ChatGPT for shaping the future of dentistry: the potential of multi-modal large language model / 国际口腔科学杂志·英文版

The ChatGPT, a lite and conversational variant of Generative Pretrained Transformer 4 (GPT-4) developed by OpenAI, is one of the milestone Large Language Models (LLMs) with billions of parameters. LLMs have stirred up much interest among researchers and practitioners in their impressive skills in natural language processing tasks, which profoundly impact various fields. This paper mainly discusses the future applications of LLMs in dentistry. We introduce two primary LLM deployment methods in dentistry, including automated dental diagnosis and cross-modal dental diagnosis, and examine their potential applications. Especially, equipped with a cross-modal encoder, a single LLM can manage multi-source data and conduct advanced natural language reasoning to perform complex clinical operations. We also present cases to demonstrate the potential of a fully automatic Multi-Modal LLM AI system for dentistry clinical application. While LLMs offer significant potential benefits, the challenges, such as data privacy, data quality, and model bias, need further study. Overall, LLMs have the potential to revolutionize dental diagnosis and treatment, which indicates a promising avenue for clinical application and research in dentistry.

Analysis of NSD1 gene variant in a child with autism spectrum disorder in conjunct with congenital heart disease / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical characteristics and genetic basis of a child with autism spectrum disorder (ASD) in conjunct with congenital heart disease (CHD).@*METHODS@#A child who was hospitalized at the Third People's Hospital of Chengdu on April 13, 2021 was selected as the study subject. Clinical data of the child were collected. Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing (WES). A GTX genetic analysis system was used to analyze the WES data and screen candidate variants for ASD. Candidate variant was verified by Sanger sequencing and bioinformatics analysis. Real-time fluorescent quantitative PCR (qPCR) was carried out to compare the expression of mRNA of the NSD1 gene between this child and 3 healthy controls and 5 other children with ASD.@*RESULTS@#The patient, an 8-year-old male, has manifested with ASD, mental retardation and CHD. WES analysis revealed that he has harbored a heterozygous c.3385+2T>C variant in the NSD1 gene, which may affect the function of its protein product. Sanger sequencing showed that neither of his parent has carried the same variant. By bioinformatic analysis, the variant has not been recorded in the ESP, 1000 Genomes and ExAC databases. Analysis with Mutation Taster online software indicated it to be disease causing. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was predicted to be pathogenic. By qPCR analysis, the expression level of mRNA of the NSD1 gene in this child and 5 other children with ASD was significantly lower than that of the healthy controls (P < 0.001).@*CONCLUSION@#The c.3385+2T>C variant of the NSD1 gene can significantly reduce its expression, which may predispose to ASD. Above finding has enriched the mutational spectrum the NSD1 gene.

Clinical effect of manipulation therapy for the treatment of degenerative lumbar instability based on myofascial chain theory / 中国骨伤

OBJECTIVE@#To explore clinical effects of manipulation therapy in treating degenerative lumbar instability based on myofascial chain theory.@*METHODS@#Fifty-seven patients with degenerative lumbar spine instability were analyzed retrospectively from January 2018 to December 2019, and treated with massage manipulation therapy. Among them, 29 patients were treated with massage manipulation therapy based on the myofascial chain theory (myofascial chain group), including 14 males and 15 females, aged from 40 to 69 years old with an average of (51.76±5.07) years old, the courses of disease was (3.4±1.6) years. Twenty-eight patients were treated with massage manipulation therapy based on TCM meridian theory (TCM meridian group), including 12 males and 16 females, aged from 42 to 70 years old with an average of(52.48±4.31) years old, the courses of disease was (3.3±1.7) years. Before treatment, after treatment, 1 and 3 months after treatment, visual analogue scale (VAS) was used to evaluate pain degree of lumbar, Japanese Orthopaedic Association (JOA) and modified Oswestry Disability Index (ODI) were used to assess improvement of lumbar function, and changes of lumbar muscle tension were used to evaluate clinical effect.@*RESULTS@#VAS score, JOA score, modified ODI score and lumbar muscle tension after treatment were significantly improved than those of before treatment between two groups (@*CONCLUSION@#Manipulation therapyon in treating degenerative lumbar instability based on myofascial chain theory could effectively relieve low back pain symptom and improve lumbar function. It is worthy of promoting.

Changes of postoperative velopharyngeal function in children with cleft palate under 5 years old / 华西口腔医学杂志

OBJECTIVE@#To demonstrate the regularity of velopharyngeal function recovery after primary cleft palatoplasty and its correlation with different surgical procedures, ages, cleft types, and follow-up times.@*METHODS@#Patients with cleft palate under 5 years old who had more than two follow-up records were included in this study, and consecutive evaluations of postoperative velopharyngeal function were performed. Univariate and multivariate logistic regression analysis were used to reveal the regularity of postoperative velopharyngeal function and the possible influencing factors.@*RESULTS@#A total of 165 patients were included. Inconsistent functions of the velopharyngeal closure were observed in 31 patients, of which velopharyngeal insufficiency (VPI) in the first follow-up converted to velopharyngeal competence (VPC) in the second follow-up, accounting for 18.79% of the total, and 134 patients had consistent velopharyngeal function. The patients in the group who had consistent velopharyngeal function were younger than those in the group who were inconsistent, and the differences between the two groups were statistically significant. The younger the operation age, the patient's velopharyngeal function was more likely to stabilize at the first follow-up. At the time of the first follow-up in 15, 28, and 40 months, the probability that the patients had stable postoperative velopharyngeal function was 80%, 90%, and 95%, respectively.@*CONCLUSIONS@#The recovery of velopharyn-geal function after surgery is a dynamic process. The velopharyngeal status of patients can be converted from VPI to VPC. Meanwhile, VPC cannot switch to VPI. The follow-up time is the most important factor affecting the consistency of the evaluation of velopharyngeal function. Choosing appro-priate follow-up time is the key to obtain the stable evaluation of velopharyngeal function.

Velopharyngeal closure pattern and speech characteristics of patients congenital velopharyngeal insufficiency / 华西口腔医学杂志

OBJECTIVE@#To analyze velopharyngeal closure patterns and speech characteristics of patients with congenital velopharyngeal insufficiency.@*METHODS@#Patients visiting the Department of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University between 2009 and 2017 were reviewed. Outcomes of subjective speech evaluation, including resonance, consonant articulation, and correction rate, were analyzed. Furthermore, the mobility of soft palate and pharyngeal walls under nasopharyngeal fiberscope were analyzed retrospectively.@*RESULTS@#A total of 47 cases were retrieved and subjected to nasopharyngeal fiberscopic examination. Among them, 29 (61.7%) demonstrated a circular closure pattern, 16 (34.0%) showed a coronal pattern, and 2 (4.3%) had a sagittal pattern. Furthermore, 25 (53.2%) presented medium soft-palate mobility, 22 (46.8%) had weak lateral pharyngeal wall mobility, and 41 (87.2%) had no posterior pharyngeal wall mobility. Among all of the patients, 23 (48.9%) presented medium hypernasality, accounting for the highest proportion. Consonant misarticulation occurred in 89.4% of the cases. The articulation manners with the highest correction rate were in the following order: nasal, lateral, fricatives, stops, and affricates. The articulation places with the highest correction rate were in the following order: bilabial, alveolar, velar, and linguadental.@*CONCLUSIONS@#Circular closure was the most prevalent velopharyngeal closure pattern among patients with congenital velopharyngeal insufficiency, and consonant omission was the most common articulation abnormality.

Advance in Respiratory Training for Prevention and Treatment of Nonspecific Low Back Pain (review) / 中国康复理论与实践

Respiratory training can prevent and treat nonspecific low back pain, mainly by activating the deep stabilizing muscles of trunk, establishing appropriate intra-abdominal pressure and optimizing the proprioceptive input of lumbar back, so as to maintain the stability and control of the spine. At present, the commonly used breathing training methods in clinic mainly include diaphragmatic breathing, inspiratory muscle training and abdominal breathing. However, the formulation of respiratory training prescriptions and the comparative study of therapeutic effects among different respiratory training methods still need to be further explored.

Treatment of cervical spodylotic radiculopathy with posterior intervertebral foraminal discectomy via Delta channel / 中国骨伤

OBJECTIVE@#To explore the clinical efficacy and safety of posterior intervertebral foraminal discectomy via Delta channel for cervical spondylotic radiculopathy in the early phase.@*METHODS@#From September 2017 to July 2018, 10 patients with cervical spondylotic radiculopathy underwent posterior intervertebral foraminal discectomy via Delta channel. There were 6 males and 4 females, aged from 30 to 62 years old with an average of (41.5±4.3) years old. All of them had unilateral symptoms caused by cervical nerve root compression, including 2 cases of C, 5 cases of C and 3 cases of C. CT and MRI examination of all the patients did not show ossification of posterior longitudinal ligament or calcification of ligamentum flavum, and no cervical spine instability was present in dynamic radiographs. The clinical outcome was poor after more than 6 weeks of systematic non-surgical treatment. The VAS score, JOA score, NDI score, the cervical spine physiological curvature, and the height and stability of the compressed cervical vertebrae were measured before operation and at the latest follow-up.@*RESULTS@#All patients successfully completed the surgeries without any spinal cord, nerve root or major blood vessel injury. The operation time was 70 to 120 min with an average of 90 min. Intraoperative blood loss ranged from 30 to 90 ml with an average of 40 ml. All the 10 patients were followed up for 6 to 14 months with an average of 9 months. Postoperative nerve root pain got relievd and nerve function was improved in all patients. VAS score decreased from 7.15±2.01 before surgery to 1.59±0.83 at the latest follow-up;JOA score increased from 12.57±1.24 before surgery to 16.42±0.58 at the latest follow-up;NDI score increased from 41.82±4.71 before surgery to 9.59±3.52 at the latest follow-up. All the results above presented significant difference between latest follow-up and preoperative (0.05). At the latest follow-up, no cervical instability was observed on dynamic radiographs.@*CONCLUSION@#Treatment of cervical spondylotic radiculopathy by posterior intervertebral foraminal discectomy via Delta channel can obtain a satisfactory clinical outcome without affecting the stability of cervical vertebra. The surgery is safe, reliable and worthy of clinical application.

Factors affecting the postoperative velopharyngeal function among aged patients with cleft palate / 华西口腔医学杂志

OBJECTIVE@#To explore the prognostic factors affecting the primary surgical management of aged patients with cleft palate.@*METHODS@#This study reviewed aged patients with cleft palate who received Furlow palatoplasty (surgical age≥5 years) at the cleft center at West China Hospital of Stomatology from 2009 to 2014. The study retrieved intraoperative mea-surements, including velar length, pharyngeal depth, cleft width, maxillary width, cleft palate index, and palatopharyngeal ratio. Speech evaluation results at follow-up at least a year after surgery were also obtained. Logistic regression and retrospec-tive analyses were performed to identify correlative prognostic factors.@*RESULTS@#One hundred and thirty-one patients were included (70 males and 61 females). Dichotomy logistic regression analysis revealed that pharyngeal depth was the only mea-surement considerably associated with postoperative velopharyngeal function. Pharyngeal depth deeper than 16 mm indicated high risk of postoperative velopharyngeal insufficiency.@*CONCLUSIONS@#Pharyn-geal depth is a significant prognostic factor for the primary surgical management of aged patients with cleft palate. Pharyn-goplasty might be considered when planning the primary management of aged patients.

Outcome and influential factors of speech therapy delivered to cleft patients with post-operative velopharyngeal competence / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To analyze the training technique, intervention timing, and other related factors involved in the speech therapy delivered to cleft patients with velopharyngeal competence after surgery.</p><p><b>METHODS</b>A retrospective study was conducted on 32 patients who received phonology-articulation speech therapies during 2012 to 2013 in Dept. of Cleft Lip and Palate, West China Hospital of Stomatology, Sichuan University. All patients achieved normal speech one year after therapy. Information collected included the types and number of consonant articulation error, the overall period of training, the interval between surgery and speech training, and the age during speech training. Statistical analyses were performed in SPSS 16.0.</p><p><b>RESULTS</b>Ten patients received less than five sessions of training, seventeen received six to ten sessions, and five received eleven to twenty sessions. The number of sessions was positively correlated with the number of errors (r(s)=0.394, P=0.026). On the average, each additional error cost another 0.570 session for correction (confidence interval: 0.137-1.004). Moreover, the number of sessions was negatively correlated with age (P=0.055). Patients between 5 to 10 years old took significantly lesser sessions than those above 10 years. No correlation was found between the number of sessions and the interval between surgeries and trainings.</p><p><b>CONCLUSIONS</b>Appropriate speech therapy efficiently rehabilitate the speech condition of cleft patients with velopharyngeal sufficiency after surgery. The number of errors is directly proportional to the number of sessions needed. Patients above 10 years require more sessions than those less than 10 years.</p>

Velopharyngeal closure pattern and speech performance among submucous cleft palate patients / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To characterize the velopharyngeal closure patterns and speech performance among submucous cleft palate patients.</p><p><b>METHODS</b>Patients with submucous cleft palate visiting the Department of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University between 2008 and 2016 were reviewed. Outcomes of subjective speech evaluation including velopharyngeal function, consonant articulation, and objective nasopharyngeal endoscopy including the mobility of soft palate, pharyngeal walls were retrospectively analyzed.</p><p><b>RESULTS</b>A total of 353 cases were retrieved in this study, among which 138 (39.09%) demonstrated velopharyngeal competence, 176 (49.86%) velopharyngeal incompetence, and 39 (11.05%) marginal velopharyngeal incompetence. A total of 268 cases were subjected to nasopharyngeal endoscopy examination, where 167 (62.31%) demonstrated circular closure pattern, 89 (33.21%) coronal pattern, and 12 (4.48%) sagittal pattern. Passavant's ridge existed in 45.51% (76/167) patients with circular closure and 13.48% (12/89) patients with coronal closure. Among the 353 patients included in this study, 137 (38.81%) presented normal articulation, 124 (35.13%) consonant elimination, 51 (14.45%) compensatory articulation, 36 (10.20%) consonant weakening, 25 (7.08%) consonant replacement, and 36 (10.20%) multiple articulation errors.</p><p><b>CONCLUSIONS</b>Circular closure was the most prevalent velopharyngeal closure pattern among patients with submucous cleft palate, and high-pressure consonant deletion was the most common articulation abnormality. Articulation error occurred more frequently among patients with a low velopharyngeal closure rate.</p>

Analysis on dosage form theory and current application situation of traditional Chinese medicine pill / 中国中药杂志

Traditional Chinese medicine(TCM) pill, the most representative and successive dosage form, is called as one of the four classical TCM dosage forms. "Pills could keep the lasting and lenitive therapeutic efficacy for a long period" is the most classical dosage form theory, showing a guidance significance in making recipe, preparations and clinic application. In this article, we would elucidate the inheritance and development significance of TCM pills in three key points, including dosage form theory, pharmaceutical preparation technology and clinic usage based on the pharmaceutics connotation of this theory. From this, it can provide the basis for researches on pills mechanism, material basis and mode of action in clinical application.

Morphological classification and velopharyngeal function analysis of submucous cleft palate patients / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To enhance the accuracy in diagnosis and management of submucous cleft palate via a thorough analysis of its anatomical and functional details.</p><p><b>METHODS</b>Two hundred seventy-six submucous cleft palate cases from 2008 to 2014 were retrospectively investigated. Subgroup analysis were performed on the basis of preoperative velopharyngeal function, palatal morphology, cleft lip concurrence, and patient motives for treatment.</p><p><b>RESULTS</b>Among the included cases, 96 (34.78%) were presented as velopharyngeal competence (VPC), 151 (54.71%) as velopharyngeal insufficiency (VPI), and 29 (10.51%) as marginal VPI (MVPI). Eighty cases (28.99%) also demonstrated cleft lip deformity, and 196 cases (71.01%) were merely submucous cleft palate. Compared with patients with submucous cleft palate only, those with cleft lips exhibited higher rates of complete velopharyngeal closure. The pathological spectrum of submucous cleft palate varied significantly. Only 103 (37.32%) cases met all the three diagnostic criteria proposed by Calnan.</p><p><b>CONCLUSIONS</b>Given that the velopharyngeal closure rate varies among the subgroups, the factors analyzed in this study should be considered in the personalized manage-ment of submucous cleft palate.</p>

Effects of Jisuikang on Nogo-NgR gene expression in spinal cord rats with injury / 中国骨伤

<p><b>OBJECTIVE</b>To study the effects of Jisuikang (Chinese characters) on Nogo-NgR gene expression, and to explore the protective effects and mechanism of Jisuikang (Chinese characters) on spinal cord injury in rats.</p><p><b>METHODS</b>One hundred eighty female rats were randomly assigned to 6 groups(30 rats per group). Sham group: T10 lamina was resected only and spinal cord was untreated. Model group: spine cord injury (SCI) was created with a modified impinger of Allen's by impacting on the T10 spinal cord. Prednisolone group: Prednisolone (0.06 g/kg) was given by intragastric administration at a time interval of 24 hours after operation. The Jisuikang (Chinese characters) high, moderate and low dose groups: Jisuikang (Chinese characters) was supplied with different dose (50 g/kg, 25 g/kg, 12.5 g/kg) by intragastric administration in rats after operation,for the first time at 30 min after surgery. Animals were killed 3, 7, 14 days after surgery. The expression levels of Nogo-A and NgR were observed by Western Blot and Real-time PCR.</p><p><b>RESULTS</b>The expression of Nogo-A and NgR was at the basic level at all time points in sham group. Compared with model group, the protein expression levels of Nogo-A and NgR in sham, prednisolone, Jisuikang (Chinese characters) moderate dose groups were statistically significant at all time points (P < 0.05). No difference was found in Jisuikang (Chinese characters) high and low dose groups (P > 0.05). Three days after surgery, the mRNA levels of Nogo-A and NgR in treatment group were significantly lower than that in model group (P < 0.01); 7 days after surgery,Nogo-A and NgR mRNA expression were dramatically upregulated and peaked; 14 days after operation, the expression was decreased, but still significantly higher than that in other treatment groups (P < 0.01). Prednisolone and Jisuikang (Chinese characters) moderate dose groups showed the most significant effects among all groups,but there was no statistically significant difference between two groups (P > 0.05).</p><p><b>CONCLUSION</b>The decoction Jisuikang (Chinese characters) can promote the nerve cell regeneration by regulating Nogo-A and NgR gene expression, activating Nogo- NgR signaling pathways after acute spinal cord injury.</p>

Triple-Endobutton plates for the treatment of rockwood type III to V acromioclavicular joint dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical results of Triple-Endobutton plates for the treatment of Rockwood type III to V acromioclavicular joint dislocation.</p><p><b>METHODS</b>From March 2008 to June 2010,28 patients with Rockwood type II to V acromioclavicular joint dislocations were treated with Triple-Endobutton plates. There were 18 males and 10 females,ranging in age from 20 to 60 years old (averaged 38 years old). Twenty patients had dislocations in the left and 8 patients had dislocations in the right. All the patients had close injury. The Constant criterion was used to evaluate shoulder joint function.</p><p><b>RESULTS</b>All the patients were followed up,and the duration ranged from 18 to 24 months,with an average of 20 months. All the patients got good shoulder joint function,and no re-dislocation and pain occurred. The X-ray showed all acromioclavicular joints got good reduction. According to Constant criterion,preoperative score was 25.4 +/- 2.0, postoperative scores were 65.9 +/- 3.0, 87.2 +/- 3.2 and 95.7+/- 1.6 at 1 month,3 months and 6 months separately.</p><p><b>CONCLUSION</b>Treatment of Rockwood type III to V acromioclavicular joint dislocation with Triple-Endobutton plates has satisfactory clinical outcome, simple operation, few complications, without secondary operation and early functional exercise postoperatively.</p>

Influential factors affecting the postoperative velopharyngeal function among aged cleft palate patients / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To determine the factors affecting post-operative velopharyngeal function of cleft palate patients aged over two years old.</p><p><b>METHODS</b>The data on 245 patients, including first visit case records and those in the database, were searched and recorded. Post-operative velopharyngeal function and clinical features, such as cleft ratio, adequate ratio, diagnosis, operative age and method, were analyzed retrospectively.</p><p><b>RESULTS</b>Cleft ratio and adequate ratio in the velopharyngeal competence (VPC) group were not statistically different from those in the velopharyngeal incompetence (VPI) group. The difference in VPC rate in different age groups and diagnosis was not significant. The post-operative VPC rates under different methods were significantly different.</p><p><b>CONCLUSION</b>The current therapeutic schedule for patients younger than two years old is inappropriate for patients older than two years old. Cleft ratio is not the main factor affecting postoperative velopharygeal function. Sommerlad-Levator Veli Palatini reconstructional operation combined with sphincter pharyngoplasty can obviously improve the velopharyngeal function of patients aged 2 years old and up. This method should be applied in primary palatoplasty.</p>

Correlative factors on the articulation disorder of patients with cleft palate / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the correlation between articulation, velopharyngeal function, and surgical age by comparing the changes in articulation after velopharyngeal closure is performed. This study is also conducted to investigate the influencing factors of omission change between pre- and post-operation.</p><p><b>METHODS</b>A total of 48 patients, including 18 males and 30 females, mean age (13.3 ± 5.8) years, with non-syndromic cleft lips and palates were selected from January 2011 to December 2011. Their speech data and articulation between pre- and post-operation were retrospectively analyzed using non-parametric tests. Correlation study was performed to analyze the influencing factors of the changes in articulation. P < 0.05 was considered statistically significant.</p><p><b>RESULTS</b>The difference in articulation after velopharyngeal closure occurred was significant (Z = -3.796, P = 0.000). A negative correlation between the ratio of post-operative normal articulation and surgical age (R = -0.487, P = 0.000) was observed. The change in omission was positively correlated with surgical age (R = 0.589, P = 0.000) and gender (R = 0.404, P = 0.047). By comparison, the change in omission was negatively correlated with follow-up time (R = -0.235, P = 0.040).</p><p><b>CONCLUSION</b>Articulation and intelligibility are significantly improved after velopharyngeal closure is performed. These parameters are negatively correlated with surgical age to some extent. In addition, the change in omission is positively correlated with surgical age and gender, whereas the change in omission is negatively correlated with follow-up time.</p>

Angiogenesis and scar inhibition after subcutaneous implantation of Shengji Yuhong collagen / 中国组织工程研究

BACKGROUND:Shengji Yuhong col agen showed good curative effect of promoting angiogenesis and tissue healing compared with Shengji Yuhong Gao and col agen alone or gelatin alone. OBJECTIVE:To explore the curative effect and mechanism of subcutaneous implantation of Shengji Yuhong col agen in rabbits in promoting angiogenesis and repair. METHODS:Shengji Yuhong col agen as the experimental group and collagen as the control group was implanted inside the rabbit subcutaneous pockets of the back of New Zealand rabbits. The implanted samples and surrounding tissues were obtained at 3, 7, 14, 28 and 56 days fol owing surgery. Pathological sections were made and the repair of surrounding tissue was observed. Hemoglobin levels in col agen were measured. Immunofluorescence and CD34 dyeing marking method were utilized to observe capil ary angiogenesis. Western blot assay was employed to examine vascular endothelial growth factor and angiogenin-1 expression. Immunohistochemistry was used to observe the secretion of typeⅠ and Ⅲ col agen on the surrounding tissues. RESULTS AND CONCLUSION:The experimental group showed increased subcutaneous vascularization. There were reduced inflammatory exudation, granulation tissue hyperplasia, and mature fiber connective tissue at 28 days. Angiogenesis and hemoglobin contents were greater in the experimental group than in the control group (Pidentical between the experimental and control groups. However, the secretion of type Ⅲ col agen was higher in the experimental group than in the control group at 28 and 56 days (Pcol agen was lower in the experimental group than in the control group at 28 and 56 days (Pmechanisms of adjusting the protein expression of vascular endothelial growth factor and angiogenin-1. At the same time, it has the function of regulating col agen formation with better ratio of typeⅠ and type Ⅲ col agen to acquire higher quality of wound healing with reduced scar formation.

Individualized treatment of the atlantoaxial dislocation in craniovertebral junction abnormalities / 中华外科杂志

<p><b>OBJECTIVES</b>To analyze the clinical characteristics of the atlantoaxial dislocation (AAD) in craniovertebral junction (CVJ) abnormalities and to study the setup of its surgery strategy.</p><p><b>METHODS</b>From April 2009 to November 2011, 56 patients of AAD and CVJ abnormalities including 22 male and 34 female patients who had received surgery were analyzed. There were 2 cases of reducible AAD and 54 cases of irreducible AAD. The age of the patients ranged from 9 to 56 years (mean 34 years). Among them, 14 cases achieved reduction/partial reduction via direct posterior fixation, 41 cases had transoral anterior deconpression and occipito-cervical/C₁-C₂ fusion and 1 case had the posterior odontoidectomy and spinal fusion.</p><p><b>RESULTS</b>Fifty-three cases had a follow-up between 6 months and 36 months (mean 20 months) and 3 cases lost follow-up (had improvement at discharge). Seven cases had complications as follows: 1 case had irreversible spinal cord injury and muscle weakness of extremities, 2 cases had cerebrospinal leak, 2 cases had pulmonary infection, 1 case had local granuloma hyperplasia and 1 case had delayed healing of the incision. The later 6 cases all got recovery after reasonable treatments. The grades of Nurick at last follow-up were as follows: 6 cases (11.3%) improved by 3 grades, 30 cases (56.6%) improved by 2 grades, 13 cases (24.5%) improved by 1 grade, 3 cases (5.7%) without change, 1 case (1.9%) get worse.</p><p><b>CONCLUSIONS</b>Reducible AAD could achieve direct reduction and fixation via posterior pathways. Irreducible AAD needs individualized treatment. To choose the direct reduction and fixation or transoral odontoidectomy and posterior fixation and fusion should consider the pathogenetic condition, the image data and personal clinical experience.</p>

A preliminary study on the consonant articulation of older patients with cleft palate / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the consonant pronunciation characteristics of older unoperated cleft palate patients.</p><p><b>METHODS</b>One hundred unoperated cleft palate patients (more than 8 years old) were included. Subjective speech assessment was delivered to each patient. The incidence and distribution of varies consonant misarticulation errors consisting of manners and places of articulation were summarized.</p><p><b>RESULTS</b>Consonant misarticulation existed among 86% of all cases. Compensatory misarticulation was observed in 66% patients, while 14% patients demonstrated completely normal articulation. The articulation manners of the highest correction rate, in succession, were nasals, lateral, fricatives, stops, and affricates. The error type of stops and affricates mainly consisted of compensation and omission. The articulation places of the highest correction rate, in succession, were bilabial, alveolar, linguadental, and velar.</p><p><b>CONCLUSION</b>Compensatory, omission, and substitution, which happen in all the stops, fricatives and affricates, are the top three misarticulation. The misarticulation incidence of unaspirated sound is higher than that of aspirated. Compensatory errors a the most common ones in aspirated sounds, while omission and weak pressure are more frequent in unaspirated sounds. Weak pressure is mainly observed in unaspirated consonants. As the articulation spot move backward, the compensation of fricatives and stops deteriorate, the omission of affricates increase.</p>

Construction of special reporter to detect DNA methylation regulatory activity in FCER1G gene promoter through patch-methylation / 中南大学学报(医学版)

OBJECTIVE@#To construct a special luciferase reporter to detect DNA methylation regulatory activity in FCER1G gene promoter regulatory element.@*METHODS@#We constructed special full and mock methylated FCER1G gene promoter regulatory luciferase reporters by patch-methylation, and detected DNA methylation regulatory activity by comparing the luciferase activity of full-methylated luciferase reporters with mock-methylated reporters.@*RESULTS@#We successfully constructed the full and mock methylated FCER1G gene promoter regulatory luciferase reporters. The ratio of luciferase activity between the full methylated and the mock methylated was (0.36±0.07):1 (P<0.001).@*CONCLUSION@#FCER1G promoter activity is methylation-sensitive and is regulated by DNA methylation.