Xanthones from Securidaca inappendiculata antagonized the antirheumatic effects of methotrexate in vivo by promoting its secretion into urine.

BACKGROUND: This study was designed to characterize the interaction between Securidaca inappendiculata Hassk. derived xanthones and methotrexate (MTX). METHODS: Collagen-induced arthritis (CIA) was induced in rats, which were treated with MTX, a xanthone-rich fraction (XRF), or MTX+XRF by gavage for 30 days. Clinical efficacy was assessed based on arthritis scores, serological analysis, and histological examination. Protein expression was investigated by either immunohistochemical or immunoblotting methods. MTX concentrations were determined by HPLC or LC-MS methods. Obtained results were further validated by in vitro assays using 1,7-dihydroxy-3,4-dimethoxyxanthone and HEK 293 T cells. RESULTS: XRF antagonized the antirheumatic effects of MTX in vivo, suggested by higher levels of proinflammatory cytokines, and severer swelling and deformation of joints in CIA rats in the MTX+XRF group compared with MTX monotherapy. XRF reduced MTX concentration in plasma and promoted its excretion into urine. As a result, XRF attenuated MTX-induced edema of the proximal tubule. Furthermore, XRF restored the decreased expression of organic anion transporter three (OAT3), which accounts for MTX secretion in the kidney. Consistently, 1,7-dihydroxy-3,4-dimethoxyxanthone promoted the cellular intake of MTX by increasing OTA3 expression. CONCLUSION: It is suggested that the combined use of S. inappendulata with MTX should be optimized to avoid the antagonistic effects and improve the safety of the MTX regimen.

Development of a liquid chromatography-tandem mass spectrometry method for determination of butoconazole nitrate in human plasma and its application to a pharmacokinetic study.

A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for the determination of butoconazole in human plasma. Human plasma samples of 0.2 µL were pretreated by a single step protein precipitation procedure and analyzed using a high performance liquid chromatography (HPLC) electrospray tandem mass spectrometer system. The compounds were eluted isocratically on an Inertsil ODS-SP column (100 mm×2.1 mm, 3 µm), ionized using a positive ion atmospheric pressure electrospray ionization source and analyzed using multiple reaction monitoring (MRM) mode. The ion transitions monitored were m/z 412.8→165.1 for butoconazole and m/z 453.4→230.3 for the internal standard. The chromatographic run time was 3.5 min per injection, with retention time of 2.47 min and 2.15 min for butoconazole and repaglinide, respectively. The method was validated to be linear over the range of 20 to 8000 pg/mL (r>0.999) by using a weighted (1/x(2)) quadratic regression. The mean recovery rate was more than 86.7%, and the intra- and inter-day precision of the quality control samples (QCs) was less than 8.3% and the accuracy ranged from 96.0% to 110.2%, which indicated that the quantitative method was reliable and accurate. The method is simple, rapid, and has been applied successfully to a pharmacokinetics study of butoconazole nitrate suppositories in healthy Chinese females.

[Measurement of the volume absorption of alveolar bone grafting].

PURPOSE: To determine the bone absorption at different time after alveolar autogenous bone grafting using spiral CT three-dimensional reconstruction. METHODS: Twenty unilateral cleft lip and palate patients(15 males,5 females) were chosen to undergo three-dimensional CT scans after alveolar bone graft, region of interest(ROI) volume measurement of GE AW 4.1 software was used to calculate the capacity of alveolar cleft at 1 week, 3 months, 6 months after surgery. RESULTS: An average bone loss of 35.74% was found after 3 months, 55.89% after 6 months. In labial and palatal direction, labial bony bridge was more obvious than palatal bony bridge. CONCLUSIONS: Bone resorption is present after alveolar bone graft, and becomes more severe with time going on.

[Classification and surgical treatment of the deviated nose with unilateral cleft lip].

OBJECTIVE: To present a classification of the deviated nose with unilateral cleft lip and the associated surgical correction. METHODS: A total of 176 cases of nasal deformities with unilateral cleft lip treated in Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine & Shanghai Research Institute of Stomatology & Shanghai Key Laboratory of Stomatology from 2007 to 2009 were analyzed. Depending on the relationship between the external pyramid and the facial midline, the nasal deviations with cleft lip were classified into 3 types: I, deviated bony pyramid, II, deviated cartilaginous pyramid; III, deviated lobular. The surgical treatment included surgical correction of deviated bony pyramid, deviated cartilaginous pyramid, deviated lobular and deviated septa. RESULTS: Among the 176 patients, there were 97 males and 79 females, aging from 16 to 42 years with a mean of 20. There were 93 patients without deviated and 83 patients with deviated. Among the 83 deviated patients, deviated bony pyramid was found in 8 (10%), deviated cartilaginous pyramid in 29 (35%), deviated lobular in 46 (55%). Most patients who underwent surgical correction were satisfied. CONCLUSIONS: There were nearly half of the unilateral cleft lip nasal deformity presenting with deviated noses. There was least deviated bony pyramid and most deviated lobular in the unilateral cleft lip deviated nose. The proposed classification for the deviated nose with unilateral cleft lip could serve as a practical guide for surgical planning.

[Treatment of cleft lip and palate: past, present and future].

Comparing the survey results of 224 Centers of Cleft Lip and Palate in the United States with the current status in China, and reviewing the experience and lessons systemically, we could get a conclusion that the repair of cleft lip and palate depends on the experience and excellent skills of the surgeons, and its important role in combined and sequential treatment (team approach) of cleft lip and palate should not be ignored. The team approach program requires multidisciplinary cooperation and good compliance of the patients. In order to improve the treatment outcomes of cleft lip and palate, it is necessary for us to study the advanced program and methods and combined the situation of our country.

[A preliminary study of the influence of different consonants on the vowel in normal people].

PURPOSE: To study the influence of different consonants on the vowel in normal people for guiding research and treatment of cleft palate misarticulations. METHODS: 35 normal students including 15 males and 20 females were selected for this study. The average age was 20.43 year. The six test syllables were divided into three groups: /si/-/ji/, /bo/-/po/ and /jü/-/qü/. The measured indexes of vowel, which were input into CSL4400, were duration (Dur), pitch, the first three formants (F1, F2, F3) and energy (E). The acoustic features of the vowel of each group were compared by SPSS software with Paired t test. RESULTS: Dur of the vowel was 0.39+/-0.08 in /si/ and 0.31+/-0.07 in /ji/, F2 of the vowel was 2093.55+/-350.62 in /si/ and 2454.33+/-422.00 in /ji/, there was significant difference in Dur and F2 between the vowels of /si/-/ji/ (P<0.01); Dur of the vowel was 0.35+/-0.09 in /bo/ and 0.53+/-0.07 in /po/, E of the vowel was 64.11+/-4.58 in /bo/ and 69.94+/-3.59 in /po/, there was significant difference in Dur and E between the vowels of /bo/-/po/ (P<0.01); Dur of the vowel was 0.29+/-0.07 in /jü/ and 0.35+/-0.09 in /qü/, F3 of the vowel was 3180.30+/-301.72 in /jü/ and 2901.06+/-259.75 in /qü/, E of the vowel was 68.99+/-4.59 in /jü/ and 71.70+/-5.21 in /qü/, there was significant difference in Dur, E and F3 between the vowels of /jü/-/qü/ (P<0.05). CONCLUSIONS: It is suggested that the aspiration of the consonant, the part and the extent of the block of the consonant could affect the next vowel, but couldn't change its quality.

[Primary study of pharyngeal flap surgery in congenital velopharyngeal insufficiency].

OBJECTIVE: To study effective operation method of congenital velopharyngeal insufficiency by reviewing clinical data of 29 patients with pharyngoplasties. METHODS: 29 patients (9 male and 20 female, ranged from 4 to 25 years old, mean age was 13.5) with congenital velopharyngeal insufficiency were available for this study. All cases received Chinese speech intelligibility test and blowing test before and after the pharyngeal flap surgery. RESULTS: Chinese speech intelligibility of 29 cases who underwent pharyngoplasties was improved from 33.86% to 43.13%, and the blowing time was increased from 4.60 to 17.72 seconds, the degree of abnormal speech was reduced. CONCLUSION: The pharyngeal flap surgery is an effective method for congenital velopharyngeal insufficiency, which reduces hypernasality and increases oral pressure, improves the velopharyngeal function.

[An evaluation of the speech therapy methods for patients after pharyngoplasty.].

PURPOSE: Speech therapy was carried out for patients with speech disorders after pharyngoplasty, and the comparison of speech articulation before and after treatment, was done to evaluate the new method. METHODS: 82 patients with the varying age from 4 to 31 years were included in the current study. The patients' speeches including syllables, word, phrase and sentence were compared before and after treatment according to Chinese Speech Intelligibility Testing Form. The systematic speech training was carried out according to the compensatory articulation characteristics. The steps were as follows. Firstly, the function of velopharyngeal closure should be strengthened. Secondly, the patients were trained with an average duration of 3.83 months (range from 1.5-12 months) according to the following three sequences: One was from phoneme, syllables, phrase, sentence to short paragraph or dialogue, another was from anterior to posterior according to the speech position, and the other was from easy to difficult according to the articulation method, such as from aspirated syllables to non-aspirated syllables, from plosive, fricative to affricative. RESULTS: There were 71 patients with compensatory articulation characteristic of velopharyngeal incompetence, the speech articulation of patients with glottis plosive increased from preoperative 46.27% to postoperative 97.16% (P<0.001). The speech articulation of patients with pharynx fricative increased from preoperative 57.19% to postoperative 97.72% (P<0.001). There were 11 patients with compensatory articulation characteristic of velopharyngeal adequacy, and the speech articulation of 11 patients with palatalized and lateral misarticulation increased from preoperative 71.10% to postoperative 98.55% (P<0.001). CONCLUSIONS: The training of velopharyngeal closure should be emphasized on the patients with compensatory articulation resulting from velopharyngeal incompetence after pharyngoplasty, then the correct speech position and method was established. While to the patients with compensatory articulation without velopharyngeal incompetence after pharyngoplasty, the correct speech position and method could be directly established.

[Surgery for velopharyngeal insufficiency: a review of 219 modified pharyngoplasties].

OBJECTIVE: Two-hundreds and nineteen velopharyngeal insufficiency cases treated with a modified pharyngoplasty were retrospectively analyzed, the effectiveness of the surgery was studied. METHODS: Two-hundreds and nineteen patients (111 males, 108 females, range from 4 to 33 years, mean age 14.2 years) with velopharyngeal insufficiency were studied. Among 219 patients, 44 with congenital velopharyngeal insufficiency, 21 with fistula after palatoplasty and 154 with velopharyngeal insufficiency after primary palatoplasty. All cases had special examination, Chinese speech intelligibility test and blowing test before and after modified pharyngoplasty. RESULTS: Hypernasality in all cases were reduced and blowing test increased with various degrees. The Chinese speech intelligibility rose from 41% to 63%. CONCLUSIONS: The modify pharyngoplasty is a safe and effective method for velopharyngeal insufficiency of patient.

[A preliminary study on speech therapy for adult cleft palate patients].

OBJECTIVE: To study speech feature and treatment of adult with misarticulation by review 20 patients' clinical information. METHODS: 20 adult patients (10 male, 10 female, age ranging from 20 to 38 years, mean age 20.35 years) with misarticulation were available for this study. All received specialized examination, Chinese speech intelligibility test and blowing test before speech treatment, 17 cases underwent posterior pharyngeal flap operation before speech treatment. Speech treatment included audio discrimination, behaviour training, lip phone training, aspirates and fricatives training, tongue lolling out, comprehensive training, et al. RESULTS: All cases were restored normal speech approximately after speech treatment, consonants loss and hypernasality of some patients totally disappeared. But there were some complications in speech treatment of 4 cases. CONCLUSION: The outcome of appropriate adult speech treatment was satisfactory, though adult speech treatment was more difficult than child's.

[The evaluation of the Chinese intelligibility of patients with velopharyngeal incompetence].

OBJECTIVE: To study the Chinese intelligibility of patients with velopharyngeal incompetence (VPI). METHODS: 100 patients with VPI and 32 normal students were selected for this study. Of 10 patients, 15 with cleft palate, 21 with congenital velopharyngeal incompetence, 56 with post-palatoplasty VPI and 8 with post-pharyngoplasty VPI. Chinese intelligibility was measured by three speech pathologists and relation between degree of abnormal articulation and Chinese intelligibility were studied. RESULTS: Chinese intelligibility of the controls was 99.0% and the patients with VPI were 35.2%. Of the patients, the cleft palate was 19.9%, the congenital velopharyngeal incompetence was 32.8%, the post-palatoplasty VPI was 40.3% and the post-pharyngoplasty VPI was 35.2%. The data showed obvious difference among the controls and sub-types of VPI (P < 0.01). CONCLUSIONS: (1) Chinese intelligibility of VPI accompanied with hypernasality is worse. (2) Of misarticulation of VPI, the cleft palate is the worst, in turn the others are the congenital velopharyngeal incompetence, the post-pharyngoplasty VPI and the post-palatoplasty VPI.

[The study on the acoustic features of congenital velopharyngeal insufficiency in 28 patients].

OBJECTIVE: To study the acoustic features of the patients with congenital velopharyngeal insufficiency (CVPI). METHODS: The acoustic features of 28 patients with CVPI were analyzed with the computer speech lab, contrasted by the features of 20 controls. RESULTS: There was significant difference in F2, B2, F3, B3 and VOT between the patients and the controls (P<0.05). It was not same on every syllable; From phonetic images, F1, F2 and F3 of the controls were more clear than those of the patients, the other districts of the controls were lighter than those of the patients. F1 of the patients was darker and broader, their F2 and F3 were lower, weaker and broader. Among F1, F2 and F3 of the patients, there were some extra FORMANTs. Erected stripes and fills before the vowel of the patients were fewer than those of the controls. CONCLUSION: There were apparent distinctions in F2, B2, F3 and B3 between the patients and the controls, and there was significant difference in phonetic images of two groups, especially in FORMANTs, and consonants.

[Clinical practice of behavior therapy in speech treatment].

OBJECTIVE: To apply behavior therapy to treat patients with velopharyngeal insufficiency(VPI),with the aim of improving speech treatment. METHODS: 20 patients(10 male, 10 female,ranged from 4.0 to 38.4 years, mean age 17.8 years)with VPI were available for this study. Of 20 patients, 5 with congenital velopharyngeal insufficiency,10 with posterior pharyngeal flap,5 with palatoplasty. Behavior therapy was adopted in speech treatment. The quantitative measurement of Chinese speech intelligibility and blowing test was carried out before speech therapy and after speech therapy. RESULTS: The effect of behavior therapy in speech treatment was satisfied. Their Chinese speech intelligibility and blowing test after speech therapy were obviously better than before. CONCLUSION: The behavior therapy is a very effective method in speech in treatment, but it was important to select indications and treat individually.

[Intelligence evaluation of 22 patients with congenital velopharyngeal incompetence].

OBJECTIVE: To study the intelligence of 22 patients with CVPI. METHODS: We examined the IQ of 22 patients with CVPI by Wechsler Primary Preschool Scale of Intelligence (WPSSI) and Wechsler Intelligence Scale for Children-Revised (WISC-R). RESULTS: The IQ of patients with CVPI was 44-109. The mean value and SD were 67.46+/-19.29. Patients with normal IQ accounted for 45.5%. 54.5% of patients with CVPI had mental retardation (MR), most of which were mild. CONCLUSION: More than half of the patients with CVPI showed MR. It's necessary to evaluate the intelligence in patients with CVPI, and give treatment as early as possible.