Objective To analyze the efficacy of repairing unilateral cleft lip (UCL) with Millard method, and explore the individual operative procedure. Methods According to the difference of lip height between non-cleft and cleft sides, MillardⅠ, MillardⅡ or modified Millard Ⅱ operative approach was chosen to repair UCL, then the clinical effect of operation was evaluated. Results The ideal operative effects were obtained in 208 cases of UCL using various operative approaches based on the individual deformity. There were consistent lip height between both sides, normal vermillion bulk and satisfactory facial appearance after operation. Conclusion The satisfactory efficacy could be obtained by choosing Millard method's operative approaches based on the individual deformity. The modified Millard operative approach could repair all kinds of UCL.

Objective To discuss the preventive measures of anterior palatal fistula by modified the operation of cleft palate. Methods For 23 patients of complete cleft palate with alveolar ridge cleft, bilateral mucoperiosteum flap was moved forward as possible so as to close fistula front of hard palate, and incised junction of the hard and soft palate to prolong soft palate and the wound was repaired by buccal mucosal flap.The incidence of anterior palatal fistula and velopharyngeal closure after operation was observed. Results Twenty-three patients were rechecked 1 month after operation ,there was no anterior palatal fistula occurring,10 cases were examined by epipharyngoscope 1 year after operation,the velopharyngeal closure was 90%-100%. Six cases were followed up for 6 months,the velopharyngeal closure was 80%-85%. Conclusions For second-stage operation methods of anterior palatal fistula, there are too many discussions of selection criterias, advantages and disadvantages. If first-stage operation is taken measures to prevent anterior palatal fistula or decrease the diameter of fistula as possible. It reduces percentage of second-stage operation or decreases the difficulty. It should get more attention in the clinical works.

Objective To investigate expression level and clinical application value of microRNA(miR)-494-3p and long non-coding RNA(LncRNA)MAGI2-antisense RNA 3(MAGI2-AS3)in urine exosomes of patients with bladder cancer.Methods A total of 105 bladder cancer patients admitted to Chongqing Liangjiang New Area People's Hospital from July 2021 to June 2023 were selected as the cancer group,and 101 patients with benign bladder diseases were as the benign group.Real-time fluorescence quantitative PCR(qRT-PCR)was applied to detect miR-494-3p and LncRNA MAGI2-AS3 levels in urine exosomes.Kappa test was used to analyze the consistency among miR-494-3p,LncRNA MAGI2-AS3 in urinary exosomes and pathological biopsy diagnosis of bladder cancer.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of miR-494-3p and LncRNA MAGI2-AS3 levels in urinary exosomes for bladder cancer.Results The level of miR-494-3p(1.41±0.32)in the urine exosomes of the cancer group was higher than that of the benign group(1.02±0.24),while the level of LncRNA MAGI2-AS3[(0.79±0.19)vs(1.05±0.22)]was lower than that of the benign group(1.05±0.22),and the differences were statistically significant(t=9.866,9.089,all P＜0.05).The proportions of tumor diameter＞3 cm,T3～T4 stage,and lymph node metastasis in the high expression group of miR-494-3p were higher than those in the low expression group,and the differences were significant(x2=5.806,6.999,8.289,all P＜0.05).The proportions of T3～T4 stages and lymph node metastasis in the low expression group of LncRNA MAGI2-AS3 were higher than those in the high expression group,and the differences were significant(x2=9.244,7.795,all P＜0.05).MiR-494-3p and LncRNA MAGI2-AS3 in urine exosomes combined with pathological biopsy showed high consistency in the diagnosis of bladder cancer(Kappa value=0.718,P＜0.05).ROC curve showed that the areas under the curve(95％confidence interval)[AUC(95％CI)]of miR-494-3p and LncRNA MAGI2-AS3 levels in urinary exosomes alone for diagnosis of bladder cancer were 0.812(0.752～0.863)and 0.779(0.716～0.833),respectively.MiR-494-3p and LncRNA MAGI2-AS3 levels in urinary exosomes combined to diagnose the AUC(95％CI)of bladder cancer 0.877(0.824～0.918)were higher than that of AUC(95％CI)diagnosed separately(Z=2.053,2.647,P=0.040,0.008).Conclusion The level of miR-494-3p in urine exosomes of patients with bladder cancer was increased,while the level of LncRNA MAGI2-AS3 was decreased.The combination of the two may have high diagnostic value for bladder cancer.

Objective To explore the effectiveness of modified Bardach two-flap palatoplasty combined modified Furlow double-opposing Z-plasty in wide palatal cleft repair.Methods 80 patients aged 2-18 years old with Ⅲ cleft palate from our department were divided into two groups,the experimental group (n=40) was repaired with modified Bardach two-flaps palatoplasty combined modified Furlow double-opposing Z-plasty (modified B+F technique).The control group (n =40) was repaired with Sommerlad levator muscle of palatine velum reconstruction (S technique).Results The healing of incisions was better in the experimental group than the control group.The fistula rate in the experimental group was 2.5％,which seemed to be remarkable lower than that of the control group (7.5％) post operation one month.Conclusions Application modified Bardach two-flaps palatoplasty combined modified Furlow double-opposing Z-plasty in wide palatal cleft will promote healing of incisions,reduce the occurrence rate of cleft palate fistuia,inhibit the scar contracture of soft palate,maintain the length of soft palate,augment movement of soft palate,and improve the speech quality of patients.