Nanomaterials for refining tumor microenvironment and enhancing therapy in head and neck squamous cell carcinoma: a review

Head and neck squamous cell carcinoma (HNSCC) is a prevalent and lethal solid tumor with a high mortality rate. Conventional cancertreatments, including surgery, radiotherapy, and chemotherapy, primarily target cancer cell eradication. However, uncontrolled proliferation and metabolic activities of these cells result in abnormalities in nutrient levels, hypoxia, and immunosuppression within the tumor microenvironment (TME). These factors constrain the efficacy of traditional treatments by promoting drug resistance, recurrence, and metastasis. Nanomaterials (NMs), such as nanozymes, can exhibit enzymatic activity similar to that of natural enzymes and offer a promising avenuefor the direct modification of the TME through catalytic oxidation-reduction processes. Moreover, they can serve as sensitizers or drug deliverycarriers, enhancing the efficacy of traditional treatment methods. Recently, NMs have garnered significant attention from oncologists. Thisreview begins with an overview of the composition and unique characteristics of the TME. Subsequently, we comprehensively exploredthe application of NMs in the treatment of HNSCC. Finally, we discuss the potential prospects and challenges associated with usingNMs in biomedical research.

Classificatory updates in verrucous and cuniculatum carcinomas:Insights from the 5^(th) edition of WHO-IARC head and neck tumor classification

The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular updates in this classification accommodate emerging molecular discoveries,advances in immunohistochemical techniques,and evolving clinical insights.The 5th edition of the WHO/IARC classification of head and neck tumors refines the'Oral Cavity and Mobile Tongue'chapter,including sections for non-neoplastic lesions,epithelial tumors,and tumors of uncertain histogenesis.Notably,the epithelial tumors section is rearranged by tumor behavior,starting with benign squamous papillomas and progressing through potentially malignant oral disorders to oral squamous cell carcinoma(OSCC).The section on OSCC reflects recent information on epidemiology,pathogenesis,and histological prognostic factors.Noteworthy is the specific categorization of verrucous carcinoma(VC)and carcinoma cuniculatum(CC),both associated with the oral cavity and distinct in clinical and histologic characteristics.This classification adjustment emphasizes the oral cavity as their predominant site in the head and neck.Designating specific sections for VC and CC aims to provide comprehensive insights into these unique subtypes,elucidating their clinical features,distinct histological characteristics,prevalence,significance,and clinical relevance.By categorizing these subtypes into specific sections,the 5th edition of the WHO classification aims to provide a more nuanced and detailed account,enhancing our understanding of these specific variants within the broader spectrum of head and neck tumors.

PTEN as a Novel Diagnostic and Prognostic Biomarker of Head and Neck Squamous Cell Carcinoma

This review article explores phosphatase and tensin homolog(PTEN)’s role in head and neck squamous cell carcinoma(HNSCC)through comprehensive expression and methylation examinations,genetic mutation investigation,and prognostic evaluation.Using the UALCAN informational collection,PTEN expression examination uncovered a critical over-expression in HNSCC cells isolated from normal control samples,proposing its role in HNSCC multiplication.Further,analysis of PTEN expression across various clinical limits has shown critical up-regulation in different cancer development stages,racial groups,gender,and age classes within the context of HNSCC patients,suggesting its major role in cancer duplication.PTEN expression was validated by utilizing the GEPIA2.0 online tool,which showed PTEN expression was particularly significantly expressed in HNSCC cancer improvement when it appeared differently from normal control samples.Accordingly,examining PTEN validation across different phases of cancer advancement showed dysregulation in each of the four phases with the most raised expression in stage I and the least expression in stage IV.Thus,this study investigated the promoter methylation level of PTEN,figuring out a basic relationship between HNSCC samples and normal control samples.Analyzing promoter methylation across various clinical limits uncovered massive variations,with specific methylation patterns seen across malignant growth stages,race groups,gender,and age groups.Overall survival and disease-free survival(OS and DFS)utilizing the KM plotter tool showed a critical relationship between PTEN expression levels in HNSCC patients,showing high PTEN expression exhibited good overall survival when showed up distinctively comparable to low PTEN expression levels.In addition,in disease-free survival(DFS)evaluation HNSCC patients showing low PTEN expression experienced great DFS relative to HNSCC patients with high PTEN expression.Moreover,to validate PTEN expression against survival,the study examined the HNSCC patients into low and high-expression groups of PTEN.In HNSCC,low PTEN expression was connected with great overall survival(OS)when it appeared contrastingly relative to the high PTEN expression.In like manner,the study found that low PTEN expression level was connected with great DFS in HNSCC when it appeared contrastingly related to the high PTEN expression group.Genetic mutation analysis via cBioPortal identifies a minimal proportion of PTEN mutations in HNSCC,predominantly in-frame mutation,missense mutation,splice mutation,truncating mutation,and structural variant,indicating their basal significance in PTEN dysregulation within HNSCC.Further investigation of PTEN molecular components and their exchange inside the HNSCC microenvironment might disclose novel roads for designated treatment and accurate medication approaches in battling this harmful disease.

ATM is a Prognostic Biomarker of Survival in Head and Neck Squamous Cell Carcinoma Patients

This review examines the role of ATM expression in head and neck squamous cell carcinoma(HNSCC).Analysis revealed significant overexpression of ATM in HNSCC cells compared to normal control samples,suggesting its involvement in cancer proliferation.ATM expression was notably upregulated across various clinical parameters,including different stages of cancer,racial groups,genders,and age groups,highlighting its role in cancer progression.Validation using the GEPIA2 tool confirmed strong ATM expression throughout all four stages of HNSCC,with the highest levels in stage II and the lowest in stage I.Promoter methylation analysis of ATM showed distinct patterns across different demographics and cancer stages,reinforcing its significance.The study also explored the relationship between ATM expression and patient outcomes using the KM plotter tool,finding that high ATM expression was associated with better overall survival(OS),while low ATM expression correlated with better disease-free survival(DFS).Genetic mutation analysis via cBioPortal identified minimal ATM mutations in HNSCC,including in-frame,splice,truncating,and missense mutations,suggesting their role in ATM dysregulation.The STRING tool was used to construct a protein-protein interaction(PPI)network,revealing that the ATM gene interacts with ten key genes(NBN,ATR,CHEK2,MDC1,MSH2,MSH6,MRE11,TP53,TP53BP1,BRCA1),indicating its involvement in various biological functions.Functional annotation of differentially expressed genes(DEGs)through the DAVID web server revealed their participation in critical biological processes,including double-strand break repair,cellular response to DNA damage,and DNA damage checkpoints.KEGG pathway analysis further linked DEGs to cellular senescence,platinum drug resistance,homologous recombination,p53 signaling,and the cell cycle,underscoring ATM’s multifaceted role in HNSCC.

Reconstruction surgery in head and neck cancer patients amidst the COVID-19 pandemic:Current practice and lessons for the future

The coronavirus disease 2019(COVID-19)pandemic has imposed a radical change in daily life and work routine.In this context,health systems have suffered important and serious repercussions in all fields.Among the changes brought about by the state of global health emergency,adjustments to guidelines,priorities,structures,professional teams,and epidemiological data stand out.In light of this,the oncological field has witnessed several changes in the approach to cancer,whether due to delay in diagnosis,screening deficit,personnel shortage or the psychological impact that the pandemic has had on cancer patients.This article focuses on the management of oral carcinoma and the surgical approaches that oral and maxillofacial specialists have had at their disposal during the health emergency.In this period,the oral and maxillofacial surgeons have faced many obstacles.The proximity of maxillofacial structures to the airways,the need of elective and punctual procedures in cancerous lesions,the aggressiveness of head and neck tumors,and the need for important healthcare costs to support such delicate surgeries are examples of some of the challenges imposed for this field.One of the possible surgical'solutions'to the difficulties in managing surgical cases of oral carcinoma during the pandemic is locoregional flaps,which in the pre-COVID-19 era were less used than free flaps.However,during the health emergency,its use has been widely reassessed.This setback may represent a precedent for opening up new reflections.In the course of a long-term pandemic,a reassessment of the validity of different medical and surgical therapeutic approaches should be considered.Finally,given that the pandemic has highlighted vulnerabilities and shortcomings in a number of ways,including the issues of essential resource shortages,underinvestment in public health services,lack of coordination and versatility among politicians,policymakers and health leaders,resulting in overloaded health systems,rapid case development,and high mortality,a more careful analysis of the changes needed in different health systems to satisfactorily face future emergencies is essential to be carried out.This should be directed especially towards improving the management of health systems,their coordination as well as reviewing related practices,even in the surgical field.

Factors influencing comfort level in head and neck neoplasm patients receiving radiotherapy

Objective:To determine factors that influence comfort in head and neck neoplasm patients receiving radiotherapy.Methods:In total,200 head and neck neoplasm patients receiving radiotherapy were recruited from three tertiary first class hospitals.They were assessed by Radiotherapy Comfort Questionnaire for patients with head and neck neoplasm,Social Support Scale,and Medical Coping Modes Questionnaire.Results:The total score of comfort was 60.54±8.32.Multiple linear regression analysis indicated that number of radiation treatments,family accompaniment,educational level,resignation coping mode,complications due to diabetes,accompanying chemotherapy,and the utilization of social support significantly influenced comfort level(p<0.05).Among these,number of radiation treatments,complications due to diabetes,accompanying chemotherapy,and resignation coping were negative factors.Conclusion:Encouraging utilization of social support systems and a positive coping mode is important for increasing comfort level in head and neck neoplasm patients during radiotherapy.Nurses should pay particular attention to those patients during later stages of radiotherapy or chemotherapy,with diabetes,without family accompaniment,and with lower education level.

Targeting head and neck tumoral stem cells： From biologicalaspects to therapeutic perspectives

Head and neck squamous cell cancer(HNSCC) is the sixth most common cancer in the world. Effective therapeutic modalities such as surgery, radiation, chemotherapy and combinations of each are used in the management of the disease. In most cases, treatment fails to obtain total cancer cure. In recent years, it appears that one of the key determinants of treatment failure may be the presence of cancer stem cells(CSCs) that escape currently available therapies. CSCs form a small portion of the total tumor burden but may play a disproportionately important role in determining outcomes. CSCs have stem features such as self-renewal, high migration capacity, drug resistance, high proliferation abilities. A large body of evidence points to the fact that CSCs are particularly resistant to radiotherapy and chemotherapy. In HNSCC, CSCs have been increasingly shown to have an integral role in tumor initiation, disease progression, metastasis and treatment resistance. In the light of such observations, the present review summarizes biological characteristics of CSCs in HNSCC, outlines targeted strategies for the successful eradication of CSCs in HNSCC including targeting the self-renewal controlling pathways, blocking epithelial mesenchymal transition, niche targeting, immunotherapy approaches and highlights the need to better understand CSCs biology for new treatments modalities.

Clinical Investigation of ^(99m)Tc-MIBI Imaging in Head and Neck Tumors

Objective： To investigate the diagnostic potential value of ^99Tc-MIBI imaging in head and neck tumors. Methods： Ninety-one patients with malignant and benign head and neck lesions were subjected to ^99mTc-MIBI tomography, and 20 healthy volunteers served as control group. Results： The overall sensitivity,specificity, accuracy and positive predictive accuracy of early/delay ^99mTc-MIBI imaging in diagnosis of head and neck malignant tumors were 78.7%/72.3%, 72.1%/88.4%, 75.6%/80.0% and 75.5%/87.2% respectively. The results of ^99mTc-MIBI Imaging in diagnosis of nasopharyngeal cancer and sinonasal non-Hodgkin＇s lymphoma were more satisfactory than those in maxillary sinus cancer. In distinguishing recurrent/residual nasopharyngeal carcinoma and sinonasal non-Hodgkin＇s lymphoma, ^99mTc-MIBI scintigraphy was superior to CT/MRI. Conclusion： ^99mTc-MIBI imaging is a promising useful tool in identifying head and neck tumor, and it has a special value to evaluate the local invasion and metastasis involved.

Reliability and validity of the Chinese version of the Head and Neck Information Needs Questionnaire for patients with head and neck cancer and their caregivers

Objectives:This study aimed to assess the reliability and validity of the Chinese version of the Head and Neck Information Needs Questionnaire(HaNiQ).Methods:The HaNiQ was translated into a Chinese version using internationally recognized forwardand back-translation procedures.The reliability and validity of the HaNiQ were measured using Cronbach’s a coefficient,split-half reliability,exploratory factor analysis,and Pearson correlation analysis.Results:A total of 207 patients in different head and neck cancer(HNC)stages and 174 caregivers completed the Chinese version of the HaNiQ.Internal consistencies varied between good and very well(Cronbach’s α coefficient 0.74-0.90);the split-half coefficient and the content validity index(CVI)of the questionnaire were 83.5%and 83.33%,respectively.The cumulative contribution rates of the 5 subscales in patients with HNCand their caregivers were 62.41%and 61.19%,respectively.However,there are some differences between the Chinese questionnaire for caregiver and the original questionnaire regarding the attribution of items.Items 22,23,and 27 in the Psychosocial subscale of the English version were assigned to the Survivorship subscale in the Chinese version for caregivers.Conclusions:The results demonstrated that the Chinese version of the HaNiQ is a reliable and valid instrument for measuring the information needs of patients with HNC and that of their caregivers.Though the structure of the Chinese versionwas different from the English version for caregivers of HNC patients,the Chinese version of the HaNiQ appears to be reliable and would benefit from further testing.

Restricting carbohydrates to fight head and neck cancer——is this realistic?

Head and neck cancers(HNCs) are aggressive tumors that typically demonstrate a high glycolytic rate, which results in resistance to cytotoxic therapy and poor prognosis. Due to their location these tumors specifically impair food intake and quality of life, so that prevention of weight loss through nutrition support becomes an important treatment goal. Dietary restriction of carbohydrates(CHOs) and their replacement with fat, mostly in form of a ketogenic diet(KD), have been suggested to accommodate for both the altered tumor cell metabolism and cancer-associated weight loss. In this review, I present three specific rationales for CHO restriction and nutritional ketosis as supportive treatment options for the HNC patient. These are(1) targeting the origin and specific aspects of tumor glycolysis;(2) protecting normal tissue from but sensitizing tumor tissue to radiation- and chemotherapy induced cell kill;(3) supporting body and muscle mass maintenance. While most of these benefits of CHO restriction apply to cancer in general, specific aspects of implementation are discussed in relation to HNC patients. While CHO restriction seems feasible in HNC patients the available evidence indicates that its role may extend beyond fighting malnutrition to fighting HNC itself.

Ultrasound Diagnosis of Cervical Vagal Schwannoma Misdiagnosed as Nodular Goiter

Background: Schwannoma is a benign tumor derived from Schwann cells. The most common location was cerebellopontine angle (CPA). Neurilemmoma originated from the thyroid gland is very rare. Purpose: To discuss the diagnosis and treatment of cervical vagal schwannoma and the causes of misdiagnosis and preventive measures. Case Presentation: A case of cervical vagal schwannoma misdiagnosed as nodular goiter by ultrasonography was analyzed retrospectively. This patient was found to have pain in the neck for 1 month and then went to our hospital for treatment. After admission, a 5 cm × 4 cm mass was found on the left side of the neck, with a medium texture and clear margin. It could move with swallowing. Initially ultrasound showed a well circumscribed hypoechoic mass in the left thyroid lobe, which is suggestive of hemorrhage of thyroid nodule. Biopsy of thyroid nodules after ultrasound guided biopsy revealed Schwannoma. Surgical treatment and postoperative pathological examination confirmed cervical vagal schwannoma. The patient recovered well and was discharged 9 days after operation. Conclusion: The location of thyroid schwannoma is rare, the relationship between thyroid schwannoma and surrounding tissues is unclear, and there is no typical ultrasonic manifestation. Moreover, if doctors are not aware of their knowledge, it is easy to cause misdiagnosis. Radiologists should raise awareness of the disease and carefully analyze the results of ultrasonography in combination with the clinical manifestations of the patients so as to reduce or avoid misdiagnosis of cervical schwannoma.

Rupture of carotid artery pseudoaneurysm in the modern era of definitive chemoradiation for head and neck cancer:Two case reports

BACKGROUND Carotid blowout syndrome(CBS)is a rupture of the carotid artery and is mainly caused by radiation and resection of head and neck cancers or direct tumor invasion of the carotid artery wall.It is a life-threatening clinical situation.There is no established and effective mode of management of CBS.Furthermore,there is no established preceding sign or symptom;therefore,preventive efforts are not clinically meaningful.CASE SUMMARY We described two cases of CBS that occurred in patients with head and neck cancer after definitive chemoradiotherapy(CRT)using three-dimensional conformal intensity-modulated radiation therapy.Two men aged 61 and 56 years with locally advanced head and neck cancer were treated with definitive CRT.After completing CRT,both of them achieved complete remission.Subsequently,they had persistent severe pain in the oropharyngeal mucosal region and the irradiated neck despite the use of opioid analgesics and rehabilitation for relief of contracted skin.However,continuous follow-up imaging studies showed no evidence of cancer recurrence.Eleven to twelve months after completing CRT,the patients visited the emergency room complaining about massive oronasal bleeding.Angiograms showed rupture of carotid artery pseudoaneurysms on the irradiated side.Despite attempting to secure hemostasis with carotid arterial stent insertion and coil embolization,both patients died because of repeated bleeding from the pseudoaneurysms.CONCLUSION In patients with persistent pain in irradiated sites,clinicians should be suspicious of progressing or impending CBS,even in the three-dimensional conformal intensity-modulated radiation therapy era.

Positron-emission tomography/computed tomography imaging in head and neck oncology:An update

Cancers of the head and neck account for more than half a million cases worldwide annually, with a significant majority diagnosed as squamous cell carcinoma(HNSCC). Imaging studies such as contrast-enhanced computed tomography(CT), magnetic resonance imaging(MRI) and ^(18)F-2-fluoro-2-deoxy-D-glucose positron-emission tomography/computed tomography(^(18)F-FDG PET/CT) are widely used to determine the presence and extent of tumors and metastatic disease, both before and after treatment. Advances in PET/CT imaging have allowed it to emerge as a superior imaging modality compared to both CT and MRI, especially in detection of carcinoma of unknown primary, cervical lymph node metastasis, distant metastasis, residual/recurrent cancer and second primary tumors, often leading to alteration in management. PET/CT biomarker may further provide an overall assessment of tumor aggressiveness with prognostic implications. As new developments emerged leading to better understanding and use of PET/CT in head and neck oncology, the aim of this article is to review the roles of PET/CT in both pre- and post-treatment management of HNSCC and PET-derived parameters as prognostic indicators.

Evaluation of Quality of Life and Oral Changes of Patients in Head and Neck Radiotherapy: Observational Study

Radiotherapy (RT) in the head and neck, despite coming from technological evolution, is challenged by the acute and late side effects of local irradiation, including permanent loss of saliva, osteoradionecrosis, dental caries induced by radiation and necrosis of the oral cavity, mucositis, xerostomia and secondary infections like candidiasis. Since these manifestations are limiting and the integrity of the vital organs contemplates the patient’s general health status, the oral health-related quality of life (OHRQoL) can be significantly affected by the treatment of head and neck cancer (HNC), since cancer can cause important changes in vital functions related to communication, food and social contact, causing disturbances in the patient’s life. An observational and longitudinal study was carried out with 16 cancer patients submitted to RT in the head and neck, between the years 2019-2020 with the objectives of collecting clinical and epidemiological data on the main oral changes caused by RT in the head and neck and correlating them with the impact on OHRQoL. To analyze the OHRQoL, the University of Washington’s Quality of Life Assessment questionnaire (UW-QOL) was applied once a week for 4 weeks and to observe oral manifestations, a dental clinic file standardized by the researchers was applied. The main oral manifestations clinically observed were hyposalivation, trismus and oral mucositis. The UW-QOL presented pain, chewing and taste as the main complaints reported by patients, however, appearance, salivation and chewing showed statistically significant differences over the weeks. The main manifestations observed were hyposalivation, trismus and oral mucositis, the physical limitations resulting from these manifestations impact the OHRQoL of cancer patients in terms of appearance, salivation and chewing.

经头颈部CTA联合三维重建技术用于脑血管疾病动脉狭窄的诊断价值

目的分析经头颈部CT血管造影(CTA)联合三维重建技术对脑血管疾病的特点及对脑血管疾病动脉狭窄的诊断作用。方法选择我院在2021年8月至2022年8月期间收治的脑血管疾病动脉狭窄患者118例进行观察,所有患者均进行经头颈部CTA检查,将获取的图像,完成最大密度投影和血管三维重建,将数字减影血管造影(DSA)检查结果作为“金标准”,分析经头颈部CTA联合三维重建的诊断特点,对脑血管疾病动脉狭窄患者的诊断价值。结果以DSA检查结果作为“金标准”,经头颈部CTA联合三维重建技术对脑血管动脉狭窄患者的灵敏度、特异度、准确率、阳性及阴性预测值更高,118例脑血管动脉狭窄患者显示982条血管,经头颈部CTA联合三维重建技术与DSA检查的符合率为86.97%(854/982),118例脑血管动脉狭窄患者显示颅内侧支动脉1422条,经头颈部CTA联合三维重建技术与DSA检查的符合率为97.54%(1387/1422)。结论针对脑血管疾病动脉狭窄患者,以经头颈部CTA联合三维重建技术进行检查,对患者血管病变的分布情况、动脉狭窄程度的检查效果较好,能够有效分辨患者侧支循环等级,为后续的治疗提供参考依据。

恶性肿瘤同步放化疗患者的营养状况及其影响因素

目的调查恶性肿瘤同步放化疗患者营养状况并分析其影响因素。方法以自设问卷方式收集2019年3-5月于北京大学肿瘤医院行同步放化疗恶性肿瘤患者的相关临床资料。采用患者参与主观整体评估量表(PG-SGA)评估患者的营养状况,并分析其影响因素。结果共收回有效问卷150份。150例患者的PG-SGA评分中位数为6.0(3.0,11.0)分。56例(37.3%)患者重度营养不良,49例(32.7%)患者中度营养不良。单因素分析显示,老年、食管癌或头颈部肿瘤、Ⅳ期、放疗次数>15次、化疗次数>4次、紫杉醇+铂或铂类单药治疗方案是患者营养不良的影响因素(Z=-3.839~-2.087,P<0.05)。二元logistic回归分析显示,老年、食管癌或头颈部肿瘤、放疗次数>15次是患者重度营养不良的独立危险因素(P<0.05)。结论恶性肿瘤同步放化疗患者营养不良比例高,尤其是老年、食管癌或头颈部肿瘤、同步放化疗后期患者。医务人员应动态评估、监测患者营养状况,并及时干预。

38例头颈部髓外浆细胞瘤临床分析

目的探讨头颈部髓外浆细胞瘤(head and neck extramedullary plasmacytoma,HNEMP)的临床特征、危险因素、治疗及预后。方法回顾性分析2008年9月~2022年1月间北京同仁医院收治的38例新诊断且未治疗的HNEMP患者的临床资料,分析影响生存的因素及其预后。结果38例患者中,病变呈现鼻颅眶沟通性者5例(13.2%),肿瘤最大直径≥5 cm者8例(21.1%)。仅接受单纯手术切除的患者17例(44.7%),术后给予放疗者13例(34.2%),化疗者8例(21.1%),接受放化疗联合治疗者5例(13.2%)。治疗后评价疗效,完全缓解32例,部分缓解3例,疾病稳定1例,疾病进展2例。中位随访86个月,5年的无进展生存率和总生存率分别92.1%和94.7%。其中,颅鼻眶沟通病变患者中位无进展生存期仅13个月,5年的无进展生存率和总生存率为40%和60%,而其余组均为100%。此外,病变范围≥5 cm和累及鼻颅眶沟通是影响患者无进展生存率和总生存率的不良预后因素。结论HNEMP发病率低,治疗上以手术联合放疗为主,预后相对较好,颅鼻眶沟通病变及高肿瘤负荷为不良预后因素。

多学科诊疗模式下翻转课堂在头颈肿瘤临床教学中的应用

目的探讨多学科诊疗(multidisciplinary diagnosis and treatment,MDT)模式下翻转课堂在头颈肿瘤临床教学中的应用效果。方法于2022年9月—2023年3月选取重庆医科大学附属第一医院耳鼻咽喉头颈外科2020年9月、2021年9月及2022年9月入学的36名专业学位研究生,采用随机数字表法分为对照组和试验组,每组各18名。对照组采用传统的教学模式,试验组采用MDT模式下翻转课堂教学模式。教学完成后,采用试卷答题的形式评价2组的知识点掌握情况,通过问卷调查形式完成学生对教学模式的满意度的评价。结果试验组的理论成绩[(40.22±4.43)分]、临床病例分析成绩[(36.11±4.34)分]均高于对照组[(41.11±3.43)分、(34.22±4.30)分],差异有统计学意义(P<0.05)。试验组的自主学习能力[(88.06±5.10)分]、主动参与感[(88.61±4.00)分]、团队协作能力[(89.78±3.57)分]、医患沟通能力[(87.44±5.20)分]、创新实践能力[(82.83±4.21)分]、临床思维能力[(89.83±3.45)分]、理论联系实践能力[(88.28±3.67)分]、教学模式满意度[(91.00±3.51)分]、对带教老师的满意度[(90.33±4.36)分]、学习兴趣[(90.22±3.44)分]等方面的评分均高于对照组[(67.39±5.79)分、(71.44±4.07)分、(66.06±5.15)分、(78.61±4.57)分、(71.50±3.67)分、(67.89±4.23)分、(67.89±3.48)分、(78.72±4.75)分、(80.56±4.89)分、(80.94±2.30)分],差异有统计学意义(P<0.05)。结论MDT模式下翻转课堂在头颈肿瘤临床教学中的教学效果良好,能够充分调动学生的主观能动性,培养学生的自主学习能力。

头颈癌患者身体意象研究的范围综述

目的 对国内外头颈癌患者身体意象相关研究进行范围综述。方法 检索PubMed、Web of Science、Embase、The Cochrane Library、CINAHL、中国知网、万方数据库、维普中文科技期刊数据库的相关文献,检索时限为建库至2023年4月10日,并对纳入文献进行讨论分析。结果 共纳入33篇文献。结果显示,头颈癌患者身体意象的影响因素包括社会人口学特征、疾病治疗因素、心理和行为因素、其他因素。身体意象评估工具主要从身体意象相关的情感认知、生理功能、社会活动来进行评估。研究中头颈癌患者的干预措施主要包括美容修复技术、皮肤伪装计划、运动疗法、认知行为干预、表达性写作、积极心理干预。结论 身体意象的影响因素还需进一步探讨,未来研究应选择科学的评估工具,并在此基础上开展干预性研究,改善头颈癌患者身体意象水平。

头颈部肿瘤患者放射性皮炎预防及管理的最佳证据总结

目的 系统检索、评价和总结头颈部肿瘤患者放射性皮炎预防及管理的最新最佳证据,为临床制定个性化的皮肤管理方案提供循证依据。方法 计算机检索各指南及专业协会网站、Cochrane图书馆、JBI循证护理数据库、PubMed、CINAHL、Web of Science Core Collection、Embase、中国知网、维普数据库、万方数据库、中国生物医学文献数据库中所有关于头颈部肿瘤放射性皮炎预防及管理的文献,包括指南、专家共识、系统评价、最佳实践信息册等。检索时间为建库至2023年8月23日。结果 共纳入22篇文献,包括1篇指南、4篇专家共识、17篇系统评价或meta分析。从头颈部肿瘤患者放射性皮炎的发病率、危险因素、临床表现、评估监测、健康教育、日常护理、预防及治疗措施、感染控制、管理策略9个方面总结出43条证据。结论 头颈部肿瘤患者放射性皮炎预防及管理的最佳证据为医疗保健人员制定个性化皮肤管理方案提供循证依据,临床实践过程中需结合具体情境和患者个人意愿选择证据。