职业用嗓人群音域图和嗓音疲劳测试分析

目的 通过比较分析职业用嗓人群中有无声带病变者的音域图和嗓音疲劳测试结果差异,探讨其 在评估该人群嗓音功能中的价值。方法 选取2017 年3 月—2018 年3 月于重庆市人民医院耳鼻咽喉头颈外 科就诊的职业用嗓者112 例（包括主持人、销售员、教师、话务员及导购员等）,根据症状和体征将其分为正 常组和病理组,正常组无明显声嘶及发音障碍,检查声带无明显病变（如慢性声带炎、声带小结及声带息肉等）, 病理组有声嘶或发音障碍,检查声带存在病变。分别予以音域图和嗓音疲劳测试检查,量化评估两组嗓音功能。 结果 正常组最大声强、最高频率、最低频率、最长发声时间及嗓音障碍指数高于病理组（P <0.05）,而最 小声强、频率微扰低于病理组（P <0.05）。正常组嗓音疲劳测试失败率低于病理组（P <0.05）。正常组比病 理组噪音疲劳测试失败率低（P <0.05）。结论 音域图和嗓音疲劳测试指标可用于评估职业用嗓人群嗓音功 能和嗓音疲劳状况,可作为评价其嗓音质量的重要手段。     

清喉利咽颗粒联合金嗓散结丸对声带息肉术后发声障碍患者嗓音恢复的影响

目的观察清喉利咽颗粒联合金嗓散结丸对声带息肉术后发声障碍患者嗓音恢复的影响。方法选取2018年3月至2019年3月本院收治的80例支撑喉镜下声带息肉摘除术后发声障碍病例作为研究对象,按照入院顺序对其编号,分为对照组(奇数号)与观察组(偶数号),每组40例。对照组术后给予常规西药治疗,观察组在对照组基础上给予清喉利咽颗粒联合金嗓散结丸治疗,比较两组治疗前后中医症候积分、嗓音障碍指数(VHI)、计算机嗓音分析结果、临床疗效与不良反应发生率。结果观察组治疗总有效率为90.00%,明显高于对照组的72.50%(P<0.05);观察组各中医症候积分、VHI量表中E、P、F、T评分均明显低于对照组(P<0.05),基频微扰、振幅微扰及声门噪声能量明显优于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义。结论清喉利咽颗粒联合金嗓散结丸可有效改善声带息肉术后发声障碍患者临床症状,减轻发声障碍,促进嗓音恢复,且不良反应少。     

职业性喉病的中西医防治

以声为职业者,由于发声器官运动过度或发声的方法不当,会引起声带一系列的病态改变,称为职业性喉病。临床以声嘶为主要症状。嗓音工作者如果得了职业性喉病会影响嗓音,暂时停止工作,或者不得不中途放弃自己所喜好的职业。职业性喉病是完全可以预防的。     

运动针刺联合嗓音训练治疗声带小结的临床研究

[目的]观察运动针刺联合嗓音训练治疗声带小结的临床疗效.[方法]将50例声带小结患者随机分成治疗组和对照组,每组各25例.治疗组给予运动针刺配合嗓音训练治疗,对照组给予口服金嗓散结丸治疗,疗程为8周.观察2组患者治疗前后症状评分、嗓音嘶哑评估GRBAS分级评分中的总嘶哑度评分、最长发声时间(MPT)的变化情况,比较2组...     

职业性喉病的中西医防治

以声为职业者,由于发声器官运动过度或发声的方法不当,会引起声带一系列的病态改变,称为职业性喉病。临床以声嘶为主要症状。嗓音工作者如果得了职业性喉病会影响嗓音,暂时停止工作,或者不得不中途放弃自己所喜好的职业。职业性喉病是完全可以预防的。     

职业性喉病的中西医防治

以声为职业者,由于发声器官运动过度或发声的方法不当,会引起声带一系列的病态改变,称为职业性喉病.临床以声嘶为主要症状.嗓音工作者如果得了职业性喉病会影响嗓音,暂时停止工作,或者不得不中途放弃自己所喜好的职业.职业性喉病是完全可以预防的.     

清喉利咽汤结合金嗓散结丸对声带息肉术后患者症状恢复及发音功能的影响

目的分析清喉利咽汤结合金嗓散结丸对声带息肉术后患者康复情况的影响。方法选取我院2020年1月至2022年3月期间收取的80例声带息肉手术患者,按随机抽签法分为两组,对照组40例,应用金嗓散结丸;观察组40例,基于对照组采用清喉利咽汤治疗;对比两组患者发音功能、症状恢复情况。结果观察组在治疗结束后的声音嘶哑、咽部异物感、咽喉疼痛评分低于对照组,嗓音障碍对生理、功能、情感的影响评分低于对照组,基频微扰、振幅微扰低于对照组,最长发声时间高于对照组(P<0.05)。结论清喉利咽汤结合金嗓散结丸的应用,利于术后患者相关症状恢复,改善其发音功能。     

健侧胸舌骨肌瓣在喉发声重建中的应用

目的：探讨垂直喉部分切除术后改善发音，恢复喉功能的修复手段。方法：垂直喉部分切除术后，用患侧甲状软骨外膜修复上半喉腔缺损，取健侧胸舌骨肌（或舌骨－胸舌骨肌瓣）上半喉腔缺损并重建声带。结果：修复的新喉腔呈三角形，重建的声带具有一定的张力并参与发音，恰似一侧声带居于正中位麻痹状态，发音时由健侧声带代偿运动与新声带前2／3相互靠近。92．1％患者术后获得良好的发音功能。结论：垂直喉总部分切除术后采用患侧甲状软骨外膜和健侧舌骨肌瓣（或知－胸舌骨肌瓣）修复缺损并重建声带，使患者术后的喉腔恢复三角形形态，新声带参与发音，术后发音质量明显改善。修复方法简单，取材方便，创伤小，效果满意，可作为垂直喉部分切除术后发声重建的首选方法。     

金嗓散结丸治疗声带小结的临床观察

目的:探讨声带小结患者采用嗓音训练联合金嗓散结丸进行治疗的临床疗效。方法:选取2016年5月-2017年5月我院收治的90例声带小结患者,随机分为对照组(45例)和观察组(45例),对照组患者单纯采用嗓音训练进行治疗,观察组患者在此基础上加用金嗓散结丸进行治疗,观察并比较两组患者的治疗效果。结果:与对照组相比较,观察组患者治疗后的临床总有效率显著升高,组间比较差异有统计学意义(P<0.05)。观察组患者的标准化嗓音能量、嗓音障碍指数、嗓音相关生活质量检测值、最长发声时间等指标改善程度均较对照组患者更为显著,组间比较差异有统计学意义(P<0.05或P<0.01)。结论:采用嗓音训练联合金嗓散结丸治疗声带小结的疗效确切,能够迅速改善患者的发音功能,促进声带小结缩小,并加快患者的病情康复,值得临床推广应用。     

庆大霉素等药物喉滴配合水杨酸钠离子透入治疗急慢性声带炎临床观察

声带炎主要因发声过度,滥用嗓音,持续超负荷用声而造成声带充血、肿胀、分泌物增多,声门闭合不良,临床表现以声音嘶哑、发声疲劳为主.我们采用庆大霉素、玻璃酸酶等药物释液直接喉滴声带,配合水杨酸钠离子透入治疗声带炎,取得了较好的疗效.     

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.