Anatomic characteristics of the velopharyngeal structures may be slightly less advantageous for velopharyngeal closure in children with VPI after palatal repair, but these structural differences alone cannot explain VPI.
The VPI group had significantly reduced velar and pharyngeal mobility during speech compared with the VPC and noncleft groups. The possible physiological causes of VPI after primary palatal repair were discussed.
Primary palate repair at older than 2 years resulted in acceptable clinical speech outcomes in our patient population, there was an increase in the incidence of postoperative velopharyngeal insufficiency with increasing age at the time of palatoplasty. There was no correlation with cleft type, surgical technique, or surgeon's experience.
Neutralizing antibody (NAb) can dampen the immunogenicity of adenovirus (Ad) vector-based vaccine. Vector systems based on human adenovirus type 41 (Ad41) have been constructed and used to develop recombinant vaccines. Here, we attempted to study the seroprevalence of NAbs to Ad5 and Ad41 among children and adults in Qinghai province, China. The positive rates (titer⩾40) of Ad5 and Ad41 NAb in adults from Xining city were 75.7% and 94.7%, respectively. The moderate/high-positive rates (titer⩾160) of NAb were quite close between the two viruses in adults (70.4% for Ad5 and 73.5% for Ad41). Age-dependent increase of NAb seroprevalence was observed for both viruses in children. NAb-positive rate of Ad41 reached 50% at 3.3-4.6years of age for children from Chengxi district, Xining city, approximately 1.5years earlier than that of Ad5 did. Interestingly, NAb level was also associated with sanitary conditions among young children. For Ad5, 8-15% children (0.2-3.0years of age) from city or town, where the sanitations were relatively better, had moderate/high-positive NAb, while the same rate was 62% for children from villages. For Ad41, 22% children from city, 47% from town and 88% from villages possessed moderate/high-positive NAb. The possible influence of NAb titer distributions on the application of Ad41-vectored vaccines was discussed in detail. Our results suggested that children from places with poor sanitations should be included for comprehensive Ad NAb seroprevalence studies, and provided insights to the applications of Ad41 vectors.
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