Objective:To explore the cut-off value of metastatic lymph node ratio (LNR) for stage N3 gastric cancer and construct a new TNM staging system to predict prognosis.Methods:Clinical data of 4 291 patients from Jan 2004 to Dec 2020 in the SEER database and 567 patients from Jan 2016 to Dec 2020 in the First Affiliated Hospital of Zhengzhou University with stage N3 gastric cancer were collected. A new TNrM staging system and a nomogram model were constructed based on the optimal LNR cut-off value and compared with the 8th TNM staging model in terms of prognostic discrimination, prognostic prediction accuracy, and clinical usefulness.Results:The optimal cut-off value of LNR was 0.5. A TNrM staging system was constructed by combining the Nr stage with the T stage. Univariate and multivariate COX regression analyses showed that the TNrM staging system was a significant prognostic factor (all P<0.05). Based on the 8th TNM and TNrM staging system, two nomograms were constructed in the training set and externally validated in the validation set. Compared with the TNM staging model, the TNrM staging model had a larger C-index and area of time-dependent ROC curve(AUC) (training set: 3-year AUC: 66.5 vs. 74.4, 5-year AUC: 68.9 vs. 75.3; validation set: 3-year AUC: 62.3 vs. 73.1, 5-year AUC: 62.6 vs. 75.8), its overall survival prediction curves were closer to the ideal curve in the calibration curve, and its clinical net benefit was greater in the decision curves. Conclusions:Stage N3 gastric cancer patients with a metastatic lymph node ratio >0.5 have a poor prognosis. The TNrM staging nomogram model constructed based on the lymph node ratio has better prognostic discrimination ability and prediction accuracy and more clinical net benefits compared to the 8th edition of TNM staging nomogram model.

Objective:To explore the clinical efficacy of three different surgical timings of modified cervical cerclage in twin pregnant women with cervical insufficiency.Methods:The clinical data of 73 twin pregnant women who underwent modified cervical cerclage and had pregnancy outcomes in Qilu Hospital of Shandong University (Qingdao) from April 2014 to July 2023 were retrospectively analyzed. According to the different timings of surgery, they were divided into prophylactic cerclage group, ultrasound-indicated cerclage group (further divided into cervical length (CL)≤15 mm and 15 mm10 mg/L was a risk factor for preterm birth before 34 weeks of gestation ( OR=5.230, 95% CI: 1.616-16.929; P=0.006). Conclusions:In twin pregnant women with cervical insufficiency, prophylactic cerclage has the same surgical effect as ultrasound-indicated cerclage, while both prophylactic cerclage and ultrasound-indicated cerclage could significantly improve maternal and fetal outcomes compared with emergency cerclage. Twin pregnancies with CL≤15 mm might benefit from cervical cerclage. Postoperative CRP>10 mg/L is an independent risk factor for preterm birth before 34 weeks of gestation.

Diffuse pediatric-type high-grade glioma (pHGG), H3- and isocitrate dehydrogenase (IDH)-wild-type, is a World Health Organization (WHO) grade 4 diffuse glioma with malignant histological features, which typically affects in children and adolescents. This multidisciplinary treatment case involves a 24-year-old young female patient initially diagnosed via biopsy. After concurrent chemoradiotherapy reduced the tumor size, complete resection was achieved, followed by adjuvant therapy with temozolomide and regorafenib. After recurrence, the tumor was resected again, and a second course of radiotherapy was administered, but the disease ultimately progressed rapidly, with an overall survival exceeding 32 months. pHGGs are highly malignant, aggressive, and associated with poor prognosis. Accurate diagnosis and targeted intervention require close collaboration among a multidisciplinary team, which highlights the critical value of multidisciplinary manage-ment in clinical practice.

Objective To explore the effect of a self-developed augmented multi-task sensory exer-cise intervention on perceptual-motor skills and motor coordination in children with developmental coor-dination disorder(DCD).Methods Twenty-four DCD children aged 6～7 years were included and ran-domly divided into a control group(n=12)and an experimental group(n=12).Both groups maintained their daily physical activities and took P.E.classes in school,while the experimental group additional-ly underwent a multi-task somatosensory motor intervention consisting of 3 stages.Each stage lasted for 4 weeks,3 sessions per week,with progressively increased difficulty.A self-designed data process-ing module of the somatosensory intervention system was used to collect the scores of each task(i.e.,sensory-motor evaluation),and the changes in scores of each task at each stage were analyzed.More-over,before and after the intervention,the motor coordination ability was assessed using the Move-ment Assessment Battery for Children-Second Edition(MABC-2),and the intra-and inter-group dif-ferences in MABC-2 scores were analyzed.Two weeks after the intervention,the experimental group conducted 3 sessions of motor relearning at the difficulty level of the 3rd stage to examine the effects of motor retention and relearning.Results 1)The experimental group showed a significant increase in their scores on all tasks from T1 to T5 during the enhanced multi-task somatosensory training of all the three stages(P<0.001,P<0.05).2)After the kinesthetic exercises,the experimental group had sig-nificantly higher abilities in fine motor skills,positioning&grasping and body balance compared to the control group(P<0.05),with relatively greater effect on threading beads,drawing traces,tossing and catching bags,single-leg balance,tiptoe walking and two-legged hopping(η2≥0.114).3)In the assessment of motor skill retention and relearning,the T1～T4 scores in the first retest were lower than the previous final ones(P<0.05),with no significant difference from those at the end of the second stage,but showing significantly higher T1 and T5 scores.Moreover,all the T1～T5 scores reached the level measured at the previous end of stage three after three sessions of relearning.Conclusion The augmented multi-task somatosensory practice based on perception-motor skills theory can enhance the perception-motor skills and motor coordination ability of the DCD children,with good motor skill reten-tion and recovery effectiveness after such intervention.

ObjectiveTo establish background data for a 90-day feeding trial of SD rats to ensure the reliability of research data. MethodsBackground data from six independent 90-day feeding trials of SD rats conducted by the National Center for Safety Evaluation of Drugs from 2020 to 2023 were summarized. These studies involved a blank control group of 120 SPF-grade 4-week-old SD rats, with an equal number of males and females, which were only given standard full-nutrient pelleted rat feed. After the quarantine period, the animals were observed for an additional 90 days, followed by intraperitoneal injection of Zoletil (50 mg/mL) for anesthesia, blood sampling, euthanasia, and necropsy. By analyzing the data from the blank control group, a relevant background database for SD rats was established. ResultsBoth male and female rats exhibited steady weight gain, with a more pronounced increase in male rats. Within 90 days, the average body weight of male and female rats increased to over 500 g and 300 g, respectively. Three weeks later, the average daily food intake of male rats stabilized at approximately 25~28 g per rat, while that of female rats remained stable at approximately 16~19 g per rat. The food utilization rate of all animals gradually decreased from the first week of the experiment. In the white blood cell (WBC) differential count results, significant differences were observed in the counts of WBCs, neutrophils (Neut), lymphocytes (Lymph), and monocytes (Mono) between males and females (P<0.001). However, there were no significant differences in the percentages of neutrophil (%Neut), lymphocyte (%Lymph), and monocyte (%Mono) between the sexes (P>0.05). The average red blood cell count (RBC), hemoglobin concentration (HGB), hematocrit (HCT), platelet count (PLT), prothrombin time (PT), and activated partial thromboplastin time (APTT) were higher in male animals than in female animals (P<0.05). The average values of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), creatine phosphokinase (CK), lactate dehydrogenase (LDH), glucose (GLU), and triglyceride (TG) in male rats were higher than those in female rats (P<0.05). The urinary pH range for male animals was 5.0 to 8.5, while for female animals it was 6.5 to 9.0. The majority of male animals had a urinary specific gravity lower than 1.020, and the majority of female animals had a urinary specific gravity lower than 1.015. The weights of various organs (excluding the adrenal glands and reproductive organs) in male animals were heavier than those in female animals (P<0.001), while the organ/body weight ratios (excluding the kidneys and reproductive organs) of female animals were higher than those of male animals (P<0.001). ConclusionThis study summarizes the background reference ranges for body weight, food intake, hematology, and serum biochemistry indicators in SPF-grade SD rats in the untreated control group from six 90-day feeding trials conducted by the National Center for Safety Evaluation of Drugs. It provides important reference data for related research. By summarizing the background and spontaneous histopathological changes in rats, this study aids in the standardization and normalization of subsequent research, as well as in the evaluation and analysis of abnormal results.

Objective To observe the value of pool sign on T2WI for differentiating solitary brain metastasis(SBM)from solitary mass type high grade glioma(HGG).Methods Totally 120 patients with SBM(SBM group)and 184 patients with solitary mass type HGG(HGG group)confirmed by postoperative pathology or clinical follow-up were retrospectively enrolled.The incidence of pool sign were compared between groups,and the efficacy of pool sign for differentiating SBM from solitary mass type HGG was analyzed.Results Pool sign was noticed in 37 cases(37/120,30.83％)in SBM group and 9 cases(9/184,4.89％)in HGG group,the incidence of pool sign in SBM group was higher than that in HGG group(x2=38.063,P＜0.001).The sensitivity,specificity,positive predictive value and negative predictive value of pool sign for differentiating SBM and solitary mass type HGG was 30.83％(37/120),95.11％(175/184),80.43％(37/46)and 67.83％(175/258),respectively.In SBM group,the incidence of pool sign in cases with primary tumor of adenocarcinoma,squamous cell carcinoma and neuroendocrine carcinoma was 40.79％(31/76),16.67％(3/18)and 12.50％(3/24),respectively,with significant difference(x2=8.911,P=0.012),while compared pairwisely showed significant difference between SBM of adenocarcinoma and neuroendocrine carcinoma(x2=6.505,P=0.011).Conclusion The pool sign on T2WI was helpful for differentiating SBM,especially SBM of adenocarcinoma from solitary mass type HGG.

OBJECTIVE To develop a storage device for portable sterile surgical instrument kits that enables intelli-gent management of surgical instruments in field and disaster relief environments.METHODS Based on various in-telligent monitoring modules such as temperature sensors,humidity sensors and oxygen sensors,environmental state parameters of the surgical instrument kits at different locations were obtained.An intelligent storage manage-ment device for portable sterile surgical instrument kits was designed,which employed neural network technology to predict the expiration date of the surgical instrument kits in real-time.RESULTS The production and technical parameters,design renderings and production processes for the intelligent storage management device for portable sterile surgical instrument kits were initially completed,providing a reference for the effective application of nu-merically controlled storage devices for mobile surgical instruments in field environments in the future.CONCLUSIONS The intelligent storage management device for portable sterile surgical instrument kits meets the requirements for managing surgical instruments in field environments,achieving real-time data monitoring and management of surgical instrument kits in special environments.

Objective To determine the effect of Tai Chi practice on balance control ability of the individuals with functional ankle instability(FAI)in single-leg stance(SLS),and further observe the augmented effect from attention focus on ankle.Methods A total of 46 individuals with FAI were randomly divided into ankle focus group,free focus group and control group.The ankle focus group and free focus group performed Tai Chi practice for 10 weeks;the ankle focus group focused their attention on the ankle joint,while the free focus group didn't require attention focus;the control group maintained the origin lifestyle and didn't engage in special physical activities.The three-dimensional force plate and Y balance test(YBT)were used to evaluate the static(with eyes open and closed)and dynamic(instant and continuous)balance ability of individuals with FAI.Results For ankle focus group and free focus group,the anterior-posterior(AP)and medial-lateral(ML)sway distances of center of pressure(COP)in SLS with eyes open and closed were significantly reduced,and the reach distance in YBT in three directions were increased.For the ankle focus group,the ML stability index and the dynamic postural stability index were significantly reduced during single-leg drop landing.The ankle focus group and free focus group had a significantly smaller ML COP sway distance than control group in SLS with eyes open;the ankle focus group had a significantly smaller ML COP sway distance than free focus group and control group in SLS with eyes closed;and the reach distance of ankle focus group in posterior-medial&posterior-lateral direction in YBT was longer than that of free focus group and control group.Conclusions Tai Chi practice can comprehensively improve static and dynamic balance control ability of the individuals with FAI in SLS,and ankle attention-focused Tai Chi practice is more effective,especially for the enhancement of their ML control ability in static state with eyes closed and in continuous dynamic SLS.

Objective:To explore the cut-off value of metastatic lymph node ratio (LNR) for stage N3 gastric cancer and construct a new TNM staging system to predict prognosis.Methods:Clinical data of 4 291 patients from Jan 2004 to Dec 2020 in the SEER database and 567 patients from Jan 2016 to Dec 2020 in the First Affiliated Hospital of Zhengzhou University with stage N3 gastric cancer were collected. A new TNrM staging system and a nomogram model were constructed based on the optimal LNR cut-off value and compared with the 8th TNM staging model in terms of prognostic discrimination, prognostic prediction accuracy, and clinical usefulness.Results:The optimal cut-off value of LNR was 0.5. A TNrM staging system was constructed by combining the Nr stage with the T stage. Univariate and multivariate COX regression analyses showed that the TNrM staging system was a significant prognostic factor (all P<0.05). Based on the 8th TNM and TNrM staging system, two nomograms were constructed in the training set and externally validated in the validation set. Compared with the TNM staging model, the TNrM staging model had a larger C-index and area of time-dependent ROC curve(AUC) (training set: 3-year AUC: 66.5 vs. 74.4, 5-year AUC: 68.9 vs. 75.3; validation set: 3-year AUC: 62.3 vs. 73.1, 5-year AUC: 62.6 vs. 75.8), its overall survival prediction curves were closer to the ideal curve in the calibration curve, and its clinical net benefit was greater in the decision curves. Conclusions:Stage N3 gastric cancer patients with a metastatic lymph node ratio >0.5 have a poor prognosis. The TNrM staging nomogram model constructed based on the lymph node ratio has better prognostic discrimination ability and prediction accuracy and more clinical net benefits compared to the 8th edition of TNM staging nomogram model.

Objective To explore the effect of a self-developed augmented multi-task sensory exer-cise intervention on perceptual-motor skills and motor coordination in children with developmental coor-dination disorder(DCD).Methods Twenty-four DCD children aged 6～7 years were included and ran-domly divided into a control group(n=12)and an experimental group(n=12).Both groups maintained their daily physical activities and took P.E.classes in school,while the experimental group additional-ly underwent a multi-task somatosensory motor intervention consisting of 3 stages.Each stage lasted for 4 weeks,3 sessions per week,with progressively increased difficulty.A self-designed data process-ing module of the somatosensory intervention system was used to collect the scores of each task(i.e.,sensory-motor evaluation),and the changes in scores of each task at each stage were analyzed.More-over,before and after the intervention,the motor coordination ability was assessed using the Move-ment Assessment Battery for Children-Second Edition(MABC-2),and the intra-and inter-group dif-ferences in MABC-2 scores were analyzed.Two weeks after the intervention,the experimental group conducted 3 sessions of motor relearning at the difficulty level of the 3rd stage to examine the effects of motor retention and relearning.Results 1)The experimental group showed a significant increase in their scores on all tasks from T1 to T5 during the enhanced multi-task somatosensory training of all the three stages(P<0.001,P<0.05).2)After the kinesthetic exercises,the experimental group had sig-nificantly higher abilities in fine motor skills,positioning&grasping and body balance compared to the control group(P<0.05),with relatively greater effect on threading beads,drawing traces,tossing and catching bags,single-leg balance,tiptoe walking and two-legged hopping(η2≥0.114).3)In the assessment of motor skill retention and relearning,the T1～T4 scores in the first retest were lower than the previous final ones(P<0.05),with no significant difference from those at the end of the second stage,but showing significantly higher T1 and T5 scores.Moreover,all the T1～T5 scores reached the level measured at the previous end of stage three after three sessions of relearning.Conclusion The augmented multi-task somatosensory practice based on perception-motor skills theory can enhance the perception-motor skills and motor coordination ability of the DCD children,with good motor skill reten-tion and recovery effectiveness after such intervention.