Development of the German Speech Intelligibility Index for the treatment of oral cancer patients

ObjectivesThis study aimed at 1) adapting the well-established Speech Handicap Index (SHI) to German, 2) testing the suitability of the instrument for assessing speech-related quality of life, 3) comparing it to the German Voice-Handicap-Index (VHI), in order to support treatment of oral cancer patients who experience posttreatment speech difficulties that affect their quality of life.Material and methodsParticipants completed a web-based survey that employed a 2 (experienced problem: speech/articulation-related vs. voice-related) x 2 (SHI vs. VHI) between-subject experimental design, enabling it to distinguish between the experiences of voice and intelligibility impairments, and to determine the discriminatory ability of the two instruments.ResultsThe German SHI reliably assessed speech intelligibility and articulation-related Quality of life. While voice impairments were equally well assessed by both, VHI: M 2.48, SD 0.65; SHI: M 2.52, SD 0.63; only the latter appropriately registered intelligibility handicap in speech impairments (VHI: M 2.05, SD 0.70; SHI: 2.68, SD 0.73). The responsivity of the SHI in capturing the experienced handicap was significantly greater in the speech/articulation-impairment condition (p = .001).ConclusionThe German SHI is a reliable and responsive measure for speech intelligibility and articulation-related quality of life that should be chosen in preference to the VHI.     

Highly Improved Thermal Properties of Hydroxyl‐Containing Polymers via Modification by Benzoxazine Groups

Isocyanate functional benzoxazine (NCO‐4HBA‐a) is used for coupling with hydroxyl‐group‐containing molecules. Glycerol is used in a model reaction to study the urethane bonds formed between the NCO‐4HBA‐a and the glycerol's hydroxyl groups. The model supports a reaction between NCO‐4HBA‐a and poly(vinyl alcohol) (PVA), which leads to an improved char yield, determined by thermogravimetric analysis. Glycerol‐based benzoxazine is also an attractive benzoxazine synthesized from the products of biofuel production. Upon functionalization with benzoxazine and subsequent thermal treatment, the hydroxyl‐containing polymer gains thermal stability shown by improved char yield of polybenzoxazine cross‐linked PVA.

     

Accuracy of guided biopsy of the jawbone in a clinical setting: A retrospective analysis

The aim of this study was to investigate the accuracy of a previously described technique for guided biopsy of osseous pathologies of the jawbone in a clinical setting. The data sets of patients who had undergone guided biopsy procedures were retrospectively examined for accuracy. Digital planning of the biopsies and manufacturing of the tooth-supported drilling template were performed with superimposed cone beam computed tomography and intraoral scans using implant planning software. After a trephine biopsy was taken using the template, the postoperative low-dose cone beam computed tomography was analyzed for accuracy using the planning software with the corresponding (digitally-planned) biopsy cylinder. The mean angular deviation was 4.35 ± 2.5°. The mean depth deviation was ?1.40 ± 1.41 mm. Guided biopsy seems to be an alternative to a conventional approach for minimally invasive and highly accurate jawbone biopsy.     

Stathmin表达与局部晚期口腔鳞癌患者TPF诱导化疗远期疗效的相关性分析

目的 验证微管解聚蛋白（Stathmin）能否预测口腔鳞癌（oral squamous cell carcinoma,OSCC）患者从多西紫杉醇、顺铂、5氟尿嘧啶（TPF）诱导化疗中远期获益。方法 收集2008年3月—2010年12月入组TPF诱导化疗临床试验的256例OSCC患者的远期随访结果。收集患者肿瘤活检标本,进行Stathmin免疫组织化学染色并评分。根据Stathmin表达评分进行亚组预后分析。采用SPSS 13.0软件包将Stathmin和其他基线特征进行单因素、多因素和Cox回归模型预后分析。结果 Stathmin的表达可预测OSCC患者对TPF诱导化疗的反应,Stathmin低表达的OSCC患者从TPF诱导化疗中获益,而高Stathmin表达的OSCC患者不能获益于TPF诱导化疗。Stathmin的表达是独立的预测因子。结论 Stathmin是独立的预测OSCC诱导化疗疗效的生物标志物,基于Stathmin筛选指导OSCC患者接受TPF诱导化疗的后续临床研究具有重要意义。     

改良负压封闭引流术在游离皮瓣修复术后供区植皮中的应用

目的 探讨改良负压封闭引流术（vacuum sealing drainage,VSD）在口腔癌患者游离皮瓣修复术后供区植皮中的应用效果。方法 选择50例口腔癌游离皮瓣修复患者,其中30例采用改良VSD法进行供区植皮后处理,20例患者进行常规加压包扎法处理。采用SPSS 22.0软件包对数据进行统计学分析。结果 改良VSD 组植皮术后愈合时间较加压包扎组明显缩短,供区愈合时间、并发症发生率较加压包扎组显著降低（P<0.05）。结论 改良VSD在口腔癌游离皮瓣修复术后供区植皮效果良好,性价比高,值得在临床上应用推广。     

颏下岛状瓣修复口腔颌面部缺损专家共识

颏下岛状瓣（submental island flap, SMIF）是面动脉分支颏下动脉恒定供血的轴型皮瓣,与口腔颌面部缺损区相邻,其质地、色泽与头面部相似,血运充分。该组织瓣制备较简单,且成活率高,适用于修复口腔颌面部中型缺损。然而,国内外对于SMIF的应用仍然存在争议,主要集中在颈淋巴转移患者使用该皮瓣的肿瘤安全性、皮瓣的制备方法等方面。为统一和规范SMIF在口腔颌面-头颈部缺损修复中的应用,本文集中国内多家医学院校口腔颌面外科专家的智慧,达成专家共识,供同道参考。     

口腔微生物稳态与口腔鳞癌患者顺铂敏感性的相关性分析

目的 探讨口腔鳞癌（oral squamous cell carcinoma,OSCC）患者口腔内微生物与顺铂敏感性之间的相关性。方法 采集29例OSCC患者化疗前唾液样本,根据RECIST 1.1评价标准将患者分为顺铂耐药组（无效）和顺铂敏感组（有效）,采用16S rRNA基因测序,分析OSCC患者口腔微生物物种组成、群落多样性及丰度、样本间差异。采用SPSS 19.0软件包对数据进行统计学处理,LEfSe分析2组样本间物种差异。结果 与顺铂化疗敏感组相比,顺铂耐药组唾液样本中微生物多样性和丰度显著增加。在属水平上,顺铂耐药组患者口腔内奇异菌属、红蝽菌、微单胞菌、尤里优杆菌以及梭杆菌与顺铂敏感组相比存在显著差异。结论 顺铂耐药组与敏感组OSCC患者口腔内微生物结构和组成存在显著差异,提示微生物可能成为OSCC患者顺铂化疗前筛选的生物标志物。     

638例舌鳞癌预后及影响因素分析

目的 研究舌鳞癌患者人口学及临床病理特征对总生存率的影响,筛选可能的预后影响因素。方法 选择2003—2013年间在上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科经病理确诊为舌鳞癌、户籍所在地为上海的住院患者。从住院病史中提取年龄、性别等人口学特征,病变部位、TNM分期、临床分期、组织学分级等临床病理特征数据。采用Stata/SE 10.0统计软件,Kaplan-Meier生存分析计算1、3、5年总生存率,Log-rank检验比较各因素不同水平生存分布的差异,Cox 比例风险模型筛选预后影响因素。结果 638例舌鳞癌患者纳入研究,1、3、5年生存率分别为83.52%、68.98%、63.33%。年龄>60岁与≤60岁生存率有统计学差异,>60岁者死亡风险增高（P<0.05）;性别经年龄分层后,≤60岁舌鳞癌患者生存率有性别差异,女性预后较好（P<0.05）;舌体鳞癌患者总生存率比舌根鳞癌患者高（P<0.05）。多因素回归分析显示,与舌鳞癌预后有关的因素有T分期、N分期,分期越高,预后越差（P<0.05）;组织学分级则仅有高分化与低分化对预后影响差异显著,低分化者预后极差（P<0.05）。结论 年龄、性别、肿瘤部位、TNM分期和组织学分级等均是舌鳞癌的预后影响因素。     

半胱氨酸酶抑制剂A在口腔鳞癌中的表达及临床意义

目的 探讨半胱氨酸酶抑制剂A（CSTA）在口腔鳞癌中的表达及其与临床病理特征的关系。方法 通过免疫组织化学染色、Western 免疫印迹和实时定量PCR（qRT-PCR）检测CSTA的表达,通过Transwell迁移侵袭实验评估CSTA对口腔鳞癌细胞转移的促进作用。采用SPSS 25.0和GraphPad Prism 8.4.3软件进行数据分析。结果 CSTA在口腔鳞癌中的表达显著低于正常口腔黏膜上皮组织,其表达量与颈淋巴结转移（P=0.028）和肿瘤病理级别呈显著负相关（P=0.001）,CSTA低表达的细胞倾向分布于肿瘤侵袭前缘;CSTA低表达组患者总生存期显著短于CSTA高表达组,CSTA过表达可在体外抑制口腔鳞癌细胞迁移与侵袭。结论 CSTA在调控口腔鳞癌颈淋巴转移过程中发挥重要作用,有望成为口腔鳞癌颈淋巴转移的潜在预测和治疗靶标。     

EGFR-Targeted Therapy for Non-Small Cell Lung Cancer: Focus on EGFR Oncogenic Mutation

The two essential requirements for pathologic specimens in the era of personalized therapies for non-small cell lung carcinoma (NSCLC) are accurate subtyping as adenocarcinoma (ADC) versus squamous cell carcinoma (SqCC) and suitability for EGFR molecular testing, as well as for testing of other oncogenes such as EML4-ALK and KRAS. Actually, the value of EGFR expressed in patients with NSCLC in predicting a benefit in terms of survival from treatment with an epidermal growth factor receptor targeted therapy is still in debate, while there is a convincing evidence on the predictive role of the EGFR mutational status with regard to the response to tyrosine kinase inhibitors (TKIs).This is a literature overview on the state-of-the-art of EGFR oncogenic mutation in NSCLC. It is designed to highlight the preclinical rationale driving the molecular footprint assessment, the progressive development of a specific pharmacological treatment and the best method to identify those NSCLC who would most likely benefit from treatment with EGFR-targeted therapy. This is supported by the belief that a rationale for the prioritization of specific regimens based on patient-tailored therapy could be closer than commonly expected.