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Objective@#Velopharyngeal insufficiency (VPI) is a common postoperative sequela secondary tocleft palate. It could significantly impairpatients′living quality. Treatment of VPI includes surgery and speech therapy, but the reported success rates are inconsistent. A consensus in the literatures is needed, to guide procedure selection for patients with VPI.@*Methods@#This is a retrospective study on management options for patients with VPI.This study systematically introduces the assessment, management plan and treatment effect of VPI, in the Craniofacial center of Hospital Stomatology of Xi′an Jiaotong University.The challenges of VPI diagnosis and treatment with cleft palate are discussed in-depth.@*Results@#Most patients with VPI underwent evaluation and treatment (surgical or/and speech therapy) had speech improvement. The average value of hypernasality decreased from 3.67 before interventions to 1.57 after interventions.A multidisciplinary team using multi-modal to evaluate velopharyngeal function and speech. All patients had no bleeding, would dehiscence or fistula postoperatively. The difficulty of stimulability test was significantly reduced. Fourteen patients completed speech therapy, with the averaged treatments period of 3 months.@*Conclusions@#Speech pathologist is the manager of speech rehabilitation of cleft palate patients with VPI. The operation skill plays a key role in the treatment of VPI. Detailed diagnostic information is important for performing excellent surgical techniques. The cooperation of surgeon and speech pathologist, could be helpful to achieve the final speech rehabilitation.
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The development of an expert consensus based on specific domestic situations will provide practical guidance to the efforts aiming at improving cleft care in China. The team approach of twenty-one cleft centers were pooled together, covering pre-surgical orthopedics, primary surgical repair, orthodontic treatment, alveolar bone graft, secondary deformity correction, palatal fistulae repair, the diagnosis and treatment of velopharyngeal incompetence, speech therapy, otitis media management, and skeletal deformity correction. Agreement was achieved among the authors concerning the application of critical surgical and non-surgical techniques. The ambition of this consensus is to introduce more clinicians to the revolution of sequential treatment of clefts, and form the basis for a more comprehensive cleft care manual in the future.
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Labio Leporino , Injerto de Hueso Alveolar , Humanos , Insuficiencia VelofaríngeaRESUMEN
Objective To compare clinical-pathological features and Ki-67 expression profile between TNBC and Non-triple-negative cancer (NTNBC). Methods The expressions of ER, PR and HER2 were examined by immunohisto?chemical Envision double staining in 226 cases of breast cancer. All cases were divided into triple-negative and non-triple-negative group according to expressions of these three episodes. And Ki-67 expressions in two groups were assessed by im?munohistochemical method. The difference of Ki-67 positive index between these two groups and the difference of Ki-67 positive index between different clinical-pathological features were both analyzed by comparative analysis. Results In pa?tients with TNBC, tumor size, lymph node metastasis rate and Ki-67 index were all significantly higher than that in NTNBC. No significant difference in age and histological grade were detected between these two groups. The expression of Ki-67 was not significant correlated with age, tumor size,lymph node status and histological grade in these two groups. Conclusion Patients with triple-negative breast cancer were with larger tumor size, higher proliferation, more lymph node metastasis and poorer prognosis.
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Objective:To study the correlation between early postsurgery phonetic acquisition of speech stop and speech outcomes of young children.Methods:28 children with cleft palate were included in the study.An one-stage palatal repair procedure was per-formed by one surgeon for the children before the age of 1 8 months.Naming tests were used in the speech therapy room when the chil-dren were aged 23 months and 30 months.Stop consonant inventory number,percent correct consonants(PCC),percent correct man-ners(PCM)and percent correct places(PCP)were analyzed.Results:Number of stop consonant was significantly correlated with PCC,PCM and PCP at 24 and 30 months of age in the children.Coefficient of determination between stop consonant number and PCC was 0.535.Conclusion:Speech stop may be used as the “sensitive sound”for the analysis of speech development of the chinese children aged 2-3 years after cleft palate repair and as the individuation guideline to determine the best assessment and therapy time.
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Objective:To evaluate the effect of presurgical nasal mode(PNM)combined with nasal diorthosis in the treatment of na-sal deformity and incomplete unilateral cleft lip(IUCL)in infants.Methods:35 infants with IUCL were treated by PNM followed by nasal diorthosis and cheiloplasty.The nasal asymmetry was analysed by measurments of nostrils height,nostrils width and nasal colu-mella angle skewness on the photographs at the initial visit(T0),pre-operation(T1),1 week after operation(T2),1 month after opera-tion(T3)and a year after operation(T4).The other 35 infants with IUCL without PNM treatment were served as the controls.Re-sults:Compared with the controls,the symmetry of nostrils height,nostrils width,nasal columella angle skewness in PNM treated children were significantly improved at T0-T1 and T1-T2(P <0.05).there was no significant difference at T2-T3 and T3-T4(P >0. 05).Conclusion:Nasal asymmetry can be improved by presurgical nasal mode treatment followed by preliminary nasal deformity di-orthosis and cheiloplasty.
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Purpose To study the expression of Ki-67 in breast cancer with different molecular classification, and to discuss the rela-tionship between the expression of Ki-67 and clinical pathological features in breast cancer. Methods All 245 patients with breast cancer were divided into different molecular classification through detecting the expression of ER, PR, HER-2 by immunohistochemical method. The expression of Ki-67 was also detected, and to study relationship between the expression and clinical pathological features. Results The difference of Ki-67 index was statistically significant in different molecular classification of breast cancer. Ki-67 index in patients with lymph node metastasis and larger tumor size were higher than that with no metastasis and smaller tumor size. Ki-67 index in patients with ER and PR positive were lower than that negative, the difference was statistically significant. Ki-67 expression differ-ence was not statistically significant between the two groups according to the median age (50 years old). But when patients were divid-ed into young and elderly groups by≤40 and≥60 years old, Ki-67 index in young group was more higher than that in elderly group. Conclusion Ki-67 index in patients with triple-negative breast cancer, young age, lymph node metastasis, larger tumor size and ER and PR negative were higher. Ki-67 can be used as an important indicator to determine breast cancer prognosis.
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Objective: To establish an animal model for research of maxillary protraction. Methods: 16 pubertal rabbits were assigned randomly to 2 groups. Titanium bone markers were fixed on each side of mucogingival junction, 1 cm above incisor teeth. The experimental group underwent maxillary protraction by self-made distraction devices. A down and forward elastic force (about 3.43 N) was exerted for 30 days. Results: In 30 d, the distance of premaxilla movement in the experimental group was 1.89 mm averagely, while that in the control group was only 0.11 mm. Cephalometric analysis indicated that the maxilla of rabbits was moved forward obviously by appliance in the experimental group, and maxilla was not rotated. There was no obvious difference between the control and the experimental groups. Conclusion: Animal model used in this experiment for maxillary protraction is reliable. The appliance can move the rabbits maxilla forward obviously during the maxillary protraction.