高功能孤独症儿童疑问句表达能力的特征研究

目的 探究高功能孤独症(high-functioning autism, HFA)儿童疑问句表达能力的特征。方法 以22例3～6岁的HFA儿童(HFA组)、22例3～6岁生理年龄匹配的普通儿童(A组)、22例语言年龄匹配的普通儿童(B组)为研究对象，采用情境诱导的实验范式测试并比较HFA儿童与A组和B组儿童的疑问句表达能力。结果 HFA儿童的疑问句产出总量和目标诱导疑问句产出数量显著低于A、B组儿童(P<0.01);HFA儿童自主产出疑问句的数量与A、B组儿童无差异(P>0.05),在一般疑问句的产出上，儿童类型和一般疑问句类型的交互效应不显著(P>0.05);在特殊疑问句的产出上，儿童类型和特殊疑问句类型的交互效应显著(P<0.05)。除了“为什么”、“什么时间”类疑问句外，HFA儿童其余4种疑问句的产出数量均显著低于A、B组(P<0.05)。结论 HFA儿童的疑问句表达能力显著落后于普通儿童，差异主要体现在特殊疑问句的表达；HFA儿童存在疑问句表达灵活性不足的问题。     

外周性眩晕患者的感觉结构与稳定极限能力分析

目的 通过对突发性聋伴发眩晕、梅尼埃病和良性阵发性位置性眩晕患者的平衡功能进行分析,了解典型外周性眩晕疾病的平衡特点.方法 正常对照组:47例健康成年人,20～58岁,男性21例,女性26例,平均年龄36.2±13.3岁.眩晕组:40例外周性眩晕患者,20～68岁,男性17例,女性23例,平均年龄48.3±13.2岁;其中突发性聋伴发眩晕10例,20-67岁,男性7例,女性3例,平均年龄45.0±17.9岁;梅尼埃病14例,25～64岁,男性8例,女性6例,平均年龄48.9±11.0岁;良性阵发性位置性眩晕16例,25-68岁,男性2例,女性14例,平均年龄49.8±12.0岁.对所有受试者进行稳定极限范围测试和硬平板和泡沫板的睁、闭眼共计六种模式的平衡功能评价.结果 (1)正常对照组和眩晕组的身体压力中心移动面积平均值在T2、T3及T5时有差异,分别是P=0.006,P=0.024,P=0.000.(2)外周性眩晕患者的稳定极限范围较正常对照组减小,P=0.000.(3)突发性聋伴发眩晕、梅尼埃病和良性阵发性位置性眩晕患者的身体压力中心移动面积没有统计学差异,P=0.148-0.660;三种典型外周性眩晕疾病的稳定极限范围没有统计学差异P=0.678.结论 (1)外周性眩晕患者保持平衡的能力下降,其损伤后平衡维持和康复需要借助视觉和本体觉补偿;(2)外周性眩晕疾病的稳定极限范围减小,在眩晕患者的平衡康复训练中应适当训练以增加下肢肌肉的力量,降低跌倒的风险.     

旋律语调治疗在完全性失语症早期应用分析

目的探讨旋律语调治疗（MIT）早期应用对完全性失语症患者语言功能的影响。方法完全性失语症患者32例,随机分为治疗组与对照组,治疗组17例,予以旋律语调治疗（MIT）结合Schuell刺激疗法治疗;对照组15例,单纯予以Schuell刺激疗法治疗。两组均采用西方失语症成套测验（WAB）、功能性语言沟通能力检查法（CFCP）对比患者在治疗前、治疗12周后的疗效。结果与治疗前相比,两组患者在自发言语、听理解、复述等方面均有不同程度改善（P﹤0.05）,AQ值均较治疗前显著增加（P﹤0.05）,患者日常生活语言沟通能力均得到明显改善（P﹤0.05）。同时,治疗组在改善听理解、复述、运用、AQ值以及CFCP评分方面优于对照组（P﹤0.05）。结论早期运用旋律语调治疗可以改善完全性失语症患者语言功能及日常生活语言沟通能力。     

3~5岁听障与健听儿童情感语调发音的声学特征研究

目的探讨3~5岁听障儿童情感语调发音的声学特征。方法选取3~5岁17例(3岁8例,4岁4例,5岁5例)佩戴助听器(hearing aid,HA)儿童(HA组)、51例(3岁19例,4岁17例,5岁15例)人工耳蜗植入(cochlear implant,CI)儿童(CI组)以及32例(3岁10例,4岁9例,5岁13例)健听(normal hearing,NH)儿童(NH组),以自编6个语义中性的高兴和难过情感语调测试语料分别检测各组两种情感语调的平均基频(F0)、基频标准差(F0 SD)、基频范围(F0 range)、平均强度(intensity)、强度标准差(intensity,SD)、强度范围(intensity range)及时长(duration),比较三组儿童情感语调的声学特征。结果三组儿童高兴和难过语调发音的平均基频、平均强度和时长差异无统计学意义(P>0.05);相比难过语调,NH组儿童高兴语调的基频标准差和基频范围更大,而HA组和CI组儿童的强度标准差和强度范围更大,与NH组儿童差异有统计学意义(P<0.05);各项声学指标值在不同年龄儿童间差异均无统计学意义(P>0.05)。结论在情感语调发音中健听儿童主要利用更多的频率变化来改变语调,而佩戴助听器和人工耳蜗植入儿童则倾向于用更多的强度变化来表达情感;听障儿童在情感语调发音中展示了对韵律线索的利用能力。     

碱性成纤维细胞生长因子治疗外伤性鼓膜穿孔的临床观察

碱性成纤维细胞生长因子 (ｂＦＧＦ)有加速外伤性鼓膜穿孔愈合的作用。 2 0 0 1年 1月至 2 0 0 2年 2月用ｂＦＧＦ对外伤性鼓膜穿孔进行局部治疗 ,获得较好疗效。报道如下 :1　资料与方法1.1　临床资料　 60例四川省人民医院耳鼻咽喉科门诊和住院的外伤性鼓膜穿孔患者 ,年龄 16～ 65岁。采用Ｄｏｌｌ随机分配表进行分组 ,分为ｂＦＧＦ治疗组及非ｂＦＧＦ治疗的对照组。治疗组 3 0例 ,男 17例 ,女 13例 ,平均年龄 3 8岁 (最大 65岁 ,最小 16岁 )。对照组 3 0例 ,男 16例 ,女 14例 ,平均年龄 3 6岁(最大 5 8岁 ,最小 18岁 )。均无鼻及鼻窦疾患…     

汉语失语症患者工作记忆的特征研究

目的 采用不同的任务方式和测试材料,探讨失语症患者的工作记忆特征.方法 选取15例54~70岁汉语失语症患者(失语症组)与15例正常成人(对照组),分别进行数字、实词和虚词的听觉复述和听觉再认任务测试,以正确完成的最大字符串长度(个)作为工作记忆广度,比较两组工作记忆广度的差异.结果 不同任务和测试材料下,失语症组的工作记忆广度均显著小于对照组(P<0.01).失语症组在正序复述测试中的工作记忆广度显著大于倒序复述、正序再认和倒序再认(P<0.01),倒序复述显著大于倒序再认(P<0.01),正序再认显著大于倒序再认(P<0.01).在复述任务中,失语症组的工作记忆广度由高到低依次为数字、虚词、实词,但差异无统计学意义;在正序再认中,对数字的工作记忆广度显著大于实词(P<0.01)和虚词(P<0.01),实词显著大于虚词(P<0.01);在倒序再认任务中,对数字的记忆广度显著大于虚词(P<0.01).结论 失语症患者工作记忆广度显著低于正常成人;失语症患者对数字的工作记忆最容易;正序复述最容易,其次为倒序复述和正序再认,倒序再认最难.     

婴幼儿期植入人工耳蜗的语前聋儿童单字声调产出特点

目的 探究3岁以内单侧植入人工耳蜗、使用普通话交流且言语康复半年以上的语前聋儿童术后单字声调产出特点和发展规律.方法 以19例3岁以内单侧植入人工耳蜗的语前聋儿童(C I组,生理年龄平均3.79±1.23岁,植入年龄平均1.28±0.55岁)和24例生理年龄与CI组匹配的正常听力儿童(N H组,生理年龄平均3.90±1...     

梅尼埃病患者外周血IL-10、IL-4、IFN-γ、IL-17水平的研究

目的 通过检测梅尼埃病(Meniere’s disease, MD)患者外周血清Ⅰ型变态反应相关因子的表达,探讨Ⅰ型变态反应在MD发病机制中可能的作用。方法 以31例MD患者为MD组(年龄33～77岁),耳科正常受试者18例为对照组(年龄30～69岁),用酶联免疫吸附法检测两组血清中白介素-10(interleukin-10,IL-10)、白介素-4(interleukin-4,IL-4)、干扰素-γ(interferon-γ,IFN-γ)、白介素-17(interleukin-17,IL-17)、总免疫球蛋白E(total immunogloblin E,tIgE)水平,比较两组结果。结果 MD组tIgE阳性率明显高于对照组(51.61%vs 16.67%,P<0.05),两组间血清IL-4、IFN-γ、IL-17、IL-10浓度差异无统计学意义(P>0.05)。MD组IL-4/IFN-γ高于对照组(1.00±0.23 vs 0.73±0.23),IL-17/IL-10高于对照组(0.29±0.07 vs 0.24±0.07),差异均有统计学意义(P<0.05)。结...     

南京地区支气管哮喘患者合并变应性鼻炎的调查

目的了解南京地区支气管哮喘患者合并变应性鼻炎的情况,计算支气管哮喘患者中变应性鼻炎的发生率,并对其变应性鼻炎的治疗现状作一初步分析。方法问卷调查106例确诊为支气管哮喘的南京地区患者,详细了解其临床表现及治疗现状,建立相应的个人数据库档案,数据进行统计学分析。结果106例支气管哮喘患者,年龄3～72岁,平均年龄为31±20.9岁,男57例,女49例;其中70例(66.0%)并发变应性鼻炎,年龄5～72岁,平均年龄为33±20.7岁,男38例,女32例。106例患者中,36例(34.0%)直系三代内有气道炎症相关性疾病家族史。结论支气管哮喘合并变应性鼻炎的发生率为66.0%;气道炎症相关性疾病家族史34.0%;目前对于支气管哮喘和变应性鼻炎的治疗现状均不容乐观。     

老年语后聋患者人工耳蜗植入的听觉康复效果分析

目的探讨双耳极重度感音性聋的老年患者人工耳蜗植入后的听觉康复效果。方法 14例语后聋老年患者在我院进行人工耳蜗植入,平均年龄为67.7±4.0岁,观察其手术耐受及并发症,于开机后不同时间(3月、6月和12月)进行助听听阈和言语能力评估。结果 14例患者手术顺利,无明显严重并发症,开机后12个月助听听阈达42.1±9.4d BHL,单音节识别率为43%±15%,安静时句子识别率为63%±17%,听觉行为分级评估为5.7±1.4,人工耳蜗获益好/最好为11例(占78.6%)。结论 60岁以上极重度语后聋患者进行人工耳蜗植入是安全有效的,大部分患者术后可以获得好的言语识别率和听觉行为,年龄不应成为老年人工耳蜗植入的限制因素。     

Speech intelligibility and prosody production in children with cochlear implants

ObjectivesThe purpose of the current study was to examine the relation between speech intelligibility and prosody production in children who use cochlear implants.MethodsThe Beginner's Intelligibility Test (BIT) and Prosodic Utterance Production (PUP) task were administered to 15 children who use cochlear implants and 10 children with normal hearing. Adult listeners with normal hearing judged the intelligibility of the words in the BIT sentences, identified the PUP sentences as one of four grammatical or emotional moods (i.e., declarative, interrogative, happy, or sad), and rated the PUP sentences according to how well they thought the child conveyed the designated mood.ResultsPercent correct scores were higher for intelligibility than for prosody and higher for children with normal hearing than for children with cochlear implants. Declarative sentences were most readily identified and received the highest ratings by adult listeners; interrogative sentences were least readily identified and received the lowest ratings. Correlations between intelligibility and all mood identification and rating scores except declarative were not significant.DiscussionThe findings suggest that the development of speech intelligibility progresses ahead of prosody in both children with cochlear implants and children with normal hearing; however, children with normal hearing still perform better than children with cochlear implants on measures of intelligibility and prosody even after accounting for hearing age. Problems with interrogative intonation may be related to more general restrictions on rising intonation, and the correlation results indicate that intelligibility and sentence intonation may be relatively dissociated at these ages.Learning outcomes: As a result of this activity, readers will be able to describe (1) methods for measuring speech intelligibility and prosody production in children with cochlear implants and children with normal hearing, (2) the differences between children with normal hearing and children with cochlear implants on measures of speech intelligibility and prosody production, and (3) the relations between speech intelligibility and prosody production in children with cochlear implants and children with normal hearing.     

Sentence intonation and syllable stress in speech produced during simultaneous communication

This study investigated prosodic variables of syllable stress and intonation contours in contextual speech produced during simultaneous communication (SC). Ten normal-hearing, experienced sign language users were recorded under SC and speech only (SO) conditions speaking a set of sentences containing stressed versus unstressed versions of the same syllables and a set of sentences containing interrogative versus declarative versions of the same words. Results indicated longer sentence durations for SC than SO for all speech materials. Vowel duration and fundamental frequency differences between stressed and unstressed syllables as well as intonation contour differences between declarative and interrogative sentences were essentially the same in both SC and SO conditions. The conclusion that prosodic rules were not violated in SC is consistent with previous research indicating that temporal alterations produced by simultaneous communication do not involve violations of other temporal rules of English speech.     

汉语普通话语调的声学参数对比研究

目的 利用嗓音音质分析方法,通过对汉语语句句尾词声调分别为阴平、阳平、上声、去声的陈述句、疑问句、感叹句进行多个声学参数的测试,探索其在声学上的差异.方法 采用标准化录音获得7名男性被试在4种单一声调条件下的3种语调声音文件,利用自行编制的软件进行分析；提取每个语句中的浊音嗓音参数平均值（基频、开商、声门共振频率以及频谱倾斜频率）.运用统计学方法判断它们是否可以作为区分3种语调的参数.结果 4个参数在4个声调上,对3种语调有不同程度的区分度.结论 声门共振频率可作为区分语调特征的参数,基频和开商可以辅助区分陈述和疑问语调的特征差异.     

听力正常人对正弦波汉语普通话的识别

目的通过听力正常人对正弦波处理的汉语普通话的音调及句子识别,探讨正弦波汉语普通话的识别机制。方法测试包括正弦波处理的汉语四声调识别及句子识别。45名听力正常的年轻人,首先进行正弦波处理的汉语四声调及句子训练,然后进行测试。在训练过程中,给予受试者反馈,使其适应,学习正弦波处理的信号。正式测试中,不给予受试者反馈。声调识别测试中,受试者需要在四个声调中选择所听到的声调,在训练和测试过程中,每个声信号只能播放一次,以受试者答对的百分数计分。句子识别采用MHINT,受试者可以反复听测试材料,直至受试者完全识别正确或识别不出为止。以受试者答对的百分数进行评分。结果正弦波四声调识别的正确率平均值为32.6%,仅稍高于机率得分(25%)。受试者得分在23.5%~42.3%之间,其中绝大部分得分在25%至35%之间。在四声调识别中,一声的识别正确率最高,为42.3%;三声的识别正确率次之,为34.9%;二声和四声的识别正确率则均分别为23.5%和29.6%。正弦波汉语普通话句子识别的正确率平均值为92.3%,受试者得分在78%至100%之间,绝大部分在90%以上。配对t检验结果表明,正弦波汉语普通话四声调识别和句子识别的差异具有统计学显著性意义(P<0.05)。结论汉语普通话经过正弦波处理后,声调识别较差,句子识别很好,从上向下机制在正弦波汉语普通话句子识别中起重要作用。     

对侧助听器对人工耳蜗使用者言语感知贡献研究

目的探讨讲汉语普通话的人工耳蜗(Cochlear Implantation,以下简称CI)使用者对侧佩戴助听器(Hearing Aid,以下简称HA)的获益。方法:选取对侧使用HA的14名母语为汉语普通话的CI使用者,分别测试其在使用CI和CI+HA(即双模式)两种助听模式下的声调、双音节词、及句子的识别表现,并分析助听器耳残余听力对双模式言语表现的影响。结果:安静环境下使用CI和CI+HA模式下的声调识别率分别为67.6%±10.5%、71.6%±12.5%,双音节词识别率分别为72.3%±21.8%、74.2%±23.3%,句子识别率分别为62.3%±28.3%、61.8%±31.3%,噪声环境句子识别率分别为37.6%±36.5%、42.4%±35.9%。统计分析发现声调识别表现在CI+HA模式下显著优于CI模式(t=-2.285,P=0.04),其余言语识别表现在两种聆听模式下均无显著差异;且1000Hz及以下频率的助听器耳残余听力与CI+HA模式下言语识别表现显著相关。结论::对于"大龄"语前聋患者,一侧人工耳蜗植入联合对侧助听器的双模式应用,需考虑助听器耳的残余听力情况,极重度感音神经性聋助听器辅助效果有限,必要时需考虑双侧人工耳蜗植入。     

学龄前听障儿童与健听儿童不同语句的语调声学特点比较

目的：探讨学龄前听障儿童不同语句语调的声学特点,为其语调训练提供参考。方法选取4～5岁听障儿童和健听儿童各20例,以自编陈述和疑问语句为测试材料,获得两组儿童边界调的起点值、终点值和频率值,分析不同语调类型和儿童类型之间的差异及相互影响。结果两类学龄前儿童疑问句边界调的起点值、终点值和斜率值均大于陈述语句;与健听儿童相比,听障儿童陈述语调的第一声边界调斜率值偏低即音高下倾趋势过多,第四声边界调起点值、终点值均偏低即音高曲线整体下降过多;听障儿童疑问语调的第一、二、三声边界调斜率值偏小,即音高上扬趋势不足,第一、四声边界调起点值、终点值都偏低,即音高曲线整体提高不够。结论学龄前听障儿童陈述语调比疑问语调掌握好,在疑问语调训练时,可以依据其边界调音高曲线的起点、终点和走势特征进行针对性训练。     

The role of sequential stream segregation and frequency selectivity in the perception of simultaneous sentences by listeners with sensorineural hearing loss.

The purpose of this study was to determine the role of frequency selectivity and sequential stream segregation in the perception of simultaneous sentences by listeners with sensorineural hearing loss. Simultaneous sentence perception was tested in listeners with normal hearing and with sensorineural hearing loss using sentence pairs consisting of one sentence spoken by a male talker and one sentence spoken by a female talker. Listeners were asked to repeat both sentences and were scored on the number of words repeated correctly in each sentence. Separate scores were obtained for the first and second sentences repeated. Frequency selectivity was assessed using a notched-noise method in which thresholds for a 1,000 Hz pure-tone signal were measured in noise with spectral notch bandwidths of 0, 300, and 600 Hz. Sequential stream segregation was measured using tone sequences consisting of a fixed frequency (A) and a varying frequency tone (B). Tone sequences were presented in an ABA_ABA_... pattern starting at a frequency (B) either below or above the frequency of the fixed 1,000 Hz tone (A). Initially, the frequency difference was large and was gradually decreased until listeners indicated that they could no longer perceptually separate the two tones (fusion threshold). Scores for the first sentence repeated decreased significantly with increasing age. There was a strong relationship between fusion threshold and simultaneous sentence perception, which remained even after partialling out the effects of age. Smaller frequency differences at fusion thresholds were associated with higher sentence scores. There was no relationship between frequency selectivity and simultaneous sentence perception. Results suggest that the abilities to perceptually separate pitch patterns and separate sentences spoken simultaneously by different talkers are mediated by the same underlying perceptual and/or cognitive factors.     

Talker separation and sequential stream segregation in listeners with hearing loss: patterns associated with talker gender.

The purpose of this paper was to examine the relations between the ability to separate simultaneous sentences spoken by talkers of different gender and the ability to separate pitch patterns in a sequential stream segregation task. Simultaneous sentence pairs consisting of 1 sentence spoken by a male talker and 1 sentence spoken by a female talker were presented to 11 listeners with sensorineural hearing loss. Listeners were asked to repeat both sentences and were scored on the number of words repeated correctly. Separate scores were obtained for the male and female sentences. Sequential stream segregation was then measured using series of tones consisting of a fixed frequency (A) and a varying frequency tone (B). Tone series were presented in an ABA_ABA_... pattern starting at a varying frequency either below (ascending pattern) or above (descending pattern) the frequency of the fixed 1000 Hz tone. Fusion thresholds, defined as the frequency separation at which listeners could no longer perceptually separate the tones A and B, were obtained for both ascending and descending patterns. There was no significant difference between ascending and descending fusion thresholds based on the group data, but substantial individual differences were observed. Speech recognition scores for the male talker were strongly related to ascending fusion thresholds, but not descending thresholds. In contrast, speech recognition scores for the female talker were strongly related to the descending thresholds, but not the ascending thresholds. For both the male and female talkers, better recognition scores were associated with lower (nearer to normal) fusion thresholds. Results suggest that the importance of streaming in the perceptual separation of talkers may depend on the nature of the information provided by the changing pitch stream.