Search

The location and size of tumors, treatment methods and prognosis of patients with head and neck cancer can seriously affect their oral function and neck activity, thereby affecting daily activities such as eating, speech and upper limb movement. Early rehabilitation after head and neck cancer surgery can accelerate functional recovery, alleviate discomfort symptoms, improve quality of life, and reduce unnecessary rehabilitation or treatment measures. Developing a clinical rehabilitation nursing pathway for head and neck cancer, forming personalized rehabilitation plans, and conducting early and effective nursing interventions are currently one of the key points of clinical work for patients with head and neck cancer. At present, domestic and foreign guidelines or consensus pays less attention to the impairments of speech function, chewing and swallowing function, neck and shoulder function etc., and lacks a systematic and comprehensive rehabilitation nursing guide or consensus to provide practical guidance for the care of patients with head and neck cancer. Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine organized relevant experts from Beijing, Shanghai, Sichuan, Shaanxi, Zhejiang and Anhui to draft Expert consensus on postoperative rehabilitation nursing of patients with head and neck cancer basing on previous literature and clinical nursing skills and experiences, of which the aim is to provide guidance for those patients in the aspects of oral care, nutritional support, flap donor area care, care after tracheotomy, chewing and swallowing rehabilitation, speech function rehabilitation, neck and shoulder function rehabilitation, restricted mouth opening rehabilitation, risk identification and prevention and follow-up.

Objective·To systematically evaluate the application of return-to-work intervention programs to young and middle-aged cancer survivors and its effectiveness in improving work-related outcomes in cancer survivors.Methods·An initial literature search of eight electronic databases, including PubMed, Cochrane Library, Embase, CNKI and Wanfang was conducted with a time frame from inception to Aug 2nd, 2022 to collect randomized controlled trials (RCTs) and quasi-experimental studies of return-to-work interventions on work-related outcomes among cancer survivors. Two researchers independently conducted literature screening, data extraction, and methodological quality evaluation using the JBI (Joanna Briggs Institute) Methodology Quality Evaluation Tool.Results·A total of 13 original studies were included, involving 11 return-to-work intervention programs, containing 2 045 cancer survivors. The results of the systematic evaluation showed that 10 of the intervention programs were multidisciplinary, with intervention modules on disease/mental health education, group discussions, physical rehabilitation, work capacity exercises, multidisciplinary team meetings and counselling. Among them, three interventions also included employers in the support program. The duration of the interventions ranged from 7 d to one year. Eight of the included interventions took return-to-work rates as a primary outcome, but only three reported that the difference was statistically significant, two of which were quasi-experimental studies without control group. Besides, no clear positive effects were found on work-related outcome such as length of return-to-work, change of work status, work ability, and work meaning.Conclusion·The content, format, intensity and frequency of return-to-work intervention programs for cancer survivors vary widely, and the effects of interventions on work-related outcomes are still unclear. Researchers should further explore the mechanisms that influence cancer survivors′ return-to-work, and develop multidisciplinary intervention programs based on this to effectively help young and middle-aged cancer survivors return-to-work and society. In addition, due to the limitations of study quality and intervention program heterogeneity, more high-quality experimental studies are needed to further validate the above findings.

Background Oral cancer is highly prevalent, which is often caused by oral potentially malignant disorders, and oral leukoplakia is the most common. The malignant transformation of oral leukoplakia not only affects the physical and mental health of patients, but also imposesa heavy economic burden on the patient's families and society. Due to limited sample size, regional differences and other factors, the epidemiological characteristics of malignant transformation in Chinese patients with oral leukoplakia in China are various. Objective To perform a systematic review of the malignant transformation rate of oral leukoplakia in Chinese patients. Methods Databases of CNKI, SinoMed, CQVIP, Wanfang Data, PubMed, Web of Science, Embase and Cochrane Library were searched to identify cohort studies about malignant transformation rate of oral leukoplakia in Chinese patients included from inception to February 2022. Two researchers separately screened the cohort studies, evaluated the qualities and extracted data. Meta-analysis was conducted using Stata 15.0. Results Thirty cohort studies including 109 047 patients were finally included. Meta-analysis revealed that the malignant transformation rate of oral leukoplakia in Chinese patients was 9.0%〔95%CI (7.0%, 11.3%) 〕. The results of subgroup analysis revealed that the malignant transformation rate was 7.6% in male patients〔95%CI (5.1%, 10.6%) 〕, and was 13.2% in female patients〔95%CI (9.5%, 17.4%) 〕. The malignant transformation rate of oral leukoplakia in patients aged

Objective·To examine, using a systematic review and meta-analysis, the effectiveness of vitamin E on treating oral mucositis caused by radiotherapy and chemotherapy.Methods·A systematic literature search was performed by using PubMed, Embase, Cochrane Library, Web of Science, CINAHL, OpenGrey, Chinese biomedical literature database (CBM), Chinese national knowledge infrastructure (CNKI), Wanfang Data, and China Science and Technology Journal Database (VIP). The retrieval time was up to March 2022. The risk of bias was assessed by using the Cochrane Risk-of-Bias tool, version 2.0. RevMan 5.4 was used for meta-analysis.Results·A total of 563 literatures were retrieved. A total of 7 randomized controlled trials were included. The results of meta-analysis revealed that vitamin E supplementation did not significantly affect oral mucositis caused by chemoradiotherapy (RR=0.44, 95%CI 0.15‒1.25, Z=1.54, P=0.120). However, vitamin E may have some effect on severe oral mucositis (RR=0.22, 95%CI 0.11‒0.43, Z=4.33, P=0.000).Conclusion·It cannot be explained that vitamin E can effectively treat oral mucositis caused by radiotherapy and chemotherapy, but vitamin E may be effective for severe oral mucositis.

Objective·To study the prevalence of mouth opening restriction in oral cancer patients by meta-analysis.Methods·China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journal Database (VIP), Wanfang Data (Wanfang), Chinese BioMedical Literature Database (CBM), PubMed, Ovid, EMbase, Cochrane Library, Web of Science/SciSearch, and ClinicalTrials.gov were searched for observational studies about the prevalence rate of restricted mouth opening in oral cancer patients (including prospective, retrospective, and cross-sectional studies). The time limit for retrieval was from the database establishment to April 30th, 2022. The obtained documents were independently screened and extracted according to the inclusion and exclusion criteria, and the literature quality evaluation was performed by using methodological index for non-randomized studies (MINORS). The data were combined with the mouth-opening-restricted prevalence rate as the outcome indicator, the meta-analysis was performed by using Stata 15.0 software, and the subgroup analysis was performed based on the detection time, tumor site, and tumor stage. The evidence quality of outcome indicators was evaluated by using GRADE profiler 3.6 software according to GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system.Results·A total of 3 719 documents were obtained during the initial examination, and 18 documents were finally included, including 2 701 objects. The meta-analysis results showed that the total prevalence rate of mouth opening restriction in oral cancer patients was 42.7% (95%CI 27.0%‒59.1%). The results of subgroup analysis showed that the prevalence rates of mouth opening restriction in patients with oral cancer before surgery, and 3 months, 6 months and 1 year or more after surgery were 29.6% (95%CI 9.0%‒55.8%), 75.2% (95%CI 68.3%‒81.5%), 59.1% (95%CI 38.8%‒77.9%) and 22.3% (95%CI 2.0%‒54.3%), respectively. The prevalence rates of mouth opening restriction in patients with oral cancer at T1‒T2 stage and T3‒T4 stage were 38.6% (95%CI 26.0%‒52.0%) and 99.6% (95%CI 93.9%‒100.0%) respectively. The prevalence rates of mouth opening restriction in patients with oral cancer in the retromolar triangle, the gingiva, the tongue, the salivary gland, the floor of mouth and the lip were 93.1% (95%CI 68.5%‒100.0%), 68.1% (95%CI 52.9%‒81.7%), 46.1% (95%CI 11.6%‒82.7%), 26.1% (95%CI 15.9%‒37.5%), 21.9% (95%CI 0.7%‒54.0%), and 3.1% (95%CI 0‒9.3%), respectively. The GRADE system for evidence quality grading indicated that the quality of evidence for outcome indicator was extremely low.Conclusion·The total prevalence rate of mouth opening restriction in patients with oral cancer is high, nearly 50%; the patients at 3 months after surgery, at 6 months after surgery, at T3‒T4 stage or whose tumor located in the retromolar triangle have higher prevalence rates.

In the context of the potential immunomodulatory properties of curcumin in counteracting the detrimental effects of concurrent exposure to Deoxynivalenol (DON) and Aflatoxin B1 (AFB1), a comprehensive 28-days trial was conducted utilizing 60 randomly allocated mice divided into four groups. Administration of curcumin at a dosage of 5 mg/kg body weight in conjunction with DON at 0.1 mg/kg and AFB1 at 0.01 mg/kg body weight was undertaken to assess its efficacy. Results indicated that curcumin intervention demonstrated mitigation of splenic structural damage, augmentation of serum immunoglobulin A (IgA) and immunoglobulin G (IgG) levels, elevation in T lymphocyte subset levels, and enhancement in the mRNA expression levels of pro-inflammatory cytokines TNF-α, IFN-γ, IL-2, and IL-6. Furthermore, curcumin exhibited a suppressive effect on apoptosis in mice, as evidenced by decreased activity of caspase-3 and caspase-9, reduced expression levels of pro-apoptotic markers Bax and Cytochrome-c (Cyt-c) at both the protein and mRNA levels, and the maintenance of a balanced expression ratio of mitochondrial apoptotic regulators Bax and Bcl-2. Collectively, these findings offer novel insights into the therapeutic promise of curcumin in mitigating immunosuppression and apoptotic events triggered by mycotoxin co-exposure. [ABSTRACT FROM AUTHOR]

Purpose: Breast cancer is the leading cause of cancer mortality among women. Radiotherapy can reduce recurrence and prolong survival of patients accepting breast-conserving surgery (BCS). This study aims to compare acute skin reactions in patients receiving hypofractionated versus conventional radiotherapy at a single institution and to summarize the relevant influencing factors. Methods: This study analyzed 152 patients who underwent either hypofractionated or conventional whole-breast irradiation (WBI) after BCS. Acute skin toxicity was assessed according to the Radiation Therapy Oncology Group (RTOG) criteria. Predictive factors for acute skin toxicity were identified using multivariate analysis and visualized using a forest spot. Results: Grade 0 reactions occurred in 75.34% vs 70.89%, grade 1 in 16.44% vs 15.19%, grade 2 in 8.22% vs 12.66%, and grade 3 in 0% vs 1.27% of patients receiving hypofractionated and conventional WBI, respectively. There was no statistically significant difference in acute skin reaction in patients treated with hypofractionated radiation compared with conventional radiation (P = 0.62). Multivariate analysis revealed that metastatic lymph nodes (P = 0.021), whole-breast planning target volume (PTV-WB) (P < 0.001), and tumor bed planning target volume (PTV-TB) (P = 0.002) were significantly correlated with higher rates of acute skin toxicity. Conclusion: Hypofractionated WBI demonstrated similar acute skin adverse reactions compared to conventional WBI. These findings indicate that hypofractionated radiotherapy offers comparable tolerance, equivalent curative effect, convenience, and economic benefits, supporting its clinical promotion. [ABSTRACT FROM AUTHOR]

Purpose: To systematically review the available evidence regarding the prevalence and outcomes of cognitive frailty—a clinical syndrome characterized by the combination of physical frailty and cognitive impairment, without dementia—in community-dwelling older adults. Method: The following databases were searched: PubMed, Web of Science, Embase, EBSCO, Cochrane Central Register of Controlled Trials, ProQuest, CNKI, Wanfang, VIP, and CBMdisc (inception to October 2, 2023). Results: Twenty-four studies were included (N = 62,169) reporting a median prevalence of cognitive frailty among community-dwelling older adults of 12.2%. Frailty with cognitive impairment was independently associated with increased all-cause mortality (adjusted 8-year hazard ratio [HR] = 2.6, 95% confidence interval [CI] [2.05, 3.30]). There was evidence of increased risk of 3-year mortality for frailty (adjusted HR = 1.92, 95% CI [1.26, 2.93]) and prefrailty (adjusted HR = 1.79, 95% CI [1.33, 2.41]) with cognitive impairment. There was also evidence of increased risk of dementia for frailty (adjusted 24-month HR = 6.19, 95% CI [2.74, 13.99]; adjusted 4-year HR = 4.98, 95% CI [2.17, 11.41]) and prefrailty (adjusted 4-year HR = 5.21, 95% CI [2.95, 9.20]; adjusted 5-year HR = 14.5, 95% CI [1.68, 125.1]) with cognitive impairment. Activities of daily living (ADL) dependence was more frequent in individuals with cognitive impairment and frailty (adjusted 4-year odds ratio = 5.6, 95% CI [2.13, 14.72]). Conclusion: Of community-dwelling older adults, 12.2% have cognitive frailty as well as increased risk of all-cause mortality, dementia, and ADL dependence. Further studies on prevention and treatment of cognitive frailty is warranted. Health care providers should formulate specific interventions to decrease the impact of cognitive frailty. [Research in Gerontological Nursing, 17(4), 202–212.] [ABSTRACT FROM AUTHOR]

In order to improve the bioaccessibility of polyphenols and antioxidant activity in naked oats, this study was conducted with in vitro simulated digestion model and colonic fermentation model to compare the changes of total phenol content and antioxidant activity of germinated and un-germinated naked oat at different digestion stages and colonic fermentation stage, and to further explore the bioaccessibility of sprouted naked oat. In the simulated digestion stage in vitro, the bioaccessibility of polyphenols, DPPH free radical scavenging and hydroxyl free radical scavenging in germinated naked oats were the highest in intestinal digestion, which were 8.99%, 47.75% and 9.57% higher than those of un-germinated naked oats, respectivelyL The bioaccessibility of reducing power was the highest during gastric digestion, which was 39L82% higher than un-germinated naked oatL At the colonic fermentation stage, the highest polyphenol content and antioxidant activity in digestive residue of naked oats were found at 24-30 h. The bioaccessibility of polyphenols, DPPH scavenging ability and hydroxyl free radical scavenging ability of un-germinated naked oat digestion residue were 8L83% higher than that of germinated naked oat digestion residue, 8L16% higher than that of germinated naked oat digestion residue, and 16.68% higher than that of germinated naked oat digestion residue. However, it is almost equal to the bioaccessibility of the gastrointestinal digestive stageL These results indicate that germination can not only significantly improve the bioaccessibility of naked oats polyphenols and antioxidant activities in the gastrointestinal tract, but also maintain relatively high bioaccessibility of polyphenols in colonic fermentation, which provided a new idea for improving the bioavailability of cereal polyphenols in human digestive tractL [ABSTRACT FROM AUTHOR]