Objective:To evaluate preoperative high-resolution thin-layer cervical enhanced CT used to predict the venous route of the submental flap reflux vein and its relationship with adjacent structures in order to guide the anatomical understanding and protection of submental flap in pharyngeal cancer surgery.Methods:Sixty consecutive patients with pharyngeal cancer who underwent submental flap repair surgery in our department from March 2022 to December 2024, as well as 60 patients who were accepted neck dissection suffering other cancers, were selected. Before surgery, high-resolution cervical enhanced CT scans were performed, and the position of the transverse section of the facial vein in the venous phase horizontal image gradually variation tendency was focused layer by layer. The direction and adjacent relationship of the submental flap reflux veins were determined and recorded. Combined with 60 patients with other head and neck tumors who underwent neck dissection in our department during the same period (a total of 120 cases, 240 sides), the classification and management of the draining veins of Fang′s mental flap were conducted. Type Ⅰ mainly drains into the internal jugular vein; Type Ⅱ mainly drains into the external jugular vein and Type Ⅲ mainly drains into the anterior jugular vein (often accompanied by an external jugular draining branch). The status and proportion of venous drainage were analyzed.Results:Vascular predictive coincidence rate was 98.3% (59/60) among the 60 patients with pharyngeal cancer. Only one patient was predicted to have a simple return to the external jugular vein. However, during the operation, in addition to the main return to the external jugular vein, a small portion also returned to the internal jugular vein. Submental flap reflux vessels were classified into three types based on intraoperative submental flap venous return in 60 cases of laryngopharyngeal cancer, in conjunction with the analysis of venous return patterns from 240 cervical CT scans. Type Ⅰ mainly refluxed to the internal jugular vein, accounting for 42.1%. Type Ⅱ mainly refluxed to the external jugular vein (47.9%). Type Ⅲ mainly refluxed to the anterior jugular vein (10.0%). The total detection rate of CT reading of 240 venous reflux was 98.7% (237/240). Vascular predictive coincidence rate was 97.9%(235/240).Conclusion:The detailed analysis of submental venous return vessels can accurately predict the direction of reflux veins and its surrounding areas by preoperative high-resolution enhanced CT scan. This provides reliable guidance for the anatomy and protection of the submental flap reflux veins during surgery.

Objective:To compare the survival outcomes of different subsequent treatment regimens in patients with locally advanced hypopharyngeal squamous cell carcinoma (HPSCC) who achieved partial response (PR) after neoadjuvant chemotherapy based on the gross tumor volume regression rate (GTVRR).Methods:This retrospective study included patients with locally advanced HPSCC treated at the Department of Head and Neck Surgery, Beijing Tongren Hospital, from January 2011 to December 2023. The cohort included 135 males and 3 females, aged from 35 to 77 years. All patients received 2-3 cycles of TPF regimen (paclitaxel+cisplatin+5-fluorouracil) neoadjuvant chemotherapy. Subsequent treatments included concurrent chemoradiotherapy or surgery combined with postoperative adjuvant radiotherapy. The impacts of different subsequent treatment modalities on the survivals and prognoses of patients were compared based on GTVRR thresholds of 50% and 70%. The χ 2 test was used to analyze influencing factors; survival analysis and intergroup comparisons were performed using the Kaplan-Meier method and Log-rank test; prognostic factors were assessed using univariate and multivariate Cox regression analyses. Results:The 5-year OS and PFS rates were 56.5% and 47.9%, respectively, while, the 10-year OS and PFS rates were 25.8% and 21.2%, respectively. The median OS was 75 months, and the median PFS was 48 months. The laryngeal function preservation rate for the entire cohort was 83.3%. The patients who underwent surgery combined with postoperative radiotherapy had significantly better OS and PFS outcomes than those treated with concurrent chemoradiotherapy ( P<0.05). Stratification based on GTVRR revealed that the surgery plus postoperative radiotherapy regimen was particularly effective for PR patients with a GTVRR of 30%-70%, showing significantly better OS and PFS compared to the concurrent chemoradiotherapy group ( P<0.05). Conclusion:The optimal subsequent treatment for PR-HPSCC may be surgery-based comprehensive treatment, particularly for patients with a GTVRR of 30%-70%. This study offers valuable insights for the stratified treatment of HPSCC, which could contribute to improving overall patient prognosis.

Objective:To evaluate preoperative high-resolution thin-layer cervical enhanced CT used to predict the venous route of the submental flap reflux vein and its relationship with adjacent structures in order to guide the anatomical understanding and protection of submental flap in pharyngeal cancer surgery.Methods:Sixty consecutive patients with pharyngeal cancer who underwent submental flap repair surgery in our department from March 2022 to December 2024, as well as 60 patients who were accepted neck dissection suffering other cancers, were selected. Before surgery, high-resolution cervical enhanced CT scans were performed, and the position of the transverse section of the facial vein in the venous phase horizontal image gradually variation tendency was focused layer by layer. The direction and adjacent relationship of the submental flap reflux veins were determined and recorded. Combined with 60 patients with other head and neck tumors who underwent neck dissection in our department during the same period (a total of 120 cases, 240 sides), the classification and management of the draining veins of Fang′s mental flap were conducted. Type Ⅰ mainly drains into the internal jugular vein; Type Ⅱ mainly drains into the external jugular vein and Type Ⅲ mainly drains into the anterior jugular vein (often accompanied by an external jugular draining branch). The status and proportion of venous drainage were analyzed.Results:Vascular predictive coincidence rate was 98.3% (59/60) among the 60 patients with pharyngeal cancer. Only one patient was predicted to have a simple return to the external jugular vein. However, during the operation, in addition to the main return to the external jugular vein, a small portion also returned to the internal jugular vein. Submental flap reflux vessels were classified into three types based on intraoperative submental flap venous return in 60 cases of laryngopharyngeal cancer, in conjunction with the analysis of venous return patterns from 240 cervical CT scans. Type Ⅰ mainly refluxed to the internal jugular vein, accounting for 42.1%. Type Ⅱ mainly refluxed to the external jugular vein (47.9%). Type Ⅲ mainly refluxed to the anterior jugular vein (10.0%). The total detection rate of CT reading of 240 venous reflux was 98.7% (237/240). Vascular predictive coincidence rate was 97.9%(235/240).Conclusion:The detailed analysis of submental venous return vessels can accurately predict the direction of reflux veins and its surrounding areas by preoperative high-resolution enhanced CT scan. This provides reliable guidance for the anatomy and protection of the submental flap reflux veins during surgery.

Objective:To compare the survival outcomes of different subsequent treatment regimens in patients with locally advanced hypopharyngeal squamous cell carcinoma (HPSCC) who achieved partial response (PR) after neoadjuvant chemotherapy based on the gross tumor volume regression rate (GTVRR).Methods:This retrospective study included patients with locally advanced HPSCC treated at the Department of Head and Neck Surgery, Beijing Tongren Hospital, from January 2011 to December 2023. The cohort included 135 males and 3 females, aged from 35 to 77 years. All patients received 2-3 cycles of TPF regimen (paclitaxel+cisplatin+5-fluorouracil) neoadjuvant chemotherapy. Subsequent treatments included concurrent chemoradiotherapy or surgery combined with postoperative adjuvant radiotherapy. The impacts of different subsequent treatment modalities on the survivals and prognoses of patients were compared based on GTVRR thresholds of 50% and 70%. The χ 2 test was used to analyze influencing factors; survival analysis and intergroup comparisons were performed using the Kaplan-Meier method and Log-rank test; prognostic factors were assessed using univariate and multivariate Cox regression analyses. Results:The 5-year OS and PFS rates were 56.5% and 47.9%, respectively, while, the 10-year OS and PFS rates were 25.8% and 21.2%, respectively. The median OS was 75 months, and the median PFS was 48 months. The laryngeal function preservation rate for the entire cohort was 83.3%. The patients who underwent surgery combined with postoperative radiotherapy had significantly better OS and PFS outcomes than those treated with concurrent chemoradiotherapy ( P<0.05). Stratification based on GTVRR revealed that the surgery plus postoperative radiotherapy regimen was particularly effective for PR patients with a GTVRR of 30%-70%, showing significantly better OS and PFS compared to the concurrent chemoradiotherapy group ( P<0.05). Conclusion:The optimal subsequent treatment for PR-HPSCC may be surgery-based comprehensive treatment, particularly for patients with a GTVRR of 30%-70%. This study offers valuable insights for the stratified treatment of HPSCC, which could contribute to improving overall patient prognosis.

Objective To explore esomeprazole(EMZ)on acetaminophen(APAP)pharmacokinetics and intestinal microbial balance.Methods A total of 14 rats were randomly allocated into two groups,with 7 rats in each group:acetaminophen group(APAP group),and acetaminophen+esomeprazole combination group(APAP+EMZ group),respectively.Rats in the combination group were fed in the metabolic cage.Equivalent 3.6 mg·kg-1·d-1 esomeprazole was administered intragastrically to the combination group for 14 days;Similarly,an equal volume of 0.9％sodium chloride soution(NaCl)was fed to the APAP group for 14 days.During this period,fecal samples were collected from the rats before and after 14 days of EMZ administration for microbial 16S rRNA sequencing.On the 15th day,both the APAP group and APAP+EMZ groups were administratered an equivalent of 44.82 mg·kg-1 APAP by the same method after the regular EMZ administration.The concentrations of APAP in rat plasma were determined by the UPLC-MS/MS method.Main pharmacokinetic parameters were processed and compared using the software DAS 3.0.1 and SPSS 24.0.Results The pharmacokinetic parameter Cmax of APAP was significantly different between APAP group and APAP+EMZ group(P＜0.05).Compared with APAP group,Cmax increased by 120.38％in the APAP+EMZ group.The pharmacokinetic parameters(AUC(0-∞)、CL、t 1/2、tmax)of APAP showed no statistical differences between APAP group and APAP+EMZ group(P＞0.05).The results of 16SrRNA of intestinal flora showed that the abundance of Lactobacillus,Bacteroides,Clostridium,and Escherichia decreased compared with that before drug administration,while the abundance of Bifidobacterium increased.However,the relative abundance of the above flora showed no prominent differences before and after the EMZ intervention(P＞0.05).Conclusions This study showed that when combining EMZ with APAP,the relative abundance of those related flora,which may influence the β-Glucuronidase,all changed to some extent,but made no difference in statistics.The effect of EMZ on the Cmax of APAP was statistically significant.However,the use of EMZ for two weeks did not alter the other pharmacokinetics of APAP by affecting the gut microbiota.

Objective:By analyzing resting state functional magnetic resonance imaging data, this study aims to explore the effects of glucocorticoids (GC), glucocorticoids combined with cyclophosphamide (CTX) and/or hydroxychloroquine sulfate (HCQ) treatment on brain function in systemic lupus erythematosus patients without major neuropsychiatric manifestations, providing a basis for early identification and intervention of changes in brain function in systemic lupus erythematosus patients without major neuropsychiatric manifestations.Methods:Systemic lupus erythematosus patients without major neuropsychiatric manifestations were divided into drug na?ve group, GC group, and GC combined with CTX and/or HCQ group based on their treatment status at the time of enrollment. Health controls (HCs) were selected based on gender, age, and education level. The low frequency amplitude (ALFF), fractional low frequency amplitude (fALFF), and regional homogeneity (ReHo) were calculated for each of the four groups of participants. When comparing multiple groups, χ2 test or Fisher's exact test was used for count data, analysis of variance or Kruskal-Wallis H test was used for continuous variables, and LSD method was used for post hoc comparisons. Results:After matching, 22, 30, 50, and 29 cases were finally included. There were significant differences in brain function in multiple brain regions among the four groups. Specifically, compared with the HCs group, the ALFF values of the right posterior central gyrus ( t=-2.96) and the right paracentral lobule ( t=-2.95) in the drug na?ve group were decreased. In the GC group, the ALFF values in the right paracentral lobule ( t=-2.93), the right posterior central gyrus ( t=-2.93) and the right anterior central gyrus ( t=-2.94) were decreased. The ALFF values of the right paracentral lobule ( t=-2.90) and the right anterior central gyrus ( t=-2.90) were decreased in GC+CTX and/or HCQ groups. Compared with the drug na?ve group, ALFF values were higher in the right posterior central gyrus ( t=-3.00) and the right rolandic operculum ( t=-2.91) in GC+CTX and/or HCQ groups. Compared with the HCs group, fALFF values of the right anterior central gyrus ( t=-2.95) and the left posterior central gyrus ( t=-2.97) in the drug na?ve group decreased, and fALFF values of the right anterior central gyrus ( t=-2.94) and the left posterior central gyrus ( t=-2.98) in the GC group decreased. fALFF values decreased in the left posterior central gyrus ( t=-2.91) of GC+CTX and/or HCQ groups. fALFF values in the right anterior central gyrus ( t=-2.89) were higher in GC+CTX and/or HCQ group than in GC group. Compared with HCs, the ReHo value in the right posterior central gyrus ( t=-2.97) of the drug na?ve group decreased, and the ReHo value in the right anterior central gyrus ( t=-2.95) of the GC group decreased. The ReHo of GC+CTX and/or HCQ group was higher in the right anterior central gyrus ( t=-2.91) than that of the drug na?ve group, and the ReHo of the right posterior central gyrus ( t=-2.93) was higher than that of the GC group. The above results were adjusted by Gaussian random-field (GRF) multiple comparison ( Pvoxel<0.005, Pcluste<0.010). Conclusion:Systemic lupus erythematosus patients without major neuropsychiatric manifestations have reduced functional activity in multiple brain regions of the whole brain. GC combined with CTX and/or HCQ may have better effects on improving brain function than GC alone, and it mainly acts on sensorimotor related brain regions.

Objective:To explore the efficacy and adverse reactions of capecitabine combined with docetaxel and cisplatin (TP) regimen or 5-fluorouracil (5-Fu) combined with TP regimen induction chemotherapy for stage Ⅲ-Ⅳ B nasopharyngeal carcinoma. Methods:A retrospective case series study was conducted. The clinical data of 65 newly diagnosed nasopharyngeal carcinoma patients with clinical stages Ⅲ-Ⅳ B who were admitted to the First Affiliated Hospital of University of Science and Technology of China from June 2020 to December 2021 were collected. These patients received induction chemotherapy and were divided into capecitabine combined with TP regimen group (capecitabine group, 34 cases) and 5-Fu combined with TP regimen group (5-Fu group, 31 cases) according to different chemotherapy regimens. The objective response rate (ORR) and the incidence of adverse reactions were compared between the two groups of patients. Results:The differences in age, composition ratios of gender, T stage and N stage of patients and induction chemotherapy frequency between the two groups were not statistically significant (all P > 0.05). The ORR of nasopharynx in capecitabine group and 5-Fu group were 88.2% (30/34) and 74.2% (23/31), and the difference was statistically significant ( χ2 = 2.12, P = 0.145); the ORR of cervical lymph nodes were 85.3% (29/34) and 64.5% (20/31), with no statistically significant difference ( χ2 = 4.67, P = 0.097). The incidence of gastrointestinal reactions in the capecitabine group was lower than that in the 5-Fu group [41.2% (14/34) vs. 71.0% (22/31), χ2 = 6.45, P = 0.040], and the difference in the hematological adverse reaction between the two groups was not statistically significant ( P > 0.05). Conclusions:The efficacy of capecitabine combined with TP regimen and 5-Fu combined with TP regimen induction chemotherapy for stage Ⅲ-Ⅳ B nasopharyngeal carcinoma patients is comparable, and the adverse reactions are tolerable. However, the capecitabine combined with TP regimen has lower incidence of gastrointestinal reactions and higher compliance by the patients. Therefore, the capecitabine combined with TP regimen can be prioritized in the induction chemotherapy.

Working memory training,as a low-cost and efficient computerized cognitive training,can improve the cognitive function and behavioral decision-making of chronic disease patients,enhance their self-management awareness and ability,and demonstrate good application prospects in chronic disease management.This article reviewed the origin and development of working memory training,its application in chronic disease management,effectiveness evaluation,application challenges,and suggestions,providing references for improving the quality of chronic disease management.

Objective:By analyzing resting state functional magnetic resonance imaging data, this study aims to explore the effects of glucocorticoids (GC), glucocorticoids combined with cyclophosphamide (CTX) and/or hydroxychloroquine sulfate (HCQ) treatment on brain function in systemic lupus erythematosus patients without major neuropsychiatric manifestations, providing a basis for early identification and intervention of changes in brain function in systemic lupus erythematosus patients without major neuropsychiatric manifestations.Methods:Systemic lupus erythematosus patients without major neuropsychiatric manifestations were divided into drug na?ve group, GC group, and GC combined with CTX and/or HCQ group based on their treatment status at the time of enrollment. Health controls (HCs) were selected based on gender, age, and education level. The low frequency amplitude (ALFF), fractional low frequency amplitude (fALFF), and regional homogeneity (ReHo) were calculated for each of the four groups of participants. When comparing multiple groups, χ2 test or Fisher's exact test was used for count data, analysis of variance or Kruskal-Wallis H test was used for continuous variables, and LSD method was used for post hoc comparisons. Results:After matching, 22, 30, 50, and 29 cases were finally included. There were significant differences in brain function in multiple brain regions among the four groups. Specifically, compared with the HCs group, the ALFF values of the right posterior central gyrus ( t=-2.96) and the right paracentral lobule ( t=-2.95) in the drug na?ve group were decreased. In the GC group, the ALFF values in the right paracentral lobule ( t=-2.93), the right posterior central gyrus ( t=-2.93) and the right anterior central gyrus ( t=-2.94) were decreased. The ALFF values of the right paracentral lobule ( t=-2.90) and the right anterior central gyrus ( t=-2.90) were decreased in GC+CTX and/or HCQ groups. Compared with the drug na?ve group, ALFF values were higher in the right posterior central gyrus ( t=-3.00) and the right rolandic operculum ( t=-2.91) in GC+CTX and/or HCQ groups. Compared with the HCs group, fALFF values of the right anterior central gyrus ( t=-2.95) and the left posterior central gyrus ( t=-2.97) in the drug na?ve group decreased, and fALFF values of the right anterior central gyrus ( t=-2.94) and the left posterior central gyrus ( t=-2.98) in the GC group decreased. fALFF values decreased in the left posterior central gyrus ( t=-2.91) of GC+CTX and/or HCQ groups. fALFF values in the right anterior central gyrus ( t=-2.89) were higher in GC+CTX and/or HCQ group than in GC group. Compared with HCs, the ReHo value in the right posterior central gyrus ( t=-2.97) of the drug na?ve group decreased, and the ReHo value in the right anterior central gyrus ( t=-2.95) of the GC group decreased. The ReHo of GC+CTX and/or HCQ group was higher in the right anterior central gyrus ( t=-2.91) than that of the drug na?ve group, and the ReHo of the right posterior central gyrus ( t=-2.93) was higher than that of the GC group. The above results were adjusted by Gaussian random-field (GRF) multiple comparison ( Pvoxel<0.005, Pcluste<0.010). Conclusion:Systemic lupus erythematosus patients without major neuropsychiatric manifestations have reduced functional activity in multiple brain regions of the whole brain. GC combined with CTX and/or HCQ may have better effects on improving brain function than GC alone, and it mainly acts on sensorimotor related brain regions.

Health behavior decision-making often involves the balance of gains and losses at different time points,which affects the choice and maintenance of health behaviors.As a cognitive processing method of"pre-experiencing"future events,Episodic Future Thinking(EFT)can promote the formation of health intentions and health behavior change by increasing the value of future health outcomes.This paper reviews the concept,intervention model and action effect of EFT in health behaviors,in order to provide references for nurses to innovate health education and behavior management from the perspective of behavioral economics.