Objective:To assess respondents' understanding of the items in the Neck Dissection Impairment Index (NDII) through cognitive interviews and to revise the items accordingly.Methods:Totally 30 postoperative neck dissection patients returning for follow-up at Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University from November 2023 to February 2024, were selected by purposive sampling for two rounds of cognitive interviews. Based on the interview results, the Chinese version of the NDII was revised.Results:The Chinese version of the NDII included ten items. The first round of interviews identified issues such as "incomplete expression, abstract language, and written form, " leading to revisions of five items. The second round of interviews showed that all respondents understood the revised items, and no new suggestions for modification were made.Conclusions:Cognitive interviews can improve respondents' comprehension of the Chinese version of the NDII, identify cognitive biases caused by cultural differences and improper linguistic expressions during the translation process, and enhance the understanding and acceptance of the scale's content among the target population.

Objective:To analyze the fail mode of neoadjuvant therapy combined with surgery for locally advanced esophageal squamous cell carcinoma (ESCC) after long-term follow-up.Methods:Clinical data of consecutive 238 patients with locally advanced resectable ESCC who underwent neoadjuvant therapy combined with surgery in Zhejiang Cancer Hospital from September 2012 to October 2019 were retrospectively analyzed. The failure mode in the whole cohort was analyzed after long-term follow-up. The overall survival (OS) and disease free survival (DFS) rates were analyzed by Kaplan-Meier method. Survival differences were determined by log-rank test.Results:The pathological complete response (pCR) rate was 42.0% in 238 patients. After a median follow-up of 46.1 months, tumor progression occurred in 96 patients (40.3%), including 25 patients (10.5%) with local recurrence, 61 patients (25.6%) with distant metastases, and 10 patients (4.2%) with simultaneous local recurrence and distant metastases. The median OS and DFS were 64.7 months and 49.9 months. And the 3-, 5-, and 7-year OS and DFS rates were 70.0%, 52.8%, 36.4% and 63.5%, 42.5%, and 30.0%, respectively. The 3-, 5-, and 7-year locoregional recurrence-free survival rates and distant metastasis-free survival rates were 86.0%, 71.4%, 61.2% and 70.6%, 55.9%, 43.0%. Compared with non-pCR patients, the overall progression rate and distant metastasis rate of pCR patients were lower (26.0% vs. 50.7%, 16.0% vs. 32.6%, both P<0.05). And the 3-, 5-, and 7-year OS (83.0% vs. 60.2%, 69.7% vs. 41.7%, 50.4% vs. 27.7%, all P<0.001) and DFS rates (80.4% vs. 51.4%, 63.9% vs. 31.2%, 45.9% vs. 20.3%, all P<0.001) were significantly better in pCR patients. Conclusions:Distant metastasis is the main failure mode of patients with locally advanced ESCC after neoadjuvant therapy. Patients with postoperative pCR can achieve better long-term survival.

Objective:To compare the recovery effect of continuous infusion of dexmedetomidine combined with oxycodone or sufentanil in the anesthesia intensive care unit (AICU) in elderly patients after thoracoscopic radical surgery for lung cancer.Methods:Using the method of prospective study, 80 elderly lung cancer patients underwent selective thoracoscopic radical surgery under general anesthesia in Nanjing First Hospital from February 2021 to May 2022 were selected. The patients were divided into dexmedetomidine combined with sufentanil group (S group) and dexmedetomidine combined with oxycodone group (Q group) by random digits table method with 40 cases each group. On the basis of routine monitoring and treatment after operation, the patients in Q group were continuously injected with oxycodone 0.03 mg/(kg·h) and dexmedetomidine 0.4 μg/(kg·h) through analgesia pump, the patients in S group were continuously injected with sufentanil 0.03 mg/(kg·h) and dexmedetomidine 0.4 μg/(kg·h) through analgesia pump. The wake-up time, extubation time, awakening quality (Aldrete score and bucking score) and comfort level (Bruggrmann comfort scale score, BCS score) after entering the AICU were record; the sedation score (Ramsay score) and pain relief score (numerical rating scale score, NRS score) and hemodynamic changes (mean arterial pressure and heart rate) 3, 5, 7, 10 and 14 h after entering the AICU were record; the level of serum inflammatory factors, including tumor necrosis factor (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) immediately, 5 h and 14 h after entering the AICU; press times of analgesia pump, adverse events, bleeding volume of drainage tube during AICU and overall satisfaction score when leaving the AICU were record.Results:The bucking score in Q group was significantly lower than that in S group: (1.02 ± 0.77) scores vs. (1.88 ± 0.34) scores, the Aldrete score and BCS score were significantly higher than those in S group: (8.93 ± 0.25) scores vs. (5.97 ± 0.32) scores and (3.03 ± 0.32) scores vs. (0.93 ± 0.52) scores, and there were statistical differences ( P<0.01); there were no statistical difference in wake-up time and extubation time between two groups ( P>0.05). There were no statistical difference Ramassy score, NRS score 3 and 5 h after entering the AICU, mean arterial pressure and heart rate between two groups ( P>0.05); the Ramassy score 7, 10 and 14 h after entering the AICU in Q group was significantly lower than that in S group, the NRS score, mean arterial pressure and heart rate were significantly lower than those in S group, and there were statistical differences ( P<0.01). There were no statistical differences in TNF-α, IL-6 and CRP immediately after entering the AICU between two groups ( P>0.05); the TNF-α, IL-6 and CRP 5 and 14 h after entering the AICU in Q group were significantly lower than those in S group, and there were statistical difference ( P<0.01). The press times of analgesia pump, bleeding volume of drainage tube and the incidences of nausea vomiting, respiratory depression, lethargy, restlessness, fever and lung infection in Q group were significantly lower than those in S group: (4.63 ± 1.10) times vs. (18.80 ± 1.54) times, (129.67 ± 4.14) ml vs. (164.00 ± 8.14) ml, 10.0% (4/40) vs. 52.5% (21/40), 2.5% (1/40) vs. 25.0% (10/40), 7.5% (3/40) vs. 47.5% (19/40), 0 vs. 20.0% (8/40), 2.5% (1/40) vs. 22.5% (9/40) and 2.5% (1/40) vs. 20.0% (8/40), and there were statistical differences ( P<0.01 or <0.05); there was no severe hypotension, severe bradycardia and delirium in both groups. The overall satisfaction score in Q group was significantly higher than that in S group: (3.53 ± 0.63) scores vs. (2.70 ± 0.65) scores, and there was statistical difference ( P<0.01). Conclusions:Continuous micro-pump infusion of dexmedetomidine combined with oxycodone in AICU elderly patients with lung cancer after thoracoscopic radical surgery can significantly improve the quality of recovery and comfort during extubation, without affecting the extubation time, and can effectively reduce the degree of pain, stress and inflammatory reaction in the early recovery period, and reduce the incidence of adverse events after surgery.

Objective:To translate the Glaucoma Symptom Scale (GSS) into Chinese, and to test its reliability and validity.Methods:Following the Brislin questionnaire translation principles, GSS was translated, back-translated and culturally adapted, and the Chinese version of GSS was formed. From January 2021 to June 2022, a total of 210 glaucoma patients in Ophthalmology Outpatient and Inpatient Department of Class Ⅲ Grade A hospitals in Hefei were enrolled as the research objects by the convenience sampling method. The items of the Chinese version of GSS were screened by correlation coefficient method, critical ratio method and Cronbach's α coefficient. The reliability of the Chinese version of GSS was tested using Cronbach's α coefficient, split-half reliability and test-retest reliability. The validity of the GSS was evaluated by content validity and construct validity. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive ability of the Chinese version of GSS, and to determine the sensitivity, specificity and the most appropriate critical value of GSS. Pearson correlation analysis was used to explore the correlation between the total score of GSS and the score of each item. A total of 210 questionnaires were distributed in this study, and 205 were effectively received, with an effective recovery rate of of 97.62% (205/210) .Results:A total of 2 common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 50.64%. With clinician's diagnosis as the gold standard, the area under the curve of the Chinese version of GSS was 0.916 (95% CI: 0.886-0.947, P<0.01). The optimal critical score of the scale was 73, and the sensitivity and specificity were 85.2% and 87.3%. The concordant Kappa value of the two diagnostic results was 0.749 ( P<0.01). The Cronbach's α coefficient, split-half reliability and test-retest reliability of the Chinese version of GSS were 0.812, 0.781 and 0.912, respectively. Conclusions:The Chinese version of the GSS has good reliability and validity, and is suitable for the screening of glaucoma patients in China.

AIM: To study the effects of individual differences (gender, age, body surface area, and body weight) on the pharmacokinetics of capecitabine in cancer patients in hoping of providing evidence for the rational use of capecitabine in clinic. METHODS: A total of 76 patients with various solid tumors were given a single dose of 0.6 g (0.15 g, 4 tablets) capecitabine in postprandial and blood samples were collected at multiple time points. The plasma concentration of capecitabine and its active metablolite, 5-fluorouracil (5-FU) were analyzed by HPLC-MS/MS and the pharmacokinetic parameters of the drugs were calculated by Phoenix WinNonlin7.0 software. RESULTS: Following oral administration, the C

Objective: To explore the impact of exercise rehabilitation on cardiac function in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI). Methods: A total of 130 CAD patients received primary PCI in our hospital from 2014-01 to 2015-09 were enrolled. All patients received conventional drug therapy and post-PCI knowledge education, then were randomly divided into 2 groups: Conventional group and Rehabilitation group, in which the patients received cardiac rehabilitation exercise for 3 months at different stage and intensity. n=65 in each group. The cardiac function including left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), 6 min walking distance (6MWD) and NYHA classification were compared between 2 groups at 1, 3 and 6 months after the operation. Results: LVEF, LVEDD, 6MWD and NYHA classification were similar between 2 groups at enrollment, P>0.05. ① At 1 month post-operation: 6MWD was different between 2 groups, P<0.05, while LVEF, LVEDD, NYHA classification and the recurrence rate of angina pectoris were similar between 2 groups, P>0.05. In Rehabilitation group, 6MWD and NYHA classification were different from the enrollment condition, P<0.05, while other parameters were similar, P>0.05; in Conventional group, 6MWD was different from the enrollment condition, P<0.05, while other parameters was similar, P>0.05. ② At 3 and 6 months post-operation: all parameters were different between 2 groups, P>0.05. In Rehabilitation group, all parameters were different from the enrollment condition, P<0.05. ③ In Conventional group, at 3 months post-operation: LVEDD and 6MWD were different from the enrollment condition, P<0.05; at 6 months post-operation: 6MWD was different from the enrollment condition, P<0.05. Conclusion: Exercise rehabilitation may improve the cardiac function, therefore enhance the endurance capacity and quality of life in CAD patients after PCI.

Objective To select a cheap, portable along with avoiding cross infection method of inhaled humidified gases according to the effect of three methods for inhaled humidified gases on degree of comfort in bilateral nasal catheter patients with nasal endoscopic surgery so as to improve the compliance of humidification for nasal cavity.Methods A total of 120 bilateral nasal catheter patients with nasal endoscopic surgery were randomly divided into four groups including wet gauze group (n=30), humidified gauze mask group (n=30), humidifier group (n=30) and control group (n=30). The assessment on the visual analogue scale (VAS) and SNOT-20 were carried out along with analysing the cost, convenience and acceptance in the first to the third day after surgery.Results The score of VAS in research groups was statistically higher than that in control group in the third day after surgery (P＜0.05) with no significant difference in that among research groups (P＞0.05). There were statistically significant differences in the score of SNOT-20 between wet gauze group and control group, between humidifier group and control group in the third day after surgery (P＜0.05). There was a statistically significant difference in the score of SNOT-20 between humidified gauze mask group and control group in the second and third day after surgery (P＜0.05). The score of the nasal symptom, other symptoms and sleep disorder and so on in research groups was lower than those in control group in the third day after surgery with significant differences (P＜0.05).Conclusions Three methods (wet gauze group, humidified gauze mask group, humidifier) for inhaled humidified gases can obviously improve the degree of comfort in bilateral nasal catheter patients with nasal endoscopic surgery. The clinical nursing practice should fully consider the objective condition of patients along with applying it neatly and synthetically so as to improve the quality of life of patients.

In the context of Popular Entrepreneurship and Innovation, scientific and systemic implementation of innovation and entrepreneurship education is the focus of higher education reform at present. This paper analyzes the important significances of carrying out innovation and entrepreneurship education in higher education of traditional Chinese Medicine, introduces the specific practices and experi-ences of designing educational concept and constructing education system about innovation and entrepre-neurship education, following the objective laws of modern educational development and the growth pattern of Chinese medicine talents, in order to provide reference for further promoting innovation and entrepreneu-rship education reform.

OBJECTIVE: To investigate the expression and concentration of lipopolysaccharide (LPS) and matrix metalloproteinase-9 (MMP-9) in middle ear cholesteatoma and discuss their relations. METHOD: Twenty-nine cases of middle ear cholesteatoma tissue, 18 cases of external auditory canal tissue were detected by limulus amebocyte lysate assay (LAL-assay), and expression of MMP-9 protein in formalin-fixed, paraffin-embedded tissues was detected by immunohistochemical method. RESULT: The concentrations of LPS in cholesteatoma were higher than that in external auditory canal tissues. In group of cholesteatoma: M = 0.739 0, IQR = 0.6203, and in group of external auditory canal tissues: M = -0.2538, IQR = 1.1692 (P < 0.01). In cholesteatoma groups, in extensive type: M = 0.8403, IQR = 0.5254; in localized type: M = 0.4048, IQR = 0.6139, the concentrations of LPS were higher in extensive cholesteatoma in comparison with localized cholesteatoma (P < 00.05). In cholesteatoma epithelium samples, MMP-9 were 79.3%. Compared with external auditory canal epithelium, the expression of MMP-9 was higher in middle ear cholesteatoma epithelium (P < 0.05). There was no significant difference in the expression of MMP-9 between two types of cholesteatoma epithelium (P > 0.05). LPS, MMP-9 weren't significantly correlated by Spearman test. CONCLUSION LPS was responsible for middle ear cholesteatoma and its related bone erosion. MMP-9 was related to the development of middle ear cholesteatoma. There's no correlation between LPS and MMP-9.
Adult ; Cholesteatoma, Middle Ear ; metabolism ; pathology ; Female ; Humans ; Lipopolysaccharides ; metabolism ; Male ; Matrix Metalloproteinase 9 ; metabolism ; Receptors, Calcitriol ; metabolism

Objective To investigate the differences of measurement of gross target volume (GTV)between endoscopic ultrasonography ( EUS )-based ( GTVEUS ) and computed tomography ( CT ) -based (GTVCT) method for thoracic esophageal squamous cell carcinoma. Methods EUS was performed on 36consecutive patients with thoracic squamous cell carcinoma, and the superior and inferior boarders of the tumor defined by EUS were marked with hemoclips. The CT planning scan was then performed with the patient in supine position, and the GTVCT and GTVEUS were contoured respectively. The lengths ( LCT and LEUS) and spatial locations of longitudinal GTVCT and GTVEUS were compared. Results The mean LCT and LEUS were (7. 79 ± 3. 15 ) cm and (7. 42 ± 2. 72) cm, respectively ( t = 0. 82, P ＞ 0. 05 ), with a correlation coefficient of 0. 61 (P ＜0. 001 ). Locations of longitudinal GTVCT and GTVEUS were compared in 34cases, with 2 excluded for invisualization on CT. The mean conformal index (CI) was (0. 79 ± 0. 18 ), and spatial variations were found in 71% patients, with 8 patients at proximal end and 21 others at distal end.There was no clip placement associated complication. Conclusion Endoscopic hemoclips placement is safe and reliable. EUS can provide additional information to CT in defining longitudinal GTV in thoracic esophageal squamous cell carcinoma, especially in superficial and submucosal carcinomas.