Objective:To investigate the application effect of health education based on self-determination theory combined with mouth-opening training in patients with multiple jaw fractures so as to improve patients' compliance with postoperative rehabilitation.Methods:The randomized controlled trial methods were adopted. A total of 350 patients with multiple jaw fractures who were admitted to the Department of Oral and Maxillofacial Surgery at the First Affiliated Hospital of Zhengzhou University from January 2022 to July 2023 were selected by convenience sampling method. They were divided into the study group and the control group using the random number table method, 175 cases in each group. The control group received routine perioperative nursing and mouth-opening training. On this basis, the study group received health education based on self-determination theory combined with mouth-opening training. The postoperative Visual Analogue Score (VAS), fear of occlusion score, compliance with rehabilitation training, restriction of mouth opening, Self-rating Anxiety Scale (SAS) score, Self-rating Depression Scale (SDS) score, and satisfaction degree were compared between the two groups.Results:Finally, 342 patients completed the study. Among 172 patients in the study group, there were 80 males and 92 females, with an age of (38.73 ± 9.15) years. Among 170 patients in the control group, there were 82 males and 88 females, with an age of (40.22 ± 10.06) years. The VAS scores of the study group on postoperative days 1, 3, and 7 were (4.92 ± 0.56), (3.68 ± 0.52), and (2.28 ± 0.44), respectively, all lower than those of the control group (5.10 ± 0.60), (4.03 ± 0.55), and (2.66 ± 0.53), and the differences were statistically significant ( t=2.87, 6.05, 7.22, all P<0.05). Fear of occlusion scores of the study group on postoperative days 1, 3 and 7 were (3.88 ± 0.52), (2.67 ± 0.65) and (1.45 ± 0.32), respectively, all lower than those of the control group (4.05 ± 0.39), (3.12 ± 0.73) and (1.68 ± 0.35), and the differences were statistically significant ( t=3.42, 6.02, 6.34, all P<0.05). The total compliance rate of rehabilitation training in the research group was 95.35% (164/172), which was higher than the control group ′s 84.12% (143/170), and the difference was statistically significant ( χ2=11.74, P<0.05). After intervention, SAS score and SDS score of the study group were (36.18 ± 7.15) and (33.08 ± 8.21), respectively, witch were lower than those of the control group (38.34 ± 6.63) and (35.20 ± 7.39), and the differences were statistically significant ( t=2.90, 2.51, both P<0.05). Total satisfaction score of the study group (83.50 ± 12.68) was higher than that of the control group (79.52 ± 14.92), the difference was statistically significant( t=2.66, P<0.05). Conclusions:Health education based on self-determination theory combined with mouth-opening training can help alleviate postoperative pain and fear of occlusion in patients with multiple jaw fractures, improve their compliance with rehabilitation training as well as rehabilitation effect.

Objective:To investigate the application effect of health education based on self-determination theory combined with mouth-opening training in patients with multiple jaw fractures so as to improve patients' compliance with postoperative rehabilitation.Methods:The randomized controlled trial methods were adopted. A total of 350 patients with multiple jaw fractures who were admitted to the Department of Oral and Maxillofacial Surgery at the First Affiliated Hospital of Zhengzhou University from January 2022 to July 2023 were selected by convenience sampling method. They were divided into the study group and the control group using the random number table method, 175 cases in each group. The control group received routine perioperative nursing and mouth-opening training. On this basis, the study group received health education based on self-determination theory combined with mouth-opening training. The postoperative Visual Analogue Score (VAS), fear of occlusion score, compliance with rehabilitation training, restriction of mouth opening, Self-rating Anxiety Scale (SAS) score, Self-rating Depression Scale (SDS) score, and satisfaction degree were compared between the two groups.Results:Finally, 342 patients completed the study. Among 172 patients in the study group, there were 80 males and 92 females, with an age of (38.73 ± 9.15) years. Among 170 patients in the control group, there were 82 males and 88 females, with an age of (40.22 ± 10.06) years. The VAS scores of the study group on postoperative days 1, 3, and 7 were (4.92 ± 0.56), (3.68 ± 0.52), and (2.28 ± 0.44), respectively, all lower than those of the control group (5.10 ± 0.60), (4.03 ± 0.55), and (2.66 ± 0.53), and the differences were statistically significant ( t=2.87, 6.05, 7.22, all P<0.05). Fear of occlusion scores of the study group on postoperative days 1, 3 and 7 were (3.88 ± 0.52), (2.67 ± 0.65) and (1.45 ± 0.32), respectively, all lower than those of the control group (4.05 ± 0.39), (3.12 ± 0.73) and (1.68 ± 0.35), and the differences were statistically significant ( t=3.42, 6.02, 6.34, all P<0.05). The total compliance rate of rehabilitation training in the research group was 95.35% (164/172), which was higher than the control group ′s 84.12% (143/170), and the difference was statistically significant ( χ2=11.74, P<0.05). After intervention, SAS score and SDS score of the study group were (36.18 ± 7.15) and (33.08 ± 8.21), respectively, witch were lower than those of the control group (38.34 ± 6.63) and (35.20 ± 7.39), and the differences were statistically significant ( t=2.90, 2.51, both P<0.05). Total satisfaction score of the study group (83.50 ± 12.68) was higher than that of the control group (79.52 ± 14.92), the difference was statistically significant( t=2.66, P<0.05). Conclusions:Health education based on self-determination theory combined with mouth-opening training can help alleviate postoperative pain and fear of occlusion in patients with multiple jaw fractures, improve their compliance with rehabilitation training as well as rehabilitation effect.

Objective:To investigate the clinical outcomes of lining repair during the reconstruction of nasal defects.Methods:From January 2010 to December 2022, our team treated 15 nasal defect patients aged between 18 and 62 years with an average age of 38, including 8 males and 7 females. The range of the defect was more than one subunit in all cases. And forehead pedicled flaps were chosen for repair. For nasal reconstruction, expander was implanted to expand the central forehead flap. The choice of support depended on the range of the defect, including rib-rib cartilage composite grafts, rib cartilage grafts and ear cartilage grafts. The repair of the lining was selected with the original skin, local nasolabial flapor forehead pedicled flap to repair the mucosal defect of the nose. Postoperative follow-up was conducted to observe the effects.Results:Among the 15 patients, 8 cases underwent rib-rib cartilage composite grafts. 3 cases had rib cartilage grafts, and 4 cases had ear cartilage grafts. All the flaps survived with 1 case experiencing infection. Postoperative follow-up for 0.5 to 2 years showed that the appearance of nasal defects in all 15 cases was significantly improved, with satisfactory results.Conclusions:The repair of nasal defect lining requires a comprehensive analysis based on the specific location, range of the defect, and the selection of the donor area in order to ultimately determine the surgical approach.

Objective:To observe the changes of emotional state and quality of life in patients with oral cancer surgery after empowerment education combined with motivational psychological intervention.Methods:A total of 80 patients with oral cancer who underwent surgical treatment in the First Affiliated Hospital of Zhengzhou University were enrolled from January to December 2023. According to order of admission and comparability principle of inter-group basic data, the subjects were divided into control group (from January to May 2023, n=40) and observation group (from June to December 2023, n=40). On basis of standardized disease management, control group was given routine health education and psychological intervention, while observation group was given empowerment education combined with motivational psychological intervention. All patients were intervened till 3 months after discharge. Before intervention (admission) and after intervention (3 months after discharge), disease uncertainty, emotional state, coping styles, self-efficacy, compliance and quality of life were evaluated by Mishel uncertainty in illness scale-adult(MUIS-A), self-rating depression scale (SDS), self-rating anxiety scale (SAS), trait coping style questionnaire (TCSQ), general self-efficacy scale (GSES) and University of Washington quality of life questionnaire-4 (UW-QoLv4), respectively. The differences between the two groups (intra-group) were analyzed by SPSS 21.0 statistical software, including independent sample t-test, paired t-test and Chi-square test. Results:(1)The scores of MUIS-A, SDS, SAS, TCSQ, GSES and UW-QoLv4 were not significantly different between the two groups before intervention(all P>0.05).(2)After intervention, scores of MUIS-A, SDS, SAS and TCSQ-negative coping in observation group were 91.56±7.49, 49.83±7.63, 50.54±6.51 and 30.21±3.37, lower than those in control group (100.18±8.52, 56.95±8.11, 58.14±7.36, 32.19±2.36, t=4.806, 4.044, 4.892, 3.044, all P<0.05). The scores of TCSQ-positive coping and GSES in observation group (34.25±2.13 and 29.25±2.83) were higher than those in control group (31.14±2.06, 25.70±3.14, t=6.638, 5.311, both P<0.001). (3)The compliance of dietary management, rehabilitation training and postoperative reexamination in observation group were better than those in control group ( χ2=4.114, 6.646, 5.165, all P<0.05). (4)The incidence of flap necrosis in observation group was lower than that in control group (5.00%(2/40) vs 22.50%(9/40), χ2=5.165, P<0.05). (5)After intervention, UW-QoLv4 score in observation group was higher than that in control group (863.28±24.87 vs 751.26±38.94, t=15.334, P<0.05). Conclusion:Empowerment education combined with motivational psychological intervention can effectively improve the emotional state and quality of life of patients with oral cancer surgery.

Objective:To observe the changes of emotional state and quality of life in patients with oral cancer surgery after empowerment education combined with motivational psychological intervention.Methods:A total of 80 patients with oral cancer who underwent surgical treatment in the First Affiliated Hospital of Zhengzhou University were enrolled from January to December 2023. According to order of admission and comparability principle of inter-group basic data, the subjects were divided into control group (from January to May 2023, n=40) and observation group (from June to December 2023, n=40). On basis of standardized disease management, control group was given routine health education and psychological intervention, while observation group was given empowerment education combined with motivational psychological intervention. All patients were intervened till 3 months after discharge. Before intervention (admission) and after intervention (3 months after discharge), disease uncertainty, emotional state, coping styles, self-efficacy, compliance and quality of life were evaluated by Mishel uncertainty in illness scale-adult(MUIS-A), self-rating depression scale (SDS), self-rating anxiety scale (SAS), trait coping style questionnaire (TCSQ), general self-efficacy scale (GSES) and University of Washington quality of life questionnaire-4 (UW-QoLv4), respectively. The differences between the two groups (intra-group) were analyzed by SPSS 21.0 statistical software, including independent sample t-test, paired t-test and Chi-square test. Results:(1)The scores of MUIS-A, SDS, SAS, TCSQ, GSES and UW-QoLv4 were not significantly different between the two groups before intervention(all P>0.05).(2)After intervention, scores of MUIS-A, SDS, SAS and TCSQ-negative coping in observation group were 91.56±7.49, 49.83±7.63, 50.54±6.51 and 30.21±3.37, lower than those in control group (100.18±8.52, 56.95±8.11, 58.14±7.36, 32.19±2.36, t=4.806, 4.044, 4.892, 3.044, all P<0.05). The scores of TCSQ-positive coping and GSES in observation group (34.25±2.13 and 29.25±2.83) were higher than those in control group (31.14±2.06, 25.70±3.14, t=6.638, 5.311, both P<0.001). (3)The compliance of dietary management, rehabilitation training and postoperative reexamination in observation group were better than those in control group ( χ2=4.114, 6.646, 5.165, all P<0.05). (4)The incidence of flap necrosis in observation group was lower than that in control group (5.00%(2/40) vs 22.50%(9/40), χ2=5.165, P<0.05). (5)After intervention, UW-QoLv4 score in observation group was higher than that in control group (863.28±24.87 vs 751.26±38.94, t=15.334, P<0.05). Conclusion:Empowerment education combined with motivational psychological intervention can effectively improve the emotional state and quality of life of patients with oral cancer surgery.

Lenvatinib mesylate is an oral receptor tyrosine kinase inhibitor against targets of vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor α, stem cell growth factor receptor, and rearranged during transfection, et al. Lenvatinib has been approved by the National Medical Products Administration of China on September 4, 2018, for the first-line treatment of patients with unresectable hepatocellular carcinoma who have not received systematic treatment before. Up to February 2023, Lenvatinib has been listed in China for more than 4 years, accumulating a series of post-marketing clinical research evidences. Based on the clinical practice before and after the launch of lenvatinib and referring to the clinical experience of other anti-angiogenesis inhibitors, domestic multidisciplinary experts and scholars adopt the Delphi method to formulate the Chinese Expert Guidance on Overall Application of Lenvatinib in Hepatocellular Carcinoma after repeated discussions and revisions, in order to provide reference for reasonable and effective clinical application of lenvatinib for clinicians.

Lenvatinib mesylate is an oral receptor tyrosine kinase inhibitor against targets of vascular endothelial growth factor receptors 1-3, fibroblast growth factor receptors 1-4, platelet-derived growth factor receptor α, stem cell growth factor receptor, and rearranged during transfection, et al. Lenvatinib has been approved by the National Medical Products Administration of China on September 4,2018, for the first-line treatment of patients with unresectable hepatocellular carcinoma who have not received systematic treatment before. Up to February 2023, Lenvatinib has been listed in China for more than 4 years, accumulating a series of post-marketing clinical research evidences. Based on the clinical practice before and after the launch of lenvatinib and referring to the clinical experience of other anti-angiogenesis inhibitors, domestic multidisciplinary experts and scholars adopt the Delphi method to formulate the Chinese Expert Guidance on Overall Application of Lenvatinib in Hepatocellular Carcinoma after repeated discussions and revisions, in order to provide reference for reasonable and effective clinical application of lenvatinib for clinicians.

Hepatocellular carcinoma (HCC) greatly threatens the life and health of Chinese people. Most patients with HCC are already in the advanced stage when attending the hospital and are not eligible for radical treatment, and patients in the early stage of HCC who are eligible for radical treatment still face a high risk of recurrence after surgery. In recent years, immunotherapy based on immune checkpoint inhibitors (ICIs) has made great progress in the treatment of advanced HCC, and perioperative immunotherapy for HCC is attracting more and more attention. Immunotherapy in the perioperative period of HCC can improve the feasibility of hepatectomy, reduce the recurrence rate after hepatectomy, and prolong the survival of patients. This article discusses the application of ICIs-based immunotherapy in the perioperative period of HCC and the issues that need to be considered, so as to provide new ideas for perioperative immunotherapy for HCC.

Objective:To study the safety and treatment outcomes of portal vein embolization (PVE) combined with lenvatinib plus an anti-programmed death-1(PD-1) antibody to treat patients with initially unreasectable hepatocellular carcinoma (uHCC).Methods:This study retrospectively analyzed the data of six patients with uHCC who received first-line combined systemic therapy with lenvatinib plus an anti-PD-1 antibody, and then underwent pre-hepatectomy PVE at the Department of Liver Surgery at Zhongshan Hospital, Fudan University from May 2019 to November 2020. All enrolled patients were males, aged (54.6±6.2) (ranged 46 to 63) years. Tumor response and liver volume were evaluated by medical imagings once every 2 months (±2 weeks) and evaluated using the Response Evaluation Criteria in Solid Tumours (version 1.1). Patients were followed-up by outpatient interviews or by phone calls to record their survival and tumor outcome status.Results:Three of the six enrolled patients had Barcelona Clinic Liver Cancer stage A and three had stage B disease. One patient achieved a partial response and five patients had stable diseases. The mean ± s. d. future liver remnant (FLR) percentage was (29.0±8.9) % before PVE and the combination therapy, and was (41.3±10.8) % before the last evaluation for liver surgery ( t=10.79, P<0.001). Hepatectomy was carried out in five patients, and one patient who failed to develop significant FLR hypertrophy did not undergo hepatectomy. Grade B post-hepatectomy liver failure and major postoperative complications (i.e. pleural effusion requiring additional percutaneous drainage) occurred in one patient. After a median post-operative follow-up of 4.5 (range: 1.0-12.3) months, all five patients were alive and were tumor free. Conclusion:PVE followed by hepatectomy is feasible in a uHCC patients receiving systemic therapy with lenvatinib and an anti-PD-1 antibody.

Objective:For severe skin defects which are deep to dermis, engineered skin with epidermis and dermis (bilayered) is required. Based on the success of engineering epidermis with GT/PCL electrospun membranes, our study was to investigate whether this membrane could be also used for engineering bilayered skin graft.Methods:From 2013 to 2019, we first prepared three GT/PCL electrospun membranes with different proportion (70∶30; 50∶50; 30∶70) in our laboratory; the biocompatibility of the membrane was evaluated in vitro by seeding fibroblasts or keratinocytes on the membranes. Then the outcome of GT/PCL membranes repairing skin defects in the nude mouse was investigated.Results:Cell attachment and proliferation were significantly improved with increase of gelatin. Histological analyses showed that bilayered skin engineered with GT/PCL (70∶30) group could form relatively better structure after 3 weeks of cultivation in vitro. Further in vivo transplantation studies revealed that scaffolds were not degraded in all three groups, indicating that these materials were not suitable for engineering bilayered skin although they had good biocompatibility.Conclusions:The higher gelatin membranes possess better biocompatibility. Further in vivo transplantation studies reveal that bilayered skin engineered with GT/PCL membranes is able to repair skin defects in the nude mouse.