Objective To investigate phonological characteristics and rehabilitation training approaches of bilabial consonant articula-tion disorders in patients after repaired cleft palate. Methods From January, 2012 to January, 2016, 51 patients with velopharyngeal incom-petence (VPI) and 57 patients with velopharyngeal competence (VPC) after cleft palate repaire were enrolled. Their phonological character-istics of bilabial consonants articulation disorders were analyzed. They accepted specific rehabilitation training. The correlation between bila-bial consonants articulation disorders and age was analyzed. Results/b/ showed mainly weak pressure in both VPI and VPC patients,/p/showed mainly weak pressure in VPI patients,/p/was mainly substituted by/b/in VPC patients. 46 cases were cured and 2 cases improved in VPI patients after 1-6 weeks of rehabilitation, and the overall cure rate was 90.20%(46/51), and was respectively 100%(13/13), 93.74%(15/16), 77.27%(17/22) in those with mild, moderate and severe disorder. 53 cases were cured and 4 cases improved in VPC patients after 1-5 weeks of rehabilitation, the overall cure rate was 92.98%(53/57), and was respectively 100%(17/17), 90.48%(19/21), 89.47%(17/19) in those with mild, moderate and severe disorder. The number of incorrect words negatively correlated with age in VPC patient (r=-1.000, P<0.001). Conclusion Bilabial consonant articulation disorders occurs mainly on/b/and/p/in patients repaired cleft palate,/b/shows main-ly weak pressure,/p/shows mainly weak pressure and substitution. Specific speech rehabilitation training is significantly effective.

Objective To study the phonological characteristics and rehabilitation methods of abnormal velar consonants in operated patients with cleft palate.Methods A total of 110 patients (60 males and 50 females, aged 4 to 27 years with the mean age as 9.01±4.12) with abnormal velar consonants after cleft palate treatment over one month were involved in this study.According to the severity of articulation disorders, the patients were divided into mild, moderate and severe groups who received 1 to 5 weeks of targeted rehabilitation training.The phonological characteristics of abnormal velar consonants and the correction between velar consonant misarticulation and age/gender were analyzed.Results The error rate of /g/ was 96.36%(106/110) which was the highest, then /k/ and /h/ was 74.55%(82/110) and 19.09%(21/110), respectively.Both /g/(80.19%, 85/106) and /h/(76.19%, 16/21) mainly showed omission while /k/ was mainly substituted by /h/(54.88%, 45/82) and /t/(29.27%, 24/82).95 cases were cured and 12 cases improved after specific rehabilitation.The overall cure rate was 86.36%.The cure rates for the mild, moderate and severe groups were 96.00%(24/25), 90.91%(30/33), and 78.85%(41/52),respectively.Males accounted for 51.76%(44/85) and females for 48.24%(41/85) among omission cases;males accounted for 51.47%(35/68) and females for 48.53%(33/68) among substitution cases.There was no significant correction among the number of incorrect words and age(r=-0.140, P>0.05) as well as gender(r=0.090, P>0.1).Conclusion Abnormal velar consonants in operated patients with cleft palate mainly had problems with /g/ and /k/./g/ showed mainly omission errors and /k/ mainly substitution.The targeted rehabilitation methods established in the study are significantly beneficial.

Objective · To explore the relationship between baseline lipid profiles and long-term cardiovascular outcomes after intervention with hypoglycemic drugs metformin and glipizide and to detect lipid components that can predict the long-term cardiovascular effect of metformin and glipizide.Methods· Liquid chromatography-quadrupole time of flight-mass spectrometry (LC-QTOF/MS) was used to measure 119 lipid components in baseline serum for 116 patients with type 2 diabetes (T2DM) and atherosclerotic heart disease (CHD) who were treated with glipizide (56 cases,the glipizide group)or metformin (60 cases,the metformin group).Cardiovascular complex end points (including cardiovascular death,all-cause death,nonfatal myocardial infarction,nonfatal stroke,and arterial revascularization) of all patients were followed up.The relationship between lipid components and cardiovascular complex end points was analyzed with Logistic regression analysis.The category-free net reclassification index (cfNRI) and the integrated discrimination improvement (IDI) were used to evaluate whether lipid components are helpful for predicting the recurrent cardiovascular events.Results· The differences in baseline drug distribution,clinical characteristics,and biochemical indexes between two groups were not statistically significant,except for diuretics use,serum PC (O-34:2) level,and SM (d18:0-24:0) level.Logistic regression analysis showed that baseline ChE (20:4) was a protective factor for recurrent cardiovascular events in the glipizide group (OR=0.87,P=0.039).ChE (20:4) significantly increased the cfNRI and IDI of cardiovascular complex end points by 69％ and 0.07,respectively (P=0.011,P=0.028).Baseline SM (dl 8:1-22:0) was a risk factor for recurrent cardiovascular events in the metformin group and all participants (OR=1.65,P=0.039;OR=1.64,P=0.014).SM (d18:1-22:0) significantly increased the cfNRI of cardiovascular complex end points in the metformin group and all participants by 74％ and 55％,respectively (P=0.012,P=0.005).Conclusion· Of 119 lipid components measured with LC-QTOF/MS,baseline ChE (20:4) is a protective factor and SM (d18:1-22:0) is a risk factor for cardiovascular complex end points in with T2DM and CHD patients after long-term treatment with metformin and glipizide.Both lipid components are helpful for improving the prediction of recurrent cardiovascular events.

Exosomes are vesicular bodies secreted by living cells containing proteins and RNA, and play an important role in the process of physiology and pathology.Pancreatic cancer is one of the common gastrointestinal tumor with high morbidity and mortality.As a hotspot in oncology, exosomes have potential values in the research of development, diagnosis and treatment of pancreatic cancer.This article reviewed the role of exosomes in pancreatic cancer.

A method was proposed for the separation and determination of paraffin waxes in food by HPLC-evaporative light scattering detection (ELSD). A normal-phase column was used to separate nonparaffinic and paraffinic materials without resolving the latter into individual components. The t-test method was adopted for the evaluation of mean difference between response factors of n-alkanes in paraffin waxes on ELSD detector. No mean difference was obtained between response factors, which can be used for quantitative determination of paraffin waxes in food. The determination results obtained by HPLC-ELSD were compared with those by GC-MS. The linear range for the determination of paraffin waxes was in the range from 10 to 500 mg/L with a correlation coefficient of 0.9988, and the limit of detection was 1.0 mg/L. With the spiking level of 10, 50 and 100 mg/kg, the recovery ranged from 84.6% to 105.4% and the relative standard deviation ranging from 5.4% to 7.2%. The proposed method is simple, fast and sensitive.

Objective To explore the application and effectiveness of the combination of bilabial /Φ/and inter-dental /θ/to the training of pronouncing fricatives after cleft palate operations .Methods Seventy children aged four to eight years with abnormal fricatives after cleft palate operations over one month were enrolled in the study . They were randomly allocated into the experimental group (35 cases) and the control group (35 cases) .The chil-dren in the experimental group received the combined training of bilabial /Φ/and inter-dental /θ/while those in the control group received routine rehabilitation training .Results After 6 to 10 times of speech training ,the number of erroneous words of the experimental group decreased to 1 .20 ± 0 .35 from 70 .80 ± 0 .52 before the training .The difference was statistically significant (Z= -5 .215 , P= 0 .001) .The number of incorrect words of the control group decreased to 7 .17 ± 0 .45 from 70 .86 ± 0 .50 of the baseline .The difference was statistically significant (Z=-5 .237 ,P=0 .001) .The number of erroneous words of the two groups had no statistical differences before train-ing (t= -0 .079 ,P=0 .937) .The number of wrong words of the experimental group was significantly lower than the control group after training (Z= -7 .023 ,P=0 .001) .Conclusion The application of the combination of bilabi-al /Φ/and inter-dental /θ/to the training of pronouncing fricatives after cleft palate operations can decrease dis-tinctly the number of erroneous words .

Objective To evaluate the role of 3.0 Tesla magnetic resonance hysterosalpingography (MR?HSG) work?up in the diagnosis of female infertility. Methods Between July 2015 and December 2018, a total of 1 052 infertile women aged from 20 to 40 years in the Affiliated Hospital of Nanjing University of Chinese Medicine were prospectively enrolled in the study. All the patients underwent pelvic plain scanning and X?ray hysterosalpingography (HSG) followed by MR?HSG examination, and the patency of the fallopian tubes as well as the abnormalities of the uterus and ovaries were evaluated. Among which 33 cases were randomly selected. The chi?square test and Kappa test were used to compare the difference and the consistency of the two methods in the evaluation of fallopian tubes. Results MR?HSG and HSG had good consistency in evaluating tubal patency (Kappa=0.88, P<0.01), and there was no statistically significant difference between the two groups (P=0.65). The examination of MR?HSG was successfully completed in 97.1%(1 021/1 052) cases. There were 81.7% (834/1 021) cases had at least one abnormality. Bilateral tubal, uterine and ovarian abnormalitiesoccurred in 42.6% (435/1 021), 34.2% (349/1 021)and 46.8% (478/1 021) cases, respectively. In which tubal abnormalities display the results as follows: bilateral obstructed 4.7% (48/1 021), bilateral poor pass 8.5% (87/1 021), one smooth one obstructed11.7% (119/1 021), one smooth one poor pass 12.6% (129/1 021), and one poor pass one obstructed 5.1% (52/1 021). Conclusion 3.0 T MR?HSG is expected to be a routineexam for evaluating female infertility, which allows a comprehensive assessment of tubal patency and other pelvic abnormalities of infertile women.

Objective: To investigate the value and feasibility of C reactive protein (CRP) in predicting postoperative anastomotic leakage in rectal cancer patients with enhanced recovery after surgery (ERAS) for safer implementation of this ERAS. Methods: A cohort study on serum CRP of 455 rectal cancer patients undergoing laparoscopic radical resection according to the ERAS procedure at Gastrointestinal Unit of General Surgery Department, Guangdong General Hospital from August 2014 to June 2017 was retrospectively carried out. The serum CRP level was measured before operation and at postoperative days 1-7, and the serum CRP level of the groups with and without anastomotic leakage was compared to analyze its prediction for anastomotic leakage. Diagnostic standard of anastomotic leakage was based on the definition of postoperative anastomotic leakage in rectal cancer from International Study Group of Rectal Cancer (ISREC) : (1) Postoperative localized or diffuse peritonitis occurred, or fecal liquid was found from the abdominal drainage tube; (2) When anastomotic leakage was uncertain, peritoneal or pelvic computed tomography scan should be used to confirm. Results: All the 455 patients underwent surgery successfully, and 41 patients (9.0%) had anastomotic leakage postoperatively. Patients with anastomotic leakage were diagnosed (4.0 ± 2.0) days postoperatively, of whom 8 cases (19.5%) were diagnosed more than 5 days postoperatively. Serum CRP levels in patients with anastomotic leakage continued to increase within 1-4 days postoperatively[ (50.04 ± 27.98) mg/L to (122.75 ± 52.98) mg/L]and decreased 5 days postoperatively[ (92.02 ± 58.26) mg/L], both were higher than those of non-anastomotic leakage group, and the difference was statistically significant (all P < 0.05, except postoperative day 2) . The serum CRP level of non-anastomotic leakage group reached the peak on the second postoperative day[ (83.10 ± 37.45) mg/L] and decreased 3 days postoperatively[ (48.01 ± 27.59) mg/L]. The ROC curve was drawn with the anastomotic leakage as the state variable, and the CRP level as the detection variable. The area under the curve (AUC) at postoperative 1, 2, 4, 5, 6 and 7 days was 0.74, 0.58, 0.83, 0.82, 0.65, and 0.70, respectively. The maximum was at postoperative day 3[0.93 (95%CI: 0.86-0.99) ]. The Youden index was 0.72, and the threshold of CRP was 80.09 mg/L, as the cut-off point to predict anastomotic leakage, with sensitivity, specificity, and positive predictive value of 79.3%, 92.3%, and 74.2%, respectively. Conclusions Monitoring the postoperative serum CRP level can help predict the occurrence of anastomotic leakage after laparoscopic surgery for rectal cancer. When the serum CRP level is > 80.09 mg/L on the third postoperative day, the CRP level has the largest value in predicting postoperative anastomotic leakage, and the safety of ERAS has a certain clinical significance as well.

OBJECTIVE: To analyze the clinical, familial and hereditary features of myotonic dystrophy to improve the knowledge and provide molecule evidence for gene diagnosis and prenatal diagnosis of myotonic dystrophy or dystrophia myotonia (DM) families. METHODS: Clinical data of 2 DM families were collected based on the probands. The number of trinucleotide CTG repeat in the 3' untranslated region of myotonic dystrophy protein kinase (DMPK) gene on chromosome 19 was determined by DNA sequence and repeat fragment. RESULTS: Except for 1 subclinical patient, another 5 patients progressed slowly with the features of myotonic muscular weakness and atrophy. One patient had hatchet face, 1 had cataract and diabetes mellitus, and the other 3 were bald. Electromyologram showed 3 patients had myotonic discharge and myopathic abnormalities. The number of trinucleotide CTG repeat in the 3' untranslated region of DMPK gene of 5 patients exceeded 50. CONCLUSION DM can be anticipated. Gene analysis can verify the disease and identify subclinical patients. It helps to prevent the DM births by hereditary consultation performing prenatal diagnosis.
Adolescent ; Adult ; Female ; Humans ; Male ; Myotonic Dystrophy ; diagnosis ; genetics ; Myotonin-Protein Kinase ; Pedigree ; Polymerase Chain Reaction ; methods ; Protein-Serine-Threonine Kinases ; genetics ; Trinucleotide Repeats