FFT-based digital tactile vocoder system for real-time use

A microprocessor-based real-time digital vibrotactile vocoder system has been developed to train the deaf and for artificial hearing research. The system is composed of a microcomputer module with a digital signal processor interface units and an attenuator/driver circuit. Live or digitised (stored or synthetic) speech is presented to the skin spectrally through a belt housing eight or 16 vibrators. Speech is processed in real time using a fast Fourier transform. The system is also capable of presenting any arbitrary spatiotemporal pattern on the skin for artificial hearing experiments. A preliminary experiment with a deaf subject indicates that the system is potentially an effective device for artificial hearing.     

SPEECH EVALUATION WITH AND WITHOUT PALATAL OBTURATOR IN PATIENTS SUBMITTED TO MAXILLECTOMY

Most patients who have undergone resection of the maxillae due to benign or malignant tumors in the palatomaxillary region present with speech and swallowing disorders. Coupling of the oral and nasal cavities increases nasal resonance, resulting in hypernasality and unintelligible speech. Prosthodontic rehabilitation of maxillary resections with effective separation of the oral and nasal cavities can improve speech and esthetics, and assist the psychosocial adjustment of the patient as well. The objective of this study was to evaluate the efficacy of the palatal obturator prosthesis on speech intelligibility and resonance of 23 patients with age ranging from 18 to 83 years (Mean = 49.5 years), who had undergone inframedial-structural maxillectomy. The patients were requested to count from 1 to 20, to repeat 21 words and to spontaneously speak for 15 seconds, once with and again without the prosthesis, for tape recording purposes. The resonance and speech intelligibility were judged by 5 speech language pathologists from the tape recordings samples. The results have shown that the majority of patients (82.6%) significantly improved their speech intelligibility, and 16 patients (69.9%) exhibited a significant hypernasality reduction with the obturator in place. The results of this study indicated that maxillary obturator prosthesis was efficient to improve the speech intelligibility and resonance in patients who had undergone maxillectomy.     

Speech — A key function of man reflexions of a neurosurgeon Budapest,February 23, 1991

Summary Man is distinguished and differentiated from other living creatures by possessing less genetically determined characteristics, behaviour and reactions, with fewer features fitting him for a special environment. For this reason he enjoys greater freedom and adaptability.In order to be able to pass on the necessarry lessons for survival, man must have command of his speech, and as a species can only exist within communities. This presupposes an instinctive drive to make rules and regulations for ordered living in society.Speech is not only a means of communication but also the basis and precondition of abstract thinking. Complete aphasia implies the loss of this ability. It would deprive man from the most important of his key functions. Therefore it is inhuman.These reflections have convinced me absolutely, that neurosurgical interventions, which would have the predictable result of total aphasia, must not be performed, even though prolongation of life, but without speech, might thus be bought.     

质疑Frank—Starling心脏定律

心脏收缩释放的能量（作功）是心肌纤维长度（心室舒张末期容积，EDV）的函数，即Frank—Star一1ing（FS）心脏作功定律，被誉为心脏生理学中的“经典”理论。对此，笔者从各种不同角度进行了探讨：首先分析了Frank伸展离体心肌和Starling及其同事使用心肺制备做的实验与动物生理实际的差异，以及人们在实验中观测到的增加心肌前负荷引起收缩力增强的现象（FS现象），认为：①在正常生理条件下的动物体内，来自心脏以外的、如同心肺制备中那样人工控制心室充盈压力升高、引起EDV增加的那种血液的重力动力是不存在的。②另一方面，人为地增加前负荷，那是改变了心肌收缩时的外环境条件。③由此而激发出的FS现象，是心脏适应其外环境条件变化所作出的反应。④此种心肌收缩力增强的反应，需通过心肌细胞内部与收缩过程发生有关的心肌兴奋一收缩和化学一力学偶联等一系列生化机制（不恒定因素）方能得以实现。⑤根据他们实验中观测到的FS现象，在逻辑上不能得出前负荷这一心肌收缩时的外环境条件变化调控其作功的推论。换言之，所有的在实验中被激发出来的FS现象，都不足以成为支持FS心脏定律的证据。然后，引用国内外公认的计算心脏每搏射血作功（w）的生物物理学公式“w=P×（EDV—ESV）”，证明了w和EDV之间没有函数关系。根据心脏作功的医用物理学和生物数学的基本原理，笔者认为Frank—Starling心脏定律表达的不是心脏作功的规律。     

中药香袋敷贴神阙穴治疗126例失眠症临床观察

目的观察自行研制的中药香袋敷贴神阙穴治疗失眠的临床疗效。方法126例失眠症患者运用中药香袋每晚敷贴神阙穴，疗程14d。通过SPIEGEL量表比较治疗前后积分以评定临床疗效。结果中药香袋神阙穴敷贴对轻中度失眠症疗效较佳，尤其适用于肝郁瘀阻、肝气偏旺和肝郁化火型失眠症。结论中药香袋敷贴神阙穴治疗失眠疗效确切，简便易行。     

百赛诺治疗非酒精性脂肪肝50例疗效观察

目的观察百赛诺治疗非酒精性脂肪肝的临床疗效。方法将100例非酒精性脂肪肝患者随机分为2组。治疗组50例给予百赛诺50 mg,每日3次口服;对照组50例给予甘利欣150 mg,每日3次口服。2组均24周为1个疗程,1个疗程后统计临床疗效及治疗前后血清学变化。结果2组治疗后丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、γ-谷氨酰转肽酶（GGT）、总胆固醇（TC）及甘油三酯（TG）与本组治疗前比较差异均有统计学意义（P〈0.01）;2组治疗后TC、TG比较差异均有统计学意义（P〈0.05）。治疗组总有效率90.0%,对照组总有效率70.0%,2组比较差异有统计学意义（P〈0.05）。结论百赛诺治疗非酒精性脂肪肝疗效确切,副作用小。     

桂附地黄丸对肺纤维化模型肺组织IL-10表达的影响

目的：探讨桂附地黄丸防治肺纤维化的作用及机理。方法：用平阳霉素诱导肺纤维化模型大鼠后，用药组每天灌胃桂附地黄丸，第28d后处死各组大鼠，观察、比较各组大鼠肺部病理组织学改变及肺组织中白细胞介素10（IL-10）的表达。结果：桂附地黄丸组、强的松对照组肺纤维化程度显著低于模型对照组（P〈0．05），而肺组织IL-10的表达显著高于模型对照组；且桂附地黄丸组IL-10的表达显著高于强的松对照组。结论：桂附地黄丸能明显减轻平阳霉素所致的大鼠肺纤维化程度，并能显著增强IL-10的表达。     

转化生长因子-β和碱性成纤维细胞因子在儿童原发性局灶节段性肾小球硬化肾组织中的表达

目的：通过检测转化生长因子-β（TGF-β）和碱性成纤维细胞生长因子（bFGF）在儿童原发性局灶节段性肾小球硬化（FSGS）肾组织中的表达情况,并分析其与肾小管间质病理变化的关系,以了解TGF-β与bFGF在原发性FSGS发生发展中的作用。方法：选择肾活检明确诊断为原发性FSGS患儿的肾组织共43例,其中不伴有肾小管间质病变的FSGS肾组织共16例,设为实验1组;伴有肾小管间质病变的FSGS肾组织共27例,为实验2组。另将同期因孤立性血尿入院肾活检证实为非FSGS、病理改变较轻的肾组织作为对照组,共17例。采用免疫组化法检测细胞/生长因子TGF-β、bFGF在各组中的表达。通过方差分析（ANOVA）和相关分析法分析细胞/生长因子的表达与FSGS肾组织病理变化的关系以及细胞/生长因子之间的相互作用关系。结果：TGF-β、bFGF在各组肾组织中均有表达,表达量在对照组、实验1组和实验2组中依次升高,各组间的差异均具有统计学意义（P〈0.05）;且TGF-β和bFGF的表达与肾小管间质指数呈正相关,相关系数依次为0.763和0.661。此外,TGF-β和bFGF两者的表达量经相关分析也显示呈正相关,相关系数为0.587。结论：TGF-β和bFGF在原发性FSGS患儿肾组织中高表达;随着FSGS的发展,它们在肾组织中表达量不断增加,促使肾小管间质向纤维化发展,而且两者在促进肾脏纤维化具有一定的协同作用。     

弥漫性大B细胞淋巴瘤中CD40L的表达及意义

目的探讨弥漫性大B细胞淋巴瘤（DLBCL）组织中CD40L表达与DLBCL预后间的关系及意义。方法免疫组织化学法检测27例弥漫性大B细胞淋巴瘤、20例淋巴结反应性增生组织中CD40L的表达。结果（1）DLBCL中CD40L过度阳性率（25．93％）显著低于淋巴结反应性增生（63．64％），P〈0．05。（2）CD40L在Ⅲ、Ⅳ期DLBCL过度阳性率（14．29％）低于Ⅰ、Ⅱ期（38．46％），P〈0．05。CD40L过度阳性率在有结外浸润DLBCL（11．76％）低于无有结外浸润DLBCL（40％），P〈0．05。（3）DLBCL患者CD40L的过度阳性率与远处转移、临床分期均显著相关，P〈0．05。结论（1）CD40L过度阳性率与结外器官浸润及临床分期密切相关，其可能作为判断DLBCL侵袭性及预后的指标。（2）DLBCL中CD40L表达的减少可能是影响其发病的因素之一。     

电针周围性面瘫患者地仓穴的fMRI研究

目的：采用功能性磁共振成像（fMRI）技术,研究电针周围性面瘫患者地仓穴对脑功能的影响。方法：筛选6例左侧周围性面瘫患者为研究对象,电针刺激,同时行全脑fMR I扫描,SPM软件进行图像后处理,t检验（P〈0.01）分析得出电针不同穴位的脑功能图像。结果：双侧中央前回、双侧中央后回等多个脑区信号发生变化。结论：电针刺激引起了多个脑区信号的变化,穴位治疗作用的发生可能是多个脑区互相联络,对信息进行分析、整合,共同作用的结果。