Objective:To summarize the best available evidence for donor and recipient site flap management in head and neck cancer patients undergoing free flap reconstruction.Method:Following the 6S evidence hierarchy model, a comprehensive search was conducted in databases and websites including UpToDate, BMJ Best Practice, Guidelines International Network, National Institute for Health and Care Excellence, National Comprehensive Cancer Network, Joanna Briggs Institute Evidence-Based Healthcare Database, Cochrane Library, PubMed, Embase, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang Data. The search period covered all publications up to May 1, 2024.Results:A total of 14 articles were included, comprising two clinical decisions, two guidelines, two systematic reviews, five expert consensuses, two randomized controlled trials, and one prospective cohort study.A total of 28 pieces of evidence were summarized from six aspects: establishing multidisciplinary collaboration, standardized assessment, prehabilitation training, donor site management strategies, recipient site management strategies, and risk identification and management.Conclusions:This study provides a comprehensive summary of evidence regarding donor and recipient site flap management in patients with head and neck cancer undergoing free flap reconstruction, offering an evidence-based foundation for guiding clinical nursing practice.

Objective To construct an intelligent postoperative rehabilitation management platform and evaluate its effect in patients with head and neck cancer.Methods The postoperative intelligent rehabilitation management platform of head and neck cancer patients was divided into 5 layers from bottom to top,including the underlying environment,platform support,core database,analysis algorithm and application platform.Through the construction of head and neck tumor postoperative complications knowledge base and risk prediction model and wearable device auxiliary precision prediction risk,the head and neck cancer patients with postoperative intelligent rehabilitation management was realized.A historical controlled study was conducted and 90 participants with head and neck cancer were selected who underwent the surgical treatment in a hospital in Hangzhou,Zhejiang Province.The experimental group(45 participants admitted from February to July)received the intervention by the intelligent rehabilitation management platform,while the control group(45 patients from August to December)received the routine rehabilitation management.The outcome measures including NRS scores at 12 h,24 h,48 h and 72 h after surgery,incidence of postoperative complications,postoperative length of hospital stay,and patient satisfaction were compared between the 2 groups.Results The scores of incidences of complications,postoperative hospital stay,and NRS scores at 12 h,24 h,48 h and 72 h after surgery in the experimental group were lower than those in the control group(P＜0.05),while the scores of patient satisfaction in the experimental group were higher than those of the control group(P＜0.05).Conclusion The intelligent postoperative rehabilitation management platform can achieve accurate prediction of postoperative complications,reduce postoperative complications of head and neck tumors,timely intervene to relieve patients'pain and discomfort,shorten hospital stays,improve nursing work efficiency and improve patient satisfaction.

Objective:To summarize the best available evidence for donor and recipient site flap management in head and neck cancer patients undergoing free flap reconstruction.Method:Following the 6S evidence hierarchy model, a comprehensive search was conducted in databases and websites including UpToDate, BMJ Best Practice, Guidelines International Network, National Institute for Health and Care Excellence, National Comprehensive Cancer Network, Joanna Briggs Institute Evidence-Based Healthcare Database, Cochrane Library, PubMed, Embase, Web of Science, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang Data. The search period covered all publications up to May 1, 2024.Results:A total of 14 articles were included, comprising two clinical decisions, two guidelines, two systematic reviews, five expert consensuses, two randomized controlled trials, and one prospective cohort study.A total of 28 pieces of evidence were summarized from six aspects: establishing multidisciplinary collaboration, standardized assessment, prehabilitation training, donor site management strategies, recipient site management strategies, and risk identification and management.Conclusions:This study provides a comprehensive summary of evidence regarding donor and recipient site flap management in patients with head and neck cancer undergoing free flap reconstruction, offering an evidence-based foundation for guiding clinical nursing practice.

Objective To construct an intelligent postoperative rehabilitation management platform and evaluate its effect in patients with head and neck cancer.Methods The postoperative intelligent rehabilitation management platform of head and neck cancer patients was divided into 5 layers from bottom to top,including the underlying environment,platform support,core database,analysis algorithm and application platform.Through the construction of head and neck tumor postoperative complications knowledge base and risk prediction model and wearable device auxiliary precision prediction risk,the head and neck cancer patients with postoperative intelligent rehabilitation management was realized.A historical controlled study was conducted and 90 participants with head and neck cancer were selected who underwent the surgical treatment in a hospital in Hangzhou,Zhejiang Province.The experimental group(45 participants admitted from February to July)received the intervention by the intelligent rehabilitation management platform,while the control group(45 patients from August to December)received the routine rehabilitation management.The outcome measures including NRS scores at 12 h,24 h,48 h and 72 h after surgery,incidence of postoperative complications,postoperative length of hospital stay,and patient satisfaction were compared between the 2 groups.Results The scores of incidences of complications,postoperative hospital stay,and NRS scores at 12 h,24 h,48 h and 72 h after surgery in the experimental group were lower than those in the control group(P＜0.05),while the scores of patient satisfaction in the experimental group were higher than those of the control group(P＜0.05).Conclusion The intelligent postoperative rehabilitation management platform can achieve accurate prediction of postoperative complications,reduce postoperative complications of head and neck tumors,timely intervene to relieve patients'pain and discomfort,shorten hospital stays,improve nursing work efficiency and improve patient satisfaction.

With the application and integration of high-quality computer software and hardware as well as the advanced sensors,a rehabilitation VR system has been explored and developed for breast cancer patients.According to the changes of lymphedema and motor function,the rehabilitation process was divided into four phases.After a three-month control experiment among 76 cases of breast cancer patients,the results showed that the VR system with auxiliary game treatment to control patients' training process was able to substantially improve limb function recovery,compliance and subjective initiative in rehabilitation training,and reduce the edema of affected limbs,and the differences were statistically significant(P＜0.01,P＜0.05).Therefore,the VR system helps patients' limb function recovery and reduce negative emotions after surgery.

Objective To study the clinical significance of the change of plasma BNP levels in patients with grades sepsis and its correlation with the left ventricular ejection fraction.Methods One hundred patients of sepsis who were admitted in intensive care unit of Taizhou hospital were selected.It was divided into four groups:30 patients with septic shock,40 patients with severe sepsis,30 patients with sepsis and 20 persons without disease as control group.The concentration of plasma BNP was determined using sandwich immunoflurescence,and ultrasonic cardiogram was used to evaluate heart function and clinical features in all groups.To compare with the differences of the concentration of plasma BNP and the correlation between the concentration of Plasma BNP and LVEF in all groups,the data of clinical features,28-day mortality,prognostic values of BNP and the length of stay (ROG) in ICU were collected and compared.Result Plasma BNP levels in patients with septic shock[ (976.3 ± 160.7) pg/ml] were obvious higher than severe sepsis[ (648.4 ± 267.3) pg/ml ],sepsis [ (217.2 ± 89.7) pg/ml ] and control group [ (50.3 ± 25.4)pg/ml] (P ＜0.01).LVEF in patients with septic shock [ (48.2 ±9.6)% ] was obvious lower than severe sepsis[ (52.8 ±9.4)% ],sepsis[ (61.3 ± 8.9)% ] and control group[ (66.4 ±9.3)% ] (P ＜0.05 or P ＜0.01).It appeared to be inverse relationship between LVEF and the plasma BNP levels (r =-0.876,-0.724,P ＜0.01).BNP levels were significantly higher in non-survivors compared with survivors[ (1367.6±506.4)pg/ml vs (420.3 ±82.6)pg/ml,P ＜0.01 ].The receiver operating characteristic (ROG) curves indicated that values of areas under the curve of plasma BNP levels for 28-days mortality were 0.918(P ＜0.01).Conclusion The concentration of plasma BNP in patients was different in different grades of sepsis.It appeared to be negative correlation between the concentration of plasma BNP and LVEF.Plasma BNP levels had predictive value to the patients with sepsis.