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Background and purpose: There is a consensus within the medical community regarding the perioperative treatment of locally advanced gastric cancer (LAGC), yet the selection of an efficient and safe treatment strategy remains a contentious issue. Previous studies have validated the effectiveness of chemotherapy in conjunction with immune checkpoint inhibitor (ICI) and anti-angiogenic agents in the perioperative treatment of LAGC. This study aimed to investigate the perioperative treatment regimen combining ICI, anti-angiogenic drugs and chemotherapy, in order to provide additional references for the selection of perioperative treatment strategies for patients with LAGC. Methods: This was a prospective, single-arm exploratory study designed to assess the efficacy and safety of perioperative treatment with penpulimab combined with anlotinib and chemotherapy for potentially resectable stage T3-4N+M0 LAGC. Patients diagnosed with LAGC at the Inner Mongolia Autonomous Region People’s Hospital from January 2022 to December 2023 were enrolled in the study. The primary endpoints were pathological complete response (pCR) rate and major pathological remission (MPR) rate, while secondary endpoints included surgical conversion rate, objective response rate (ORR), disease-free survival (DFS), progression-free survival (PFS) and adverse reactions. Quality of life before and after treatment was evaluated using the European Organization for Research on Treatment of Cancer (EORTC) QLQ-STO22 Chinese version questionnaire. This study was reviewed and approved by the Ethics Committee of Inner Mongolia Autonomous Region People’s Hospital (number: 202404604L). Results: A total of 32 patients participated in the study, with an ORR of 78.1% (25/32). Of these, 18 patients underwent surgical treatment, achieving a pCR rate of 22.2% (4/18) and a MPR rate of 38.9% (7/18). The median PFS for patients who did not undergo surgery was 9.8 months (95% CI: 7.6-13.1), and the median follow-up duration was 16.4 months (95% CI: 11.7-22.5). For patients who received radical surgical resection, the median DFS was not reached, and the 1-year DFS rate was 88.8% (16/18). Common adverse reactions following the treatment included myelosuppression, liver function abnormalities, diarrhea and neurotoxicity, with most adverse events being grade 1-2, a few grade 3 adverse events, and no grade 4 or 5 adverse events. According to the EORTC QLQ-STO22 Chinese version questionnaire, significant improvements were observed in the domains of difficulty swallowing, pain and eating restrictions. Additionally, improvements were noted in anxiety and reflux symptoms, while changes in body image were less pronounced. Conclusion: In the perioperative treatment of LAGC, the combination therapy of oxaliplatin, tegafur, anlotinib and penpulimab can improve the efficacy while ensuring safety, and is expected to become a new treatment for LAGC.

Objective To understand the knowledge, skill status, general self-efficacy and the correlation of care burden of community elderly patients with skin pressure injuries and their informal caregivers. Methods A total of 280 community elderly informal nurses from 8 tertiary hospitals, 1 community hospital and 1 social medical institution in Shanghai were assessed with general information, knowledge questionnaire, behavior questionnaire, General Self-Efficacy Scale and Caregiver Burden Scale. Results The average score of informal nursing staff's care knowledge and behavior was (17. 25±2. 90) and (35. 27±6. 82) respectively, and the score of self-efficacy was (2. 33±0. 61). The score of caregiver's burden was relatively high ( 65. 12±14. 93). The general self-efficacy of caregivers on pressure injuries was positively correlated with the total score and all dimensions of care behavior (P＜0. 001). The general self-efficacy and co- caregivers, development limitation, emotional burden, average time spent caring for patients every day and caregiver knowledge questionnaire score were the influencing factors of care behavior of pressure injuries. Conclusion The level of nursing knowledge and behavior of informal nursing staff needs to be improved, the level of self-efficacy is general, and the burden of care is heavy. It is suggested to improve their knowledge, skills, behavior and self-efficacy from various aspects, the ultimate goal of promoting the healing and reducing the recurrence of stress injury of the community elderly is to build up the confidence of coping with care work. (目的 了解长期卧床伴皮肤压力性损伤的社区老年患者及其非正式护理人员主要照顾者的知识、技能现状、一般自我效能及照顾负担的相关性。方法 对上海8家三级医院、1家社区医院、1家社会办医机构合计280位长期卧床社区老年人及其非正式护理人员进行一般资料、压力性损伤的知识问卷、行为问卷、一般自我效能量表及照顾者负担量表的测评。结果 非正式护理人员照顾知识及行为得分平均分情况为(17. 25±2. 90)分及(35. 27±6. 82)分, 自我效能得分为(2. 33±0. 61)分; 照顾者负担得分较高为(65. 12±14. 93)分; 照顾者压力性损伤一般自我效能与照顾行为总分及各维度均呈现显著正相关(P＜0. 001); 一般自我效能、是否有共同照顾者、发展受限性、情感性负担、平均每天照顾患者耗时及照护者知识问卷得分6个变量是压力性损伤照顾行为的影响因素。结论 非正式护理人员照顾知识及行为水平有待提高, 自我效能水平一般, 照顾负担较重。建议从多种方面入手, 提高其知识技能行为水平及自我效能水平, 树立起应对照顾工作的信心, 从而达到促进社区老年人压力性损伤愈合及降低再发生情况的最终目标。)

Sheet metal forming limit diagram (FLD) is a comprehensive index used to evaluate sheet metal formability. In this paper, the forming limit curves of GH605 sheet materials with 0.2 mm and 2.5 mm thickness under three different heat treatment conditions were obtained by numerical simulation of bulging. Then, the simulated forming limit results of the three materials with 0.2 mm thickness were compared with the experimental results. The results show that the simulated FLDs can be in good agreement with the experimental FLDs. The influences of work hardening index (n value) and anisotropy index (r value) on the forming limit are analysed from the view of material property difference. The comprehensive simulated and experimental results show that the formability of the sheets after the two kinds of solution treatment is significantly better than that of the annealed sheets. The forming limit curve increases with the increase of n value and r value, and the influence of n value on the forming limit curve is more significant than that of r value. The forming limit diagram established by numerical simulation can provide a theoretical basis for material development and process selection.