Objective:To analyze the relationship between the optimal surgical margin value and clinical prognosis of transoral robotic surgery（TORS） in treating human papillomavirus（HPV） -positive oropharyngeal squamous cell carcinoma. Methods:A single-center, prospective, observational cohort study was conducted, enrolling patients with early and moderated stage（≤T3 stage） oropharyngeal carcinoma undergoing TORS between July 2020 and April 2024. The proposed optimal surgical margin cutoff value for TORS was set as 2 mm. The primary objectives were to evaluate the optimal clear margin for TORS and its association with overall survival（OS） and progression-free survival（PFS）. Logistic regression was used to analyze correlations between surgical margins and clinical variables, while Cox regression models assessed the impact of surgical margins on OS and PFS. Results:A total of 90 patients（60 males, 66.7%） were included, all had squamous cell carcinoma, with a mean age of 58.0±9.0 years（range: 39-84 years） old. The 1, 2 and 3-year OS rates were 92.3%, 89.9% and 85.0%, respectively, while the 1, 2 and 3-year PFS rates were all 90.1%. For surgical margins ≤2 mm, the 1, 2 and 3-year OS rates were 80.8%, 69.3% and 69.3%, respectively, and PFS rates were 77.9% across three time points. For surgical margins>2 mm, the 1, 2 and 3-year OS rates were 96.5%, 96.5% and 90.6%, respectively, with PFS rates of 94.6%. Logistic regression showed no correlation between surgical margins and tumor type, T/N stage, smoking, alcohol use, or gender（P>0.05）. Cox analysis identified surgical margins>2 mm as a significant factor improving PFS（HR=0.14, 95%CI 0.02-0.90, P=0.038）. Conclusion:This systematic analysis suggests setting a 2 mm and longer as clear surgical margin for TORS. Margins>2 mm are associated with superior postoperative PFS rate and prolonged PFS time in HPV-positive oropharyngeal carcinoma patients.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Carcinoma, Squamous Cell/virology* ; Human Papillomavirus Viruses/isolation & purification* ; Margins of Excision ; Oropharyngeal Neoplasms/virology* ; Papillomavirus Infections/virology* ; Prognosis ; Prospective Studies ; Robotic Surgical Procedures/methods*

This article reports on the nursing experience in the rehabilitation of laryngeal function with primary tracheoesophageal puncture for voice prosthesis rehabilitation after laryngectomy.The core elements of postoperative nursing included:the use of a Heat and Moisture Exchanger(HME)for airway humidification to maintain pulmonary health;the implementation of progressive speech training to aid in the reconstruction of speech function;continuous monitoring and dilatation training to ensure the appropriate size of the stoma,thereby ensuring smooth breathing and speech;nasal airflow-inducing training for the promotion of olfactory rehabilitation;standardized maintenance of the voice prosthesis to extend its lifespan and reduce the occurrence of complications.After meticulous postoperative care,the patient showed good recovery of speech,olfaction,and respiratory function at the one-month follow-up,with the stoma diameter maintained at an ideal size and no complications occurred.

The most difficult challenge of rehabilitation for total laryngectomy patients is the loss of voice function.Otolaryngologists,speech pathologists and nursing specialists have explored several different approaches to voice rehabilitation.Currently,tracheoesophageal speech and esophageal speech are the two widely used approa-ches.The differences between alaryngeal voice quality and normal voice quality are due to the substantial changes in the anatomical structure of the vibration organ and the motive power of the voice.There is a lack of consensus on the current measurement criteria.The purpose of the review is to promote the establishment of measurement standards and to provide the evidentiary basis of clinical voice rehabilitation programs and the effects of imterventions.

The most difficult challenge of rehabilitation for total laryngectomy patients is the loss of voice function.Otolaryngologists,speech pathologists and nursing specialists have explored several different approaches to voice rehabilitation.Currently,tracheoesophageal speech and esophageal speech are the two widely used approa-ches.The differences between alaryngeal voice quality and normal voice quality are due to the substantial changes in the anatomical structure of the vibration organ and the motive power of the voice.There is a lack of consensus on the current measurement criteria.The purpose of the review is to promote the establishment of measurement standards and to provide the evidentiary basis of clinical voice rehabilitation programs and the effects of imterventions.

This article reports on the nursing experience in the rehabilitation of laryngeal function with primary tracheoesophageal puncture for voice prosthesis rehabilitation after laryngectomy.The core elements of postoperative nursing included:the use of a Heat and Moisture Exchanger(HME)for airway humidification to maintain pulmonary health;the implementation of progressive speech training to aid in the reconstruction of speech function;continuous monitoring and dilatation training to ensure the appropriate size of the stoma,thereby ensuring smooth breathing and speech;nasal airflow-inducing training for the promotion of olfactory rehabilitation;standardized maintenance of the voice prosthesis to extend its lifespan and reduce the occurrence of complications.After meticulous postoperative care,the patient showed good recovery of speech,olfaction,and respiratory function at the one-month follow-up,with the stoma diameter maintained at an ideal size and no complications occurred.

The medicinal history of Zanthoxyli Radix is long,and it is recorded in the Shen Nong Ben Cao Jing under the name of Manjiao.Modern pharmacological research has proven that Zanthoxyli Radix has anti-tumor,antibacterial,antioxidant,and hemostatic effects.This article reviewed the pharmacological effects of Zanthoxyli Radix based on its functional indications.Based on the basic requirements of TCM quality markers(Q-markers),this article predicted and analyzed the Q-markers of Zanthoxyli Radix from the perspectives of plant phylogeny and chemical component specificity,chemical component and pharmacological correlation,and chemical component testability.It is proposed to select alkaloids,flavonoids,and lignans as the Q-markers for the general classification of Zanthoxyli Radix.The candidate components for Q-marker were identified,including chloramphenicol,white croaker alkaloid,magnolian alkaloid,taro alkaloid,vanillin,hesperidin,L-sesamin and L-asarone,providing a reference for further research on the quality standards of Zanthoxyli Radix.

Objective To explore the application effect of volunteer service in the practical teaching of Traditional Chi-nese Pediatrics.Methods In 2023,80 undergraduate interns from the 2021 cohort at Yunnan University of Traditional Chinese Medicine,who were shadowing in the pediatrics department of a traditional Chinese medicine hospital in Yunnan,were randomly selected as research subjects.They were divided into an experimental group and a control group.The experimental group received teaching through a combination of volunteer service and traditional teaching methods,while the control group was taught using tra-ditional classroom methods.Results The experimental group scored significantly higher than the control group in clinical skills assessments,Mini-CEX scores,subject recognition evaluations,and teaching satisfaction,with statistically significant differences(P＜0.05).Conclusion The use of volunteer service in the practical teaching of Traditional Chinese Pediatrics is highly feasi-ble and can significantly enhance students'clinical practice abilities,stimulate their enthusiasm for learning,foster independent thinking,and improve their overall clinical competencies.

Objective:To explore the prolonged therapeutic regimen for patients with plaque psoriasis, who showed a positive response to 4-week treatment with tazarotene/betamethasone dipropionate cream, but were not completely cured.Methods:A multicenter, randomized, open-labelled, parallel-controlled clinical study was conducted. A total of 232 patients with plaque psoriasis were collected, who showed a positive response to previous 4-week treatment with 0.05%/0.05% tazarotene/betamethasone dipropionate cream, but were not completely cured with the psoriasis area and severity index[PASI] improvement rate being 50%-90%. At week 5, they were randomly and equally divided into 2 groups: test group receiving treatment with 0.05%/0.05% tazarotene/betamethasone dipropionate cream once a day, and control group receiving a sequential regimen of 0.05% tazarotene gel on weekdays once a day followed by 0.05%/0.05% tazarotene/betamethasone dipropionate cream on weekends once a day. After 2-and 4-week prolonged treatment, the efficacy and safety of the 2 therapeutic regimens were evaluated and compared. Measurement data were compared between 2 groups by using covariance analysis or t test, and enumeration data were compared by using chi-square test. Results:From the 5th to the 8th week, 200 out of the 232 patients completed the treatment. Data collected from 110 patients in the test group and 112 in the control group were enrolled into the full analysis set, and those from both 113 patients in the test group and control group were enrolled into safety analysis set. After consecutive 6-and 8-week treatment, the decline rates of the PASI score were 73.05% ± 16.69% and 78.46% ± 15.40% respectively in the test group, which were significantly higher than those in the control group (66.73% ± 21.77%, 67.02% ± 34.19%, respectively, both P < 0.05) . After 6-week treatment, the proportion of subjects who achieved PASI90 was significantly higher in the test group (14 cases, 12.7%) than in the control group (5 cases, 4.5%, χ2=4.842, P=0.028) ; After 8-week treatment, the proportions of subjects who achieved PASI75 and PASI90 (61.8%, 23.6%, respectively) were significantly higher in the test group than in the control group (48.2%, 12.5%, respectively, both P < 0.05) . During the consecutive 8-week treatment, there was no significant difference in the incidence rate of adverse reactions between the test group (15.0%) and control group (23.9%, χ2=2.822, P=0.093) . Conclusion:For patients who showed a positive response to 4-week treatment with 0.05%/0.05% tazarotene/betamethasone dipropionate cream, but were not completely cured, the continuous use of 0.05%/0.05% tazarotene/betamethasone dipropionate cream for 4 weeks is a superior therapeutic regimen compared with the sequential regimen of 0.05% tazarotene gel followed by 0.05%/0.05% tazarotene/betamethasone dipropionate cream.

Objective To study the effect of paeonol on the proliferation and apoptosis of A375 human melanoma cells and its mechanism.Methods Cell counting kit-8 (CCK8) was used to evaluate the proliferative activity of A375 cells treated with paeonol of 0.5,1,2,4,8 mmol/L for 24,48 and 72 hours respectively.Subsequently,A375 cells were treated with paeonol of 1.25,2.5 and 5 mmol/L for 24 hours followed by double staining with annexin V and propidium iodide for the detection of cell apoptosis,fluorometric assay for the estimation of caspase 3,caspase 8 and caspase 9 activity,and Western blot for the determination of the levels of p53,nuclear factor-κB proteins and some of their target proteins.The A375 cells receiving no treatment served as the blank control group.Statistical analysis was carried out by t test.Results Within the investigated concentration and time ranges,paeonol significantly inhibited the proliferative activity of A375 cells in a concentration-and timedependent manner.Compared with the blank control group,a significant increase was observed in the early apoptosis rate in A375 cells treated with paeonol of 1.25,2.5 and 5 mmol/L for 24 hours (13.74％-± 1.73％,25.95％ ± 0.57％ and 46.44％ ± 0.81％ vs.3.11％ ± 0.53％,P ＜ 0.05 or 0.01),as well as in the activity of caspase 3,8 and 9 in A375 cells treated with paeonol of 2.5 and 5 mmol/L for 24 hours (P ＜ 0.05 or 0.01).After 24-hour treatment,the protein levels of p53 and Bax were elevated,but those of nuclear factor-κB,Bcl-2 and Bcl-XL were decreased in A375 cells with the increase of paeonol concentration.Conclusions Paeonol can inhibit the proliferation but induce the apoptosis of A375 cells,and the apoptosis-inducing effect may be realized through intrinsic and extrinsic pathways by modulating nuclear factor-κB and p53 genes.

OBJECTIVETo investigate the relationship between occupational stress and depression in migrant workers.

METHODSMigrant workers in the textile industry were selected as subjects, and the self-made Occupational Stress Questionnaire and Self-rating Depression Scale were used to investigate the sex, age, seniority, educational level, and marital status of these subjects. Data analysis was performed by independent-samples t test, analysis of variance, Spearman rank correlation analysis, and stepwise multiple regression analysis.

RESULTSSex, seniority, and educational level were not influential factors for depression scores. The lower age group had a higher moderate depression score than the higher age group; the unmarried group had a higher moderate depression score than the married group. Severe depression was negatively correlated with decision-making power, psychological job demands, social support, and external pay-return, but positively correlated with skills and internal input; moderate depression was positively correlated with psychological job demands and external pay, but negatively correlated with other factors; mild depression was negatively correlated with all factors. The stepwise regression analysis showed that the influential factors for depression included, from major to minor, supervisor support, skills, internal input, and colleague support, according to the standardized regression coefficients; internal input was the contribution factor, and the remaining ones were negative factors.

CONCLUSIONAmong migrant workers, certain mental health problems exist, and occupational stress is associated with depression.

Adolescent ; Adult ; Aged ; Depression ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; epidemiology ; Stress, Psychological ; epidemiology ; Surveys and Questionnaires ; Transients and Migrants ; Young Adult