Periodontal disease is a risk factor for many systemic diseases such as Alzheimer’s disease and adverse pregnancy outcomes.Cleft palate(CP),the most common congenital craniofacial defect,has a multifaceted etiology i...Periodontal disease is a risk factor for many systemic diseases such as Alzheimer’s disease and adverse pregnancy outcomes.Cleft palate(CP),the most common congenital craniofacial defect,has a multifaceted etiology influenced by complex genetic and environmental risk factors such as maternal bacterial or virus infection.A prior case-control study revealed a surprisingly strong association between maternal periodontal disease and CP in offspring.However,the precise relationship remains unclear.In this study,the relationship between maternal oral pathogen and CP in offspring was studied by sonicated P.gingivalis injected intravenously and orally into pregnant mice.We investigated an obvious increasing CP(12.5%)in sonicated P.gingivalis group which had inhibited osteogenesis in mesenchyme and blocked efferocytosis in epithelium.Then glycolysis and H4K12 lactylation(H4K12la)were detected to elevate in both mouse embryonic palatal mesenchyme(MEPM)cells and macrophages under P.gingivalis exposure which further promoted the transcription of metallopeptidase domain17(ADAM17),subsequently mediated the shedding of transforming growth factor-beta receptor 1(TGFBR1)in MEPM cells and mer tyrosine kinase(MerTK)in macrophages and resulted in the suppression of efferocytosis and osteogenesis in palate,eventually caused abnormalities in palate fusion and ossification.The abnormal efferocytosis also led to a predominance of M1 macrophages,which indirectly inhibited palatal osteogenesis via extracellular vesicles.Furthermore,pharmacological ADAM17 inhibition could ameliorate the abnormality of P.gingivalis-induced abnormal palate development.Therefore,our study extends the knowledge of how maternal oral pathogen affects fetal palate development and provides a novel perspective to understand the pathogenesis of CP.展开更多
Background: In developing countries, charity cleft surgical mission is always operated by sporadic surgical teams without systematic follow up and quality assurance. In the past few decades, many mission projects have...Background: In developing countries, charity cleft surgical mission is always operated by sporadic surgical teams without systematic follow up and quality assurance. In the past few decades, many mission projects have been held regularly in China. The purpose of this audit was a retrospective analysis of a 9-year cleft lip and palate charity project operated in a tertiary hospital in China Shenzhen Area to evaluate perioperative and postoperative complications. Nevertheless, understanding the risk profile is essential for establishing a sustainable in-house cleft service in Shenzhen. Methods: A detailed analysis of hospital centralized record in the The University of Hong Kong-Shenzhen Hospital (HKUSZH) was reviewed since the first charity project held in 2015. The parameters of this audit were focused on perioperative complications including anesthesia related problems, early postoperative complications in patients who underwent primary or secondary cleft surgeries. A total of 430 consecutive admitted cases of 311 non-syndromic cleft lip & palate patients were enrolled into the charity project from June 2015 to July 2024. The main anesthesia related complications that occurred during general anesthesia were respiratory tract problems, while intraoperative complication was excessive bleeding, so as wound local infection and reaction were the main early postoperative complications. Results: In our 9-year clinical audit of 430 cleft lip and palate charity surgeries in Shenzhen, we observed no mortalities and a anesthesia-related complication rate of 1.16%. Specific intraoperative complications included excessive bleeding, while early postoperative issues were dominated by wound infections. The fistula rate of 18.7% post palate repair and the average hospital stay of 3.71 days complete the profile of our surgical outcomes. These data underscore the project’s efficacy and offer a reference for international cleft missions aiming for safe and efficient surgical care. Conclusions: This study provides a thorough data review of the complications in the past 9 years charity missions for cleft lip and palate surgery in a well-structured hospital infrastructure and logistic support by local surgical team. There were no perioperative or postoperative death during the study period and the overall short-term complication rate was low. Therefore, it could be a reference model for other international cleft mission in developing country for a safe and efficient service in future.展开更多
Cleft palate is a common congenital malformation of the maxillofacial region,and its postoperative speech disorders(such as hypernasality,nasal emission,and articulation errors)can significantly impact patients’commu...Cleft palate is a common congenital malformation of the maxillofacial region,and its postoperative speech disorders(such as hypernasality,nasal emission,and articulation errors)can significantly impact patients’communication abilities and psychological well-being.Traditional speech-language therapy faces challenges such as insufficient personalization of training methods,limited scenarios,and low patient compliance,making it inadequate for long-term rehabilitation needs.The innovative intervention model of a mobile interactive platform combined with games and picture books,through immersive experiences,instant feedback,and engaging designs,holds promise for enhancing patient participation and overall treatment outcomes.Therefore,this paper provides a comprehensive review from five perspectives:the pathological mechanisms and treatment needs of cleft palate speech disorders,the advantages of games and picture books as carriers in cleft palate speech therapy,the technological implementation of mobile interactive platforms,clinical application effects,and current challenges and limitations.The aim is to offer valuable insights for clinical practice and technological development in cleft palate speech rehabilitation.展开更多
Objective To observe the clinical efficacy of fire needling and bloodletting at cleft points for acute gouty arthritis, and to explore its functional mechanism. Methods Thirty-five patients with acute gouty arthritis ...Objective To observe the clinical efficacy of fire needling and bloodletting at cleft points for acute gouty arthritis, and to explore its functional mechanism. Methods Thirty-five patients with acute gouty arthritis were enrolled into this study, and fire needling and bloodletting with 10 mL/ time were applied at cleft points of corresponding meridians and collaterals at the affected side. The treatment was conducted for once every other day, and treatment for three consecutive times was needed. Serum uric acid （UA） and pain score were tested in patients before treatment and on the 6th day after treatment, follow-up visit for 3 months was performed in patients who stopped treatment, and recurrence rate was calculated. Results Budzyuski 6-point behavioral rating scale was applied to score pain. T-test was conducted on mean and standard deviation of pain score before treatment （4.09 ＋ 0.82） and after treatment （1.14 ＋ 1.33）, showing that the difference was significant （P〈0.05）; t-test was also conducted on mean and standard deviation of serum UA before treatment [（555.34 ＋ 53.09） pmol/L] and after treatment [（414.23 ＋ 67.04） pmol/L], showing that the difference was significant （P〈0.05）; among the 35 patients with acute gouty arthritis, 14 patients were cured （40.0%）, improvement was found in 19 patients （54.3%）, and effectiveness was found in 33 patients （94.3%）. Based on follow-up visit for 3 months in 33 patients with efficacy, recurrence was found in 3 patients （9.1%）. Conclusion Fire needling and bloodletting at cleft points is an effective method in treatment of acute gouty arthritis with significant analgesic effect, efficacy of reducing serum UA, high cure rate and low recurrence rate, which is worth of being generalized clinically.展开更多
基金funded by grants from the National Natural Science Foundation of China(grant numbers 82170912 and 82370910)the Beijing Stomatological Hospital,Capital Medical University Young Scientist Program(No.YSP202404).
文摘Periodontal disease is a risk factor for many systemic diseases such as Alzheimer’s disease and adverse pregnancy outcomes.Cleft palate(CP),the most common congenital craniofacial defect,has a multifaceted etiology influenced by complex genetic and environmental risk factors such as maternal bacterial or virus infection.A prior case-control study revealed a surprisingly strong association between maternal periodontal disease and CP in offspring.However,the precise relationship remains unclear.In this study,the relationship between maternal oral pathogen and CP in offspring was studied by sonicated P.gingivalis injected intravenously and orally into pregnant mice.We investigated an obvious increasing CP(12.5%)in sonicated P.gingivalis group which had inhibited osteogenesis in mesenchyme and blocked efferocytosis in epithelium.Then glycolysis and H4K12 lactylation(H4K12la)were detected to elevate in both mouse embryonic palatal mesenchyme(MEPM)cells and macrophages under P.gingivalis exposure which further promoted the transcription of metallopeptidase domain17(ADAM17),subsequently mediated the shedding of transforming growth factor-beta receptor 1(TGFBR1)in MEPM cells and mer tyrosine kinase(MerTK)in macrophages and resulted in the suppression of efferocytosis and osteogenesis in palate,eventually caused abnormalities in palate fusion and ossification.The abnormal efferocytosis also led to a predominance of M1 macrophages,which indirectly inhibited palatal osteogenesis via extracellular vesicles.Furthermore,pharmacological ADAM17 inhibition could ameliorate the abnormality of P.gingivalis-induced abnormal palate development.Therefore,our study extends the knowledge of how maternal oral pathogen affects fetal palate development and provides a novel perspective to understand the pathogenesis of CP.
文摘Background: In developing countries, charity cleft surgical mission is always operated by sporadic surgical teams without systematic follow up and quality assurance. In the past few decades, many mission projects have been held regularly in China. The purpose of this audit was a retrospective analysis of a 9-year cleft lip and palate charity project operated in a tertiary hospital in China Shenzhen Area to evaluate perioperative and postoperative complications. Nevertheless, understanding the risk profile is essential for establishing a sustainable in-house cleft service in Shenzhen. Methods: A detailed analysis of hospital centralized record in the The University of Hong Kong-Shenzhen Hospital (HKUSZH) was reviewed since the first charity project held in 2015. The parameters of this audit were focused on perioperative complications including anesthesia related problems, early postoperative complications in patients who underwent primary or secondary cleft surgeries. A total of 430 consecutive admitted cases of 311 non-syndromic cleft lip & palate patients were enrolled into the charity project from June 2015 to July 2024. The main anesthesia related complications that occurred during general anesthesia were respiratory tract problems, while intraoperative complication was excessive bleeding, so as wound local infection and reaction were the main early postoperative complications. Results: In our 9-year clinical audit of 430 cleft lip and palate charity surgeries in Shenzhen, we observed no mortalities and a anesthesia-related complication rate of 1.16%. Specific intraoperative complications included excessive bleeding, while early postoperative issues were dominated by wound infections. The fistula rate of 18.7% post palate repair and the average hospital stay of 3.71 days complete the profile of our surgical outcomes. These data underscore the project’s efficacy and offer a reference for international cleft missions aiming for safe and efficient surgical care. Conclusions: This study provides a thorough data review of the complications in the past 9 years charity missions for cleft lip and palate surgery in a well-structured hospital infrastructure and logistic support by local surgical team. There were no perioperative or postoperative death during the study period and the overall short-term complication rate was low. Therefore, it could be a reference model for other international cleft mission in developing country for a safe and efficient service in future.
文摘Cleft palate is a common congenital malformation of the maxillofacial region,and its postoperative speech disorders(such as hypernasality,nasal emission,and articulation errors)can significantly impact patients’communication abilities and psychological well-being.Traditional speech-language therapy faces challenges such as insufficient personalization of training methods,limited scenarios,and low patient compliance,making it inadequate for long-term rehabilitation needs.The innovative intervention model of a mobile interactive platform combined with games and picture books,through immersive experiences,instant feedback,and engaging designs,holds promise for enhancing patient participation and overall treatment outcomes.Therefore,this paper provides a comprehensive review from five perspectives:the pathological mechanisms and treatment needs of cleft palate speech disorders,the advantages of games and picture books as carriers in cleft palate speech therapy,the technological implementation of mobile interactive platforms,clinical application effects,and current challenges and limitations.The aim is to offer valuable insights for clinical practice and technological development in cleft palate speech rehabilitation.
文摘Objective To observe the clinical efficacy of fire needling and bloodletting at cleft points for acute gouty arthritis, and to explore its functional mechanism. Methods Thirty-five patients with acute gouty arthritis were enrolled into this study, and fire needling and bloodletting with 10 mL/ time were applied at cleft points of corresponding meridians and collaterals at the affected side. The treatment was conducted for once every other day, and treatment for three consecutive times was needed. Serum uric acid （UA） and pain score were tested in patients before treatment and on the 6th day after treatment, follow-up visit for 3 months was performed in patients who stopped treatment, and recurrence rate was calculated. Results Budzyuski 6-point behavioral rating scale was applied to score pain. T-test was conducted on mean and standard deviation of pain score before treatment （4.09 ＋ 0.82） and after treatment （1.14 ＋ 1.33）, showing that the difference was significant （P〈0.05）; t-test was also conducted on mean and standard deviation of serum UA before treatment [（555.34 ＋ 53.09） pmol/L] and after treatment [（414.23 ＋ 67.04） pmol/L], showing that the difference was significant （P〈0.05）; among the 35 patients with acute gouty arthritis, 14 patients were cured （40.0%）, improvement was found in 19 patients （54.3%）, and effectiveness was found in 33 patients （94.3%）. Based on follow-up visit for 3 months in 33 patients with efficacy, recurrence was found in 3 patients （9.1%）. Conclusion Fire needling and bloodletting at cleft points is an effective method in treatment of acute gouty arthritis with significant analgesic effect, efficacy of reducing serum UA, high cure rate and low recurrence rate, which is worth of being generalized clinically.
文摘目的评估时空电阻抗断层成像(spatiotemporal electrical impedance tomography,ST-EIT)在言语发声任务下,能否有效捕捉并区分腭裂(cleft palate,CP)患者与正常对照(normal control,NC)的言语呼吸功能特征。方法本研究纳入75名受试者(CP组37例,NC组38例)。在标准化发声任务中,同步采集电阻抗断层成像(electrical impedance tomography,EIT)图像与口鼻气流信号,构建涵盖时间、气流与空间维度的三域特征,采用曼-惠特尼U检验(MannWhitney U test)比较组间差异。基于肺量计法(spirometry)、鼻音计(nasometry)及ST-EIT等多源数据,分别训练极端梯度提升(extreme gradient boosting,XGBoost)分类模型,采用5折交叉验证评估性能,并引入Shapley加性解释(Shapley additive explanations,SHAP)方法进行特征贡献分析。结果CP组呈现显著的呼吸表型差异。时间域中,吸/呼相位时长均显著缩短(P<0.001),吸/呼时间比显著升高;气流域中,呼气期平均气流与峰值气流显著增强,吸气期无明显差异;空间域中,感兴趣区(region of interest,ROI)1和4的潮气阻抗变化(tidal impedance variation,TIV)显著升高,ROI2显著降低,全局不均一性(global inhomogeneity,GI)较低,通气中心(center of ventilation,CoV)呈轻度升高。ST-EIT模型分类性能最佳,曲线下面积(area under the curve,AUC)达0.915,准确率优于单一肺功能检测或鼻音计检测。SHAP结果表明,时空特征对分类决策贡献最大。结论ST-EIT技术能有效揭示CP患者言语呼吸功能在时间-气流-空间三域的特异性改变,为床旁筛查、康复评估及随访监测提供了优于常规检测的客观量化依据。
