Prediction of postoperative dysphagia in patients with oral cancer: A prospective cohort study.

OBJECTIVES: This study aims to identify autonomous risk factors for postoperative dysphagia in oral cancer patients and construct a nomogram prediction model to improve risk assessment accuracy and feasibility in clinical settings. METHODS: A prospective cohort study was conducted from March to July 2022 among oral cancer patients undergoing surgical interventions at the Department of Head and Neck Surgery. Clinical data were collected using the Postoperative Dysphagia Risk Factor Questionnaire. Swallowing function was assessed with the Mann Assessment of Swallowing Ability-Oral Cancer (MASA-OC). Lasso regression identified potential predictor variables, followed by univariate and multivariate logistic regression analyses. A predictive model was developed using R Studio 4.1.2 and rigorously evaluated with ROC curves, Hosmer-Lemeshow tests, and calibration curves. Internal validation utilized Bootstrap methodology with 1000 repetitive samples. RESULTS: The cohort included 257 oral cancer patients, with 73.9 % experiencing postoperative dysphagia. Independent predictors included functional status, depressive symptoms, pT stage, surgical techniques, glossoplasty, maxillectomy, and post-surgery nasopharyngeal tube retention. The predictive model achieved an AUC of 0.933, sensitivity of 90.9 %, and specificity of 81.7 %. Hosmer-Lemeshow test (P = 0.715) and C-index (0.934) indicated satisfactory model fit. Internal validation yielded an AUC of 0.912, sensitivity of 93.3 %, and specificity of 63.8 %. Calibration curves demonstrated alignment between predicted and observed outcomes. CONCLUSION: A nomogram integrating recognized risk factors shows promise in predicting postoperative dysphagia in oral cancer patients, enhancing precision and aiding healthcare professionals in risk evaluation and patient care strategies.

Current status and influencing factors of fear of surgery in patients with oral and maxillofacial tumors.

OBJECTIVES: This study aimed to investigate the incidence and severity of surgical fear in patients with oral and maxillofacial tumors. METHODS: The survey participants were composed of patients with oral and maxillofacial tumors, who were scheduled to undergo surgery. A general information questionnaire, the Surgical Fear Questionnaire (SFQ), the Patient Health Questionnaire (PHQ)-9, and the Generalized Anxiety Disorder (GAD)-7 score were used for the investigation. RESULTS: A total of 203 patients were investigated. Among them, 85.22% had fear of surgery. The median score of SFQ was 20, and the quartile was (6, 36). The patients were categorized into none, mild, moderate, and severe groups according fear level. Gender, diabetes, obvious discomfort before surgery, PHQ-9, and GAD-7 scores were the variables with statistical difference in each fear level. Multifactor analysis showed that women were more likely to have moderate and severe fear than men (OR=2.19, P=0.03; OR=2.72, P=0.01), patients with obvious preoperative discomfort symptoms were more inclined to have no fear (OR=4.73, P=0.02), and patients with diabetes were more likely to have severe fear (OR=3.33, P=0.02). The incidence rates of depression and anxiety were 31.03% and 24.63%, respectively. The incidence of anxiety and depression in patients with severe fear was 40.00%. Surgical fear was moderately positively correlated with anxiety (r=0.491, P<0.001) and depression (r=0.514, P<0.001). CONCLUSIONS: The fear of surgery in patients with oral and maxillofacial tumors is common and distributed in all levels. Medical staff can screen and assess patients with moderate and severe fear of surgery in accordance with the influencing factors and implement targeted interventions to reduce fear of surgery, anxiety, and depression on the basis of the source of fear.

Facial nerve function training in patients with peripheral facial paralysis: an expert consensus.

Facial nerve training can prevent facial expression muscle atrophy and promote the recovery of facial para-lysis in patients with peripheral facial paralysis. However, there is still a lack of specific and unified technical standards for facial nerve training, which results in a variety of clinical training methods and uneven levels. In order to standardize the application of facial nerve function training technology for nursing staff, the study convened relevant domestic experts, based on evidence-based combination with the disease characteristics of peripheral facial paralysis and expert clinical experience, conducted in-depth interviews with experts, expert correspondence and expert meetings, and finally formulated the expert consensus on facial nerve function training in patients with peripheral facial paralysis. Overall, suggestions for standardizing the timing, training methods, evaluation methods, health education and other aspects were provided for clinical reference.

Systematic review of risk factors of postoperative dysphagia in patients with oral cancer.

OBJECTIVES: This study aims to identify risk factors of postoperative dysphagia in patients with oral cancer by systematic review. METHODS: Cohort studies in Chinese or English on risk factors of postoperative dysphagia in patients with oral cancer were searched from CNKI, Wanfang database, VIP Chinese Journal Database, China Biomedical Literature Service System, Chinese Clinical Trial Registry, PubMed, Cochrane Library, EMBASE, Web of Science, and Clinical Trials from the beginning to June 30, 2021. Subject words combined with free words were used to retrieve related articles. The included studies were evaluated, and the effective data were processed with Revman 5.3. RESULTS: Ten studies were selected, and they included 1 241 patients consisting of 473 patients in the exposed group and 768 patients in the control group. After the meta-analysis, the risk factors with statistical significance were as follows: age>60 years, tumor located in oropharynx or mouth floor, tumor size of T3 or T4, TNM stage of Ⅳ, resection involving suprahyoid muscle or tongue resection>50%, combination of neck dissection, tracheotomy, or reconstruction, and postoperative radiotherapy. CONCLUSIONS: Age>60 years, tumor in oropharynx or mouth floor, tumor size of T3 or T4, TNM stage of Ⅳ, resection involving suprahyoid muscle or tongue resection>50%, combination of neck dissection, tracheotomy, or reconstruction, and postoperative radiotherapy were significant risk factors of postoperative dysphagia in patients with oral cancer.

Concentration standardization improves the capacity of drainage CRP and IL-6 to predict surgical site infections.

IMPACT STATEMENT: The ability to predict surgical site infections (SSIs) early would be advantageous. Previous studies have investigated the use of inflammatory factors in fluids drained from surgical sites to predict SSI, but the diagnostic efficacy of this method requires improvement. Baseline levels of inflammatory factors vary between individuals, but this variation tends to differ in patients with and without SSIs. Therefore, we standardized subsequently acquired concentrations of interleukin 6 and C-reactive protein in fluids drained from surgical sites by dividing them by the concentrations determined at day 1 to preclude the confounding effects of differences in baseline levels. The standardized concentrations had higher predictive efficacy than the absolute concentrations. Standardizing the data rendered SSI prediction more precise and practical in a diverse group of real patients. This translational study suggests that inflammatory factors in fluid drained from injury sites are promising tools for the prediction of SSI in the clinic.

[Application of artificial intelligence in stomatology treatment and nursing].

Currently, artificial intelligence technology is being developed rapidly and is used in many clinical areas, especially in stomatology. The application of artificial intelligence technology in stomatology is a new technological revolution. This study focuses on artificial intelligence and its application status. The advantages, current situation, and development prospect of the application of artificial intelligence technology in stomatology treatment and nursing, such as oral and maxillofacial surgery, implant, prosthetics, orthodontics, oral medicine therapy, guidance, and teaching, are provided.

Current research on head and neck cancer-associated long noncoding RNAs.

Head and neck cancers (HNC) are one of the ten leading cancers worldwide, including a range of malignant tumors arising from the upper neck. Due to the complex mechanisms of HNC and lack of effective biomarkers, the 5-year survival rate of HNC has been low and the mortality rate has been high in recent decades. Long noncoding RNAs (lncRNAs), noncoding RNAs longer than 200 bps, are a focus of current cancer research, closely related to tumor biology. LncRNAs have been revealed to be aberrantly expressed in various types of HNC, and the dysregulated lncRNAs participate in HNC progression and induce malignant behavior by modulating gene expression at diverse levels. This review will focus on the functions and molecular mechanisms of dysregulated lncRNAs in HNC tumorigenesis and progression, as well as their diagnostic, therapeutic or prognostic implications in HNC.

[Application of risk management in nursing management of head and neck oncology].

OBJECTIVE: To study the effect of risk management in nursing management of head and neck oncology. METHODS: In 2010, risk management was applied to the nursing management of head and neck oncology through risk identification, increasing awareness of risk management, defining risk management responsibilities, strengthening the capacity of specialist nurses and emergency response, and strengthening risk control measures. Patients' satisfaction, care complaints, nursing risk occurrence, nurse praised visits between 2009 and 2010 were compared. RESULTS: There were significant differences comparing 2009 with 2010 in patient satisfaction, care complaints, nursing risk occurs, nurse praised visits in head and neck oncology (P<0.05). CONCLUSION: Application of risk management in nursing management will relieve care complaints and nursing risk occurrences, improve patients' satisfaction. It is worth to further promote in the clinical nursing management.

[The preliminary study on nursing the extraction of mandibular mesioangular impacted third molar using reversal high-speed air turbine].

OBJECTIVE: To study the nursing methods and its effect in mandibular mesioangular impacted third molar extraction with reversal high-speed air turbine. METHODS: 60 patients with mandibular mesioangular impacted third molar were selected in this study, who were treated in Department of Senior Dentists, West China School of Stomatology, Sichuan University, between June to December 2010. They were randomly and equally divided into control group and experimental group (n=30). The former was treated with tradition chisel splint method while the latter was treated with reversal high-speed air turbine extraction and provided appropriate nursing interventions. Postoperative reactions and wound healing status were evaluated through consultation. RESULTS: There were significant differences between control group and experimental group in terms of postoperative bleeding wound, swelling, dry socket and so on (P<0.05). CONCLUSION: Mandibular mesioangular impacted third molar extraction with reversal high-speed air turbine is effective, and the corresponding nursing measure is worthy further promotion.

[Influence of hand-mixed methods on compressive strength of zinc phosphate dental cement].

OBJECTIVE: To study the influence of hand-mixed methods on the compressive strength of the zinc phosphate dental cement. METHODS: Three skilled nurses used three kinds of common clinical hand-mixed methods (included the unidirectional rotation method, the alternate pro and con bidirectional rotation method and the pulling and pushing with folding method) to mix the zinc phosphate dental cement on the same condition (i.e. same indoor temperature and humidity, the same mixing ratio, mixing time, mixing frequency and the same mixing instruments and so on). The mixed zinc phosphate cement was packed into the plastic cylinders with 10 mm-high and 5 mm-bore. After the mixed zinc phosphate cement coagulated, compressive strength was tested separately. RESULTS: The compressive strength of the zinc phosphate dental cement mixed with the alternate pro and con bidirectional rotation method was the best, and the value was (106.11+/- 4.82) MPa. The compressive strength of the zinc phosphate dental cement mixed with the pulling and pushing with folding method was lower, and the value was (77.57 +/- 6.26) MPa. The compressive strength of the zinc phosphate dental cement mixed with the unidirectional rotation method was the lowest, and the value was (54.41 +/- 5.08) MPa. The compressive strength of the zinc phosphate dental cement mixed with the unidirectional rotation method and the pulling and pushing with folding method could not achieve the clinical required compressive strength (about 100 MPa), while the compressive strength mixed with the alternate pro and con bidirectional rotation method was above 100 MPa. CONCLUSION: The alternate pro and con bidirectional rotation method to mix the zinc phosphate dental cement is recommended in clinic.