（5.1%）， Acinetobacter baumannii complex（5.0%）and Enterobacter cloacae complex（4.1%）. The ESBL-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus mirablilis were 46.8%（2 685/5 741），18.3%（549/2 999）and 44.0%（77/175），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（76/5 741）and 15.0%（450/2 999）；32.9%（25/76）and 78.0%（351/450）of CREC and CRKP were sensitive to ceftazidime/avibactam combination，respectively. 94.7%（72/76）and 90.2%（406/450）of CREC and CRKP were sensitive to aztreonam/avibactam combination. Furthermore，57.9%（44/76）and 79.1%（356/450）were sensitive to imipenem/relebactam combination. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 64.6%（370/573），while more than 80.0% of CRAB complex was sensitive to tigecycline，eravacycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 17.0%（99/581）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of important Gram-negative bacteria resistance among different regions in China，with statistically significant differences in the prevalence of CREC，CRKP，CRPA and CRAB complex（ χ2=10.6，28.6，10.8 and 19.3， P<0.05）. The prevalence of ESBL-producing Escherichia coli， CREC，CRAB complex and CRKP were higher in provincial hospitals than those in municipal hospitals（ χ2=12.5，9.8，12.7 and 57.8，all P<0.01）. Conclusions:Gram-negative bacteria are the main pathogens causing bloodstream infections in China，and Escherichia coli is ranked in the top，while the trend of Klebsiella pneumoniae increases continuously with time. CRKP infection shows a slow upward trend，CREC infecton maintains a low prevalence level，and CRAB complex infection continues to exhibit a high prevalence rate. The composition and resistance patterns of pathogens causing bloodstream infections vary to some extent across different regions and levels of hospitals in China.

Objective:To explore the mediating role of aging attitude and anxiety in the relationship between self-worth and depression among the elderly.Methods:From July to August 2022, a total of 536 elderly people in Shijiazhuang University for the Elderly were surveyed by the elderly self-worth scale, generalized anxiety disorder-7(GAD-7), attitudes to aging questionnaire(AAQ) and patient health questionnaire(PHQ-9). SPSS 26.0 software was used for descriptive statistics and correlation analysis.AMOS 24.0 was used to construct an intermediation model, and Bootstrap method was used for mediating effect testing.Results:(1)The score of self-worth was 101.00 (92.00, 112.00), the score of aging attitude was 92.00 (83.00, 101.75), the score of anxiety was 2.00(0, 6.00), and the score of depression was 2.00 (0, 5.00). (2)Self-worth was positively correlated with aging attitude ( r=0.67, P<0.01), while negatively correlated with anxiety ( r=-0.45, P<0.01) and depression ( r=-0.48, P<0.01). The aging attitude was negatively correlated with anxiety ( r=-0.41, P<0.01) and depression ( r=-0.41, P<0.01). Anxiety was positively correlated with depression ( r=0.71, P<0.01). (3)The indirect effect of aging attitude between self-worth and depression in the elderly was -0.016, accounting for 19.75% (-0.016/-0.081)of the total indirect effect.The indirect effect of anxiety between self-worth and depression in the elderly was -0.045, accounting for 55.56%(-0.045/-0.081) of the total indirect effect.The chain mediating effect of aging attitude and anxiety between self-worth and depression in the elderly was -0.020, accounting for 24.69%(-0.020/-0.081) of the total indirect effect. Conclusion:Aging attitude and anxiety play a chain mediating role between self-worth and depression in the elderly.