Objective To evaluate the effect of different operation methods on the early swallowing function in the patients with laryngocarcinoma.Methods A total of 138 patients with the first time of open laryngectomy in this hospital from January 2021 to December 2022 were selected as the research subjects by convenience sampling method.The patients were divided into the vertical laryngeal resection group(vertical group,n=34),horizontal laryngeal partial resection(horizontal group,26 cases),suprachloroid laryngeal par-tial resection annular hyoid epiglottis fixation group(SCPL-CHEP group,n=26)and total laryngeal resection group(total laryngeal group,n=52)according to the operation methods.The Anderson Dysphagia Scale,Syd-ney Dysphagia Scale and modified swale drinking water test were used to evaluate the swallowing function on the first day of postoperative oral feeding in the patients.Results The total scores and scores of various di-mensions of the Chinese version of Anderson Dysphagia Scale,total scores and scores of various dimensions of Sydney Swallowing Scale and the results of the modified swale drinking water test had statistical differences a-mong the various groups(P＜0.01);the above indexes had statistical difference between the total laryngeal group and the other groups(P＜0.01),but the above indexes had no statistical difference between the two groups in the horizontal group,vertical group and SCPL-CHEP group(P＞0.05).Conclusion In the patients with laryngeal cancer undergoing open laryngectomy,the dysphagia is less severe during early eating after to-tal laryngectomy,which has little impact on life.

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 explore the effects of swallowing rehabilitation training on swallowing function and quality of life in patients after laryngectomy.Methods:Randomized controlled trials on the effects of swallowing rehabilitation training on swallowing function and quality of life in postoperative laryngeal cancer patients were electronically retrieved from the Cochrane Library, PubMed, Embase, Web of Science, CINAHL, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biology Medicine disc. The search period was from database establishment to February 1, 2024. The quality evaluation criteria for randomized controlled trials of Joanna Briggs Institute Evidence-Based Health Care Center (2016) was used to evaluate the included literature. RevMan 5.3 software was used for meta-analysis.Results:A total of ten articles were included, with 987 patients. Meta-analysis showed that swallowing rehabilitation training could improve the swallowing function ( P<0.01) and quality of life ( P<0.01) of patients after laryngectomy. Conclusions:Swallowing rehabilitation training can improve patients' swallowing function and quality of life after laryngectomy and is worth applying in clinical practice.

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.

Objective:To construct the nursing quality evaluation index system for Laryngeal Cancer Rehabilitation Nursing Clinic.Methods:The nursing quality evaluation index system for Laryngeal Cancer Rehabilitation Nursing Clinic was constructed through literature analysis and survey research. From October to December 2022, 17 experts were selected for two rounds of expert consultation, and indicators at all levels were screened, modified, and improved to establish the nursing quality evaluation index system for Laryngeal Cancer Rehabilitation Nursing Clinic.Results:In the two rounds of expert consultation, the effective response rate of the questionnaire was 100.0% (17/17), and the expert authority coefficients were 0.912 and 0.924, respectively. The Kendall harmony coefficients of the two rounds of consultation were 0.199 and 0.221, respectively ( P<0.05). The final constructed nursing quality evaluation index system for Laryngeal Cancer Rehabilitation Nursing Clinic included 3 primary indicators, 15 secondary indicators, and 90 tertiary indicators. Conclusions:The nursing quality evaluation index system for Laryngeal Cancer Rehabilitation Nursing Clinic is scientific and reliable, providing reference for nursing quality evaluation and standardized management of Laryngeal Cancer Rehabilitation Nursing Clinic.

Objective:Small cell lung cancer (SCLC) is a highly malignant tumor with a high risk of brain metastasis (BMs). The purpose of this study was to evaluate the clinical factors affecting the occurrence of BMs in patients with stage IIB-IIIB SCLC who achieved complete remission (CR) after thoracic radio-chemotherapy.Methods:Clinical data of 191 patients with stage IIB-IIIB SCLC who achieved CR after thoracic radio-chemotherapy in Zhejiang Cancer Hospital from January 2009 to April 2016 were retrospectively analyzed. Common clinical factors related to the risk of BMs, including gender, age, thoracic radiotherapy dose, combined mode of radiotherapy and chemotherapy, pretreatment serum NSE and LDH, whether PCI was performed, TMN stage and PS score, were analyzed using log-rank method for univariate analysis, COX regression method for multivariate analysis and Kaplan-Meier method to plot the survival curve.Results:Univariate analysis showed that pretreatment LDH level≥240IU, pretreatment NSE ≥17 ng/ml and no PCI were positively correlated with the risk of BMs (all P＜0.05). Multivariate analysis showed that the risk of BMs was only positively correlated with pretreatment LDH≥240IU [HR: 1.90, 95%CI(1.07-3.37), P=0.029], and no PCI [HR:2.08, 95%CI(1.17-3.72), P=0.013]. Conclusion:Pretreatment serum LDH levels provide important value for predicting the risk of BMs in patients with stage IIB-IIIB SCLC who achieve CR after thoracic radio-chemotherapy.

Objective:To investigate the clinical and pathological characteristics and surgical efficacy of early brain injury with focal cortical dysplasia (FCD) IIId in children.Methods:Forty-nine children with epilepsy accepted surgical treatment in our hospital from January 2008 to July 2017 were chosen in our study; these patients were pathologically diagnosed as having FCD IIId. These children were divided into 7 groups according to different brain injuries: cerebral hemorrhage ( n=13), central nervous system infectious disease ( n=19), cerebral infarction ( n=1), intrapartum hypoxia ( n=5), two kinds of early brain injury ( n=2), febrile seizure ( n=6), traumatic brain injury ( n=3). Two years after surgery, Engel grading was used to evaluate the surgical efficacy of the children. The clinical and pathological characteristics of these children were retrospectively analyzed. Results:The average age of brain injury was 0 d-3.8 years, the average age of epilepsy was 4-5.3 years, and the average age of surgery was 7-10.2 years. The incidence of multiple lobe brain injury in the cerebral hemorrhage group (100%, 13/13) was significantly higher than that in the central nervous system infectious diseases group (36.8%, 7/19,) and febrile seizure group (50%, 3/6, P<0.05). There was a significant difference in Engel grading I ratio between cerebral hemorrhage group (84.6%, 11/13) and central nervous system infectious disease group (42.1%, 8/19, P<0.05); Engel grading I and II was noted in 80.0% children (4/5) of the intrapartum hypoxia group. All children had pathological changes and pathological characteristics of FCD after early brain injury. Conclusion:FCD IIId children with cerebral hemorrhage or intrapartum hypoxia have good surgical effect, which may be related to the early occurrence of early brain damage, clear pathological changes, and clear boundary between the focus and the surrounding brain tissues.

Objective:To investigate the clinical and pathological characteristics and surgical efficacy of early brain injury with focal cortical dysplasia (FCD) IIId in children.Methods:Forty-nine children with epilepsy accepted surgical treatment in our hospital from January 2008 to July 2017 were chosen in our study; these patients were pathologically diagnosed as having FCD IIId. These children were divided into 7 groups according to different brain injuries: cerebral hemorrhage ( n=13), central nervous system infectious disease ( n=19), cerebral infarction ( n=1), intrapartum hypoxia ( n=5), two kinds of early brain injury ( n=2), febrile seizure ( n=6), traumatic brain injury ( n=3). Two years after surgery, Engel grading was used to evaluate the surgical efficacy of the children. The clinical and pathological characteristics of these children were retrospectively analyzed. Results:The average age of brain injury was 0 d-3.8 years, the average age of epilepsy was 4-5.3 years, and the average age of surgery was 7-10.2 years. The incidence of multiple lobe brain injury in the cerebral hemorrhage group (100%, 13/13) was significantly higher than that in the central nervous system infectious diseases group (36.8%, 7/19,) and febrile seizure group (50%, 3/6, P<0.05). There was a significant difference in Engel grading I ratio between cerebral hemorrhage group (84.6%, 11/13) and central nervous system infectious disease group (42.1%, 8/19, P<0.05); Engel grading I and II was noted in 80.0% children (4/5) of the intrapartum hypoxia group. All children had pathological changes and pathological characteristics of FCD after early brain injury. Conclusion:FCD IIId children with cerebral hemorrhage or intrapartum hypoxia have good surgical effect, which may be related to the early occurrence of early brain damage, clear pathological changes, and clear boundary between the focus and the surrounding brain tissues.