OBJECTIVES: A stable, reliable, and easily implementable clinical diagnostic method for marginal velopharyngeal insufficiency (MVPI) was established on the basis of the subjective hearing judgement of hypernasality and objective examination of velopharyngeal closure to address the lack of unified diagnostic criteria for MVPI. METHODS: Nasopharyngeal fiberscopy and speech assessment results were collected from postoperative patients with cleft palate. These results were used to analyze the differences in the distribution of nasal resonance in patients with different velopharyngeal closure ratios and the correlation between velopharyngeal closure ratios and nasal resonance status. Mild-to-moderate hypernasality with its corresponding elopharyngeal closure ratio was employed to establish the diagnostic criteria of MVPI. The reproducibility of the criteria and whether the patients with MVPI diagnosed by using the criteria exhibited significantly different speech characteristics compared with other patients were verified. RESULTS: A strong correlation was found between velopharyngeal closure ratios and nasal resonance (P<0.001). Mild-to-moderate hypernasality mainly corresponded to velopharyngeal closure ratios ranging from 90% to 99%, and the combination of the two characteristics as the diagnostic criteria for MVPI demonstrated good consistency (Kappa value=0.789, P<0.001). Moreover, under the diagnostic criteria, significant differences in nasal resonance (P<0.001), nasal emission (P=0.007), and misarticulation (P<0.001) were found between patients with velopharyngeal insufficiency and those with MVPI. CONCLUSIONS Combining the subjective hearing judgement of mild-to-moderate hypernasality with velopharyngeal closure ratios over 90% under nasopharyngeal fiberscopy provides a reliable and effective clinical method for diagnosing MVPI.
Humans ; Velopharyngeal Insufficiency/physiopathology* ; Reproducibility of Results ; Cleft Palate/surgery* ; Male ; Female ; Child

Objective To evaluate biomechanical strength of locking compression plate (LCP) for fixation of periprosthetic proximal femur fractures (PPFF). Methods Eight matched pairs of Vancouver type B1 adult cadaveric PPFF specimens were fixed with the LCP and the inverted distal femoral less invasive stabilization system (LISS), respectively. Four bicortical locking screws (LCP group) and four unicortical locking screws were used to the length of prosthesis stem, and four double cortical locking screws were used to fix the distal end of the fracture in two groups, the distance from the locking screws to the fracture were also equal. The maximum bending load, maximum bending displacement, bending stiffness, maximum torque, maximum torsional angle and torsional stiffness of two groups in four-point bending test and torsion test were compared and analyzed. Results The maximum bending load, maximum bending displacement and bending stiffness of LCP group were all larger than those of LISS group, but the difference was not statistically significant (P>0.05). The maximum torque, maximum torsional angle and torsional stiffness of LCP group were obviously larger than those of LISS group，and there was a statistical difference between two groups (P<0.05). Conclusions The stiffness of anti-torsion with LCP is significantly better than that with LISS. Consequently, LCP has better biomechanical stability for PPFF.

Objective To evaluate the effect of anterior minimally invasive plate osteosynthesis (MIPO) for treatment of middle humeral shaft fracture.Methods From November 2011 to March 2014,10 cases of middle humeral shaft fracture were treated using MIPO via the anterior approach (MIPO group).Another 26 cases treated by open reduction and internal fixation (ORIF) of the middle humeral shaft fracture between October 2010 and March 2014 were included as controls (ORIF group).Fracture fixation using the 4.5 mm locking compression plate (LCP) was performed in both groups.Parameter measurements included operative time,intraoperative fluoroscopy times,grafting rate,intraoperative blood loss,postoperative drainage,hospital stay,bone healing time and complications.Results MIPO and ORIF groups differed significantly with respect to intraoperative blood loss [(93.5 ± 25.6) ml vs (325.3 ± 158.3) ml],intraoperative fluoroscopy times [(13.2 ± 6.1) vs 4.0 (0-6.0)] and hospitalization [(11.9 ± 1.7)days vs (18.0 ±4.7)days] (P ＜0.05).Bone grafting and drainage were not performed in MIPO group,while bone grafting rate was 54％ and postoperative drainage volume was (120.4 ± 69.6) ml in ORIF group (P ＜0.05).MIPO and ORIF groups were comparable with respect to operative time [(79.0 ± 22.0) min vs (97.5 ± 30.8) min],bone healing time [(15.2 ± 2.5) weeks vs (18.2 ± 4.8)weeks] and postoperative complications (10％ vs23％) (P＞0.05).Conclusion Anterior MIPO is an effective procedure for treatment of middle humeral shaft fracture,with advantages of small trauma,less bleeding,low risk of nerve injury and high rate of fracture healing.

BACKGROUND:There were stil lacking related clinical researches in the aspects of whether the total blood loss and hidden blood loss were connected with pathogenesis, whether the total blood loss and hidden blood loss were different among the patients who conducted total hip arthroplasty under different pathogenesis, and whether the preoperative intervention should be conducted for a particular cause? OBJECTIVE:To compare and analyze the hidden blood loss of patients with hip osteoarthritis and femoral neck fracture after total hip replacement. METHODS:The clinical data of 150 patients who received the unilateral total hip arthroplasty treatment from June 2013 to January 2015 were colected and analyzed, including 54 patients with hip osteoarthritis (30 male cases and 24 female cases ), 96 patients with femoral neck fracture (41 male cases and 55 female cases). The pre-and post-operative blood routine and intro-and post-operative blood loss and transfusion were recorded, and hidden blood loss during pen-operation period was evaluated. RESULTS AND CONCLUSION:Total blood loss was (1 616±216) mL, hidden blood loss was (699±102) mL, and hidden blood loss accounted for 43.3% of the total blood loss. The total blood loss was (1 742±254) mL in the hip osteoarthritis group, hidden blood loss was (758±127) mL, hidden blood loss accounted for 44.6% of the total blood loss; The average total blood loss was (1 470±189) mL in the femoral neck fracture group, hidden blood loss was (625±98) mL, hidden blood loss accounts for 42.1% of the total blood loss. The total blood loss and hidden blood loss in hip osteoarthritis group were significantly higher than those in the femoral neck fracture group (P< 0.05). However, there was no significant difference on the hidden blood loss accounts for the proportion of the total blood loss between two groups (P=0.419 3). These results suggest that the total blood loss and hidden blood loss are different for the patients who underwent total hip arthroplasty in the premise of both pathogenesis. Therefore, before the total hip arthroplasty, we should fuly take into account the primary cause of patients and estimate the total blood loss and hidden blood loss, so as to take appropriate preventive measures in time to ensure the safety of the replacement process.

Objective To investigate whether oral administration of probiotics can reduce complications induced by interventional therapy in patients with primary hepatic carcinoma and liver cirrosis.Methods Two hundred and sixty four patients with primary hepatic carcinoma and liver cirrhosis who underwent transarterial chemoembolization(TACE) were randomly divided into two groups.and patients in experimental group were given probiotics but not in control group.Shoa-term clinical manifestations.liver functions,blood routine and pain scores were compared between two groups.Results On the day 3 after therapy,the incidence of abdominal distension and constipation in experimental group were less than that in control group(x2=18.22 and 55.22,P=0.000);On the day 7 after therapy,the incidence of abdominal distension,constipation and infection in experimental group were less than that in control group(x2=5.35,13.5 and 19.14,P=0.021,0.000 and 0.000).There were no significant difference in other clinical manifestations,liver function,blood routine and pain scores between the two groups. Conclusion Oral administration of probiotics can reduce the incidence of some short-term complication induced by interventional therapy in patients with hepatic carcinoma and liver cirrhosis.

[Objective] To investigate the clinical significance of approximated molecular subtype.[Methods] Four different subtypes were defined by immunohistochemical (IHC) markers as estrogen receptor (ER),progesterone receptor (PR) and HER2.Clinical characteristics as distribution,age,menopausal status,histopathologic type and grading,tumor size,lymph node status,time to and place of first tumor recurrence were analyzed.[Results] Among all 703 cases,Luminal A was the majority (51.5%) and the least were Luminal B and HER2+.90.8% the patients were less than 59 years old with Luminal A.Different subtype has different histopathologic grading.Luminal A was more than others among grading 1 tumors and it has more T1 tumors,while T4 tumors was most among HER2+ ones.Lymph nodes metastasis has no significant difference between different groups,other than high proportion tendency of N3 stage in Luminal B and HER2+.In addition,Luminal A has the longest time to the first recurrence while HER2+ was the shortest.Moreover,HER2+ and Basal-like have high rates of lung metastasis.Different from foreign reports,the distribution of the first recurrent place and distant metastases have no significant difference.[Conclusion] The classification of breast cancer approximated molecular subtype defined by IHC markers was feasible.The distribution is similar to other countries.Luminal A has rather better clinical characteristics while HER2+ and Basal-like have high rates of lung metastasis.However,Luminal A has the highest proportion of young patients,which is different from other countries.

OBJECTIVE:To establish the optimal technical condition for the extraction of volatile oil from the volatile herbs of Huoxiang zhengqi prescription with supercritical CO2 fluid(SFE-CO2).METHODS:The technical condition for the extraction of volatile oil from the volatile herbs of Huoxiang zhengqi prescription were optimized using L9(34)orthogonal design table with extraction pressure,the extraction temperature,the pressure and temperature of separator Ⅰ as factors and with the yield of the volatile oil as index.RESULTS:A highest extraction yield of volatile oil from the volatile herbs of Huoxiang zhengqi prescription was achieved(2.057%)under an optimal technical condition as follows:with extraction pressure at 25 MPa,the extraction temperature at 30 ℃,the pressure for separator Ⅰ at 9 MPa and the temperature of separator Ⅰ at 45 ℃.CONCLUSION:Extraction of volatile oil from the volatile herbs of Huoxiang zhengqi prescription by SFE-CO2 is characterized by high extraction yield,stable,pure operation,safe,and by which the biological activity of the volatile oil can be maintained,thus it is a potential extraction and separation method.

OBJECTIVE:To discuss the way to improve the service quality of outpatient pharmacy.METHODS:The pharmaceutical work in the outpatient pharmacy was optimized applying the theory of system engineering.RESULTS:The working efficiency and service quality of outpatient pharmacy were improved significantly.CONCLUSIONS:The theory of system engineering lay a focus on the optimal holistic effect of the system.Excellent results were achieved on the same objective conditions,when the stable quality of drugs,intensive scientific management,coordinating the exterior and interior relationships and reasonable usage of workers were considered as the elements of the system.