OBJECTIVETo investigate the correlation between articulation, velopharyngeal function, and surgical age by comparing the changes in articulation after velopharyngeal closure is performed. This study is also conducted to investigate the influencing factors of omission change between pre- and post-operation.

METHODSA total of 48 patients, including 18 males and 30 females, mean age (13.3 ± 5.8) years, with non-syndromic cleft lips and palates were selected from January 2011 to December 2011. Their speech data and articulation between pre- and post-operation were retrospectively analyzed using non-parametric tests. Correlation study was performed to analyze the influencing factors of the changes in articulation. P < 0.05 was considered statistically significant.

RESULTSThe difference in articulation after velopharyngeal closure occurred was significant (Z = -3.796, P = 0.000). A negative correlation between the ratio of post-operative normal articulation and surgical age (R = -0.487, P = 0.000) was observed. The change in omission was positively correlated with surgical age (R = 0.589, P = 0.000) and gender (R = 0.404, P = 0.047). By comparison, the change in omission was negatively correlated with follow-up time (R = -0.235, P = 0.040).

CONCLUSIONArticulation and intelligibility are significantly improved after velopharyngeal closure is performed. These parameters are negatively correlated with surgical age to some extent. In addition, the change in omission is positively correlated with surgical age and gender, whereas the change in omission is negatively correlated with follow-up time.

Adolescent ; Articulation Disorders ; Child ; Cleft Lip ; Cleft Palate ; Female ; Humans ; Male ; Retrospective Studies ; Velopharyngeal Insufficiency ; Young Adult

Objective To analyze the application value of the rapid testing for influenza during 2007-2008 flu season at fever clinic in Beijing Chaoyang hospital Methods 500 patients with diagnosis of influenza-like illness were prospectively enrolled. Pharyngeal swabs were collected for influenza viral culture and rapid testing for influenza. Demographic characteristics, age, symptoms, lab tests, symptom recovery time and medical expense were also collected. The sensitivity, specificity, positive predictive value and negative predictive value for rapid testing were analyzed. Results A total of 500 patients were enrolled between Dec 2007 and March 2008. Among them 498 cases were used for analysis. Influenza B was most common by virus culture methed(n=208,41.8%) ,followed by influenza A (n=51,10.2%). The average age was 35, and the ratio of male to female was 1.47:1. Compared with the group of positive culture, patients with influenza were more likely to get cough, sore throat, and nasal congestion (t=13.728, 4.014and 4.720,P<0.001 or 0.05, respectively). A total of 260 cases were subjected to rapid testing, Among them 18 cases were influenza A positive and 132 cases were influenza B positive. The rapid testing had a sensitivity of 77.1 % and a specificity of 70.1%. The positive predictive value was 78.6% and the negative predictive value was 68.2%. The rapid testing had enhanced the proportion of anti-viral treatment from 0 to 26% and reduced the proportion of antibiotic use from 63.4% to 20. 7%. Conclusions Influenza B is the most predominant pathogen during 2007-2008 flu season among patients with influenza-like illness in Beijing. The rapid testing with high sensitivity and specificity provides guidance on clinical practice.

OBJECTIVETo investigate the consonant pronunciation characteristics of older unoperated cleft palate patients.

METHODSOne hundred unoperated cleft palate patients (more than 8 years old) were included. Subjective speech assessment was delivered to each patient. The incidence and distribution of varies consonant misarticulation errors consisting of manners and places of articulation were summarized.

RESULTSConsonant misarticulation existed among 86% of all cases. Compensatory misarticulation was observed in 66% patients, while 14% patients demonstrated completely normal articulation. The articulation manners of the highest correction rate, in succession, were nasals, lateral, fricatives, stops, and affricates. The error type of stops and affricates mainly consisted of compensation and omission. The articulation places of the highest correction rate, in succession, were bilabial, alveolar, linguadental, and velar.

CONCLUSIONCompensatory, omission, and substitution, which happen in all the stops, fricatives and affricates, are the top three misarticulation. The misarticulation incidence of unaspirated sound is higher than that of aspirated. Compensatory errors a the most common ones in aspirated sounds, while omission and weak pressure are more frequent in unaspirated sounds. Weak pressure is mainly observed in unaspirated consonants. As the articulation spot move backward, the compensation of fricatives and stops deteriorate, the omission of affricates increase.

Articulation Disorders ; Cleft Palate ; Female ; Humans ; Male

OBJECTIVETo investigate the application of the perceptual assessment in the diagnosis of the velopharyngeal function, to provide a reference to the improvement of the velopharyngeal function diagnosis through comparing the consistency between the diagnosis of the perceptual assessment and the objective assessment.

METHODSAll subjects (254) were selected from the Department of Cleft Lip and Palate Surgery, West China School of Stomatology, Sichuan University, from 2000-2010. The results of the perceptual and the nasopharyngeal fiberscope (NPF) assessment were retrospectively analyzed, and the consistent rate between the two assessment methods was calculated. The Kappa test and the correlation analysis were performed to analyze the consistency and correlation, and the factors relating to the perceptual assessment were analyzed by the correlation coefficient.

RESULTSThere were 254 patients met the inclusion criteria. The consistent number of the patients diagnosed by the perceptual and the objective assessment as velopharyngeal competence (VPC) and velopharyngeal insufficiency (VPI) were 58 and 167 respectively. The consistent rate was 88.58% for all patients, and 66.67% for the VPC patients. The Kappa value was 0.721, Spearman's R=0.751, P<0.05. There were correlation between the hypernasality, the nasal emission and the subjective assessment, and Spearman's R=0.697, 0.590, P<0.05.

CONCLUSIONThe VPC patients and the VPI patients with moderate and severe hypernasality and nasal emission diagnosed by the perceptual assessment could be exempt from the objective examination. Patients diagnosed with mild hypernasality and nasal emission by the perceptual assessment should be further referred to NPF or other instruments.

China ; Cleft Lip ; Cleft Palate ; Humans ; Retrospective Studies ; Velopharyngeal Insufficiency

Objective:To explore the journey map of patients with chronic constipation during fecal microbiota transplantation.Methods:This study adopted phenomenological methods. From October to December 2023, purposive sampling was used to select chronic constipation follow-up patients who underwent fecal microbiota transplantation at the Intestinal Microecology Center of Shanghai Tenth People's Hospital as respondents for semi-structured interviews. Colaizzi 7-step analysis method and NVivo 11.0 software were used for data analysis.Results:A total of 15 interviewees were interviewed. During fecal microbiota transplantation, the journey map of constipation patients included stages, mood changes, touchpoints, themes, emotional experiences and opportunities. The patient's experience and needs were summarized into three themes and ten sub-themes, including pre-transplant adaptation disorders to new environments (unfamiliarity and confusion-admission coordination disorders, anxiety and expectations-diverse complex emotions, puzzle and helplessness-asymmetric doctor and patient information), effectiveness-related psychological and social experiences in transplantation (attention and expectations-longing for positive efficacy, perception of benefits and risk avoidance, shame and inferiority-treatment stigmatization experience, questioning and despair-unrealized expectations, treatment resistance-sensitive economic burden), post-transplant transition dilemmas (inaccessible medical services-lack of continuous treatment and nursing, disease recurrence troubles) .Conclusions:This study visualizes the experiences and needs of constipation patients during microbiota transplantation through a patient journey map and identifies multidimensional issues and needs of patients. Clinical medical and nursing staff should pay attention to the needs of patients at different stages of the treatment process when formulating intervention programs to improve the quality of fecal microbiota transplantation nursing.

Objective To systematically evaluate the predictive value of controlling nutritional status(CONUT)score for short-term neurological function and clinical outcome of stroke.Methods Cochrane library,PubMed,Web of Science,Embase,CNKI,Wan-fang,VIP,and CBM were searched by computer to find studies on the use of CONUT score to evaluate the nutritional status and follow-up of stroke patients from the establishment of the database to April 11,2023.Literature was searched and screened independently by two researchers.The Newcastle-Ottawa scale(NOS)was used to evaluate the quality of the included studies.Stata 15.Osoftware was used for Meta-analysis.Results A total of 12 literatures were included,all of which were high quality.Meta-analysis results showed that high CONUT score(≥2)was strongly associated with poorer functional outcomes(OR=1.41,95％CI:1.25-1.60,P＜0.001,I2=49.4％),and associated with increased mortality(OR=2.85,95％CI:2.03-4.00,P＜0.001,I2=0)increase.Conclusion High CONUT score may be a predictor of neurological recovery status and survival outcome in patients after stroke,and the prognostic mechanism of CONUT score in stroke patients is unclear and needs to be confirmed by further studies.

Objective To explore the dilemmas faced by surrogate decision-makers of severe stroke patients in treatment decision-making,and to provide a basis for developing decision support strategies.Methods From April to December 2023,through phenomenological qualitative research with 16 surrogate decision-makers with severe stroke patients from ICU of the department of neurology in a tertiary hospital in Jing'an District,Shanghai.semi-structured in-depth interviews were used to examine the perceptions of decision-making on surrogate.Data were analyzed via Braun's style of thematic analysis.Results 4 themes and 10 sub-themes were identified.Theme 1:negative emotional dilemmas(urgent decision-making leads to anxiety,fear,and unknown stroke trajectory increases the sense of uncertainty).Theme 2:supportive environment dilemmas(lack of information support delays decision-making;lack of family support increases decision-making stress;insufficient economic support increases the burden of decision-making).Theme 3:the dilemma of weighing the pros and cons(difficult trade-offs between risk and reward,tough decisions between reality and ethics,conflicting choices of life and dignity).Theme 4:preference management dilemmas(practical difficulties in adhering to patient preferences,impediments to decision-making due to unknown patient preferences).Conclusion Surrogate decision-makers of severe stroke patients face multiple decision-making dilemmas.Healthcare professionals should provide emotional support in multiple ways and comprehensive support to reduce the decision-making dilemmas experienced by surrogate decision-makers,as well as implement death education for surrogate decision-makers and promote advance care planning to reduce their decision-making stress.

Objective To investigate the correlation between articulation, velopharyngeal function, and surgical age by comparing the changes in articulation after velopharyngeal closure is performed. This study is also conducted to investigate the influencing factors of omission change between pre- and post-operation. Methods A total of 48 patients, including 18 males and 30 females, mean age (13.3±5.8) years, with non-syndromic cleft lips and palates were selected from January 2011 to December 2011. Their speech data and articulation between pre- and post-operation were retrospectively analyzed using non-parametric tests. Correlation study was performed to analyze the influencing factors of the changes in articulation. P<0.05 was considered statistically significant. Results The difference in articulation after velopharyngeal closure occurred was significant (Z=-3.796, P=0.000). A negative correlation between the ratio of post-operative normal articulation and surgical age (R=-0.487, P=0.000) was observed. The change in omission was positively correlated with surgical age (R=0.589, P=0.000) and gender (R=0.404, P=0.047). By comparison, the change in omission was negatively correlated with follow-up time (R=-0.235, P=0.040). Conclusion Articulation and intelligibility are significantly improved after velopharyngeal closure is performed. These parameters are negatively correlated with surgical age to some extent. In addition, the change in omission is positively correlated with surgical age and gender, whereas the change in omission is negatively correlated with follow-up time.

In response to the Opinions of the CPC Central Committee and the State Council on Promoting the Inheritance， Innovation， and Development of traditional Chinese medicine（TCM） and the spirit of the National Conference on TCM， Chinese Association of Chinese Medicine organized experts in Otorhinolaryngology Head and Neck Surgery of traditional Chinese and western medicine to discuss the clinical advantages of TCM and integrated traditional Chinese and western medicine in the treatment of allergic rhinitis （AR） and they reached a basic consensus. In recent years， the prevalence of AR has been on the rise， threatening the quality of life of patients and giving rise to a heavy burden to both the patients and the society. AR is resulted from immune imbalance rather than reduced immunity or hyperimmunity， and the imbalance is similar to the Yin-yang disharmony in TCM. In the treatment of this disease， western medicine features rapid onset. However， it is cost-intensive and causes severe surgical trauma， and the recurrence is common. TCM boasts diverse methods for AR， which can be used in all stages of this disease. It has advantages in controlling symptoms such as nasal congestion， runny nose， or dysosmia in the attack stage， preventing recurrence in the remission stage， and treating refractory AR or steroid-resistant AR. In particular， acupuncture enjoys a reputation in treatment of AR， which has been supported by evidence-based medicine and recommended by guidelines. While treating local symptoms of AR， TCM regulates the psychosomatic conditions， which facilitates chronic disease management and long-term follow-up. We should integrate the advantages of TCM and western medicine， give full play to the unique nonnegligible and irreplaceable advantages of TCM， formulate a comprehensive diagnosis and treatment scheme for learning and promotion， and summarize the research outcomes to promote the theoretical innovation of TCM on AR from the perspective of integrated traditional Chinese and western medicine.