Objective To investigate articulation characteristics and rehabilitation training methods of abnor-mal supradental of patients with dysarthria after lingual frenectomy.Methods A total of 107 patients with dysar-thria after lingual frenectomy were studied for articulation characteristics.Then 32 patients with dysarthria were re-cruited from those 107 patients for further research of the training methods.Results The articulation disorders of/z/and/s/were replaced by/d/when/z/and/s/were combined with/a/,/o/,/e/,/u/or the vowels whose head vowels were them,/z/and/s/were replaced by/j/and/x/when they were combined with/i/.The proportion of these disorders were 32.71%,26.17%,30.84% and 40.19%,respectively.The articulation disorders of/c/was re-placed by/d/or/t/when/c/was combined with/a/,/o/,/e/,/u/or the vowels whose head vowels were them. The proportions were 5.61% and 25.23%,respectively.When/c/was replaced by/q/and/j/.When/c/was com-bined with/i/,the proportions respectively were 42.06% and 14.02%.Then/z/,/c/,/s/were totally replaced to/zh/,/ch/and ,/sh/or lateralization.The proportions of these disorders were 14.02%,15.89%,13.08% and 10.28%,9.35%,11.21%,respectively.After the speech training,the patients made less mistakes about supradental consonant,the number changed from 34.53±6.08 to 7.97±2.52.The differences were statistically significant(t=30.035,P<0.001).Conclusion The main articulation disorders were replacement and lateralization.The training methods that this research has established are significantly effective,and is worth receiving further study and possi-ble clinical application.

Objective To study the clinical effects of the combination of the topping tongue method and the scraping tongue method in speech training after the operation of ankyloglossia with lingua apical articulation disor-der.Methods Based on the random control study design,50 cases of ankyloglossia with lingua apical articulation disorders were randomly allocated into experimental group (25 cases)and control group (25cases).Patients of ex-perimental group were given routine speech training with the topping tongue and scraping tongue methods.Patients of control group were given routine speech training,and data of voice intelligibility of two groups of patients were collected at the time before speech training and after 3 courses of speech training.Results The voice intelligibility of two groups of patients before speech training had no statistically significant differences(t =0.726,P >0.05 ).But the voice intelligibility of the patients after 3 courses of speech training in both groups was obviously improved. There were statistically significant differences(P <0.001).Patients in the experimental group had a higher voice in-telligibility score assessed after 3 courses of speech training than the control group.After treatment,the voice intel-ligibility of the patients in experimental group increased from 37.91% to 87.69%.The voice intelligibility of the pa-tients in the control group increased from 37.69% to 72.99%.There were statistically significant differences(P <0.001).Conclusion The combination of the topping tongue and scraping tongue methods can improve the speech intelligi-bility for patients after operation of ankyloglossia and promote rehabilitation training of the lingua- apical articulation.

Objective To study the phonological characteristics and rehabilitation training methods of abnor-mal blade-alveolar consonants in children with functional articulation disorders(FAD).Methods A total of 150 children of 4 to 25 years old with blade-alveolar consonant articulation disorders were selected from 194 children di-agnosed with FAD as the research objects.The phonological characteristics of abnormal blade-alveolar consonants were analysed;30 children of 4 to 17 years old accepted speech therapy,exhaling training and functional treatment of blade-alveolar consonants (/d/,/t/,/n/,/l/).Patients were given speech assessments in the first and last training by using computer speech lab.Results The occurrence rate of abnormal blade-alveolar consonant was 77.32%(150/194);the error rate of/l/was 82.0% which was the highest;/d/was mainly substituted by/j/,and/t/was mainly substituted by/q/,/d/.Both/l/and/n/mainly showed omission.Males accounted for 82.35%(98/119) and females accounted for 80.65%(25/31)among substitution cases.Males accounted for 80.67%(96/119)and fe-males for 90.32%(28/31)among omission cases.The number of incorrect words decreased to (6.30±2.72)after speech training from(50.60±9.04)before speech training was established.The differences were statistically signifi-cant(Z= -4.875,P<0.05).The number of erroneous words was negatively correlated with age (r= -0.736,P<0.01).Conclusion Blade-alveolar consonant articulation disorders occur mainly on/d/,/t/,/l/,and the main erro-neous articulation patterns are substitution and omission.The training scheme and training methods established in this study are significantly effective.

Objective To explore the age effects on the prognosis of patients with dysarthria after lingual fre-nectomy ,to provide clinical basis for the corresponding speech evaluation and treatment of the patients .Methods 154 patients with dysarthria one month after lingual frenectomy were recruited as the research objects ,83 cases of preschool ,52 cases of school-age ,adolescent 11 cases and 8 cases of adult were included .Their articulation was re-corded after postoperative recovery one month by the computer speech lab (Model 4500) according to the test table , then the recording materials were analyzed .After the patients' phonetic intelligibility(PI) was evaluated ,the corre-lation and simple linear regression analysis for age and PI were carried on .Results The PI of patients with dysar-thria one month after lingual frenectomy was positively correlated with age (r=0 .467 ,P<0 .05) .That indicates PI has an increasing trend with the growth of age .The result of simple linear regression analysis showed that the deter-mination coefficient of age to PI was 0 .270 .It showed that age had an influence on the prognosis of patients with PI after lingual frenectomy .Conclusion Aging was one of the important factors for the prognosis of patients with dys-arthria after lingual frenectomy ,but it is not the only factor .The patients with dysarthria one month after lingual fre-nectomy should be received treatment in time ,speech training must be corrected at about 4 to 8 years old with dysarthriawithout surgery .

Objective To evaluate the agreement between colposcopic diagnosis with 2011 colposcopic terminology of the International Federation for Cervical Pathology and Colposcopy (IFCPC) and cervical pathology in cervical lesions. Methods A retrospective cohort study was performed, which included 376 patients who underwent colposcopy with 2011 international terminology of colposcopy at Obstetrics and Gynecology Hospital of Fudan University from September 2014 to November 2014. With conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated and correlations between variables were analyzed. Results With 2011 international terminology of colposcopy, agreement of colposcopic diagnosis and cervical pathology was 60.9%(229/376)perfectly matched, and the strength of agreement with weighted Kappa statistic was 0.401 (P<0.01), and agreement within one grade was 97.6%(367/376), which were improved compared with traditional methods. Colposcopic diagnosis were 19.9%(75/376) overestimated and 19.1%(72/376) underestimated. There were no significant difference between agreements in various grade lesions (χ2=1.996, P=0.573). Positive predictive value of high grade colposcopy or more was 84.4%, the negative predictive value of low grade colposcopy or less was 88.8%, whereas false positives were 3.5%and false negatives were 39.3%. A linear trend among three types of transformation zone and patient ages was found (χ2=45.910, P<0.01), whereas lesion sizes were not linearly correlated with lesion degrees (χ2=0.690, P=0.406). In grade 1, grade 2 and nonspecific findings, thin acetowhite epithelium, dense acetowhite epithelium and Lugol′s non-staining were most frequent, the Youden indexes of each were 0.170, 0.373 and 0.145, 0.069 respectively. Positive predictive value of some other findings (such as fine mosaic) and two new signs (inner border sign and ridge sign) were 100.0%. There were no significant difference between agreements in examiners with different levels of experience (χ2=1.197,P=0.550). Conclusions Compared to traditional methods (such as Reid index), 2011 international terminology of colposcopy could improve the agreement between colposcopic diagnosis and pathologic diagnosis, without significant differences by the severity of lesion and the level of examiners′experience. Common findings were classified reasonably, and some signs were highly reliable, which is important for guiding biopsy. However, the reproducibility of transformation zone types and the implication of lesion size need to be further discussed.

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 clinical characteristics of lateral misarticulation. Methods 39 patients with lateral misarticulation were recruited. Their articulation was recorded by the computer speech lab according to the Putonghua syllable chart of the collocation of consonants and vowels, then the recording materials were analyzed. Results 22 cases with lateral misarticulation were on both sides, 14 cases were on the right side and 3 cases on the left side. Lateral misarticulation mainly occurred in consonants with the highest incidence in /z/, / c/, /s/, /zh/, /ch/, /sh/, /j/, /q/ and /x/. There were two or more release bursts in the spectrogram of lateral misarticulation. There was no significant correlation between the number of lateral misarticulation and age (r=0.110, P=0.507). Conclusion Lateral misarticulation mainly occurs in supradental, blade-palatal and lingua-palatal phoneme. The time-domain waveform diagram and spectrogram are helpful for the diagnosis of lateral misarticulation. Lateral misarticulation should be corrected in time.

BACKGROUND:The blastula culture medium can assist the development of zygote from the fertilized egg to the blast blastula. The safety and quality of blastula culture medium directly influences the quality of blastula. OBJECTIVE:To evaluate the effect of blastula culture medium on the development of mouse embryos. METHODS: In this study, B6D2F1 mice were used. The female mice were superovulated and mated with male B6D2F1 mice. One day later, the zygotes were colected and cultured in the M16 medium to 4-cel stage. Then, 4-cel stage embryos were transferred into the tested blastula culture medium (experimental group). After 5 days of culture, the forming rate of blastula was examined. Meanwhile, the M16 medium containing endotoxin was used to culture 1-cel mouse zygote (positive control group). The M16 medium with no embryo toxicity was used to culture 1-cel zygote (negative control group). RESULTS AND CONCLUSION:The formation rate of blastula was 0 in the positive group, 87.1% in the negative control group, and 87.3% in the experimental group. From the results, the tested blastula culture medium could assist the 1-cel zygote growing to the stage of blastula, and the formation rate of blastula was above 80%. The tested blastula culture medium had no toxicity to the mouse embryo.

Objective To investigate the clinical outcomes of using modified antegrade digital artery island flap for the treatment of the severely flexion contracture of the burned finger.Methods Between August,2013 to August,2015,21 patients (21 fingers) with severely flexion contracture of the burned finger were hospitalized for treatment.According to the Stren classification standard for the interphalangeal joint flexion contracture,all the patients were rated as type Ⅲ.The volar soft-tissue defect with exposed tendons,nerves,vessels or bone ranged from 1.0 cm × 2.0 cm to 2.5 cm × 4.0 cm after scar relaxation.The artery and the nerve defect were 1.5 to 4.5 cm and 2.0 to 4.2 cm,respectively.The wound were reconstructed with the modified antegrade digital artery island flap.The dorsal branches of the proper digital nerve of the flap were anastomosised with the proper digital nerve of the wound.The flap donor site was resurfaced with full-thickness skin grafting from inner aspect of the forearm.All the cases were called back for postoperative follow-up.Results All the reconstructed fingers and flaps survived completely without vascular problems.The donor skin graft survived and wound healed by first intention.All the patients were followed up with 11.5 months (range,6-22 months).The finger appearance was satisfactory.The texture and color of flaps in all cases were good.There was no pigmentation and contraction relapse.The contracted fingers received no cold intolerance.At the final examination,the average values of static 2-point discrimination were 5.2 mm (range,4.3-6.5 mm) of the flap.In the series,based on the Michigan Hand Outcome Questionnaire,18 patients were strongly satisfied with the injured finger appearance and 3 patients satisfied with the appearance.Conclusion The modified antegrade digital artery island flap,which is easy to raise with large flap size and can result with the good finger appearance and function,is an ideal technique for reconstruction of the severe flexion contracture of the burned finger.