汉语阅读障碍儿童语音加工能力研究

目的研究汉语阅读障碍儿童的语音加工能力,探索汉语阅读障碍发病机制,为研究其神经机制奠定理论基础.方法以正常儿童做对照组,根据汉语拼音特点,采用人-机对话的方式,进行拼音声母、韵母的识别和编码.结果声母识别任务,阅读障碍儿童组加工需要的反应时间(8.07±3.02)比对照组(5.75±2.03)显著延长(P <0.01),但是识别正确的个数却较低(实验组与对照组分别是18.33±3.27,20.90±3.09);韵母识别任务基本同上.声母、韵母编码任务,阅读障碍组与对照组儿童的差距更加明显,以声母编码为例,实验组比对照组儿童的反应时间长(分别是20.22±5.87,14.90±4.26),差异有统计学意义(P <0.01).结论汉语阅读障碍儿童与表音文字的同辈类似,也存在语音加工缺陷.语音加工缺陷可能也是汉语阅读障碍儿童的发病机制之一.     

阅读障碍儿童的言语工作记忆缺陷

目的 探索阅读障碍儿童的言语工作记忆缺陷的特点.方法 采用言语工作记忆的经典范式n-back任务对比17名正常儿童和15名阅读障碍儿童在3种更新难度下的记忆成绩(正确率).结果 在更新0次、1次和2次水平,阅读障碍儿童的记忆成绩正确率[(81.7±7.0)%,(70.8±12.0)%,(60.0±7.0)%]均显著低于正常儿童[(88.6±6.0)%,(83.5±7.0)%,(75.6±9.0)%,P<0.01],在更新效应(随着更新难度增加,工作记忆成绩下降的幅度上,阅读障碍儿童[(25.9±12.0)%]明显大于正常儿童[(14.2±12.0)%,P<0.01].结论 更新0次的成绩落后表明了阅读障碍儿童在记忆的基础性加工上的缺陷,更大的更新效应说明阅读障碍儿童在言语工作记忆的执行加工,即更新操作上的明显缺陷.     

注意缺陷多动障碍患儿感觉统合能力的比较

目的 比较各亚型注意缺陷多动障碍(ADHD)患儿的感觉统合能力,为临床制定合适的治疗方案提供依据。方法 实验组:将 108例符合DSM Ⅳ中ADHD诊断标准的儿童,根据整合视听连续执行测试(IVA CPT)结果,分为注意缺陷为主型、多动 冲动为主型、混合型 3个亚型。对照组为 108例性别、年龄与实验组相匹配的正常儿童。同时测试两组儿童的感觉统合能力。结果 与对照组相比,实验组儿童的大肌肉及平衡感因子分(37. 87±13. 47 )、本体感及身体协调因子分 ( 38. 82±12. 53 )显著降低 (P<0. 05),学习能力发展因子分 ( 31. 63±9. 31 )极显著降低 (P<0. 01 ),触觉防御及情绪因子分 ( 41. 78±10. 66)无显著差异 (P>0. 05)。与对照组相比,注意缺陷为主型儿童的大肌肉及平衡感因子分 (36. 88±11. 75)和学习能力发展因子分(32. 08±8. 66)极显著降低(P<0. 01);多动 冲动为主型儿童学习能力发展因子分(34. 77±11. 03)极显著降低(P<0. 01);混合型儿童本体感及身体协调因子分 (36. 13±12. 56)显著降低(P<0. 05),大肌肉及平衡感(35. 76±11. 87)和学习能力发展因子分 (28. 04±8. 23)极显著降低(P<0. 01),各亚型ADHD儿童触觉防御及情绪因子分与对照组相比差异不显著 (P>0. 05 )。结论ADHD儿童存在感觉统合失调障碍,各亚型ADH     

阅读障碍与注意缺陷多动障碍儿童的形似同音错字词组的N400研究

目的本研究拟结合当前汉语阅读障碍的研究趋势,设计词形、词义、词音的识别任务,并在执行任务同时记录在中央脑区(CZ脑区)的N400波形,比较探讨四组儿童N400脑电生理指标的异同。方法宁波市区某小学经前期筛查、后期复核诊断注意缺陷多动障碍(ADHD)21例、阅读障碍(RD)19例、ADHD+RD 17例及正常对照组19例(均为小学三至五年级学生)。使用SNAP-Ⅳ问卷(父母版)评估ADHD症状;儿童汉语阅读障碍量表评估阅读成绩。比较四组儿童在执行形似同音错字词组识别任务时应答反应时间及正确率,及中央脑区N400(波幅和潜伏期)波形差异在组间效应。结果平均反应时及正确应答率,正常对照组均优于其他三组;与RD组相比,ADHD组、ADHD+RD组的平均反应时略长,而正确率方面三组差异无显著性;ADHD组与ADHD+RD组在平均反应时及正确率方面比较差异无显著性。与对照组相比,ADHD组、RD组及ADHD+RD组潜伏期均延迟,而ADHD组、RD组及ADHD+RD组之间两两比较,差异均无显著性;而波幅方面,四组两两相比,差异均无显著性。结论 ADHD本身亦存在言语加工障碍,RD亦存在注意缺陷方面的问题,两者共病并未表现出更严重的言语加工障碍。     

汉语阅读障碍儿童语言认知能力缺陷特征分析

目的 探讨中年级汉语阅读障碍儿童合并不同语言认知能力缺陷的特征。方法 于2020年11—12月选取成都市某公立小学三年级儿童197名为研究对象,按照平均数以下1个标准差为筛查标准,筛选阅读障碍儿童25名,并匹配智力与生理年龄相当的37名儿童为对照组,采用差异检验比较考察阅读障碍儿童的语言认知缺陷。结果 与对照组比较,阅读障碍儿童在4项语言认知能力方面均存在明显落后;阅读障碍儿童在单项语言认知能力缺陷组、双重缺陷组和全损组的占比分别为40%(n=10)、24%(n=6)和8%(n=2)。结论 阅读障碍儿童在4项认知能力上存在不同程度的缺陷,相比单一认知能力缺陷的儿童,存在多重认知能力缺陷的儿童其阅读表现更差。     

注意缺陷多动障碍与正常儿童汉字事件相关电位的比较

目的 通过对注意缺陷多动障碍(ADHD)儿童和正常儿童执行语义启动任务的认知电位的比较,探讨ADHD患儿汉字语义理解的神经机制.方法 选择ADHD患儿52例,正常对照组儿童45名.使用汉字语义启动任务(相关、不相关、假字组)分别对ADHD及正常儿童进行检测,BESA软件提取认知电位进行比较分析.结果 (1)行为学:不相关反应时间ADHD组为(1252±256)ms,长于正常对照组[(1131±194)ms,P<0.05].(2)事件相关电位(ERP)-N2:汉字相关任务Cz导联N2波幅ADHD组高于正常对照组[-7.7(-12.8,-5.0)μV比-5.6(-9.4,-3.2)μV,P<0.05].(3)ERP-P3:汉字不相关任务Cz导联P3波幅ADHD组低于正常对照组[5.4(2.0,9.5)μV比9.5(4.2,16.9)μV,P<0.01].结论 汉字相关ERP-N2和不相关ERP-P3波幅可成为监测ADHD汉字认知水平的量化指标,并能对ADHD的诊断及疗效的评估提供一定的帮助.     

汉语发展性阅读困难儿童的语义启动加工研究

目的:探讨汉语发展性阅读障碍儿童的语义启动加工特性。方法:依据汉语阅读障碍量表、识字量测试、瑞文标准推理测试,从新疆乌恰县某小学筛选出19名柯尔克孜族汉语阅读困难(developmental dyslexia,DD)儿童(DD组),按年龄、智力水平匹配19名同年龄对照组(same chronological age,C...     

发展性阅读障碍儿童听觉功能的事件相关电位研究

目的探讨发展性阅读障碍儿童听觉功能的神经心理学特性,研究其听觉功能与正常儿童的差异,进一步探讨与阅读障碍儿童的神经结构特征.方法本实验设计利用频率500Hz和1000Hz的2个纯音刺激激活大脑听觉神经系统的活动,同时使用ERP分析系统记录被试完成简单听觉任务的波形.结果1.听觉ERP波形为头皮前部一个大的负波,又可表述为四个相对独立的成分:P60,N160,P200和N240;2.对纯音的加工有显著的左右半球差异;3.阅读障碍儿童在听觉加工的ERP波形上与正常儿童相比表现为潜伏期的显著延迟以及波幅的明显降低:阅读障碍儿童N160的峰潜伏期长于正常儿童,分别为(182.8±5.9)ms和(166.6±5.9)ms;而且,阅读障碍儿童的波幅低于正常儿童.结论阅读障碍儿童的听觉系统发育可能落后于正常儿童,主要表现为峰潜伏期的显著延迟以及波幅的明显降低,这可能是阅读障碍儿童听觉系统功能发育的主要神经心理学特性.     

汉语阅读障碍儿童脑SPECT研究

目的 :观察汉语阅读障碍 (CRD)儿童局部脑血流 (rCBF)改变情况 ,探讨CRD儿童局部脑功能状态。方法 :符合ICD - 10阅读障碍诊断标准的 172例患儿和 6 3例正常儿童纳入研究 ,以韦氏儿童智力量表 (C -WISC)和韦氏记忆量表 (WMS -RC)以及汉语阅读技能诊断测验 (CRSDT)作为诊断与评估工作 ,其中 37例汉语阅读障碍儿童和 13例正常儿童行SPECT检查。结果 :35例汉语阅读障碍儿童SPECT检查异常 ,左、右半球额叶、枕叶、颞叶、顶叶不同脑区的rCBF均发现下降 ,以左额叶、右枕叶多见。结论 :汉语阅读障碍儿童脑功能缺陷涉及左、右两个半球的不同脑区 ,以额叶、枕叶功能障碍多见     

REZ-1型人工耳蜗成人语后聋植入者普通话声调识别分析

目的 评估REZ-1型人工耳蜗成人语后聋植入者的汉语言语识别和普通话声调识别水平,探讨其对汉语普通话声调识别特点及影响因素.方法 采用中国聋儿康复研究中心<听觉、语言能力评估方法和标准>对2009年6至10月复旦大学附属眼耳鼻喉科医院耳鼻喉科的34例接受REZ-1型人工耳蜗成人语后聋植入者术耳进行术前及术后(开机1、2、3、6、12个月)韵母、声母、单音节词和声调识别能力的评估及统计学分析.结果 34例患者开机12个月平均韵母、声母、单音节词和声调正确识别率分别为(82±8)%、(70±8)%、(76±10)%和(77±13)%,与术前(0)相比显著提高,差异有统计学意义(P<0.01),且随着开机时间的增加识别率逐步提高.结论 REZ-1型人工耳蜗成人语后聋植入者在安静环境下可以获得较好的汉语普通话声调识别效果,随着患者使用时间的增加,言语识别和声调识别能力均逐步改善.

Abstract：

Objective To assess the tone recognition of cochlear-implant subjects by a REZ-1 device.Methods Speech recognition experiments were conducted to measure the tone recognition with standard assessment table and standard testing program. A total of 34 postlingual hearing-impaired adults who were native speakers of Mandarin undergoing operations from June to October, 2009 were tested and scored both preoperatively and postoperatively (1, 2, 3, 6, 12 months post-implantation)for speech recognition. Results All patient scores of speech recognition (initials, finals, monosyllabic words & tones) decreased gradually during the postoperative follow-up period. Preoperative speech recognition scores were all 0. And after a 12-month training, their average scores were increased significantly [(70±8)%±(82±8)%]. Significant statistical differences existed between pre- and post-implantation in each test (P<0.01). Conclusion REZ-1 cochlear implantation may improve the tone recognition of adults with severe-to-profound postlingual hearing loss in a quiet environment.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.