Objective:To investigate the impact of bundled management of late-pregnancy induction strategies on induction time and maternal and perinatal clinical outcomes.Methods:This was a historical control study, including 61 pregnant women before the implementation of the bundled management strategies for induction protocol in September 2024, and 78 pregnant women after the implementation in December 2024, who received regular prenatal check-ups and finally admitted to Peking University Third Hospital for elective induction of labor at term. The rate of successful induction, the rate of reaching active phase, induction to labor length, duration of labor, hospital stay, and adverse maternal and preinatal outcomes and other information were compared between two groups. Logistic regression model was used to analyze the factors affecting the rates of successful labor induction and reaching active phase. Kaplan-Meier survival curves were plotted for induction to labor length and duration of labor, and the Cox proportional hazards regression model was used to analyze the impact of the bundled management strategies for induction strategies on the above indicators.Results:(1) Compared with the group before implementation, the group after implementation had a shorter induction to labor length (median: 47.4 vs 35.1 h), a shorter duration of labor (median: 14.0 vs 10.5 h), and a shorter hospital stay (median: 6 vs 4 d). The rate of successful induction increased [87% (53/61) vs 97% (76/78)], and the rate of reaching active phase increased [70% (43/61) vs 86% (67/78)]; the differences were statistically significant (all P<0.05). (2) Multivariate logistic regression analysis showed that the implementation of the bundled management strategies promoted successful induction ( OR=7.299, 95% CI: 1.189-44.800; P=0.032) and reaching active phase ( OR=2.640, 95% CI: 1.003-6.951; P=0.049). A pre-pregnancy body mass index<18.5 kg/m2 promoted successful induction ( OR=9.142, 95% CI: 1.154-72.423; P=0.036). (3) Kaplan-Meier curve analysis indicated that compared with the group before the implementation, the group after the implementation had a significantly shorter induction to labor length ( χ2=13.883, P<0.001) and a shorter duration of labor ( χ2=5.72, P=0.017). Cox proportional hazards regression analysis showed that the implementation of the bundled management strategies for induction protocol was a protective factor for shortening induction to labor length ( HR=1.806, 95% CI: 1.186-2.749; P=0.006) and duration of labor ( HR=1.677, 95% CI: 1.066-2.637; P=0.025). A cervical Bishop score >3 at admission was a protective factor for shortening the induction to labor length ( HR=1.627, 95% CI: 1.110-2.384; P=0.013), and parity was a protective factor for shortening the duration of labor ( HR=3.370, 95% CI: 1.806-6.288; P<0.001). Conclusions:By the implementation of the bundled management strategies for induction protocol, it is possible to promote successful induction of labor and reaching the active phase for pregnant women undergoing induction. This approach also shortens induction to labor length and the duration of labor, without increasing the risk of maternal and perinatal complications.

Objective:To clarify the changes in incidence and mortality of various cancers based on analysis on registration data of malignant tumor incidence and mortality from Dehui City and Yanji City in Jilin Province.Methods:The incidence and mortality data of malignant tumors from 2009 to 2016 in Dehui City and Yanji City in Jilin Province,were collected from the Chinese Cancer Registry Annual Report published by the National Cancer Center.The number of cases,deaths,crude incidence rate,crude mortality rate,age-standardized incidence rate(ASIR),age-standardized mortality rate(ASMR),and annual percentage change(APC)of the malignant tumors were analyzed by cancer sites and genders.Results:From 2009 to 2016,the CIR of malignant tumors in Dehui City(APC=1.2%,P=0.019)and Yanji City(APC=3.6%,P=0.058)showed an increasing trend.After standard population age adjustment,the ASIR in males in Dehui City showed a significant decline(APC=-5.7%,P=0.021),while the ASIR in females exhibited an overall downward trend,but the difference was not significant(APC=-2.2%,P=0.111).In Yanji City,the ASIR in males(APC=-1.4%,P=0.535)and females(APC=0.0%,P=0.988)showed no significant changes.The CMR of malignant tumors in Dehui City(APC=1.9%,P=0.001)and Yanji City(APC=5.9%,P=0.001)showed a continuous upward trend.After age-standardization,the ASMR in males(APC=-3.1%,P=0.100)and females(APC=-4.2%,P=0.053)in Dehui City,as well as in males(APC=-1.3%,P=0.438)in Yanji City,showed a slight downward trend.Although the ASMR in females in Yanji City showed a slight increase,the difference was not statistically significant(APC=0.5%,P=0.838).In 2016,the most common malignant tumor in terms of both incidence and mortality in Dehui City was lung cancer,with a CIR of 60.76/100 000 and a CMR of 46.96/100 000.In Yanji City,the most common malignant tumor was liver cancer,with a CIR of 49.04/100 000 and a CMR of 51.09/100 000.Conclusion:Lung cancer,liver cancer,and gastric cancer are the major malignant tumors threatening residents in Dehui City,Yanji City,and even the entire Jilin Province,and should be prioritized in cancer prevention and control efforts.Early diagnosis and treatment should be strengthened.

Objective To investigate the clinicopathological features of odontogenic myxoma(OM).Methods The clinicopath-ologic data of 15 patients with odontogenic myxoma(OM)diagnosed by routine pathology in Stomatological Hospital Affiliated to Nanjing Medical University from January 2013 to June 2023 were retrospectively analyzed.Results(1)The most common cases were female(66.7％),20-40 years old(73.3％),mandible(60.0％)and posterior dental area(93.3％).(2)The characteristic imaging findings were multilocular cystic low-density radiography,resembling honey comb/tennis racket/soap bubble structures.(3)Microscopi-cally,star or spindle tumor cells can be seen scattered in the background of light blue mucoid matrix,and occasionally a few odonto-genic epithelial clusters.(4)In 15 odontogenic myxoma(OM)samples,①β-catenin was not expressed in 1 case of mucous type,par-tially or diffusely expressed in 6 cases,not expressed in 2 cases of fibrous type,partially or diffusely expressed in 6 cases;②CD34 and S100 were negative;③Ki-67 index was lower than 1％.(5)Of the 15 patients,only one relapsed,and the rest had a good prognosis.(6)Surgical treatment is the main treatment plan at present,and the appropriate surgical plan should be selected according to the size of the tumor,the scope of the lesion and the situation of the patient.Conclusion Although odontogenic myxoma is a benign tumor,it is locally invasive and recurrent.It is necessary to distinguish it from low-grade malignant myxosarcoma,chondromyxoid fibroma and odontogenic fibroma.Understanding of and familiarity with its clinicopathological features is helpful to its diagnosis and improving the prognosis of patients.

Objective To investigate the clinicopathological features of odontogenic myxoma(OM).Methods The clinicopath-ologic data of 15 patients with odontogenic myxoma(OM)diagnosed by routine pathology in Stomatological Hospital Affiliated to Nanjing Medical University from January 2013 to June 2023 were retrospectively analyzed.Results(1)The most common cases were female(66.7％),20-40 years old(73.3％),mandible(60.0％)and posterior dental area(93.3％).(2)The characteristic imaging findings were multilocular cystic low-density radiography,resembling honey comb/tennis racket/soap bubble structures.(3)Microscopi-cally,star or spindle tumor cells can be seen scattered in the background of light blue mucoid matrix,and occasionally a few odonto-genic epithelial clusters.(4)In 15 odontogenic myxoma(OM)samples,①β-catenin was not expressed in 1 case of mucous type,par-tially or diffusely expressed in 6 cases,not expressed in 2 cases of fibrous type,partially or diffusely expressed in 6 cases;②CD34 and S100 were negative;③Ki-67 index was lower than 1％.(5)Of the 15 patients,only one relapsed,and the rest had a good prognosis.(6)Surgical treatment is the main treatment plan at present,and the appropriate surgical plan should be selected according to the size of the tumor,the scope of the lesion and the situation of the patient.Conclusion Although odontogenic myxoma is a benign tumor,it is locally invasive and recurrent.It is necessary to distinguish it from low-grade malignant myxosarcoma,chondromyxoid fibroma and odontogenic fibroma.Understanding of and familiarity with its clinicopathological features is helpful to its diagnosis and improving the prognosis of patients.

Objective:To investigate the impact of bundled management of late-pregnancy induction strategies on induction time and maternal and perinatal clinical outcomes.Methods:This was a historical control study, including 61 pregnant women before the implementation of the bundled management strategies for induction protocol in September 2024, and 78 pregnant women after the implementation in December 2024, who received regular prenatal check-ups and finally admitted to Peking University Third Hospital for elective induction of labor at term. The rate of successful induction, the rate of reaching active phase, induction to labor length, duration of labor, hospital stay, and adverse maternal and preinatal outcomes and other information were compared between two groups. Logistic regression model was used to analyze the factors affecting the rates of successful labor induction and reaching active phase. Kaplan-Meier survival curves were plotted for induction to labor length and duration of labor, and the Cox proportional hazards regression model was used to analyze the impact of the bundled management strategies for induction strategies on the above indicators.Results:(1) Compared with the group before implementation, the group after implementation had a shorter induction to labor length (median: 47.4 vs 35.1 h), a shorter duration of labor (median: 14.0 vs 10.5 h), and a shorter hospital stay (median: 6 vs 4 d). The rate of successful induction increased [87% (53/61) vs 97% (76/78)], and the rate of reaching active phase increased [70% (43/61) vs 86% (67/78)]; the differences were statistically significant (all P<0.05). (2) Multivariate logistic regression analysis showed that the implementation of the bundled management strategies promoted successful induction ( OR=7.299, 95% CI: 1.189-44.800; P=0.032) and reaching active phase ( OR=2.640, 95% CI: 1.003-6.951; P=0.049). A pre-pregnancy body mass index<18.5 kg/m2 promoted successful induction ( OR=9.142, 95% CI: 1.154-72.423; P=0.036). (3) Kaplan-Meier curve analysis indicated that compared with the group before the implementation, the group after the implementation had a significantly shorter induction to labor length ( χ2=13.883, P<0.001) and a shorter duration of labor ( χ2=5.72, P=0.017). Cox proportional hazards regression analysis showed that the implementation of the bundled management strategies for induction protocol was a protective factor for shortening induction to labor length ( HR=1.806, 95% CI: 1.186-2.749; P=0.006) and duration of labor ( HR=1.677, 95% CI: 1.066-2.637; P=0.025). A cervical Bishop score >3 at admission was a protective factor for shortening the induction to labor length ( HR=1.627, 95% CI: 1.110-2.384; P=0.013), and parity was a protective factor for shortening the duration of labor ( HR=3.370, 95% CI: 1.806-6.288; P<0.001). Conclusions:By the implementation of the bundled management strategies for induction protocol, it is possible to promote successful induction of labor and reaching the active phase for pregnant women undergoing induction. This approach also shortens induction to labor length and the duration of labor, without increasing the risk of maternal and perinatal complications.

Objective:To investigate the characteristics of fetal cardiac dysfunction in monochorionic diamniotic(MCDA)twin pregnancies,and establish a prediction model for their perinatal outcomes mainly based on ultra-sound indicators using information method.Methods:A total of 104 twin cases with ultrasound indicating fetal heart abnormalities were selected.Based on their chorionic and fetal heart abnormalities,they were divided into three groups:MCDA dysfunction group(61 cases),MCDA structural abnormalities group(23 cases),and dichori-onic diamniotic(DCDA)structural abnormalities group(20 cases).The clinical features of the three groups were analyzed and compared,and clinical outcomes were followed up until 3 years postpartum.A perinatal outcome prediction model for fetal cardiac dysfunction was established using the information method.All ultrasound abnor-mal indicators(7 categories)from the MCDA functional abnormality group,as well as 3 common clinical indicators,were included in the information model calculation.At the same time,the effectiveness of the model prediction was evaluated using receiver operating characteristic(ROC)curves and reserved cases(5 cases).Results:① Com-pared with the group with MCDA structural abnormalities,the group with MCDA functional abnormalities had a higher proportion of twin specific complications and a more severe staging.There was no statistically significant difference(P>0.05)in the proportion of live and non-live birth among the three groups,as well as the differences between different live birth outcomes and non-live birth outcomes.However,follow-up found that the majority(22/24)of live births in the MCDA dysfunction group had their heart function returning to normal on their own.②The pre-diction results of the information model showed that the classification criteria for adverse perinatal outcome or risks(I)of fetal cardiac dysfunction were:when I>1.0,the risk of fetal death was high;when-1.0

Objective:To investigate the characteristics of fetal cardiac dysfunction in monochorionic diamniotic(MCDA)twin pregnancies,and establish a prediction model for their perinatal outcomes mainly based on ultra-sound indicators using information method.Methods:A total of 104 twin cases with ultrasound indicating fetal heart abnormalities were selected.Based on their chorionic and fetal heart abnormalities,they were divided into three groups:MCDA dysfunction group(61 cases),MCDA structural abnormalities group(23 cases),and dichori-onic diamniotic(DCDA)structural abnormalities group(20 cases).The clinical features of the three groups were analyzed and compared,and clinical outcomes were followed up until 3 years postpartum.A perinatal outcome prediction model for fetal cardiac dysfunction was established using the information method.All ultrasound abnor-mal indicators(7 categories)from the MCDA functional abnormality group,as well as 3 common clinical indicators,were included in the information model calculation.At the same time,the effectiveness of the model prediction was evaluated using receiver operating characteristic(ROC)curves and reserved cases(5 cases).Results:① Com-pared with the group with MCDA structural abnormalities,the group with MCDA functional abnormalities had a higher proportion of twin specific complications and a more severe staging.There was no statistically significant difference(P>0.05)in the proportion of live and non-live birth among the three groups,as well as the differences between different live birth outcomes and non-live birth outcomes.However,follow-up found that the majority(22/24)of live births in the MCDA dysfunction group had their heart function returning to normal on their own.②The pre-diction results of the information model showed that the classification criteria for adverse perinatal outcome or risks(I)of fetal cardiac dysfunction were:when I>1.0,the risk of fetal death was high;when-1.0

Objective:To investigate the characteristics of fetal cardiac dysfunction in monochorionic diamniotic(MCDA)twin pregnancies,and establish a prediction model for their perinatal outcomes mainly based on ultra-sound indicators using information method.Methods:A total of 104 twin cases with ultrasound indicating fetal heart abnormalities were selected.Based on their chorionic and fetal heart abnormalities,they were divided into three groups:MCDA dysfunction group(61 cases),MCDA structural abnormalities group(23 cases),and dichori-onic diamniotic(DCDA)structural abnormalities group(20 cases).The clinical features of the three groups were analyzed and compared,and clinical outcomes were followed up until 3 years postpartum.A perinatal outcome prediction model for fetal cardiac dysfunction was established using the information method.All ultrasound abnor-mal indicators(7 categories)from the MCDA functional abnormality group,as well as 3 common clinical indicators,were included in the information model calculation.At the same time,the effectiveness of the model prediction was evaluated using receiver operating characteristic(ROC)curves and reserved cases(5 cases).Results:① Com-pared with the group with MCDA structural abnormalities,the group with MCDA functional abnormalities had a higher proportion of twin specific complications and a more severe staging.There was no statistically significant difference(P>0.05)in the proportion of live and non-live birth among the three groups,as well as the differences between different live birth outcomes and non-live birth outcomes.However,follow-up found that the majority(22/24)of live births in the MCDA dysfunction group had their heart function returning to normal on their own.②The pre-diction results of the information model showed that the classification criteria for adverse perinatal outcome or risks(I)of fetal cardiac dysfunction were:when I>1.0,the risk of fetal death was high;when-1.0

Objective:To investigate the characteristics of fetal cardiac dysfunction in monochorionic diamniotic(MCDA)twin pregnancies,and establish a prediction model for their perinatal outcomes mainly based on ultra-sound indicators using information method.Methods:A total of 104 twin cases with ultrasound indicating fetal heart abnormalities were selected.Based on their chorionic and fetal heart abnormalities,they were divided into three groups:MCDA dysfunction group(61 cases),MCDA structural abnormalities group(23 cases),and dichori-onic diamniotic(DCDA)structural abnormalities group(20 cases).The clinical features of the three groups were analyzed and compared,and clinical outcomes were followed up until 3 years postpartum.A perinatal outcome prediction model for fetal cardiac dysfunction was established using the information method.All ultrasound abnor-mal indicators(7 categories)from the MCDA functional abnormality group,as well as 3 common clinical indicators,were included in the information model calculation.At the same time,the effectiveness of the model prediction was evaluated using receiver operating characteristic(ROC)curves and reserved cases(5 cases).Results:① Com-pared with the group with MCDA structural abnormalities,the group with MCDA functional abnormalities had a higher proportion of twin specific complications and a more severe staging.There was no statistically significant difference(P>0.05)in the proportion of live and non-live birth among the three groups,as well as the differences between different live birth outcomes and non-live birth outcomes.However,follow-up found that the majority(22/24)of live births in the MCDA dysfunction group had their heart function returning to normal on their own.②The pre-diction results of the information model showed that the classification criteria for adverse perinatal outcome or risks(I)of fetal cardiac dysfunction were:when I>1.0,the risk of fetal death was high;when-1.0

Objective:To investigate the effect of prenatal dexamethasone on short-term outcomes and long-term neurological development in late preterm infants with twin pregnancy.Methods:A total of 315 pregnant women with twin pregnancy and their preterm infants who delivered in Peking University Third Hospital from January 2019 to December 2022 were retrospectively analyzed. The clinical data of pregnant women and preterm infants were collected. They were divided into non-medication group (93 pregnant women and 186 preterm infants), medication after 34 weeks group (123 pregnant women and 246 preterm infants), and medication before 34 weeks group (99 pregnant women and 198 preterm infants). Short-term outcomes of preterm infants were analyzed, including the incidence of neonatal respiratory distress syndrome (NRDS), wet lung, hypoglycemia, neonatal septicemia, intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD) and neonatal necrotizing enterocolitis (NEC). "Ages and Stages Questionnaire-Third Edition (ASQ-3) scale" was used to follow up the late neurological development of preterm infants at the corrected age of 6-54 months, and the level of neurological development was compared.Results:(1) General conditions: the gestational age at delivery in the non-medication group [36.1 weeks (35.6, 36.6 weeks)] was later than that in the medication after 34 weeks group [36.1 weeks (35.2, 36.4 weeks)] and medication before 34 weeks group [35.2 weeks (34.2, 36.2 weeks)] groups, and the differences were statistically significant (all P<0.05). After correcting for gestational age, there was no significant difference in birth weight among the three groups ( H=3.808, P=0.149). There were no significant differences in gender and the proportion of small for gestational age among the three groups (all P>0.05). (2) Short-term outcome: the incidence of wet lung was 7.0% (13/186), 11.0% (27/246) and 16.2% (32/198) in the non-medication group, medication after 34 weeks group and medication before 34 weeks group, respectively, and the difference was statistically significant ( P=0.018). There were no significant differences in the incidence rates of NRDS, hypoglycemia, sepsis, IVH, BPD, and NEC among the three groups (all P>0.05). Logistic regression analysis with gestational age and newborn birth weight as confounding factors showed that early gestational age ( OR=0.884, 95% CI: 0.837-0.933, P<0.001) and increased incidence of selective intrauterine growth restriction type I ( OR=2.967, 95% CI: 1.153-7.639, P=0.024) could both lead to an increased incidence of wet lung. (3) Long-term outcomes: a total of 109 pregnant women completed the follow-up, and 218 preterm infants with a corrected age of 6-54 months at the end of follow-up were enrolled, including 86 cases in the non-medication group, 66 cases in the medication after 34 weeks group, and 66 cases in the medication before 34 weeks group. There were no significant differences in the scores of communication, gross motor, fine motor, problem solving and personal-social among the three groups (all P>0.05). Conclusion:Prenatal administration of a single course of dexamethasone does not affect the neonatal birth weight and short-term outcomes of twin late preterm infants, and has no adverse effect on the neurological development of twin late preterm infants with a corrected age of 6-54 months.