Histological response to combination therapy with nucleos(t)ide analogs and peginterferon alpha in treatment-naïve chronic hepatitis B patients.

Although nucleos(t)ide analog (NA) monotherapy is effective in hepatitis B virus suppression and fibrosis regression, serological response rates are not satisfactory. Studies assessing the benefits of combination therapy with NAs and peginterferon alpha (PegIFNα) in patients with chronic hepatitis B (CHB) have produced conflicting results and mainly focused on serological outcomes. Histological changes in response to combination therapy have not been evaluated in real-world practice. This study aimed to evaluate the histological changes in response to NA-PegIFNα combination therapy in CHB patients and to comprehensively compare the efficacy of NA-PegIFNα combination therapy and NA monotherapy. We conducted a retrospective analysis of data from 40 CHB patients who underwent either NA-PegIFNα combination therapy or NA monotherapy. Changes in histology at 48 weeks after treatment initiation were evaluated. Serological characteristics were also analysed and compared between the NA-PegIFNα combination therapy and NA monotherapy groups and between histological responders and nonresponders. Compared to baseline biopsies, both fibrosis staging and necroinflammatory grading scores were significantly lower in the second biopsies examined post-treatment in both groups. Nearly all patients experienced a reduction in inflammation (87.5% in both groups), but there was a subgroup of patients who exhibited either no significant improvement or fibrosis progression (33.3% and 31.2% in the NA monotherapy and NA-PegIFNα combination therapy groups, respectively). Nearly, all patients achieved ALT normalization and sustained virological response (SVR) after 48 weeks of antiviral treatment. Approximately one-third of individuals (36.8% and 30% in the two groups, respectively) achieved HBeAg loss at 48 weeks after treatment initiation. Although there were no significant differences in overall rates of histological, biochemical, virological and serological responses between the two groups, an earlier virological response and a higher cumulative SVR rate over time were observed during long-term follow-up in patients treated with NA-PegIFNα combination therapy (P = 0.0129). Trends of more rapid HBeAg loss and a higher cumulative HBeAg loss rate throughout long-term follow-up were also observed but were not statistically significant. The ALT normalization rates at 24 and 48 weeks after treatment initiation were associated with the histological response. Significant regression of fibrosis and resolution of necroinflammation were induced with either NA-PegIFNα combination therapy or NA monotherapy. Significant biochemical, virological and serological responses were observed in both groups, and the response rates at 48 weeks were similar in the two groups. Over time during long-term follow-up, the virological and serological responses were faster and superior following the combination regimen.

Histological responses of peginterferon alpha add-on therapy in patients with chronic hepatitis B with advanced liver fibrosis after long-term nucleos(t)ide analog treatment.

Although long-term antiviral treatment with nucleos(t)ide analogs (NAs) can lead to histological improvement in patients with chronic hepatitis B (CHB), a substantial proportion of patients still fail to achieve regression of fibrosis. Here, we investigated whether peginterferon alpha (Peg-IFNα） add-on therapy had benefits on fibrosis regression in patients with sustained severe fibrosis even after long-term NA treatment. We conducted a retrospective analysis of data from 50 patients with CHB receiving 48 weeks of Peg-IFNα add-on therapy. All enrolled patients had advanced fibrosis or cirrhosis (S score ≥ 3) at baseline and underwent NA treatment for at least 1 year before Peg-IFNα addition. Paired liver biopsies before and after Peg-IFNα add-on treatment and laboratory tests at baseline, 24 weeks of treatment, 48 weeks of treatment and long-term follow-up were analysed. Of the 50 patients enrolled in this study, 34 patients (68.0%) had significant regression of fibrosis, and 42 (84.0%) showed significant remission of inflammation after Peg-IFNα add-on treatment. Compared with nonresponders, patients with significant histological improvement showed faster hepatitis B surface antigen (HBsAg) decline and tended to have higher cumulative hepatitis B e antigen (HBeAg) and HBsAg loss rates during long-term follow-up. Peg-IFNα add-on therapy led to significant regression of fibrosis and resolution of inflammation in patients with advanced fibrosis after long-term NA treatment.

Study on Tooth Movement After the Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate.

OBJECTIVES: The aim of the study was to explore the effectiveness of the cleft-adjacent teeth moved into the grafted alveolar bone in unilateral cleft lip and palate (UCLP) patients, and to evaluate the alveolar bone support of the teeth. METHODS: Twenty unilateral cleft lip and palate patients were recruited in this study. The average age was 12 years and 8 months. Periapical radiographs were taken for the cleft-adjacent teeth 3 months after bone grafting (T1) and after teeth moving into the grafted bone (T2), and for the contralateral teeth (T3) when teeth aligned. Alveolar bone support of the moved teeth and the contralateral teeth were measured using the ratio of bone support height to root length. Paired t test was performed for statistical analysis with SPSS17.0 software package. RESULTS: All the cleft-adjacent teeth were bodily moved into the grafted area. Average alveolar bone support ratio for the moved teeth was 86.48% (T1), 87.11% (T2), and 90.81% (T3) for the contralateral teeth. There was no statistically significant difference between T1 and T2 (P > 0.05). Although the contralateral teeth had the highest alveolar bone support ratio, significant differences were found between T3 and T2 (P < 0.05). CONCLUSIONS: Cleft-adjacent teeth could be bodily moved into the grafted bone from the iliac crest in UCLP patients. A successful level of alveolar bone support for the moved teeth was achieved. Moved-in teeth could be functionally loaded and may be benefit to the reduction of the resorption of grafted bone.

Malformations of the zygomatic and maxillary regions.

The maxillofacial region develops during 3 to 8 weeks in an embryo. The process involves neural crest cell migration and proliferation as well as facial protrusion jointing and fusion. The maxillofacial region is one of the predilection sites of congenital malformations. We treated a 5-year-old Chinese boy with abnormal development of the left maxillofacial region. We describe in detail the patient's characteristics, diagnosis, and treatment processes and try to explain the possible causes of the disease.

Non-Coding-RNA-Activated Core/Chitosan Shell Nanounits Coated with Polyetheretherketone for Promoting Bone Regeneration and Osseointegration via Osteoimmunology.

Bone implant outcome and bone regeneration properties can be improved by the immunomodulation of exosomes (Exos) derived from bone marrow mesenchymal stem cells (BMSCs), which contain cytokines, signaling lipids, and regulatory miRNAs. Analysis of miRNAs in BMSCs-derived exosomes showed that miR-21a-5p exhibited the highest expression and was associated with the NF-κB pathway. Hence, we developed an implant with miR-21a-5p functionality to promote bone incorporation by immunoregulation. Mediated by the potent interaction between tannic acid (TA) and biomacromolecules, the tannic acid modified mesoporous bioactive glass nanoparticles coated with miR-21a-5p (miR-21a-5p@T-MBGNs) were reversibly attached to TA-modified polyetheretherketone (T-PEEK). Cocultured cells could phagocytose miR-21a-5p@T-MBGNs slowly released from miR-21a-5p@T-MBGNs loaded T-PEEK (miMT-PEEK). Moreover, miMT-PEEK boosted macrophage M2 polarization via the NF-κB pathway to increase BMSCs osteogenic differentiation. In vivo testing of miMT-PEEK in the rat air-pouch model and rat femoral drilling model indicated effective macrophage M2 polarization, new bone formation, and excellent osseointegration. Overall, the osteoimmunomodulation of the miR-21a-5p@T-MBGNs-functionalized implant promoted osteogenesis and osseointegration.

In situ sprayed hydrogels containing resiquimod-loaded liposomes reduce chronic osteomyelitis recurrence by intracellular bacteria clearance.

At present, surgical debridement and systematic administration of antibiotics represent the mainstay of treatment for chronic osteomyelitis. However, it is now understood that Staphylococcus aureus (S. aureus) can survive within excessively polarized M2 macrophages and evade antibiotics, accounting for the high recurrence of chronic osteomyelitis. Effective treatments for intracellular infection have rarely been reported. Herein, we designed an in situ sprayed liposomes hydrogels spray with macrophage-targeted effects and the ability to reverse polarization and eradicate intracellular bacteria to reduce the recurrence of osteomyelitis. Resiquimod (R848)-loaded and phosphatidylserine (PS)-coating nanoliposomes were introduced into fibrinogen and thrombin to form the PSL-R848@Fibrin spray. Characterization and phagocytosis experiments were performed to confirm the successful preparation of the PSL-R848@Fibrin spray. Meanwhile, in vitro cell experiments validated its ability to eliminate intracellular S. aureus by reprogramming macrophages from the M2 to the M1 phenotype. Additionally, we established a chronic osteomyelitis rat model to simulate the treatment and recurrence process. Histological analysis demonstrated a significant increase in M1 macrophages and the elimination of intracellular bacteria. Imaging revealed a significant decrease in osteomyelitis recurrence. Overall, the liposome hydrogels could target macrophages to promote antibacterial properties against intracellular infection and reduce the recurrence of chronic osteomyelitis, providing the foothold for improving the outcomes of this patient population. STATEMENT OF SIGNIFICANCE: Chronic osteomyelitis remains a high recurrence although undergoing traditional treatment of debridement and antibiotics. S. aureus can survive within the excessively polarized M2 macrophages to evade the effects of antibiotics. However, few studies have sought to investigate effective intracellular bacteria eradication. Herein, we designed a macrophage-targeted R848-containing liposomes fibrin hydrogels spray (PSL-R848@Fibrin) that can reprogram polarization of macrophages and eradicate intracellular bacteria for osteomyelitis treatment. With great properties of rapid gelation, strong adhesion, high flexibility and fit-to-shape capacity, the facile-operated immunotherapeutic in-situ-spray fibrin hydrogels exhibited huge promise of reversing polarization and fighting intracellular infections. Importantly, we revealed a hitherto undocumented treatment strategy for reducing the recurrence of chronic osteomyelitis and potentially improving the prognosis of chronic osteomyelitis patients.

Zeolitic Imidazolate Framework-8 with Encapsulated Naringin Synergistically Improves Antibacterial and Osteogenic Properties of Ti Implants for Osseointegration.

Titanium (Ti)-based implants are widely utilized in artificial joints, pedicle screws, and dental implantations due to their excellent biocompatibility, near perfect mechanical capacities, and strong corrosion resistance. However, the Ti substrates are bioinert and lack desirable antibacterial abilities, severely hindering their bone regeneration applications. Herein, the titania nanotubes (TNTs) are fabricated onto the Ti surfaces through anodic oxidation. They are then modified with naringin (Nar)-loaded zeolitic imidazolate framework-8 (ZIF-8) in order to obtain a multifunctional coating (TNT-ZIF-8@Nar) via hydrothermal treatment. The TNT-ZIF-8@Nar exhibits excellent pH-responsive properties and a strong antimicrobial effect against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) by releasing Zn2+ and Nar. TNT-ZIF-8@Nar coatings significantly enhance the proliferation and osteogenic differentiation of osteoblasts. Furthermore, in vivo studies demonstrated the efficacy of TNT-ZIF-8@Nar coatings in improving osseointegration and antibacterial capabilities. This work shows the promising therapeutic potential of TNT-ZIF-8@Nar in its ability to inhibit implant-associated infections and achieve favorable osseointegration simultaneously.

Three-dimensional reconstruction of maxillae using spiral computed tomography and its application in postoperative adult patients with unilateral complete cleft lip and palate.

PURPOSE: To establish a method to analyze malformed maxillae of postoperative adult patients with unilateral complete cleft lip and palate in 3 dimensions. MATERIALS AND METHODS: A total of 35 landmarks were defined and used to reconstruct 3-dimensional maxillary images of healthy Chinese Han subjects and 30 postoperative Chinese Han adult patients (17 men and 13 women, with mean age of 19.07 years) with unilateral complete cleft lip and palate. This was done using spiral computed tomography, and their corresponding parameters were analyzed using SimPlant software, version 11.04, and compared by t test using SAS software, version 6.12. RESULTS: Of the 7 centered landmarks, A and ANS in the patients were obviously deviated to the nonoperative side (P < .01) and the symmetrical landmark pairs INM'-INM, SNM'-SNM and SPr'-SPr, but not MA'-MA, SoF'-SoF, and LPAC-LPA in the infraorbital region and piriform aperture peritreme in healthy subjects were shifted toward the coordinate sagittal plane S. The data also showed that the maxillae in the patients' operative side were hypoplastic, especially in the posteroanterior direction compared with the nonoperative side and healthy subjects. CONCLUSIONS: The proposed method can precisely measure the distances of the maxillary landmarks to 3-dimensional coordinates and has application potential in evaluating maxillary deformity in patients with postoperative unilateral complete cleft lip and palate.

Influence of alveolar-bone grafting on the nasal profile: unilateral cleft lips, alveoli, and palates.

PURPOSE: Secondary bone grafting plays an important role in the multimodal therapy of patients with cleft lips, alveoli, or palates. Through a comparative study of the nasal profile before and after alveolar bone grafting, this article aimed to determine the appropriate timing of operation and keys to success. METHODS: In the study, 38 cases (23 boys and 15 girls aged 9-13 years, with an average of 11.4 years) were examined of patients with unilateral cleft lips or palates, upon whom secondary bone grafting was performed under general anesthesia. Comparative studies are conducted on their nostril widths and heights in both the cleft side and the noncleft side as well as the widths and angles of the alar bases measured in the preoperative, postoperative, and follow-up (6 months) periods respectively. RESULTS: Of the 29 cases examined 6 months after the operation, 4 indicate failure as the amount of bone loss exceeds 50%, whereas in the other 25 cases, both the nostril widths of the cleft side have increased, and the nostril heights of the cleft side have decreased significantly (P < 0.01). CONCLUSIONS: As shown in the study, the nasal profile after alveolar bone grafting is changed obviously; thus, it is recommended that patients not receive rhinoplasty before bone grafting or have both operations at the same time.

Utilization of three-dimensional computed tomography for craniofacial phenotypic analysis in children with velocardiofacial syndrome.

OBJECTIVES: To analyze variants of the craniofacial phenotypes in children with velocardiofacial syndrome (VCFS) and children with cleft palates with a new protocol of landmarks using a three-dimensional computed tomography (CT)-reconstructed model in a cross-sectional group experimental design. MATERIALS AND METHODS: We present a retrospectively reviewed case series of 21 patients with VCFS, verified by short-tandem repeat techniques, and 20 children with cleft palate with age- and sex-matched controls from the Craniofacial Cleft Department of Oral and Maxillofacial Surgery of the 9th Shanghai People's Hospital. The records during the period between January 2005 and December 2008 were analyzed. The sample population of 41 children in this study was scanned with spiral CT. These images were reconstructed into three-dimensional models by SimPlant 11.2 and were analyzed with a new protocol of landmarks to test the variants of craniofacial phenotypes. RESULTS: All of the children with VCFS demonstrated velopharyngeal incompetence and craniofacial deformities. Measurements in the standard coordinate system demonstrated significant shorter cranial base, cervical vertebrae, longer maxilla height, and palatal angle. For the velopharyngeal variants, greater depth but lesser width of the pharyngeal cavity was shown in the VCFS group. CONCLUSIONS: Three-dimensional CT can provide precise data on craniofacial variants in children with distinctive morphologic features of VCFS.

Correction of labial tubercle defect in repaired bilateral cleft lips using bilateral vermilion musculomucosal sliding flaps: Case series.

RATIONALE: Insignifificant, asymmetrical or lack of labial tubercle often occurs after cleft lip surgery due to improper treatment of vermilion tissue. Especially in the cases of bilateral cleft lip, because of short front lip and insuffificient vermilion tissue, the median vermilion depression often occurs after surgery, forming a "whistling" deformity. The object of this study is to verify the outcomes of patients with median labial tubercle detects after treatment with bilateral vermilion musculomucosal sliding flflaps (VMSF). PATIENT CONCERNS: Six patients with median labial tubercle defect after bilateral cleft lip repair from March 2015 to May 2017 were enrolled in our department and subjected to bilateral lip deformity correction under general anesthesia. DIAGNOSES: Secondary deformity of bilateral cleft lip forming a "whistling" deformity were diagnosed in all the patients. INTERVENTIONS: Bilateral VMSF were designed and used to reconstruct the median labial tubercles by sliding downward so as to eliminate the whistling deformity. OUTCOMES: During the 10 to 37 months of follow-up, the reconstructed vermilion tubercles had stable morphology showing no whistling deformity and the overall lip shapes were satisfactory. LESSONS: Reconstructing MVTD and eliminating whistling deformity using the scar tissues that need to be removed previously on the vermilion musculomucosa has achieved stable and satisfactory results and is worthy of clinical application.

Characterization of aqueous dispersions of Fe(3)O(4) nanoparticles and their biomedical applications.

A newly developed non-polymer coated Fe(3)O(4) nanoparticles showing well-dispersion were synthesized using Fe(II) and Fe(III) salt chemical coprecipitation with tetramethylammonium hydroxide (N(CH(3))(4)OH) in an aqueous solution. Transmission electron microscopy (TEM), X-ray diffraction (XRD), Fourier transform infrared spectrometer (FT-IR), X-ray photoelectron spectrometer (XPS) and superconducting quantum interference measurement device (SQUID) measurements were employed to investigate the iron oxide properties. The resulting iron oxide particles were manipulated to be as small as 9 nm diameter in size. Based on FT-IR and X-ray photoelectron spectrometer results, it is suggested that the surfaces of the magnetite (Fe(3)O(4)) particles are covered with hydroxide (-OH) groups incorporated with (CH(3))(4)N(+) through electrostatic interaction. The in vitro cytotoxicity test revealed that the magnetite particles exhibited excellent biocompatibility, suggesting that they may be further explored for biomedical applications. NMR measurements revealed significantly reduced water proton relaxation times T1 and T2. The MR images of the nanoparticles in water, serum, and whole blood were investigated using a 1.5 T clinical MR imager. Significant reduction of the background medium signal was achieved in the T2-weighted and the T2*-weighted sequence especially in the serum and whole blood. Combining the advantage of MRI signal contrast, the non-polymer-coated surface chemistry for distinct bioconjugation and the homogenous nanometer size for better controlled biodistribution, these preliminary experiments demonstrated the potential of the as-synthesized magnetite material in functional molecular imaging for biomedical research and clinical diagnosis.

[Effect of the presurgical nasoalveolar molding using computer-aided design technique].

OBJECTIVE: To develop a new method of presurgical nasoalveolar molding based on computer-aided design technique. METHODS: Twenty patients(16 boys, 4 girls) with complete unilateral cleft lip and palate(UCLP) who received presurgical nasoalveolar molding were recruited as the treatment group. Twenty patients(15 boys, 5 girls) with complete UCLP who did not receive presurgical orthopedic treatment were selected as the control group. All parameters of the digital maxillary model were measured using the Rapidform XOR3 software. The statistical analysis was performed with SPSS 15.0. RESULTS: A'-X and B-Il were reduced significantly after presurgical nasoalveolar molding. However, the mean alveolar height [F- hight (3.7 ± 1.1) mm, F'-height (4.6 ± 0.9) mm] decreased significantly after treatment(P <0.05). There were significant differences between the treatment group and the control group(P<0.05). CONCLUSIONS: Maxillary alveolar morphology could be improved in UCLP infants treated with computer-aided presurgical nasoalveolar molding. The width of the cleft could be reduced and the maxillary midline corrected effectively. However, the alveolar height decreased significantly after the treatment.

Multiple congenital granular cell epulis in a female newborn: a case report.

INTRODUCTION: Congenital granular cell epulis is an uncommon tumor which is apparent at birth. CASE PRESENTATION: Here we report an unusual case of congenital granular cell epulis present in the mouth of a 4-day-old Asian Chinese female newborn. She had six round, soft, multiple, pedunculated swelling masses, of which two were on her upper anterior ridge and four on her lower anterior ridge. The size of the largest lesion was 3.5×3cm, which was causing difficulty in feeding. CONCLUSIONS: The case of a patient with congenital granular cell epulis was reported here because of its rarity. The lesions were surgically removed and satisfactory results were achieved.

Severe bilateral Tessier 3 clefts in a Uighur girl: the significance and surgical repair.

The Tessier 3 cleft is one of the rarest congenital craniofacial clefts, which often extends through the upper lip, the alar groove and the medial canthus. Only a few cases have been reported. There is no standardized method for the surgical treatment for this condition in the literature, and to obtain an acceptable outcome is difficult. A Uighur girl with severe bilateral Tessier 3 clefts and associated orofacial deformities is described here, and a novel protocol for clefts of this severity and rarity is presented. This study focuses particularly on describing the surgical procedures and techniques. Further treatments required for the cleft-associated deformities during later growth and developmental stages are also discussed in detail.

Chondrogenesis of myoblasts in biodegradable poly-lactide-co-glycolide scaffolds.

Myoblasts are considered to be an alternative cell source for cell-based meniscal repair due to their multiple differentiation potentials. This study addresses the chondrogenic differentiation of myoblasts seeded into poly-lactide-co-glycolide (PLGA) scaffolds following implantation in a subcutaneous pocket of nude mice. Canine myoblasts isolated from a Beagle were expanded and seeded into PLGA scaffolds and cultured in cartilage-derived morphogenetic protein-2 (CDMP-2) and transforming growth factor-ß1 (TGF-ß1)-containing medium for 2 weeks in vitro. The constructs were implanted into a subcutaneous pocket of 24 combined immunodeficiency mice and harvested after 8 and 12 weeks, respectively. Hematoxylin and eosin staining of the sections of the engineered cartilage at 8 and 12 weeks revealed the regeneration of fibrocartilage. Immunohistochemical staining confirmed a similar distribution of collagen type â…¡ in the engineered cartilage as the normal meniscus. At 12 weeks, expression of mRNAs for type â…  collagen, type â…¡ collagen and aggrecan was detected by RT-PCR. The compressive moduli of engineered cartilage reached 85.72% of the normal meniscus at 12 weeks, with a high level of glycosaminoglycan (GAG) content (no statistical difference from normal). Myoblast-seeded PLGA scaffolds express a stable chondrogenic phenotype in a heterotopic model of cartilage transplantation and represent a suitable tool for tissue engineering of cartilage.

Investigation of cell wall composition related to stem lodging resistance in wheat (Triticum aestivum L.) by FTIR spectroscopy.

We explored the rapid qualitative analysis of wheat cultivars with good lodging resistances by Fourier transform infrared resonance (FTIR) spectroscopy and multivariate statistical analysis. FTIR imaging showing that wheat stem cell walls were mainly composed of cellulose, pectin, protein, and lignin. Principal components analysis (PCA) was used to eliminate multicollinearity among multiple peak absorptions. PCA revealed the developmental internodes of wheat stems could be distributed from low to high along the load of the second principal component, which was consistent with the corresponding bands of cellulose in the FTIR spectra of the cell walls. Furthermore, four distinct stem populations could also be identified by spectral features related to their corresponding mechanical properties via PCA and cluster analysis. Histochemical staining of four types of wheat stems with various abilities to resist lodging revealed that cellulose contributed more than lignin to the ability to resist lodging. These results strongly suggested that the main cell wall component responsible for these differences was cellulose. Therefore, the combination of multivariate analysis and FTIR could rapidly screen wheat cultivars with good lodging resistance. Furthermore, the application of these methods to a much wider range of cultivars of unknown mechanical properties promises to be of interest.

[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.

[The role of inter-dental consonant si in treating articulation disorders].

PURPOSE: The aim of this study was to rectify deviant tongue position and make accurate pronunciation via making use of the protrusion and containment effect of interdental consonant [si] for the tongue. METHODS: One hundred and fifty-seven patients with articulation disorders (postpalatoplasty and non-cleft palate) which were diagnosed as velopharyngeal sufficiency were included in this study. There were 111 males and 46 females, aging from 5 to 28 years old. Among them,29 patients were pharyngeal fricative, 73 patients were palatalized misarticulation, 36 patients were lateralization misarticulation and 19 patients were misarticulation mixed with palatalized and lateralization. During the treatment, the patients were asked to stick out the tongue to make the tooth gently biting it and pronounce a interdental consonant si smoothly. When the tongue was fully protracted, the tongue was retracted to the lingual side of mandibular anterior teeth to produce a normal apex linguae consonant [s]. RESULTS: This training method had a significant effect for patients with articulation disorders. The effect was most significant for patients with pharyngeal fricative, with a effective rate of 96.55%(28/29), followed by 91.78%(67/73) in palatalized misarticulation, 84.21%(16/19) in palatalized mixed with lateralization misarticulation, and 77.78%(28/36) in lateralization misarticulation. CONCLUSION: Training the pronunciation of interdental consonant [si] may control the retrusion, arching and curling movement of tongue, which therefore provides an effective treatment for articulation disorders such as pharyngeal fricative, palatalized and lateralization misarticulation. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality (Grant No.08DZ2271100), Shanghai leading Academic Discipline Project (Grant No.S30206), Research Fund of Bureau of Health of Shanghai Municipality(Grant No.2008160) and Phosphor Science Foundation of Educational Commission of Shanghai Municipality (Grant No.2000SG41).

[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.