3～5岁痉挛型脑瘫患儿构音清晰度研究

目的：研究痉挛型脑瘫患儿构音清晰度及其影响因素。方法以76例3～5岁痉挛型脑瘫患儿为研究对象,采用儿童词语理解能力测验评估患儿的语言理解能力,黄昭鸣-韩知娟词表测试患儿的构音清晰度,测量其汉语顶点元音/i/、/u/、/a/的第一共振峰（F1）和第二共振峰（F2）,求得元音空间、舌距F2（i）-F2（u）和下颌距F1（a）-F1（i）,检验患儿构音清晰度与年龄、舌距、下颌距、元音空间、词语理解能力得分之间的相关性。结果76例痉挛型脑瘫患儿整体构音清晰度分数平均为（66.8±29.3）%。37～47月龄组的整体构音清晰度低于48～59月龄组和60～71月龄组,差异有统计学意义。语言理解能力迟缓患儿的整体构音清晰度低于语言理解能力中等患儿,差异有统计学意义。不同性别脑瘫患儿整体构音清晰度差异没有统计学意义。76例痉挛型脑瘫患儿中有34例患儿存在构音障碍,构音障碍率为44.7%。语言理解能力迟缓患儿构音障碍率高于语言理解能力中等患儿,差异有极显著统计学意义（P=0.002）。不同年龄、性别的脑瘫患儿构音障碍率差异没有统计学意义。痉挛型脑瘫患儿整体构音清晰度与年龄、舌距、下颌距、元音空间、词语理解能力得分呈正相关,具有统计学意义。结论3～5岁痉挛型脑瘫患儿的构音清晰度随着年龄、舌距、下颌距、元音空间、词语理解能力得分的增加而提高,不受性别因素的影响。     

构音运动定量测量及其临床应用研究

目的 探讨定量测量下颌及舌的构音运动能力的方法。方法 通过提取/a/、/i/、/u/的共振峰,计算出下颌距（△F1）、舌距（△F2）值,并将测量方法应用在案例中。 结果 下颌距、舌距是测量下颌以及舌运动能力的敏感参数,具有重要的临床意义。 结论 下颌距、舌距可作为下颌及舌构音运动能力的定量测量参数,同时可以监控治疗效果。     

听障儿童下颌构音运动异常矫治个案研究

目的探讨听障儿童下颌构音运动异常康复训练的有效方法。方法对1名下颌构音运动异常的听障患儿进行下颌口部运动与下颌构音运动训练,结合促进治疗法和重读治疗法对其进行综合康复训练。采用主观分级评估的方法监控患儿口部运动功能的康复效果;采用单一被试研究法观察分析个案训练前后／i／、／e／的第一共振峰（F1）,监控下颌上位、半开位的构音运动能力的康复效果;观察分析／ie／的语谱图变化,监控下颌上位至半开位构音转换能力的康复效果。结果训练前后下颌运动分级明显提高;／i／的F1差异极其显著（P〈0．01）;／e／的F1无显著性差异（P〉0．05）。结论下颌口部运动训练、下颌构音运动训练与促进治疗法、重读训练综合运用对改善听障儿童的下颌构音运动异常有较好的康复效果。     

极重度听障儿童单元音共振峰测量及分析

目的 探讨3～6岁极重度听障儿童单元音共振峰的平均值与健听儿童的差异,为指导听障儿童的语言康复训练提供参考.方法 使用语音工作站采样分析,让10名3～6岁的极重度听障儿童在自然舒适状态下发/a/、/o/、/e/、/i/、/u/、/ü/6个元音,每个音持续3 s以上,并截取各声样中的3 s平稳段进行声学参数的检测和分析.同时,与同年龄段健听儿童的数据做对照.结果 听障组6个单元音的3个共振峰与健听组相比较,所有元音的F1无显著性差异(P＞0.05);元音/o/和/u/的F2无显著性差异(P＞0.05),其余各元音的F2有显著性差异(P＜0.05);所有元音的F3都有显著性差异(P＜0.05).结论 极重度听障儿童的单元音共振峰与健听儿童有差异,这可能是引起听障儿童发这些元音不清楚的原因之一.     

阻塞性睡眠呼吸暂停低通气综合征患者悬雍垂腭咽成形术后嗓音声学分析

目的探讨悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者嗓音的影响。方法对42例OSAHS患者在行腭咽成形术前和术后一周、一个月、三个月时分别应用电子计算机语音分析系统采集其嗓音声学样本进行声学分析,分析/a:/、/i:/、/u:/、/ai:/、/o:/5个元音的声学指标差异。结果与术前相比较,术后一周、一个月、三个月时各元音基频(F0)无差异(P>0.05)。元音/ai/、/o:/共振峰各峰值无变化(P>0.05),元音/a:/、/u:/第三、四共振峰(F3、F4)峰值均低于术前(P<0.01),术后一个月和三个月元音/i:/第三共振峰(F3)降低,第四共振峰(F4)增高,差异均有显著统计学意义(P<0.01)。结论 UPPP对OSAHS患者元音/a:/、/u:/、/i:/的F3、F4有影响(P<0.01)。     

学龄唐氏综合征患儿与正常儿童口腔共鸣声学特征比较

目的探讨7～16岁唐氏综合征儿童与正常儿童口腔共鸣声学特征的差异。方法29例7～16岁唐氏综合征儿童和90例7～16岁正常儿童发/a/、/u/、/i/音各3次,每次1～2秒,采用启音博士言语测量仪分别测量两组3个元音的第一共振峰（F1）、第二共振峰（F2）、舌距和下颌距,比较两组结果。结果随年龄增长,正常儿童的F2（a ）呈显著降低的趋势、F2（i ）和舌距则呈显著增高的趋势,而唐氏综合征患儿的F2（i ）呈显著增高趋势;不同性别正常儿童各口腔共鸣指标均无显著差异,而唐氏综合征男童的 F1（i ）和 F1（u ）显著低于唐氏综合征女童（P＜0．05）,其下颌距则显著大于唐氏综合征女童（P＜0．05）;唐氏综合征患儿的F2（u）和F1（i）显著大于正常儿童（分别为 P＜0．001和 P＜0．01）,而舌距显著小于正常儿童（ P＜0．001）。结论随着年龄的增长,正常儿童舌向前运动的幅度和舌前后运动的范围会显著增加,口腔聚焦点会逐渐前移,而唐氏综合征患儿舌的向后运动幅度及前后运动范围的发展均落后于正常儿童,更易出现口腔共鸣障碍。     

人工耳蜗植入儿童元音声学参数的跟踪研究

目的研究人工耳蜗植入儿童10个月内6个元音的声学参数变化情况.方法选取6名4~5岁的人工耳蜗植入儿童,在连续的10个月内,每隔2个月对他们进行一次测试,用语音工作站软件采集6个元音/a/、/o/、/e/、/i/、/u/、/ü/的3秒稳定段元音声学数据(基频,共振峰等),对数据进行分析,研究10个月内元音声学参数的变化情况.结果人工耳蜗儿童在10个月内6个元音的平均基频变化值无统计学差异(P>0.05),第一共振峰和第二共振峰无统计学差异(P>0.05).结论人工耳蜗植入儿童在10个月内,元音声学参数没有发生明显变化.     

配戴助听器儿童单元音基频和共振峰的测量及分析

目的：观察配戴助听器儿童和健听儿童单元音基频和共振峰的差异。方法分别选取20位3～8岁配戴助听器儿童及健听儿童形成实验组与对照组,用语音工作站VS 3.0分析软件对其/a、o、e、i、u、u/6个元音3秒稳定段进行声学分析,提取基频和共振峰,并进行对比分析。结果实验组的基频和F1共振峰与对照组相比,基频和元音/a、o/的共振峰无显著差异,P〉0.05;元音/e、u/和/u/的共振峰均有显著差异,P〈0.05。结论配戴助听器儿童的基频和单元音共振峰与健听儿童不同。     

轻中度OSAHS成年男性患者软腭射频消融前后嗓音共振峰的变化

目的探讨软腭射频消融对轻中度OSAHS成年男性患者嗓音共振峰的影响。方法 30名轻中度OSAHS男性患者,年龄24～58岁,平均40±9岁,均于局麻下行软腭射频消融术。分别于术前及术后1月行嗓音声学分析,比较手术前后基频(F0)和第一、二、三共振峰(F1、F2、F3)的变化。结果 30名患者的/a/、/e/、/i/、/o/元音F0、F1、F2、F3手术前后频率差异无统计学意义(P>0.05)。结论软腭射频消融对轻中度OSAHS患者的嗓音共振峰没有明显影响。     

中国人嗓音共鸣功能的声学基础研究

目的:探索核心单韵母共振峰随着年龄增长的发展规律以及性别的差异;为言语共鸣障碍的评定及治疗奠定研究基础。方法:随机选择2492例被试者,男1318例,女1174例;被试者均接受/a/、/i/、/u/的标准普通话跟读录音。采用D1200数字录音机进行标准录音,并将声音文件导入实时言语测量仪提取共振峰数据,用SPSS13.0进行统计分析。结果:核心单韵母共振峰随着年龄的增长出现显著的变化(P<0.05),总体呈现下降趋势,其变化主要体现在F1方面;在性别方面,主要反映F2以及共振峰幅度差(ΔA)差异的显著性;核心单韵母间的共振峰差异存在统计学意义(P<0.05)。结论:①F1、F2受到年龄、性别及核心单韵母(a、i、u)因素的显著影响;②F1、F2随年龄的增长与F0的发展存在关联。     

The expression of vascular endothelial growth factor (VEGF) and VEGF‐C in early laryngeal cancer: relationship with radioresistance

The expression of vascular endothelial growth factor (VEGF) and VEGF‐C in early laryngeal cancer: relationship with radioresistance Angiogenesis is essential for tumour growth and invasion. Vascular endothelial growth factor (VEGF) is a prime mediator of tumour angiogenesis. VEGF‐C is a closely related protein that effects lymphatic endothelial cells and may be important in the process of lymphatic metastasis. The purpose of this study was to evaluate the expression of these cytokines in patients with T1 and T2a glottic, squamous cell carcinoma, in comparison with normal epithelial control tissue, to ascertain any association with radioresistance. Twenty‐two tumours treated by radiotherapy (13 radiosensitive, nine radioresistant) and seven normal control tissues were studied. The minimum follow‐up was 2 years after radiotherapy. Expression of VEGF and VEGF‐C was evaluated by immunohistochemistry of formalin‐fixed, paraffin‐embedded biopsy specimens. Analysis was carried out using a quantitative computer image analyser. Both VEGF and VEGF‐C were detectable in tumour and normal control specimens. There was increased expression in tumour specimens of both VEGF (P = 0.03) and VEGF‐C (P < 0.001). In addition, the expression of VEGF‐C was associated with tumours of higher histological grade (P = 0.021). There was, however, no difference in VEGF and VEGF‐C expression between radioresistant and radiosensitive tumours. The expression of VEGF and VEGF‐C is increased in early laryngeal squamous cell carcinoma (SCC). However, measuring the expression of these proteins cannot predict radioresistance in this tumour group.     

Treatment of Maxillary Sinus Carcinoma: Clinical Results Using the Kitasato Modality

The conventional therapeutic regimen for maxillary sinus carcinoma consists of dissection of the maxilla, full-dose irradiation and extensive chemotherapy. However, the results obtained with this treatment are often poor. Even when patients recover, their quality of life is significantly reduced as a result of deformity of facial structures and swallowing and articulation dysfunctions. A retrospective analysis of 68 patients with maxillary sinus carcinoma treated with the Kitasato modality between 1975 and 1999 was conducted. All patients underwent pergingival maxillary sinus surgery combined with pre- and postoperative irradiation therapy with standardized total doses of 16 Gy; the postoperative irradiation was given in combination with regional intra-arterial infusion chemotherapy administered via the superficial temporal artery. All visible tumor lesions were removed where possible in order to preserve or facilitate cellular immunity after surgery. The cumulative 5-year survival rates were 85.7% for Stage II patients, 88.1% for Stage III, 76.6% for Stage IVA and 75.0% for Stage IVB.     

Tongue Base Reduction with Temperature-controlled Radiofrequency Volumetric Tissue Reduction for Treatment of Obstructive Sleep Apnea Syndrome

In recent years a considerable effort has been made to establish the use of different surgical techniques for the treatment of obstructive sleep apnea syndrome (OSAS). Nevertheless, treatment of hypopharyngeal obstruction due to tongue base hypertrophy remains in many ways an unsolved problem. The aim of this study was to evaluate the safety and efficacy of tongue base reduction with temperature-controlled radiofrequency volumetric tissue reduction in the treatment of OSAS. Twenty patients with OSAS and tongue base hypertrophy were treated with radiofrequency tissue ablation. An intensified treatment protocol was used, delivering 2,800 J per treatment session under local anesthesia. Two nights of polysomnography testing were performed before and after treatment. Daytime sleepiness, snoring and postoperative morbidity were assessed using questionnaires. Mean respiratory disturbance index (RDI) was reduced from 32.1 to 24.9/h after a mean of 3.4 treatment sessions. Six patients (33%) were cured after the procedure (reduction in RDI of &#83 50% and a postoperative RDI of <15/h) and ten (55%) showed an improvement of >20% in their RDI. Daytime sleepiness and snoring improved significantly. Peri- and postoperative morbidity was low; one severe complication occurred (tongue base abscess). We were able to achieve similar cure and responder rates to those reported in a recently published pilot study but with a reduced number of treatment sessions. We believe that this technique may improve patient acceptance and have beneficial cost implications.     

Cervical Reflex Induced by Click Stimuli in Cats

We studied click-evoked potentials in the anterior horn of the spinal cord in 17 cats. A concentric needle electrode was inserted into the anterior horn of the spinal cord at levels C3-C6. Potentials evoked with 105 dB SPL clicks were recorded with a peak latency of 4.89-5.10 ms only at the C3 level. These responses were observed 45-60 dB SPL above the auditory brainstem response (ABR) threshold, and no potentials were evoked by stimulation of the contralateral ear. Average was performed 100 times with changes in stimulation frequency of 1-20 Hz. The amplitude of the potentials decreased with increasing stimulus frequency, but there were no changes in ABRs. The responses disappeared after destruction of the medial vestibulospinal tract at the obex level, but ABRs were still recorded. The spinal nucleus of the accessory nerves was located in the anterior horn of the spinal cord at levels C1-C6, and the sternocleidomastoid muscle motoneurons were found at levels C1-C3. The click-evoked potentials recorded in this study reflect responses of the spinal nucleus of accessory nerves through the vestibulospinal tract to click stimulation. The responses have the same characteristics as vestibular-evoked myogenic potentials that can be recorded using surface electrodes over the sternocleidomastoid muscles of humans.     

Lack of significant estrogen and progesterone receptor expression in nasal telangiectasias in hereditary hemorrhagic telangiectasia: an immunohistochemical analysis

Obstructive sleep apnea syndrome (OSAS) is characterized by snoring and apnea during sleep leading to decreased oxygen saturation and disturbed sleep, excessive daytime sleepiness and neuropsychological disturbances. This study investigates cognitive neuropsychological abilities in a group of 53 OSAS patients before and after treatment with uvulopalatopharyngoplasty. General intellectual ability, verbal learning and memory as well as executive functioning were measured at baseline and 6 months postoperatively. After surgery there were significant improvements in verbal learning and memory (mean change - 39, SD 57.3, p <0.001), recall (mean change - 24.3, SD 39.3, p <0.001) and executive functioning (as assessed by percentage of errors on the Wisconsin Card Sorting Test; mean change-9.1, SD 15.7, p <0.001). These improvements were in accordance with improvements in the degree of sleep apnea, the oxygen desaturation index (mean change -9.7, SD 15.9, p <0.001) and arterial minimum oxygen saturation (mean change 4.5%, SD 10.2%, p <0.01). Surgical treatment seems to improve verbal learning, memory and recall and executive functions in parallel with better oxygenation in OSAS.     

Measurement of chemosensory function

Although hundreds of thousands of patients seek medical help annually for disorders of taste and smell, relatively few medical practitioners quantitatively test their patients' chemosensory function, taking their complaints at face value. This is clearly not the approach paid to patients complaining of visual, hearing, or balance problems. Accurate chemosensory testing is essential to establish the nature, degree, and veracity of a patient's complaint, as well as to aid in counseling and in monitoring the effectiveness of treatment strategies and decisions. In many cases, patients perseverate on chemosensory loss that objective assessment demonstrates has resolved. In other cases, patients are malingering. Olfactory testing is critical for not only establishing the validity and degree of the chemosensory dysfunction, but for helping patients place their dysfunction into perspective relative to the function of their peer group. It is well established, for example, that olfactory dysfunction is the rule, rather than the exception, in members of the older population. Moreover, it is now apparent that such dysfunction can be an early sign of neurodegenerative diseases such as Alzheimer's and Parkinson's. Importantly, older anosmics are three times more likely to die over the course of an ensuring five-year period than their normosmic peers, a situation that may be averted in some cases by appropriate nutritional and safety counseling. This review provides the clinician, as well as the academic and industrial researcher, with an overview of the available means for accurately assessing smell and taste function, including up-to-date information and normative data for advances in this field.