Objective:To develop and validate a perioperative oral care protocol for patients undergoing oral vestibular approach endoscopic thyroid cancer radical surgery, providing practical guidance for clinical nursing.Methods:The protocol was constructed through literature analysis and Delphi expert consultation. A prospective non-randomized controlled study was conducted using convenience sampling, enrolling 60 patients who underwent oral vestibular approach endoscopic thyroid cancer radical surgery at the First Affiliated Hospital with Nanjing Medical University Thyroid Center between August 2023 and May 2024. Participants were divided into control group (from August to December, 2023) and experimental group (from January to May, 2024) based on admission dates with 30 cases in each group. The control group received routine care, while the experimental group received the developed oral care protocolin on the basis of the control group. Postoperative pain scores, mouth-opening difficulties, and oral cleanliness were compared on days 1, 3, and 7 after surgery.Results:The final protocol comprised 7 first-level indicators (team collaboration, health education, preoperative oral assessment, preoperative management, intraoperative management, postoperative management, and discharge follow-up), 17 second-level indicators, and 49 third-level indicators. The control group had 4 males and 26 females, with an age of (29.57 ± 5.34) years; the experimental group had 6 males and 24 females, with an age of (29.87 ± 6.25) years. On postoperative days 1, 3, and 7, the pain scores were 3.87 ± 1.01, 3.30 ± 0.92, and 2.53 ± 0.68 in the control group and 3.20 ± 0.87, 2.10 ± 0.76, and 1.50 ± 0.51 in the experimental group, respectively. The differences between the two groups were statistically significant ( t = 2.89, 5.12, 6.34, all P<0.05). For mouth-opening difficulties, the control group had 6, 13, and 15 patients with grade I on postoperativedays 1, 3, and 7, respectively, while the experimental group had 10, 20, and 25 patients with gradeⅠ. The control group had 20, 14, and 14 patients with gradeⅡonpostoperative days 1, 3, and 7, respectively, while the experimental group had 17, 10, and 5 patients with gradeⅡ. The control group had 4, 3, and 1 patients with grade Ⅲ on postoperative days 1, 3, and 7, respectively, while the experimental group had 3, 0, and 0 patients with grade Ⅲ. There were 0 cases in both groups with grade Ⅳ. The differences between the two groups on postoperative days 3, and 7 were statistically significant ( χ2 = 10.45, 18.67, both P<0.05). For oral cleanliness, the control group had 3, 4, and 5 patients with excellent cleanliness on postoperative days 1, 3, and 7, respectively, while the experimental group had 11, 16, and 19 patients with excellent cleanliness. The control group had 20, 22, and 23 patients with good cleanliness on postoperative days 1, 3, and 7, respectively, while the experimental group had 18, 13, and 10 patients with good cleanliness. The control group had 7 (23.33%), 4 (13.33%), and 2 (6.67%) patients with poor cleanliness on postoperative days 1, 3, and 7, respectively, while the experimental group had 1 (3.33%), 1 (3.33%), and 1 (3.33%) patients with poor cleanliness. The differences between the two groups were statistically significant ( χ2 = 9.19, 11.32, 16.68, all P<0.05). Conclusions:The developed perioperative oral care protocol is scientifically sound, feasible, and practical. Following the intervention, significant decreases in pain scores, alleviation of trismus symptoms, and marked improvements in oral cleanliness were observed in patients compared to pre-intervention assessments, and worth further clinical application.

Objective:To develop and validate a perioperative oral care protocol for patients undergoing oral vestibular approach endoscopic thyroid cancer radical surgery, providing practical guidance for clinical nursing.Methods:The protocol was constructed through literature analysis and Delphi expert consultation. A prospective non-randomized controlled study was conducted using convenience sampling, enrolling 60 patients who underwent oral vestibular approach endoscopic thyroid cancer radical surgery at the First Affiliated Hospital with Nanjing Medical University Thyroid Center between August 2023 and May 2024. Participants were divided into control group (from August to December, 2023) and experimental group (from January to May, 2024) based on admission dates with 30 cases in each group. The control group received routine care, while the experimental group received the developed oral care protocolin on the basis of the control group. Postoperative pain scores, mouth-opening difficulties, and oral cleanliness were compared on days 1, 3, and 7 after surgery.Results:The final protocol comprised 7 first-level indicators (team collaboration, health education, preoperative oral assessment, preoperative management, intraoperative management, postoperative management, and discharge follow-up), 17 second-level indicators, and 49 third-level indicators. The control group had 4 males and 26 females, with an age of (29.57 ± 5.34) years; the experimental group had 6 males and 24 females, with an age of (29.87 ± 6.25) years. On postoperative days 1, 3, and 7, the pain scores were 3.87 ± 1.01, 3.30 ± 0.92, and 2.53 ± 0.68 in the control group and 3.20 ± 0.87, 2.10 ± 0.76, and 1.50 ± 0.51 in the experimental group, respectively. The differences between the two groups were statistically significant ( t = 2.89, 5.12, 6.34, all P<0.05). For mouth-opening difficulties, the control group had 6, 13, and 15 patients with grade I on postoperativedays 1, 3, and 7, respectively, while the experimental group had 10, 20, and 25 patients with gradeⅠ. The control group had 20, 14, and 14 patients with gradeⅡonpostoperative days 1, 3, and 7, respectively, while the experimental group had 17, 10, and 5 patients with gradeⅡ. The control group had 4, 3, and 1 patients with grade Ⅲ on postoperative days 1, 3, and 7, respectively, while the experimental group had 3, 0, and 0 patients with grade Ⅲ. There were 0 cases in both groups with grade Ⅳ. The differences between the two groups on postoperative days 3, and 7 were statistically significant ( χ2 = 10.45, 18.67, both P<0.05). For oral cleanliness, the control group had 3, 4, and 5 patients with excellent cleanliness on postoperative days 1, 3, and 7, respectively, while the experimental group had 11, 16, and 19 patients with excellent cleanliness. The control group had 20, 22, and 23 patients with good cleanliness on postoperative days 1, 3, and 7, respectively, while the experimental group had 18, 13, and 10 patients with good cleanliness. The control group had 7 (23.33%), 4 (13.33%), and 2 (6.67%) patients with poor cleanliness on postoperative days 1, 3, and 7, respectively, while the experimental group had 1 (3.33%), 1 (3.33%), and 1 (3.33%) patients with poor cleanliness. The differences between the two groups were statistically significant ( χ2 = 9.19, 11.32, 16.68, all P<0.05). Conclusions:The developed perioperative oral care protocol is scientifically sound, feasible, and practical. Following the intervention, significant decreases in pain scores, alleviation of trismus symptoms, and marked improvements in oral cleanliness were observed in patients compared to pre-intervention assessments, and worth further clinical application.

Objective:To study the effect of graphene oxide (GO) on adipose-derived mesenchymal stem cells (Ad-MSCs) to promote diabetic skin wound healing.Methods:Ad-MSCs were cultured with GO at concentration of 100, 200, and 400 μg/mL and with 25 mmol/L of glucose for 48 h. The apoptosis of Ad-MSCs was detected by flow cytometry and Western blotting. Eighteen BALB/c thymus free female nude mice were selected to establish the skin defect model of diabetic nude mice. Then phosphate-buffered saline, Ad-MSCs, and GO+ Ad-MSCs were injected into the damaged skin of nude mice by intradermal injection for treatment, thereby created the control group, Ad-MSCs group, and GO+ Ad-MSCs group, 6 mice each group. The survival of wound cells and skin healing of mice were observed after surgery, and the wound healing was determined by HE staining and Masson staining.The level of epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), and interleukin 6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA).Results:Compared with the high glucose group without GO(control group), the apoptosis rate of Ad-MSCs co-culture with GO was significantly reduced( P<0.05), and the apoptosis rate decreased with the increase of GO concentration. The expression level of Bax protein decreased, and the expression level of Bcl-2 protein increased ( P<0.05). Diabetic skin defect model showed that the survival rate of Ad-MSCs and wound healing degree in GO+ Ad-MSCs group were significantly increased ( P<0.05), and the degree of epithelialization and thickness of collagen regeneration were better than those in other groups. ELISA results showed that the expressions of EGF and VEGF were significantly increased in GO+ Ad-MSCs group ( P<0.05), while the expressions of TNF-α and IL-6 were significantly decreased ( P<0.05). Conclusion:GO can inhibit the apoptosis of Ad-MSCs in vitro. In vivo, Ad-MSCs treated with GO have higher survival rate, faster wound healing, and better effect than Ad-MSCs treated alone.

Objective To detect the expression of mitochondrial dynamics proteins (Mfn2 and Drp1) in thyroid squa?mous carcinoma cell line SW579 and the effects of Mitochondrial division inhibitor, Mdivi-1, on proliferation, apoptosis and invasion of SW579. Methods In SW579 and Nthy-ori 3-1 cell lines, the expression levels of Mfn2 and Drp1 were deter?mined by western blot while the transcription level of Mfn2 and Drp1 mRNA were measured by RT-PCR. Then, SW579 cells were divided into control group (DMSO, 0.1%) and Mdivi-1 low, medium and high dose groups (Mdivi-1 of 15,30 and 45μmol/L were incubated with cells for 16 hours respectively). Then the ability of cell proliferation was detected using MTT assay, the mitochondrial membrane potential was determined by fluorescence spectrophotometer, the expression levels of cy?tochrome C and Caspase-3 were quantified by Western blot and the transcription level of the Cyt C and Caspase-3 mRNA were determined by RT-PCR. The ability of invasion in each group was measured with Transwell assays. Results Com?pared with Nthy-ori 3-1, the mRNA transcription and protein expression levels of the Mfn2 was remarkably decreased, while the mRNA transcription and protein expression of the Drp1 was significantly increased in SW579 cells (P<0.01). Compared with control group, the cell survival rates and mitochondrial membrane potential of SW579 were decreased dramat?ically (P<0.01). The mRNA transcription and protein expression of the cytochrome C and Caspase-3 were increased dra?matically (P<0.01) and the capability of invasion was markedly decreased in all the Mdivi-1 groups in a dosage dependent manner compared with those in control groups (P<0.01). Conclusion Abnormal mitochondrial dynamics may be involved in thyroid squamous cell carcinoma SW579 cells;Mdivi-1 can inhibit the cell proliferation and invasion as well as induce apoptosis.