Congenital orofacial cleft, the most common birth defect in the maxillofacial region, exhibits a wide range of prognosis depending on the severity of deformity and underlying etiology. Non-syndromic congenital orofacial clefts typically present with milder deformities and more favorable treatment outcomes, whereas syndromic congenital orofacial clefts often manifest with concomitant organ abnormalities, which pose greater challenges for treatment and result in poorer prognosis. This consensus provides an elaborate classification system for varying degrees of orofacial clefts along with corresponding diagnostic and therapeutic guidelines. Results serve as a crucial resource for families to navigate prenatal screening results or make informed decisions regarding treatment options while also contributing significantly to preventing serious birth defects within the development of population.
Humans ; Cleft Lip/diagnosis* ; Cleft Palate/diagnosis* ; Consensus ; Prenatal Diagnosis ; Female

Objective The aim of this study is to explore the practical value of prenatal magnetic resonance imaging(MRI)in the assessment of congenital cystic lung disease in fetuses,to evaluate the relative size of the lesion and the status of lung development,and to make an attempt at utilizing the strength of MRI in post-processing to obtain assessment indicators of the size of the lesion and the status of lung development,with which predictions can be made for the prognosis that these fetuses may face after birth.We retrospectively collected and analyzed the data of fetuses diagnosed with congenital cystic lung disease.Prenatal ultrasound examination of these fetuses led to the diagnosis that they were suspected of having congenital cystic lung disease and the diagnosis was confirmed by subsequent prenatal MRI.The fetuses were followed up to track their condition at birth(postnatal respiratory distress,mechanical ventilation,etc.),whether the fetuses underwent surgical treatment,and the recovery of the fetuses after surgical treatment.The recovery of the fetuses was followed up to explore the feasibility of prenatal MRI examination to assess fetal congenital pulmonary cystic disease,and to preliminarily explore the predictive value of prenatal MRI for the prognosis of fetuses with congenital pulmonary cystic disease.Methods MRI fetal images were collected from pregnant women who attended the West China Second University Hospital of Sichuan University between May 2018 and March 2023 and who were diagnosed with fetal congenital pulmonary cystic disease by prenatal ultrasound and subsequent MRI.Fetal MRI images of congenital cystic lung disease were post-processed to obtain the fetal lung lesion volume,the fetal affected lung volume,the healthy lung volume,and the fetal head circumference measurements.The signal intensity of both lungs and livers,the lesion volume/the affected lung volume,the lesion volume/total lung volume,the cystic volume ratio(CVR),and the bilateral lung-liver signal intensity ratio were measured.The feasibility and value of MRI post-processing acquisition indexes for evaluating the prognosis of fetuses with congenital cystic lung disease were further analyzed by combining the follow-up results obtained 6 months after the birth of the fetus.Logistic regression models were used to quantify the differences in maternal age,gestational week at the time of MRI,CVR,and bilateral lung-to-liver signal intensity ratio,and to assess whether these metrics correlate with poor prognosis.Receiver operating characteristic(ROC)curves were used to assess the value of the parameters obtained by MRI calculations alone and in combination with multiple metrics for predicting poor prognosis after birth.Results We collected a total of 67 cases of fetuses diagnosed with congenital cystic lung disease by fetal MRI between May 2018 and March 2023,and excluded 6 cases with no normal lung tissue in the affected lungs,11 cases of fetal induction,and 3 cases of loss of pregnancy.In the end,47 cases of fetuses with congenital cystic lung disease were included,of which 30 cases had a good prognosis and 17 cases had a poor prognosis.The difference in the difference between the signal intensity ratios of the affected and healthy sides of the lungs and livers of the fetuses in the good prognosis group and that in the poor prognosis group was statistically significant(P<0.05),and the signal intensity ratio of the healthy side of the lungs and livers was higher than the signal intensity ratio of the affected side of the lungs and livers.Further analysis showed that CVR(odds ratio[OR]=1.058,95% confidence interval[CI]:1.014-1.104),and the difference between the lung-to-liver signal intensity ratios of the affected and healthy sides(OR=0.814,95% CI:0.700-0.947)were correlated with poor prognosis of birth in fetuses with congenital cystic lung disease.In addition,ROC curve analysis showed that the combined application of lesion volume/affected lung volume and the observed difference in the signal intensity ratio between the affected and healthy lungs and liver predicted the prognosis of children with congenital cystic lung disease more accurately than the single-parameter judgment did,with the area under the curve being 0.988,and the cut-off value being 0.33,which corresponded to a sensitivity of 100%,a specificity of 93.3%,and a 95% CI of 0.966-1.000.Conclusions Based on the MRI of fetuses with congenital cystic lung disease,we obtained information on lesion volume,lesion volume/affected lung volume,lesion volume/total lung volume,CVR,and bilateral lung-to-liver signal intensity ratio difference,all of which showing some clinical value in predicting the poor prognosis in fetuses with congenital cystic lung disease.Furthermore,among the combined indexes,the lesion volume/affected lung volume and bilateral lung-to-liver signal intensity ratio difference are more effective predictors for the poor prognosis of fetuses with congenital cystic lung disease,and show better efficacy in predicting the poor prognosis of fetuses with congenital cystic lung disease.This provides a new and effective predictive method for further assessment of pulmonary lung development in fetuses with congenital cystic lung disease,and helps improve the assessment and prediction of the prognosis of fetuses with congenital cystic lung disease.

Objective:To provide warning information for early renal injury in pilots by investigating the relationship between serum cystatin C (Cys-C) level and renal blood flow parameters in healthy pilots.Methods:A total of 347 military pilots who underwent annual physical examination in the Air Service Department of the 960th Hospital of Joint Logistics Support Force from July of 2019 to December of 2021 were selected as the pilot group, and 347 healthy subjects who were in same age span and examined at same period were selected as the control group. Color Doppler flow imaging was used to qualitatively analyze renal artery blood flow parameters, including the peak systolic velocity (PSV), end-diastolic blood flow velocity (EDV) and resistance index (RI) of the main renal artery, segmental artery and interlobar arteries. The serum urea nitrogen, serum creatinine and uric acid of subjects were measured. Both pilot group and the control group were divided into 21-30 years old, 31-40 years old and 41-50 years old groups. According to the median level of serum Cys-C, the pilots were divided into high Cys-C group and low Cys-C group. The Cys-C level and renal blood flow parameters of each group were compared, and the correlation between Cys-C level and renal blood flow parameters of pilots was analyzed.Results:There were no significant differences on serum Cys-C level between the pilot group and the control group at all ages (all P>0.05). There was a significant difference on Cys-C levels among the pilots of different ages ( H=8.24, P=0.045). There was no significant difference in Cys-C levels among control groups at different ages ( P>0.05). The levels of endogenous creatinine clearance and uric acid in the high Cys-C group were higher than those in the low Cys-C group, and the differences were significant ( Z=-4.17, -2.98, P<0.001, =0.003). The EDV of main renal artery in high Cys-C group was lower than that in low Cys-C group, and the difference was significant ( t=4.82, P=0.021). The EDV of interlobar arteries in high Cys-C group was lower than that in low Cys-C group, and the difference was significant ( Z=-5.48, P=0.030). Correlation analysis showed that the Cys-C level of pilots was positively correlated with age, flying hours and uric acid level ( r=0.381, 0.165, 0.359, P=0.001, 0.002, 0.003). Cys-C level was negatively correlated with EDV of main renal artery and interlobar arteries ( r=-0.306, -0.321, P=0.048, 0.024), and positively correlated with RI of main renal artery ( r=0.417, P=0.029). Conclusions:The serum Cys-C of pilots could reflect certain basic data of renal function and is hopeful to provide warning for early renal injury due it correlated to the EDV of main renal artery and interlobar arteries and the RI of main renal artery.

Objective:To provide warning information for early renal injury in pilots by investigating the relationship between serum cystatin C (Cys-C) level and renal blood flow parameters in healthy pilots.Methods:A total of 347 military pilots who underwent annual physical examination in the Air Service Department of the 960th Hospital of Joint Logistics Support Force from July of 2019 to December of 2021 were selected as the pilot group, and 347 healthy subjects who were in same age span and examined at same period were selected as the control group. Color Doppler flow imaging was used to qualitatively analyze renal artery blood flow parameters, including the peak systolic velocity (PSV), end-diastolic blood flow velocity (EDV) and resistance index (RI) of the main renal artery, segmental artery and interlobar arteries. The serum urea nitrogen, serum creatinine and uric acid of subjects were measured. Both pilot group and the control group were divided into 21-30 years old, 31-40 years old and 41-50 years old groups. According to the median level of serum Cys-C, the pilots were divided into high Cys-C group and low Cys-C group. The Cys-C level and renal blood flow parameters of each group were compared, and the correlation between Cys-C level and renal blood flow parameters of pilots was analyzed.Results:There were no significant differences on serum Cys-C level between the pilot group and the control group at all ages (all P>0.05). There was a significant difference on Cys-C levels among the pilots of different ages ( H=8.24, P=0.045). There was no significant difference in Cys-C levels among control groups at different ages ( P>0.05). The levels of endogenous creatinine clearance and uric acid in the high Cys-C group were higher than those in the low Cys-C group, and the differences were significant ( Z=-4.17, -2.98, P<0.001, =0.003). The EDV of main renal artery in high Cys-C group was lower than that in low Cys-C group, and the difference was significant ( t=4.82, P=0.021). The EDV of interlobar arteries in high Cys-C group was lower than that in low Cys-C group, and the difference was significant ( Z=-5.48, P=0.030). Correlation analysis showed that the Cys-C level of pilots was positively correlated with age, flying hours and uric acid level ( r=0.381, 0.165, 0.359, P=0.001, 0.002, 0.003). Cys-C level was negatively correlated with EDV of main renal artery and interlobar arteries ( r=-0.306, -0.321, P=0.048, 0.024), and positively correlated with RI of main renal artery ( r=0.417, P=0.029). Conclusions:The serum Cys-C of pilots could reflect certain basic data of renal function and is hopeful to provide warning for early renal injury due it correlated to the EDV of main renal artery and interlobar arteries and the RI of main renal artery.

Humans ; Muscular Dystrophy, Duchenne/epidemiology* ; Prevalence ; Myocardium

Objective:To evaluate the value of conventional ultrasound, shear wave elastography and thyroglobulin antibody in the differential diagnosis of benign and malignant thyroid nodules in pilots by Logistic regression model.Methods:The cohort study was used. The clinical data of pilots with thyroid nodules who were admitted to the 960th Hospital of the Joint Logistics Support Force from January of 2010 to May of 2022 were collected, including thyroglobulin antibody results and ultrasound images. The pathological results were used as the gold standard to establish a binary Logistic regression model and evaluate its ability to predict benign and malignant nodules.Results:Seventy-two pilots were included, all were male, with 22-55 years old and 75-5 600 h flying hours. A total of 85 nodules were detected. Among them, 48 nodules were benign nodules, including 34 nodular goiters, 10 adenomas, and 4 thyroid cystic nodules. There were 37 malignant nodules, all of which were papillary carcinomas. A total of 4 statistically significant characteristic variables were screened out, including thyroid nodule morphology, microcalcification, serum thyroglobulin antibody, and maximum elastic modulus. The sensitivity, specificity and accuracy of Logistic regression model in predicting benign and malignant thyroid nodules was 83.9%, 79.6% and 81.5%, respectively. The area under the receiver operating characteristic curve was 0.908 (95% CI: 0.850-0.966). Conclusions:The Logistic regression model established by shear wave elastography combined with thyroglobulin antibody has high diagnostic value. It is helpful to the differential diagnosis of benign and malignant thyroid nodules in pilots.

Objective:To evaluate the value of conventional ultrasound, shear wave elastography and thyroglobulin antibody in the differential diagnosis of benign and malignant thyroid nodules in pilots by Logistic regression model.Methods:The cohort study was used. The clinical data of pilots with thyroid nodules who were admitted to the 960th Hospital of the Joint Logistics Support Force from January of 2010 to May of 2022 were collected, including thyroglobulin antibody results and ultrasound images. The pathological results were used as the gold standard to establish a binary Logistic regression model and evaluate its ability to predict benign and malignant nodules.Results:Seventy-two pilots were included, all were male, with 22-55 years old and 75-5 600 h flying hours. A total of 85 nodules were detected. Among them, 48 nodules were benign nodules, including 34 nodular goiters, 10 adenomas, and 4 thyroid cystic nodules. There were 37 malignant nodules, all of which were papillary carcinomas. A total of 4 statistically significant characteristic variables were screened out, including thyroid nodule morphology, microcalcification, serum thyroglobulin antibody, and maximum elastic modulus. The sensitivity, specificity and accuracy of Logistic regression model in predicting benign and malignant thyroid nodules was 83.9%, 79.6% and 81.5%, respectively. The area under the receiver operating characteristic curve was 0.908 (95% CI: 0.850-0.966). Conclusions:The Logistic regression model established by shear wave elastography combined with thyroglobulin antibody has high diagnostic value. It is helpful to the differential diagnosis of benign and malignant thyroid nodules in pilots.

Objective To explore the effects of real-time shear wave elastography (SWE) on diagnosing benign and malignant thyroid nodules in pilots . Methods Fifty-two pilots were diagnosed as thyroid nodules (60 nodules) in 456th Hospital of People's Liberation Army from May 2014 to May 2017 .They were checked by real -time shear wave elastography and the Young＇s moduli of nodules and normal thyroid tissues were recorded .The Young＇s modulus of patients' normal thyroid tissues was taken as control value and was compared to that of thyroid nodules .By referring to the pathological examination result as the gold stand ,the receiver operating characteristic (ROC ) curve was plotted to determine if the thyroid nodules were benign or malignant in SWE diagnosis .The area under the ROC curve (AUC) was compared to determine the best diagnostic boundary . Results Out of 52 cases of thyroid nodules ,43 cases (48 nodules) were benign lesions .The pathological types included nodular goiter (n＝ 33) and adenomas (n＝ 15) .There were 9 cases of malignant lesions (12 nodules) including papillary carcinoma (n＝ 10) and small papillary carcinoma (n＝ 2) .The maximum ,average and minimum Young's modulus values showed significant difference between control group and those with thyroid adenoma ,nodular goiter and thyroid malignant tumor (F＝258 .19 ,268 .39 ,421 .84 ,P＜0 .01) .The mean ,maximum and minimum Young's modulus values of malignant nodules were (58 .68 ± 9 .27) kPa ,(78 .64 ± 11 .53) kPa and (38 .51 ± 5 .81) kPa respectively , and were higher than those of benign thyroid nodules (41 .48 ± 5 .69) kPa , (52 .23 ± 7 .71 ) kPa , (31 .51 ± 2 .47) kPa .The differences had statistical significance (t＝8 .16 ,9 .55 ,6 .44 , P＜0 .01) .The AUC corresponding to the maximum ,average and minimum Young's modulus value was 0 .929 , 0 .863 and 0 .798 respectively .The best diagnostic efficiency was at the maximum Young's modulus in the nodule and its diagnostic threshold was 54 .42 kPa . Conclusions The Young's modulus of benign thyroid nodules is smaller than that of malignant nodules in pilots .Applying the maximum value of the Young's modulus enables better diagnosis accuracy than using its average or minimum value in determining malignant thyroid nodules .The quantitative SWE is helpful for diagnosing benign and malignant thyroid nodules in pilots .

Objective To explore the effects of real-time shear wave elastography (SWE) on diagnosing benign and malignant thyroid nodules in pilots . Methods Fifty-two pilots were diagnosed as thyroid nodules (60 nodules) in 456th Hospital of People's Liberation Army from May 2014 to May 2017 .They were checked by real -time shear wave elastography and the Young＇s moduli of nodules and normal thyroid tissues were recorded .The Young＇s modulus of patients' normal thyroid tissues was taken as control value and was compared to that of thyroid nodules .By referring to the pathological examination result as the gold stand ,the receiver operating characteristic (ROC ) curve was plotted to determine if the thyroid nodules were benign or malignant in SWE diagnosis .The area under the ROC curve (AUC) was compared to determine the best diagnostic boundary . Results Out of 52 cases of thyroid nodules ,43 cases (48 nodules) were benign lesions .The pathological types included nodular goiter (n＝ 33) and adenomas (n＝ 15) .There were 9 cases of malignant lesions (12 nodules) including papillary carcinoma (n＝ 10) and small papillary carcinoma (n＝ 2) .The maximum ,average and minimum Young's modulus values showed significant difference between control group and those with thyroid adenoma ,nodular goiter and thyroid malignant tumor (F＝258 .19 ,268 .39 ,421 .84 ,P＜0 .01) .The mean ,maximum and minimum Young's modulus values of malignant nodules were (58 .68 ± 9 .27) kPa ,(78 .64 ± 11 .53) kPa and (38 .51 ± 5 .81) kPa respectively , and were higher than those of benign thyroid nodules (41 .48 ± 5 .69) kPa , (52 .23 ± 7 .71 ) kPa , (31 .51 ± 2 .47) kPa .The differences had statistical significance (t＝8 .16 ,9 .55 ,6 .44 , P＜0 .01) .The AUC corresponding to the maximum ,average and minimum Young's modulus value was 0 .929 , 0 .863 and 0 .798 respectively .The best diagnostic efficiency was at the maximum Young's modulus in the nodule and its diagnostic threshold was 54 .42 kPa . Conclusions The Young's modulus of benign thyroid nodules is smaller than that of malignant nodules in pilots .Applying the maximum value of the Young's modulus enables better diagnosis accuracy than using its average or minimum value in determining malignant thyroid nodules .The quantitative SWE is helpful for diagnosing benign and malignant thyroid nodules in pilots .

Objective To evaluate the clinical diagnostic value of prospective electrocardiograph (ECG)-gating of CT cardiac angiography in congenital heart diseases of Chinese population through a Meta-analysis.Methods The articles were searched to study CT prospective ECG-gating in diagnosis of congenital heart disease from January 1995 to February 2016 in domestic and foreign publications.The study quality was assessed by the Quality Assessment for Diagnostic Accuracy Studies and the data extraction was performed.The software of Meta-disc1.4 was used for heterogeneity test.Different effect models were choosen according to the results of heterogeneity analysis.Meanwhile,this soft was used to calculate the sensitivity,specificity,likelihood ratio and its 95％ confidence interval (CI),respectively.The forest maps and summary receiver operator characteristic (SROC) curve were drawn.In addition,the area under curve (AUC) was calculated.Results Twelve articles were included in the Meta-analysis.The study included 1 431 congenital heart malformations confirmed by surgery or cardiac catheterization angiography.CT prospective ECG-gating technique had no heterogeneity in sensitivity and specificity of congenital heart disease.The total sensitivity,the total specificity,positive likelihood ratios,negative likelihood ratios and its 95％ CI of CT cardiac angiography were 96％ (95％ CI 94％ to 97％),100％ (95％ CI 100％ to 100％),365.94(95％ CI 231.18 to 579.26),0.04(95％ CI 0.03 to 0.05) with fixed effect model,respectively.The AUC of the SROC was 99.86％,Q =0.987 9.Conclusions Prospectively ECG-gating of CT cardiac angiography has high sensitivity and specificity in the diagnosis of congenital heart diseases.Its AUC of the SROC is large.It has high diagnostic value in congenital heart diseases.