OBJECTIVEThe glucocorticoid dexamethasone (DEX) can induce palatal cleft; however, the mechanism involved remains unclear. E-cadherin is an important cell adhesion molecule, and it can significantly affect cell fate and embryonic development. Recent studies have indicated that E-cadherin expression in palatal epithelial cells is suppressed in normal palate fusion. This study aimed to determine whether the change in E-cadherin expression is related to the incidence of cleft palate in DEX-induced mice.

METHODSMice were divided into the experimental group and the control group. Pregnant mice were injected with DEX on E10.0-E12.0, whereas mice in the control group were injected with normal saline. Hematoxylin and eosin (HE) staining, immunohistochemistry, and real-time quantitative polymerase chain reaction were employed to evaluate the effect of DEX on fetal mouse palatal processes, particularly the changes in E-cadherin and β-catenin expression levels in the phases of the experimental and control groups.

RESULTSData indicated that the incidence of cleft palate in the DEX group was 43.59% (17/39), whereas that in the control group was only 3.03% (1/33). The results of HE staining showed that the obviously shortened palatal processes could not contact and fuse with one another in the DEX-treated mice model compared with those in the control group. The ectopic expression of E-cadherin in embryonic palatal mesenchymal cells was also analyzed. The expression levels of E-cadherin and β-catenin in the experimental group were higher than those in the control group.

CONCLUSIONThese findings indicated that DEX could induce E-cadherin gene upregulation and ectopic expression, as well as high β-catenin expression, thereby inhibiting the growth of mesenchyme cells and cleft palate.

Animals ; Cadherins ; genetics ; metabolism ; Cleft Palate ; chemically induced ; embryology ; Dexamethasone ; adverse effects ; Disease Models, Animal ; Epithelial Cells ; Female ; Glucocorticoids ; Immunohistochemistry ; Mice ; Pregnancy ; beta Catenin ; metabolism

OBJECTIVE: To select the optimal microwave technique for drying Weishu powder. METHODS: An orthogonal experiment was carried out to investigate the content of water in Weishu powder by taking drying time, microwave power, and granularity of the powder as indices. RESULTS:Weishu powder crushed and filtered through the sieve with 24 meshes then dried discontinuously for 6min(1.5min?4)with low-power microwave(800W?58%)achieved the best results. CONCLUSION: The optimal technique is effective and time saving .

OBJECTIVETo explore evaluation strategies for middle ear dysfunction in cleft palate patients, to optimize the diagnosis and treatment of this dysfunction, and ultimately to improve the comprehensive treatment of cleft palate.

METHODSThe relationship among abnormal tympanic types (B, C, and Anomaly), effusion rate, tympanic pressure, and hearing loss were analyzed. We collected relevant information on 469 ears of cleft palate patients and traced one-year longitudinal changes in the tympana of 124 ears from 62 patients with both cleft lip and cleft palate.

RESULTSThe effusion rates of cleft palate patients with type B, type C, and type Anomaly were 50.3% (97/193), 34.8% (8/23), and 20.9% (53/253), respectively. The tympanic pressure of the ears with and without effusion showed no significant difference (P>0.05). The hearing loss in type B cleft palate patients with middle ear effusion was worse than that in patients without effusion (P=0.001). However, the hearing loss in type Anomaly showed no difference (P>0.05). The constituent ratio of each tympanic type remained constant during the period between cheiloplasty and palatoplasty for cleft lip and palate patients (P>0.05).

CONCLUSIONCleft palate patients of all tympanic types may all suffer from middle ear effusion at different rates. Examination by centesis is suggested for ears with abnormal tympanic types. Early aggressive therapy is essential for type B cleft palate patients with middle ear effusion to avoid hearing loss. However, catheterization may be not necessary for type Anomaly patients, and conservative observation should be performed instead. Myringotomy with grommet insertion during palatoplasty does not delay treatment timing for patients with both cleft lip and cleft palateg.

Cleft Lip ; Cleft Palate ; Ear, Middle ; physiology ; Humans ; Middle Ear Ventilation ; Otitis Media with Effusion ; diagnosis ; epidemiology

Hand Deformities ; pathology ; Humans ; Klippel-Feil Syndrome ; pathology ; Thumb

Objective To analyse the clinical characterization of intraductal papillary mucinous neoplasm of pancreas (IPMNs) and to improve the understanding of IPMNs.Methods Three hundred and sixty-one patients with IPMN at Shanghai Changhai Hospital between 1993 and 2012 were retrospectively analyzed.Results Among 361 cases of IPMNs,241 were men and 120 were female,with a female to male ratio of 2.6∶1.Mean age of the patients was 62 years old (16 ～ 87 years old).The duct type included the main duct in 102 patients (28.3％),a branch duct in 109 (30.2％),and mixed ducts in 150 (41.6％).The most common symptom at presentation is pancreatitis,which occur in 167 patients (46.3％).The sensitivity for the detection of IPMN was 80.2％ by ERCP,76.9％ by MRCP,63.9％ by CT,and 50.5％ by EUS.One hundred and twenty-nine patients (35.7％) were operated and diagnosed with 87 (67.2％) IPMA,21 (16.4％) IPMB,10(8.2％) IPMC(CIS) and 10 (8.2％) had invasive carcinomas.The 5-year survival rates of IPMA,IPMB,IPMC,and invasive carcinomas were 100％,100％,66.5％,and 44.7％,respectively.Conclusions IPMNs were fregrently occured is 60 years old,half of patients had acute pancreatitis history and the frequtly attack,mixed type is most anatomy type,and the outcome after surgery is good.

Objective To explore the feasibility of second-generation dual-layer detector spectral CT ab-dominal virtual non-contrast(VNC) for diagnosing fatty liver.Methods The imaging data of 128 patients with second-generation dual-layer detector spectral CT abdominal enhanced CT in West China Hospital of Si-chuan University from June 2022 to December 2022 were retrospectively analyzed.The CT values of the left lobe,right anterior lobe,right posterior lobe and spleen of all patients were measured on TNC,arterial stage VNC (A-VNC) and venous stage VNC (V-VNC) images.The difference value (L-S) and ratio value (L/S) between the CT value of liver and CT value of spleen were calculated.According to the threshold value of TNC image diagnosis of fatty liver in previous studies,the included cases were divided into two groups:fatty liver group and non-fatty liver group.The Mann-Whitney U test was used to compare the difference of quanti-tative parameters between the fatty liver group and non-fatty liver group.The efficiency of VNC in the diagno-sis of fatty liver was evaluated by the receiver operating characteristic (ROC) curve,and the difference be-tween ROC curves was compared with DeLong's test.The intra-group and inter-group correlation coefficient (ICC) values were used to evaluate the consistency of data measurement.Results The ICC values of intra-group and inter-group consistency of data ranged (0.835-0.986) and (0.810-0.978),respectively (P<0.05).The mean value of left lobe,right anterior lobe,right posterior lobe and triple lobe of liver and CT val-ue of spleen in A-VNC and V-VNC images were lower than those of TNC images,and the differences were statistically significant (P<0.05).The CT values of TNC,A-VNC,V-VNC,(L-S) values and (L/S) values of the non-fatty liver group were higher than those of the fatty liver group,and the differences were statistical-ly significant (P<0.05).The CT value,(L-S) value and (L/S) value of TNC,A-VNC and V-VNC images in the non-fatty liver group were higher than those in the fatty liver group,and the differences were statistically significant (P<0.05).The area under the curve (AUC) of CT values of A-VNC and V-VNC for the diagnosis of fatty liver all were 0.997,and their efficiencies for diagnosing fatty liver had no statistical difference (Z=0.407,P=0.684).AUC of A-VNC (L-S) and V-VNC (L-S) in the diagnosis of fatty liver was 1.000 and 0.981,respectively,and their efficiencies for diagnosing fatty liver had no statistical difference (Z=1.790,P=0.074).AUC of A-VNC (L/S) and V-VNC (L/S) in the diagnosis of fatty liver was 0.992 and 0.987,respec-tively,and their efficiencies for diagnosing fatty liver also had no statistical difference (Z=0.665,P=0.506). Conclusion The CT values of liver and spleen in VNC images reconstructed by second-generation dual-layer detector spectral CT are lower than TNC,but it is still feasible to diagnose fatty liver based on VNC images.

ObjectiveTo?explore?evaluation?strategies?for?middle?ear?dysfunction?in?cleft?palate?patients,?to?optimize?the?diagnosis?and?treatment?of?this?dysfunction,?and?ultimately?to?improve?the?comprehensive?treatment?of?cleft?palate.?Methods?The?relationship?among?abnormal?tympanic?types?(B,?C,?and?Anomaly),?effusion?rate,?tympanic?pressure,?and?hearing?loss?were?analyzed.?We?collected?relevant?information?on?469?ears?of?cleft?palate?patients?and?traced?one-year?longitudinal?changes?in?the?tympana?of?124?ears?from?62?patients?with?both?cleft?lip?and?cleft?palate.?Results???The?effusion?rates?of?cleft?palate?patients?with?type?B,?type?C,?and?type?Anomaly?were?50.3%?(97/193),?34.8%?(8/23),?and?20.9%?(53/253),?respectively.?The?tympanic?pressure?of?the?ears?with?and?without?effusion?showed?no?significant?difference?(P>0.05).?The?hearing?loss?in?type?B?cleft?palate?patients?with?middle?ear?effusion?was?worse?than?that?in?patients?without?effusion?(P=0.001). However, the hearing?loss?in?type?Anomaly?showed?no?difference?(P>0.05).?The?constituent?ratio?of?each?tympanic?type?remained?constant?during?the?period?between?cheiloplasty?and?palatoplasty?for?cleft?lip?and?palate?patients?(P>0.05).?Conclusion???Cleft?palate?patients?of?all?tympanic?types?may?all?suffer?from?middle?ear?effusion?at?different?rates.?Examination?by?centesis?is?suggested?for?ears?with?abnormal?tympanic?types.?Early?aggressive?therapy?is?essential?for?type?B?cleft?palate?patients?with?middle?ear?effusion?to?avoid?hearing?loss.?However,?catheterization?may?be?not?necessary?for?type?Anomaly?patients,?and?conservative?observation?should?be?performed?instead.?Myringotomy?with?grommet?insertion?during?palatoplasty?does?not?delay?treatment?timing?for?patients?with?both?cleft?lip?and?cleft?palateg.

Objective:To develop a new congenital cleft palate model suitable for the evaluation of cleft palate surgery and other related treatments.Methods:Ten New Zealand female rabbits (aged 40 weeks, 4.5-5.0 kg) were selected. The next day after mating with male rabbits of the same strain was regarded as the day 1 of gestation (GD1). Ten pregnant rabbits were enrolled with intramuscular injection 1.0 mg dosage of dexamethasone once a day from GD13 to GD16. The caesarean section was performed to obtain the newborn rabbits on GD31 for each pregnant rabbit. Then the rates of the survival and cleft palate rabbits were calculated. The rabbits were divided into two groups according to the method of random number table (10 non-cleft palate rabbits as the control group and 10 cleft palate rabbits as the experimental group). The body weights and physiological behaviors of the rabbits were evaluated and recorded at the age of 1, 2 and 4 weeks respectively after being fed by using standardized gastric tube feeding method. At 4 weeks old, three rabbits in each group were randomly selected for the observation of local anatomy of different layers of the mouth and upper jaw. The anatomical results were photographed for comparative analysis.Results:In this experiment, 48 infants of 10 pregnant rabbits survived under the condition with a survival rate of 66% (48/73), among which the incidence of cleft palate was 60% (29/48). All the rabbits in the control group and the experimental group were able to survive for at least 1 month with stable weight gain. There was no significant difference in weight ( P>0.05) and physiological appearance between the two groups. In cleft palate group, most of fetuses showed complete cleft palate with significant differences in the anatomical structure of the upper jaw compared with the control group including the changes in the morphology of the palatal mucosa, the terminal distribution of the soft palate muscles, and the dysplasia and absence of bone structures along the mid-maxillary line. Conclusions:In this study, it was the first time to successfully establish the dexamethasone-induced congenital cleft palate model in New Zealand rabbits for cleft surgical research.

Objective:To examine the effect of short-term regular aerobic exercise on physical fitness of children with pulmonary with atresia ventricular septal defect after radical biventricular treatment.Methods:This was a prospective self pre-and post-control observation study. The subjects performed regular aerobic exercise for 10 days according to the exercise prescription. Body composition measurement and cardiopulmonary exercise test[lung ventilation function, maximum oxygen uptake(VO 2max), maximum oxygen pulse(O 2/HR max), ventilation oxygen uptake efficiency(OUES), exercise load time], 6 min walking distance(6MWD), sports psychometric test, motor function screening test and fitness test, were collected. The changes of test parameters and scale scoring before and after exercise were analyzed and compared. Results:A total of 7 children with PA/VSD after biventricular surgery were enrolled. The age ranged 8.2-16.2 years old, and there were 2 males and 5 females. VO 2max[(1 196.71±395.31)ml/min vs.(1 297.43±425.73)ml/min, P=0.031], O 2/HRmax[(82.43±7.53)ml/beat vs.(91.57±6.95)ml/beat, P<0.001]increased after exercise. The exercise load time was significantly increased compared with that before intervention[(476.43±35.73)s vs.(531.43±45.76)s, P=0.002]. Resting heart rate before exercise( P=0.013) and peak respiration exchange ratio(PeakRER, P=0.021) were significantly lower. Body composition tests suggest weight, intracellular water, protein and muscle content of lower limb were higher( P<0.05). The motor function score was higher than before( P=0.015); the score of sports fear was lower than before( P=0.009). There was no significant difference in lung capacity and 6-minute walking distance before and after exercise( P>0.05). There were no cardiovascular events during the study period. Conclusion:Short-term regular aerobic exercise for children with PA/VSD after biventricular surgery can improve exercise tolerance, increase lower limb muscle content, improve exercise fear and exercise function, and has good safety and feasibility.

Objective:To investigate the metabolic disorders in placental tissues of dexamethasone induced cleft palate mode.Methods:Twelve pregnant rabbits were randomly divided into dexamethasone group (experimental group, 8) and saline control group (4), and a certain amount of dexamethasone and saline were administered intramuscularly to the experimental and control groups respectively from embryonic days (ED) 13 to 16, and placental tissue samples were collected on day 21 of gestation. The corresponding profiles of the embryonic placental tissue samples were obtained by liquid chromatography-triple tandem quadrupole(LC-MS), and the metabolites of the embryonic placental tissues were characterized by principal component analysis among the dexamethasone-treated group with cleft palate (D-CP group), the dexamethasone-treated group without cleft palate (D-NCP group) and the control group.Results:There were significant metabolic differences among the D-CP group, D-NCP group and control group, with a total of 133 differential metabolites (VIP>1, P<0.05) involving in important metabolic pathways including vitamin B6 metabolism, lysine metabolism, arginine anabolic metabolism, and galactose metabolism. The four metabolites, vitamin B6, galactose, lysine and urea, differed among the three groups ( P<0.05). There were significant differences in vitamin B6 (0.960±0.249, 0.856±0.368, 1.319±0.322), galactose (0.888±0.171, 1.033±0.182, 1.127±0.127), lysine (1.551±0.924, 1.789±1.435, 0.541±0.424) and urea (0.743±0.142, 1.137±0.301, 1.171±0.457, respectively) levels among control group, D-NCP group and D-CP group ( F=5.90, P=0.008; F=5.59, P=0.009; F=4.26, P=0.025; F=5.29, P=0.012). Conclusions:The results indicated that dexamethasone induced cleft palate may be highly correlated with metabolic disorders including vitamin B6 metabolism, lysine metabolism, arginine anabolic metabolism and galactose metabolism.