Objective:To evaluate the safety, and feasibility of transoral robot-assisted retropharyngeal lymph node (RPLN) dissection.Methods:Clinical data of head and neck cancer patients who underwent transoral robot-assisted RPLN dissection at the Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, and Sun Yat-sen University Cancer Centre from December 2017 to March 2024 were retrospectively analyzed. A total of 35 patients(22 males, 13 females, aged 47.4±13.4 years old) with RPLN metastases from head and neck cancer, including 20 cases of nasopharyngeal cancer, 9 cases of thyroid cancer, 2 cases of salivary adenocarcinoma, 2 cases of tonsil cancer, and 2 cases of hypopharyngeal cancer. Operation time, intraoperative bleeding and complications, postoperative nasogastric tube retention time, hospital stay and complications were evaluated. Statistical analysis was performed using SPSS 22.0 software.Results:All patients successfully received transoral robot-assisted RPLN dissection without intermediate open surgery, with removals of 2 (1, 3) RPLNs. The total operation time was 130 (102, 210) minutes. The intraoperative bleeding was 50 (20, 100) ml, and there was no major bleeding or organ damage during the operation. Prophylactic tracheotomy was performed in 8 cases, and postoperatively nasogastric tubes were left in 22 patients, with retention time of 10.5 (7.5, 14.0) days. Postoperative hospital stay was 5 (4, 9) days. Postoperative complications included incision dehiscence in 4 cases and dysphagia in 4 cases. The median postoperative follow-up was 23.4 months, with progression or recurrence in 5 patients, including regional recurrence in 3 patients, lung metastasis in 1 patient, and bone metastasis in 1 patient. The 2-year regional failure-free survival and disease-free survival rates were 91.43% and 85.71%, respectively.Conclusion:Transoral robot-assisted RPLN dissection is a safe and feasible surgical method with less trauma, fewer complications, and higher safety. Patients need to be carefully selected at the initial stage of application.

Objective:To explore the clinical application value of transoral robotic surgery (TORS) in the treatment of tonsil squamous cell carcinoma (TSCC).Methods:A retrospective analysis was conducted. The clinical data of 157 TSCC patients were collected who received TORS at five medical centers, namely, the Sun Yat-sen University Cancer Center, Sun Yat-sen Memorial Hospital, Eye Ear Nose and Throat Hospital of Fudan University, the First Affiliated Hospital of China Medical University, and Tongji Hospital of Tongji Medical College, from January 1 2017 to July 31 2022. There were 130 males and 27 females, aged 24-85 years. All patients were followed-up at least for 2 years (2-year group), among them, 99 patients had a follow-up of 3 years (3-year group). The overall survival (OS), progression-free survival (PFS), clinical stage, human papillomavirus (HPV) infection status were analyzed. SPSS 25.0 and SAS 9.4 were used for statistical analysis.Results:The OS and PFS of the 2-year group were 91.7% and 87.9%, respectively. The OS and PFS of the 3-year group were 85.9% and 82.8%, respectively. The prognosis of patients with locally early-stage was better than that of locally advanced patients, with the OS of 94.4% for T1-2 vs. 78.0% for T3 ( P=0.005) and the PFS of 91.2% for T1-2 vs. 75.0% for T3 ( P=0.011) in the 2-year group; the OS of 91.1% for T1-2 vs. 65.0% for T3 ( P=0.004) and the PFS of 88.6% for T1-2 vs. 60.0% for T3 ( P=0.002) in the 3-year group; and also, the OS of 90.0% for stage Ⅰ-Ⅱ vs. 79.5% for stage Ⅲ-Ⅳ ( P=0.204) and the PFS of 86.7% for stage Ⅰ-Ⅱ vs. 76.9% for stage Ⅲ-Ⅳ ( P=0.188) in the 3-year group. The prognosis of HPV-positive TSCC patients was better than that of HPV-negative patients in the 3-year group, with the OS of 90.9% for HPV-positive vs. 80.5% for HPV-negative ( P=0.045) and the PFS of 90.9% for HPV-positive vs. 75.6% for HPV-negative ( P=0.047). The average time of postoperative tracheal cannula indwelling was 25.1 days. The indwelling rate and average indwelling time of the postoperative nasogastric tube were 94.3% (148/157) and 8.5 days, respectively. Conclusion:TORS has outstanding survival benefits for TSCC patients. HPV-positive TSCC patients have a better prognosis than HPV-negative patients. TORS treatment of TSCC patients has advantages in postoperative recovery and quality of life.

Objective:To evaluate the safety, and feasibility of transoral robot-assisted retropharyngeal lymph node (RPLN) dissection.Methods:Clinical data of head and neck cancer patients who underwent transoral robot-assisted RPLN dissection at the Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, and Sun Yat-sen University Cancer Centre from December 2017 to March 2024 were retrospectively analyzed. A total of 35 patients(22 males, 13 females, aged 47.4±13.4 years old) with RPLN metastases from head and neck cancer, including 20 cases of nasopharyngeal cancer, 9 cases of thyroid cancer, 2 cases of salivary adenocarcinoma, 2 cases of tonsil cancer, and 2 cases of hypopharyngeal cancer. Operation time, intraoperative bleeding and complications, postoperative nasogastric tube retention time, hospital stay and complications were evaluated. Statistical analysis was performed using SPSS 22.0 software.Results:All patients successfully received transoral robot-assisted RPLN dissection without intermediate open surgery, with removals of 2 (1, 3) RPLNs. The total operation time was 130 (102, 210) minutes. The intraoperative bleeding was 50 (20, 100) ml, and there was no major bleeding or organ damage during the operation. Prophylactic tracheotomy was performed in 8 cases, and postoperatively nasogastric tubes were left in 22 patients, with retention time of 10.5 (7.5, 14.0) days. Postoperative hospital stay was 5 (4, 9) days. Postoperative complications included incision dehiscence in 4 cases and dysphagia in 4 cases. The median postoperative follow-up was 23.4 months, with progression or recurrence in 5 patients, including regional recurrence in 3 patients, lung metastasis in 1 patient, and bone metastasis in 1 patient. The 2-year regional failure-free survival and disease-free survival rates were 91.43% and 85.71%, respectively.Conclusion:Transoral robot-assisted RPLN dissection is a safe and feasible surgical method with less trauma, fewer complications, and higher safety. Patients need to be carefully selected at the initial stage of application.

Objective:To explore the clinical application value of transoral robotic surgery (TORS) in the treatment of tonsil squamous cell carcinoma (TSCC).Methods:A retrospective analysis was conducted. The clinical data of 157 TSCC patients were collected who received TORS at five medical centers, namely, the Sun Yat-sen University Cancer Center, Sun Yat-sen Memorial Hospital, Eye Ear Nose and Throat Hospital of Fudan University, the First Affiliated Hospital of China Medical University, and Tongji Hospital of Tongji Medical College, from January 1 2017 to July 31 2022. There were 130 males and 27 females, aged 24-85 years. All patients were followed-up at least for 2 years (2-year group), among them, 99 patients had a follow-up of 3 years (3-year group). The overall survival (OS), progression-free survival (PFS), clinical stage, human papillomavirus (HPV) infection status were analyzed. SPSS 25.0 and SAS 9.4 were used for statistical analysis.Results:The OS and PFS of the 2-year group were 91.7% and 87.9%, respectively. The OS and PFS of the 3-year group were 85.9% and 82.8%, respectively. The prognosis of patients with locally early-stage was better than that of locally advanced patients, with the OS of 94.4% for T1-2 vs. 78.0% for T3 ( P=0.005) and the PFS of 91.2% for T1-2 vs. 75.0% for T3 ( P=0.011) in the 2-year group; the OS of 91.1% for T1-2 vs. 65.0% for T3 ( P=0.004) and the PFS of 88.6% for T1-2 vs. 60.0% for T3 ( P=0.002) in the 3-year group; and also, the OS of 90.0% for stage Ⅰ-Ⅱ vs. 79.5% for stage Ⅲ-Ⅳ ( P=0.204) and the PFS of 86.7% for stage Ⅰ-Ⅱ vs. 76.9% for stage Ⅲ-Ⅳ ( P=0.188) in the 3-year group. The prognosis of HPV-positive TSCC patients was better than that of HPV-negative patients in the 3-year group, with the OS of 90.9% for HPV-positive vs. 80.5% for HPV-negative ( P=0.045) and the PFS of 90.9% for HPV-positive vs. 75.6% for HPV-negative ( P=0.047). The average time of postoperative tracheal cannula indwelling was 25.1 days. The indwelling rate and average indwelling time of the postoperative nasogastric tube were 94.3% (148/157) and 8.5 days, respectively. Conclusion:TORS has outstanding survival benefits for TSCC patients. HPV-positive TSCC patients have a better prognosis than HPV-negative patients. TORS treatment of TSCC patients has advantages in postoperative recovery and quality of life.

Objective:To investigate the application and effects of WeChat official account in improving the nursing trainees' core post competency.Methods:The study included in 105 nursing trainees of Batch 2015 as experimental group, taking the nursing practice WeChat official account based on the routine clinical teaching pattern, and 95 nursing trainees of Batch 2014 as control group, taking traditional teaching mode. At the end of the internship, the scores of special examinations for nursing students and the national examination for nursing qualifications ("nursing qualification examination" for short) of the two group were compared, and the critical thinking ability, ability to acquire information lifelong learning ability, nurse-patient clinical communication ability and teaching satisfaction of the two groups of students were analyzed. SPSS 23.0 software was used for t test. Results:The scores of special examinations, nursing qualification examination and each module at main dimensions of the core post competency of nursing students in the experimental group were higher than those in the control group ( P<0.05). The nursing trainees in the experimental group were satisfied with the teaching effects of the WeChat official account. Conclusion:The WeChat official account in clinical nursing practice helps improve the quality of clinical practice teaching and assist in enhancing core post competency of nursing trainees.

Objective:To observe the application effect of high-flow nasal canula oxygen therapy (HFNC) after extubation in patients with mechanical ventilation (MV) in the intensive care unit (ICU).Methods:A prospective study was conducted. From January 2018 to June 2020, 163 MV patients admitted to Yijishan Hospital of Wannan Medical College were enrolled, and they were divided into HFNC group (82 cases) and traditional oxygen therapy group (81 cases) according to the oxygen therapy model. The patients included in the study were given conventional treatment according to their condition. In the HFNC group, oxygen was inhaled by a nasal high-flow humidification therapy instrument. The gas flow was gradually increased from 35 L/min to 60 L/min according to the patient's tolerance, and the temperature was set at 34-37 ℃. The fraction of inspiration oxygen (FiO 2) was set according to the patient's pulse oxygen saturation (SpO 2) and SpO 2 was maintained at 0.95-0.98. A disposable oxygen mask or nasal cannula was used to inhale oxygen in the traditional oxygen therapy group, and the oxygen flow was 5-8 L/min, maintaining the patient's SpO 2 at 0.95-0.98. The differences in MV duration before extubation, total MV duration, intubation time, reintubation time, extubation failure rate, ICU mortality, ICU stay, and in-hospital stay were compared between the two groups, and weaning failure were analyzed. Results:There was no significant differences in MV duration before extubation (days: 4.33±3.83 vs. 4.15±3.03), tracheal intubation duration (days: 4.34±1.87 vs. 4.20±3.35), ICU mortality [4.9% (4/82) vs. 3.7% (3/81)] and in-hospital stay [days: 28.93 (15.00, 32.00) vs. 27.69 (15.00, 38.00)] between HFNC group and traditional oxygen therapy group (all P > 0.05). The total MV duration in the HFNC group (days: 4.48±2.43 vs. 5.67±3.84) and ICU stay [days: 6.57 (4.00, 7.00) vs. 7.74 (5.00, 9.00)] were significantly shorter than those in the traditional oxygen therapy group, the reintubation duration of the HFNC group was significantly longer than that of the traditional oxygen therapy group (hours: 35.75±10.15 vs. 19.92±13.12), and the weaning failure rate was significantly lower than that of the traditional oxygen therapy group [4.9% (4/82) vs. 16.0% (13/81), all P < 0.05]. Among the reasons for weaning failure traditional oxygen therapy group had lower ability of airway secretion clearance than that of the HFNC group [8.64% (7/81) vs. 0% (0/82), P < 0.05], there was no statistically differences in the morbidity of heart failure, respiratory muscle weakness, hypoxemia, and change of consciousness between the two groups. Conclusion:For MV patients in the ICU, the sequential application of HFNC after extubation can reduce the rate of weaning failure and the incidence of adverse events, shorten the length of ICU stay.

OBJECTIVETo evaluate the effects of acupoint massage for postpartum hypogalactia in puerpera.

METHODSA total of 60 puerpera of cesarean section were randomized into an observation group and a control group, 30 cases in each one. In the observation group, 2 cases were dropped out. Finally, there were 28 cases in the observation group and 30 cases in the control group. In the control group, the routine nursing after operation in obstetrics department was given, guiding maternal breastfeeding and postpartum health education. In the observation group, on the basis of the treatment as the control group, the corresponding acupoints were selected from the breast related meridians for massage. Acupoint massage was given since the 3rd day after operation, 8:00 am to 9:00 am, once a day, 1 min at one acupoint, continuously for 5 days. The lactation volume, breast filling, galactostasis and milk viscosity were compared in the parturient of the two groups. The clinical therapeutic effects were compared between the two groups.

RESULTSFrom the 1st to the 2nd days, the differences were not significant in lactation volume, breast filling and galactostasis score between the two groups (all>0.05). From the 3rd to 5th days, the lactation volume, breast filling and galactostasis score in the observation group were all lower than those in the control group (all<0.01). The difference in milk viscosity was not significant in the first 4 days between the two groups (all>0.05). On the 5th day, the score of milk viscosity in the observation group was lower than that in the control group (<0.01). The cured rate was 64.3% (18/28) in the observation group, which was better than 13.3% (4/30) in the control group (<0.05).

CONCLUSIONMassage at the acupoints from the breast related meridians effectively promotes the lactation secretion in puerpera of postpartum hypogalactia and alleviates breast distention.

Objective To investigate the relation among clinical nurses′resilience, emotional, the pressure load and self-efficacy with the 10-item Connor-Davidson Resilience Scale. Methods A total of 449 nurse in Guangzhou were recruited to investigate by 10-item Connor-Davidson Resilience Scale (CD-RISC-10), Kessler 10 Scale (K10), General Self-Efficacy Scale (GSES), Chinese Stress Overload Scale (SOS). Results The average score was 23.6±6.7 for CD-RISC-10 , 24.4±8.2 for K10,24.7±5.7 for GSES , 63.3 ±16.6 for SOS ,and the individual vulnerability scoring was (31.2±10.0) points, events load was (32.0±7.5) points. High mental toughness of nurses in general self-efficacy scores higher than that of low mental toughness group (t=-8.53, P<0.01), in the K10 dated, S0S scores were lower than low mental toughness group (t=11.23, 7.70, P<0.01). Nurse relevant regression analysis results showed that gender, general self-efficacy, K10 dated, SOS as the main factors influencing nurses mental toughness, could explain 40%of variances. Conclusions The CD-RISC-10 can better reflect the level of clinical nurses′resilience, and the gender, self-efficacy were the main effects, as well as effectively predict the nurses′emotional distress and stress level. However how to improve the toughness of the clinical nurses need more research.

Objective To observe the effect of five-tone music therapy on relieving anxiety and depression and on improving the quality of life of patients receiving chemotherapy after gastric cancer radical surgery.Methods Ninety anxiety and depression in-patients treated with chemotherapy after gastric cancer radical surgery were randomly divided into observation group and control group,45 cases in each group.Patients of the two groups were treated with the same chemotherapy regimen and nursing,and additionally,the observation group was given fivetone musie therapy and the control group was given conventional music therapy.The intervention effects were evaluated by scoring with Self-rating Anxiety Scale (SAS),Self-rating Depression Scale (SDS) and questionnaire for the quality of life of gastric cancer patients (QLQ-STO22) at admission time and when discharging from hospital.Results The SAS and SDS standard scores and the scores of each dimension of QLQ-STO22 in the observation group were markedly decreased after intervention,the differences being statistically significant (P ＜ 0.01 compared with those before intervention).And the SAS and SDS standard scores of the observation group after intervention were lower than those of the control group (P ＜ 0.01).In the aspects of quality of life,the scores of all dimension of QLQ-STO22 except taste,appearance and hair loss in the observation group were lower than those in the control group (P ＜ O.05).Conclusion Five-tone music therapy is effective on relieving anxiety and depression and on improving the quality of life of patients receiving chemotherapy after gastric cancer radical surgery.

Objective To observe the intervention effect of premature pathological jaundice treated with conventional blue light phototherapy combined with acupoint massage plus body massage. Methods Ninety premature infants with pathological jaundice were randomized into control group 1, control group 2 and observation group, 30 cases in each group. The control group 1 was given blue light phototherapy plus oral use of vitamin B2, the control group 2 was given body massage based on the treatment for the control group 1, and observation group was given acupoint massage based on the treatment for the control group 2, the treatment for the three groups lasting for 7 continuous days. Before and after treatment, the levels of transcutaneous bilirubin (TCB), serum total bilirubin (TB), and serum direct bilirubin (DB) were observed, and then the therapeutic effects on jaundice in the three groups were compared. Results After treatment, the overall therapeutic effect and the daily decline of TCB, TB and DB in the observation group were superior to those in the two control groups, the difference being significant (P < 0.05 or P < 0.01). In the control group 2, the post-treatment average decline of TB and the decline of TCB on treatment day 4-7 were superior to those in the control group 1, the difference being significant(P<0.05). Conclusion Acupoint massage plus body massage is effective and safe for the treatment of pathological jaundice in premature infants, and the therapy being simple and practical.