[Quality Control Indexes for Oncology (2023 edition) and hot topics in breast surgery].

The National Health Commission of the People's Republic of China has formulated the Quality Control Indexes for Oncology (2023 edition), with the objective of improving medical quality scientifically, refined and standardized. Among these indexes, the rate of pretreatment clinical TNM staging and the coincidence rate of evaluation of pretreatment TNM staging lay national standards for patients to formulate rational and targeted treatment strategies. This article reviewed the literature and referred to Chinese Medical Association Clinical Practice Guide for Breast Surgery, and presented recommendations for the hot topics of breast surgery, such as pathological sampling of the breast specimen, sentinel lymph node biopsy for early-stage breast cancer, breast conserving surgery, axillary lymph node dissection, breast reconstruction surgery, endoscopic-assisted breast surgery, the principles of surgical treatment for metastatic breast cancer, neoadjuvant treatment for advanced disease, and surgical grade of breast surgery, which have been widely concerned in recent years, to help improve homogenization of breast cancer treatment in China.

Finite element modelling strategy for determining directivity of thermoelastically generated laser ultrasound.

Laser ultrasound (LU) is a contactless and couplant-free remote non-destructive (NDE) technique, which uses lasers for ultrasonic generation and detection rather than conventional piezoelectric transducers. For a transducer, an important characteristic is the directivity, the angle-dependent amplitude of the ultrasonic waves generated in the material. In the non-destructive thermoelastic regime, LU source has been widely modelled as a surface force dipole. However, the directivity of LU in more complex material, where there is an increasing demand for NDE, such as carbon fibre reinforced plastic (CFRP), is yet to be understood. In the current paper, a finite element (FE) modelling methodology to obtain the directivity of LU in complex material is presented. The method is applied to a conductive isotropic material (aluminium, Al) for validation against an existing analytical solution and then applied to a heterogeneous anisotropic material (carbon-fibre reinforced plastic, CFRP). To get the directivity of a specific wave mode, the signal for that mode needs to be resolved in time from other modes at all angles. This is challenging for shear (S) waves in a small model domain due to the head wave, so a technique for suppressing the head wave is shown. The multi-physics model solves for thermal expansion, which models the laser source as a surface heat flux for the Al case, and a buried heat source for the CFRP case, according to where the energy is deposited in the material. The same ultrasound generation pattern can be obtained by using a suitable pure elastodynamic loading, which is shown to be a surface force dipole as per the validation case for Al, and a buried quadrupole for the CFRP case. The modelled directivities are scaled and fitted to experimental measurements using maximum likelihood, and the goodness of fit is discussed. For the Al case, the S wave is preferred over the longitudinal (L) wave for inspection due to greater signal amplitude. For the CFRP case, the quasi-longitudinal (qL) wave in CFRP shows a maximum amplitude directly below the source, and has a greater amplitude than the quasi-shear (qS) wave, suggesting a better choice for inspection.

A CBT-based mobile intervention as an adjunct treatment for adolescents with symptoms of depression: a virtual randomized controlled feasibility trial.

Background: High rates of adolescent depression demand for more effective, accessible treatment options. A virtual randomized controlled trial was used to assess the feasibility and acceptability of a 5-week, self-guided, cognitive behavioral therapy (CBT)-based mobile application, Spark, compared to a psychoeducational mobile application (Active Control) as an adjunct treatment for adolescents with depression during the COVID-19 pandemic. Methods: A community sample aged 13-21, with self-reported symptoms of depression, was recruited nationwide. Participants were randomly assigned to use either Spark or Active Control (NSpark = 35; NActive Control = 25). Questionnaires, including the PHQ-8 measuring depression symptoms, completed before, during, and immediately following completion of the intervention, evaluated depressive symptoms, usability, engagement, and participant safety. App engagement data were also analyzed. Results: 60 eligible adolescents (female = 47) were enrolled in 2 months. 35.6% of those expressing interest were consented and all enrolled. Study retention was high (85%). Spark users rated the app as usable (System Usability Scalemean = 80.67) and engaging (User Engagement Scale-Short Formmean = 3.62). Median daily use was 29%, and 23% completed all levels. There was a significant negative relationship between behavioral activations completed and change in PHQ-8. Efficacy analyses revealed a significant main effect of time, F = 40.60, p < .001, associated with decreased PHQ-8 scores over time. There was no significant Group × Time interaction (F = 0.13, p = .72) though the numeric decrease in PHQ-8 was greater for Spark (4.69 vs. 3.56). No serious adverse events or adverse device effects were reported for Spark users. Two serious adverse events reported in the Active Control group were addressed per our safety protocol. Conclusion: Recruitment, enrollment, and retention rates demonstrated study feasibility by being comparable or better than other mental health apps. Spark was highly acceptable relative to published norms. The study's novel safety protocol efficiently detected and managed adverse events. The lack of significant difference in depression symptom reduction between Spark and Active Control may be explained by study design and study design factors. Procedures established during this feasibility study will be leveraged for subsequent powered clinical trials evaluating app efficacy and safety. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT04524598.

Risk factors for bloodstream infection in paediatric haematopoietic stem cell transplantation: a systematic review and meta-analysis.

BACKGROUND: Haematopoietic stem cell transplantation (HSCT), a standard treatment for paediatric haematological diseases, is highly associated with bloodstream infection (BSI), which may increase mortality. AIM: To explore the risk factors for BSI in paediatric HSCT recipients. METHODS: Three English databases and four Chinese databases were searched from inception to March 17th, 2022. Eligible studies included randomized controlled trials, cohort studies, and case-control studies that enrolled HSCT recipients aged ≤18 years and reported BSI risk factors. Two reviewers independently screened studies, extracted data, and assessed the risk of bias. Using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), certainty of body of evidence was assessed. FINDINGS: Fourteen studies involving 4602 persons were included. The incidences of BSI and associated mortality in paediatric HSCT recipients were approximately 10-50% and 5-15%, respectively. Meta-analysis of all studies revealed that previous BSI before HSCT (relative effect (RE): 2.28; 95% confidence interval (CI) 1.19-4.34, moderate certainty) and receiving an umbilical cord blood transplant (RE: 1.55; 95% CI: 1.22-1.97, moderate certainty) were probably associated with an increased risk of BSI. Meta-analysis of studies with low risk of bias reassured that previous BSI before HSCT probably increased the risk of BSI (RE: 2.28; 95% CI: 1.19-4.34, moderate certainty), and revealed that steroid use (RE: 2.72; 95% CI: 1.31-5.64, moderate certainty) was likely a risk factor whereas autologous HSCT was probably a protective factor of BSI (RE: 0.65; 95% CI: 0.45-0.94, moderate certainty). CONCLUSION: These findings could inform the management of paediatric HSCT recipients, helping identify who may benefit from prophylactic antibiotics.

Comparative effectiveness and safety of antibiotic prophylaxis during induction chemotherapy in children with acute leukaemia: a systematic review and meta-analysis.

BACKGROUND: Bacterial infections are common during induction therapy in children and adolescents with acute leukaemia and may cause infection-related mortality. AIM: To determine the efficacy and safety of prophylactic antibiotics in paediatric patients with acute leukaemia receiving induction chemotherapy. METHODS: From three English databases and four Chinese databases, we searched for randomized controlled trials (RCTs) and cohort studies that compared prophylactic antibiotics to placebo, no prophylaxis, or that compared one antibiotic versus another in paediatric patients with acute leukaemia undergoing induction chemotherapy. Two reviewers independently screened the studies, extracted data, and assessed the risk of bias using Cochrane Risk of Bias 2 tool and Newcastle-Ottawa Scale, and the certainty of evidence using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). FINDINGS: Two RCTs and ten cohort studies were finally included. For children with acute lymphoblastic leukaemia, antibiotic prophylaxis, including levofloxacin, sulfamethoxazole-trimethoprim, or other antibiotics, probably reduced bacteraemia (risk ratio (RR): 0.44; 95% confidence interval (CI): 0.33-0.60; moderate certainty) without significantly increasing Clostridioides difficile infection (CDI) or invasive fungal infection. Levofloxacin reduced the CDI rate (RR: 0.08; 95% CI: 0.01-0.62; high certainty). Ciprofloxacin prophylaxis probably reduced infection-related mortality (RR: 0.12; 95% CI: 0.01-0.97; moderate certainty). In children with acute myeloid leukaemia, ciprofloxacin plus vancomycin may reduce febrile neutropenia (RR: 0.79; 95% CI: 0.66-0.94; low certainty). Individual studies indicated that prophylaxis increased antibiotic exposure but reduced non-preventive antibiotic exposure. CONCLUSION: In children with acute leukaemia undergoing induction therapy, antibiotic prophylaxis may improve the bacterial infection and mortality.

Morphological classification and clinical significance of medial malleolus based on computed tomography three-dimensional reconstruction.

BACKGROUND: Internal malleolus fractures and postoperative functional limitations are serious complications of deltoid ligament repair, reconstruction, while studies on conducting beak. Anatomical structure classification of medial malleolus at home and abroad is reported rarely. Hence, this morphological study is mainly designed to investigate the anatomical morphological classification and clinical significance of medial malleolus based on computed tomography (CT) three-dimensional reconstruction. MATERIALS AND METHODS: From October 2018 to January 2021, 373 patients who underwent CT examination of malleolus medialis joint in the Jiang'an Hospital of Traditional Chinese Medicine were observed. The medial malleolus was observed and classified; then, geometric parameters were measured according to different medial malleolus types. RESULTS: According to the results of 373 cases, medial malleolus can be divided into four types: omega type (66%), radical sign type (16%), inverted triangle type (14%), and wave type (4%). CONCLUSIONS: There are four main shapes: omega, inverted triangle, radical sign, and wave in the medial malleolus of all normal ankles. The measurement of medial malleolus parameters according to medial malleolus in different shapes was of importance to guide smooth operation of medial malleolus fixation and deltoid ligament reconstruction and epidemiological.

Dual-energy CT perfusion imaging for differentiating invasive thymomas, thymic carcinomas, and lymphomas in adults.

AIM: To evaluate the role of dual-energy computed tomography perfusion (DECTP) imaging in differentiating invasive thymomas (ITs), thymic cancers (TCs), and lymphomas in adults. MATERIALS AND METHODS: Ninety-five patients with solid masses in the prevascular mediastinum who underwent DECTP examinations were enrolled in this study. The perfusion parameters (blood flow, BF; blood volume, BV; mean transit time, MTT; permeability surface, PS) and spectral parameters (water concentration, WC; iodine concentration, IC; normalised iodine concentration, NIC; the slope of spectral radiodensity [Hounsfield units] curve, λHU) of the lesions were analysed. RESULTS: There were no differences in the MTT or WC values among ITs, TCs, and lymphomas (all p>0.05). The IC, NIC, and λHU values in the optimal arterial and venous phases and PS values of TCs were higher than those of ITs and lymphomas (all p<0.05), and there were no differences between ITs and lymphomas (all p>0.05). The BF and BV values of lymphomas were lower than those of ITs and TCs (all p<0.05), and there were no differences between ITs and TCs (all p>0.05). The cut-off values for BF and BV used to differentiate lymphomas from ITs and TCs were 42.83 ml/min/100 g and 4.66 ml/100 g, respectively (area under the receiver operating characteristic curve: 0.847 and 0.839; sensitivity, 80.6% and 82.1%; specificity, 75% and 71.4%; accuracy, 78.9% and 81.1%). CONCLUSIONS: The perfusion and spectral parameters of DECTP imaging help to identify ITs, TCs, and lymphomas, and BF and BV values help to differentiate lymphomas from ITs and TCs.

[Expression characteristics and functional analysis of ELK3 in gastric cancer].

OBJECTIVE: To explore the expression characteristics of ELK3 and its role in the occurrence, progression and prognosis of gastric cancer. METHODS: We analyzed the expression characteristics of ELK3 in gastric cancer based on E-MTAB-6693 dataset and explored the prognostic value of ELK3 using Kaplan-Meier survival analysis and univariate and multivariate Cox regression analysis. Chip-Atlas, ChipBase, Genes Transcription Regulation Database, and hTFtarget were used for predicting the target genes of ELK3 and constructing the transcription regulation network. Functional enrichment analysis of the target genes was performed using R software. The proportions of infiltrating immune cells in gastric cancer were analyzed using Cibersort tool, and the Pearson coefficients between ELK3 and these cells were calculated. The expression profile of ELK3 was verified based on Gene Expression Profiling Interactive Analysis and Human Protein Atlas databases. We also collected 5 pairs of gastric cancer and adjacent tissue samples and detected the expression of ELK3 at both the mRNA and protein levels using RT-PCR and Western blotting. RESULTS: In public datasets and clinical samples, ELK3 was highly expressed in gastric cancer (P < 0.05), and its expression increased with the progression of M stage, AJCC stage, and perineural invasion (P < 0.05). ELK3 expression was correlated with N stage, AJCC stage, Lauren classification, differentiation, pathological classification, and microsatellite status of gastric cancer (P < 0.05). A high expression of ELK3 was associated with significantly reduced overall survival and disease-free survival of the patients, and served as an independent prognostic factor of gastric cancer (P < 0.05). Comprehensive analysis identified 176 potential target genes of ELK3, and enrichment analysis showed that ELK3 may regulate Rap1, AMPK, chemokines, VEGF, TNF, and tumor PD-L1/PD-1 signaling (PP < 0.05). The expression of ELK3 was negatively correlated with regulatory T cells, follicular helper T cells, and CD8+T cells in gastric cancer (P < 0.05). CONCLUSION: ELK3 acts as an oncogene in gastric cancer, and its high expression may promote the occurrence, progression and immune escape of gastric cancer.

Digital learning in medical education: comparing experiences of Malaysian and Japanese students.

BACKGROUND: Medical education has undergone a transformation from conventional to digital learning, enabling learning without any time and place restrictions. Nevertheless, the actual trends of usage and its impact on learning motivation among medical students between developed and developing nations are yet to be investigated. Hence, this study compares the effect of digital learning on learning motivation among Malaysian and Japanese medical students in Universiti Kebangsaan Malaysia (UKM) and Shiga University of Medical Science (SUMS) respectively. METHODS: A modified Students Motivation towards Science Learning (SMTSL) was used to assess the digital learning usage and learning motivation among 150 UKM and 147 SUMS medical students throughout Year 1 to 5. RESULTS: The frequency of digital learning usage and learning motivation among UKM medical students was significantly higher as compared to SUMS (p < 0.001). Electronic books (e-books) were the most preferred source of digital learning among UKM medical students as compared to SUMS medical students who used research articles, e-books, online courses and videos at similar frequencies. UKM medical students in the clinical phase exhibited a significantly higher learning motivation as compared to preclinical students (p < 0.05) but not among SUMS medical students. CONCLUSION: A suitable learning environment should be developed to encourage digital learning usage among different levels of medical students to enhance its complementary role in medical education and augment the level of motivation among medical students in continuous lifelong learning.

[The low expression of long non-coding RNA Linc00638 contributes to rheumatoid arthritis progression by regulating inflammation and oxidative stress].

OBJECTIVE: To investigate the expression of long non-coding RNA (lncRNA) Linc00638 in rheumatoid arthritis (RA) and its regulatory role in inflammation and oxidative stress of synovial fibroblasts in RA patients (RA-FLS). METHODS: Peripheral blood mononuclear cells (PBMCs) were collected from 20 healthy individuals and 35 RA patients for detecting the expression of Linc00638 using RT-qPCR to analyze the correlation of Linc00638 expression with the clinical indicators of RA patients. A Linc00638 overexpression plasmid and siRNA targeting Linc00638 were transfected into RA-FLS, and the changes in cell viability was observed using CCK8 assay; the changes in the expression levels of interleukin-4 (IL-4), IL-6, reactive oxygen species (ROS) and superoxide dismutase (SOD) in the supernatant were detected using ELISA. RESULTS: Compared with the healthy control subjects, RA patients had significantly increased ESR, CRP, RF, anti-CCP, IgA, and C4 levels (P < 0.05) and significantly decreased Linc00638 expression in the PBMCs (P < 0.01). The area under the receiver-operating characteristic (ROC) curve of Linc00638 was 91.86% with the best cut-off value of 0.74 for diagnosis of RA. Spearman correlation analysis showed that Linc00638 expression level was negatively correlated with age, course of disease, DAS28, ESR, CRP, RF and anti-CCP, and positively correlated with IL-4 and SOD levels (P < 0.05). Association rule analysis showed that a decreased Linc00638 expression was strongly correlated with an increase of age (>60 years), a longer disease course (>10 years), elevated levels of ESR, RF and anti-CCP, and decreased levels of IL-4 and SOD. In RA-FLS, overexpression of Linc00638 significantly inhibited while Linc00638 interference obviously enhanced the cell viability. Over-expression of Linc00638 also significantly increased the levels of IL-4 and SOD (P < 0.05) and decreased the expressions of IL-6 and ROS (P < 0.05), while interference of Linc00638 produced the opposite effects in the cells (P < 0.05). CONCLUSION: RA patients have low expression levels of Linc00638, which may participate in disease progression by regulating inflammation and oxidative stress.

Twenty-year changes in mortality rates and underlying causes of death in patients with rheumatoid arthritis-associated interstitial lung disease.

Objectives: Despite recent advances in the treatment of rheumatoid arthritis (RA), few population-based studies have assessed the mortality rates and the underlying causes of death (UCDs) among patients with RA and RA-associated interstitial lung disease (RA-ILD). This study evaluated the trends in mortality rates, demographic characteristics, and UCDs among patients with RA-ILD.Method: Using data from death certificates (1999-2018) from the US Centers for Disease Control and Prevention Multiple Cause of Death files, we explored the trends in mortality rates and UCD for patients with RA and RA-ILD. Moreover, we examined the crude and age-standardized mortality rates (ASMRs) for such patients.Results: Among patients with RA or RA-ILD, ASMR variation decreased over 20 years. The ASMR ratio of RA-ILD to RA decreased by 5.84%. The ASMR for RA and RA-ILD stratified by gender or age group also decreased. The change in the ASMR ratio of RA-ILD to RA trended downwards in women and upwards in men. Arthropathies and ILD were the most frequent UCDs for RA-ILD, while arthropathies and ischaemic heart disease were the most frequent UCDs for RA.Conclusions: Although RA and RA-ILD presented a downward trend in mortality, RA combined with ILD may reduce life expectancy. Specifically, the mortality rate for patients with RA-ILD remained relatively stable during the study period when ILD was the UCD, suggesting the need for active prevention, early diagnosis, and effective management of RA-ILD.

Titanium dioxide nanotubes promote M2 polarization by inhibiting macrophage glycolysis and ultimately accelerate endothelialization.

Titanium has been widely used in prosthetic valves, but they are associated with serious defects in titanium-based prosthetic valves, such as thrombosis, calcification, and decay. Therefore, it is very important to biofunctionalize titanium-based valves to reduce inflammation and accelerate endothelialization of stents and antithrombosis. The titanium dioxide nanotubes were prepared from pure titanium (Ti) by anodic oxidation method in this study. The effects of titanium dioxide nanotubes on the metabolism of macrophages and the inflammatory reaction as implants were studied in vitro. The polarization state of macrophages and the ability to accelerate endothelialization were analyzed. The results demonstrated that titanium nanotubes promote M2 polarization of macrophages by inhibiting glycolysis and activating the Adenosine monophosphate-activated protein kinase (AMPK) signaling pathway. In general, biofunctionalization titanium with nanotube could inhibit macrophage glycolysis, reduce inflammatory factor release and promote M2 polarization by activating the AMPK signaling pathway. And endothelialization was accelerated in vitro. Our result demonstrated that titanium nanotube could act as a potential approach to biofunctionlize titanium-based prosthetic valves for endothelialization.

[Docetaxel, carboplatin plus trastuzumab as neoadjuvant setting in patients with early-stage human epidermal growth factor receptor 2 positive breast cancer: a retrospective analysis].

Objective: To examine the efficacy of docetaxel, carboplatin plus trastuzumab regimen (TCH) as neoadjuvant setting in early-stage human epidermal growth factor receptor 2 (HER2) positive breast cancer. Methods: Totally 522 patients diagnosed with early-stage HER2 positive breast cancer at Breast Disease Center, Peking University First Hospital between January 2013 to December 2018 were enrolled, which constituted 21.8% (522/2 394) of early-stage invasive breast cancer. Clinical pathological factors were retrospectively analyzed. There were 113 female patients underwent TCH neoadjuvant chemotherapy, aging 52(13) years (range: 23 to 69 years). Pathologic complete pathological response(pCR) was defined as ypT0N0M0, and the rate of pCR was calculated. Kaplan-Meier method and Log-rank test were used for survival comparison. Results: Patients who received trastuzumab-based therapy(n=294) had higher disease-free survival (DFS) compared with those who omitted trastuzumab(n=177) (84.4% vs. 72.4%, χ²=4.095, P=0.046). Eighteen of 113 patients (15.9%) experienced grade 3 to 4 chemotherapy-realted toxicity. Grade 3 to 4 neutropenia occurred in 12 patients, while grade 3 to 4 diarrhea occurred in 6 patients. Thirty-one of 113 (27.4%) patients achieved pCR. DFS and overall survival (OS) were similar between patients who achieved pCR and non-pCR (DFS: 91.8% vs. 85.0%, OS: 92.5% vs. 90.5%, all P>0.05). According to Miller-Payne system, patients who achieved G4 to G5 had improved DFS compared with G1 to G3 (89.6% vs. 81.5%, χ²=5.340, P=0.021), but they had similar OS (91.4% vs. 89.1%, χ²=1.008, P=0.315). Conclusions: TCH is an effective regimen in neoadjuvant setting for patients with HER2 positive breast cancer. Patients who achieved G4 to G5 had improved DFS.

[A retrospective evaluation of clinicalopathologic characteristics and prognostic factors for synchronous bilateral breast cancer in a single center].

Objective: To investigate the clinicopathologic features of synchronous bilateral breast cancer (SBBC) and prognostic factors. Methods: The clinicopathologic features of patients with SBBC treated in Peking University First Hospital from January 2008 to March 2019 were retrospectively analyzed. Results: Of all 4 111 patients diagnosed with breast cancer, 57(1.4%) cases were diagnosed with SBBC.Forty-three (75.4%) patients were treated with bilateral mastectomy. The median follow-up time was 58 months. The 5-year disease-free survival of SBBC was 80.7% and 5-year overall survival was 84.1%. The N stage and HER2 status of second primary breast cancer were associated with prognosis by univariated analysis (Z=5.866 and 4.231, both P<0.05). Conclusion: Majority of patients with SBBC were treated with bilateral mastectomy. While therapeutic strategy of SBBC should take both tumor burden and biomarker status of bilateral breast cancer into consideration.

Overexpression of DJ-1 expression protects cardiomyocyte apoptosis induced by ischemia reperfusion.

Since this article has been suspected of research misconduct and the corresponding authors did not respond to our request to prove originality of data and figures, "Overexpression of DJ-1 expression protects cardiomyocyte apoptosis induced by ischemia reperfusion, by L.-H. Xin, W.-J. Liu, T. Song, L. Zhang, published in Eur Rev Med Pharmacol Sci 2019; 23 (4): 1722-1729-DOI: 10.26355/eurrev_201902_17134-PMID: 30840297" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/17134.

[Phenylpropanoid glycosides from Sophorae Tonkinensis Radix et Rhizoma].

Three phenylpropanoid glycosides were purified by extensive chromatographic techniques including column chromatography over microporous resin, MCI, diol, sephadex LH-20, reverse phase C_(18) from water-extracts of Sophorae Tonkinensis Radix et Rhizoma. Their planar structures were elucidated by combination of various spectroscopic method, such as IR, UV, MS, and NMR. The absolute configuration of aglycone was determined by quantum chemical calculations. Their structures were elucidated as(8R)-3-(4-hydroxyphenyl)-1-propanol-2-O-ß-D-glucopyranoside(1), kalopanaxin D(2),(E)-4-hydroxycinnamyl alcohol 4-O-[2'-O-ß-D-apiofuranosyl(1″→2')]-ß-D-glucopyranoside(3). Compound 1 was undescribed previously. Compounds 2 and 3 were firstly isolated from Sophora genus.

[The Breast Cancer Cohort Study in Chinese Women: research design and preliminary results of clinical multi-center cohort].

Objective: The incidence of breast cancer in Chinese women continues to rise. The large breast cancer cohort studies in China are relatively scarce. There are many bottlenecks in the construction of large clinical cohort for breast cancer diagnosis, treatment, and prognoses, such as inconsistent standards, high rates of lost follow-up, repeated construction, and inability to share. To better solving the difficulties and problems faced by large-scale clinical cohort research in China, this project will cooperate with several tertiary A hospitals to establish a breast cancer cohort in Chinese women. It also provides a data platform and technical support for breast cancer multi-center clinical cohort research. Methods: Based on the evidence-based medicine and expert opinion and consensus, we established a breast cancer cohort standardized indicator set-recording baseline information, diagnosis and treatment-related information of the enrolled patients, and collecting biological specimens. According to the technical specification of long-term follow-up for the endpoint, data management, and data security and in the large population-based cohort study, a standardized follow-up system for the diagnosis, treatment, and prognosis of breast cancer prospective cohorts is formed. Results: Based on standardized data sets and the computer discipline's advantage from the University of Science and Technology Beijing, we integrate the new information technology methods, including dynamic information collection terminals and social networks. Thus, the quality of control programs on compliance and intelligence data was improved, and a Chinese women breast cancer cohort database was developed. By February 2020, 12 147 patients were included in the clinical cohort database. Biological specimens'resources in cohort construction were collected and cooperated with Shandong University to research the multi-center quality control system and shared evaluation system of biobanks. Building an open and shared biobank network and forming a full chain of breast cancer research platform. Conclusion: With the implementation of the "13(th) Five-Year Plan" precision medicine research, this study provides a research foundation for precision diagnosis and treatment of breast cancer and provides data support for the country to formulate relevant medical policies.

[Moxa nitrogen content determination and its application in moxa floss grade identification].

Artemisia argyi samples were collected from different areas in Hubei Qichun and medicinal botanical garden of Hubei University of Traditional Chinese Medicine, and samples were purchased from different areas in Qichun medicinal market. The same method was used to prepare A. argyi samples from different areas into moxa floss of different leaf velvet ratio. The nitrogen content of A. argyi was determined by Kjeldahl method. The results show that there was an inverse relationship between the content of nitrogen and the level of the leaf velvet ratio grades of moxa floss and nitrogen content. Therefore, six functional models were established to illustrate the relationship between the grades of leaf velvet ratio and nitrogen content. The accuracy of the functional models was evaluated by ■. The cubic function model and exponential function model are selected as the best models and the formula is: Y_(grades)=-4.26 N~3+26.09 N~2-61.09 N+55.84, Y_(grades)=63.68×10~(-1.374N), with R~2 values of 0.976 5 and 0.969 6, respectively. The accuracy reached above 95% of the two function models when verified by laboratory-made moxa floss, while the accuracy of the models was 85.44% when verifed by commercial moxa floss. These results indicate that the model could be applied to the identification of the grades of moxa floss.