汉语普通话腭裂语音数据库的搭建与应用

目的 收集腭裂患者语音样本,统一进行归类标注、分级、整理后建立汉语普通话腭裂语音数据库,对于高鼻音乃至腭裂语音的诊断、临床教学、腭裂专业语音师的规范培训以及腭裂语音相关的科研工作建立基础。方法 收集2016年5月—2018年3月四川大学华西口腔医院语音治疗中心的患者与志愿者共768人,按照汉语普通话标准评估材料,收集语音样本,对所有的语音样本进行切分和按照高鼻音等级分类,整理后放入四川大学华西口腔医院唇腭裂生物信息数据库平台。结果 数据库纳入被采集者共768人,其中儿童456人（男227,女229）,成人312人（其中男178,女134）,正常共鸣369人,轻度高鼻音155人,中度高鼻音102人,重度高鼻音142人。包括64 512个词语、24 576个音素、7 680个数字,完成汉语普通话语音高鼻音数据库的搭建。结论 本研究首次建立了针对汉语普通话腭裂高鼻音数据库,已经为多项语音信号研究提供了源数据,并投入临床教学,未来对于汉语普通话腭裂患者的诊断教学以及相关科研活动有着重要的帮助和指导作用。     

腭裂普通话语音的特点与分析

目的 研究腭裂患者发普通话语音的特点。方法 对52例腭裂病人的普通话声母和单元音韵母采用传统语音学听音、记音的方法进行比较分析。结果 鼻音化现象较普遍，可存在于普通话的声母、韵母和音节中。辅音的不送气音和塞音容易形成“鼻化音”或同一发音部位的鼻音，辅音中存在发音部位和发音方法的替代现象，一部分音节的声母脱落，结论 传统语音学是腭裂语音研究的基础。腭裂患者普通话语音发音错误的主要原因在辅音，音节中声母的发音错误及脱落等能引起词义的改变。     

97例口腔癌患者术前生存质量的初步评价

目的:描述口腔癌患者术前的生存质量(quality of life,QOL)状况;分析社会人口学特点、临床特点对术前QOL的影响.方法:采用36条目简明健康状况调查问卷(SF-36)中文版和华盛顿大学生存质量问卷(UW-QOL)第4版,对97例口腔鳞癌患者术前的QOL进行测量.将97例患者分别按社会人口学特点和临床特点分组.组间差异采用SPSS12.0软件包进行Mann-Whitney U检验.将癌症患者SF-36的得分与普通人群参考值进行独立样本t检验.结果:①与普通人群配伍组比较,高龄患者有着相似的QOL值,而低龄患者则在躯体角色、身体疼痛和情感角色等领域表现出较低的QOL值;②T分期是影响术前QOL的最重要因素;③社会人口学特点如性别、年龄和共病等对QOL的影响主要体现在活力、躯体功能、躯体角色、情绪等反映身体状况和心理状况的指标上,而与口腔相关的特异性问题(口干除外)基本无关.而临床特点如肿瘤分期和部位对QOL的影响则不仅表现在与口腔相关的多项特异性问题上,如咀嚼、吞咽、发音、味觉等,还与身体疼痛、躯体角色、情感角色等反映身体状况和心理状况的指标密切相关.结论:与普通人群参考值进行比较.能更精确地反映口腔癌患者的QOL信息;临床特点对术前QOL的影响大于社会人口学特点;将普适性测量与头颈特异性量表结合,能更全面地评价口腔癌患者的QOL.联合使用UW-QOL和SF-36能较好地达到这一目的.     

手机语音识别技术对普通话儿童声母发音客观评估的初步研究

目的通过探讨手机语音识别技术对构音正常儿童声母发音的识别率,研究目前较为常见的手机语音识别软件对声母识别效果,为探索语音识别软件在构音障碍儿童语音评估和矫正中的应用提供基础。方法应用基于手机i OS系统的两种语音识别软件(XF~@和WX~@)对31例构音正常的儿童进行语音评估,计算识别率,运用SPSS 19.0进行配对t检验,比较不同语音识别软件的识别率。将目标音根据发音方式与发音部位分类,运用多个率卡方检验与Scheffe可信区间法筛识别率较低的发音类型。结果 WX~@语音识别率为(86.84±3.90)%、XF~@语音识别率(89.01±4.00)%,经统计学处理发现两种识别软件的识别率存在显著差异(P<0.05)。根据发音方式分类,不同声母的识别率存在显著差异,送气塞擦音识别率(82.88%)低于其他部分发音。根据发音部位分类,不同声母的识别率亦存在差异,舌尖前音(92.56%)与舌尖后音(95.15%)低于其他部分发音。结论不同手机语音识别软件与发音类型对构音正常儿童声母发音的识别率有影响。本研究结果对语音识别技术在语音评估及治疗领域的应用提供一定依据与参考。     

口腔癌动物模型的建立

为进一步探讨口腔癌的发生和发展提供实验研究基础，建立与人类口腔癌相似的动物模型是十分必要的。本文就目前建立口腔癌动物模型方法的研究进展作一综述。     

146例口腔癌患者术后生存质量评价

目的探讨口腔癌患者术后生存质量的变化及其影响因素。方法通过对术后6个月的146例患者华盛顿大学生存质量问卷调查而分析生存质量的变化及影响因素。结果术后患者总体生活质量下降，术后T3、T4组、N0、N1组、颌骨连续性破坏组及根治性颈淋巴结清扫术组分别低于T1、T2组、N3、N4组、颌骨连续组及功能性淋巴结清扫术组。结论术后6个月时口腔癌患者生存质量下降，肿瘤大小、颈淋巴结转移、手术后颌骨的连续性、颈淋巴结清扫术式影响术后生存质量。     

汉语最小语音对和语音清晰度关系的初步研究

目的　从最小语音对的角度建立《最小语音对检测表》,分析最小语音对和语音清晰度的关系,为语音评估和治疗提供理论依据。方法　选择语音障碍患者60例,其中腭裂患者和非腭裂患者各30例,进行《最小语音对检测表》的测评,通过SPSS 17.0软件进行分析,统计语音清晰度和最小语音对误念率。通过相关分析,寻找与语音清晰度密切相关的语音对。结果　腭裂组的语音清晰度范围为35.0%~91.0%。语音对误念率范围为0.10~0.63。误念率最高的6类语音对(从高到低排列)依次为:舌面音和舌尖前音（0.63）、塞擦音的不送气和送气对（0.61）、塞音的不送气和送气对（0.54）、舌尖中音和舌根音（0.52）、不送气塞擦音和擦音（0.48）、送气塞音和鼻音（0.47）;非腭裂组的语音清晰度范围71.0%~ 94.0%。语音对误念率范围0.10~0.78。误念率最高的6类语音对(从高到低排列)依次为:舌尖中音和舌根音（0.78）、舌尖后音和舌尖前音（0.61）、塞擦音的不送气和送气对（0.58）、舌面音和舌尖后音（0.51）、舌面音和舌尖前音（0.49）、不送气塞擦音和擦音（0.47）。结论　《最小语音对检测表》的建立,从最小语音对的角度考察,可以有效地对语音障碍患者的语音状况进行定性和定量评估,弥补了以往研究中字表只能定量评估的不足。     

口腔癌患者术后吞咽障碍评价与其早期预后的相关性研究

目的 通过对口腔癌患者术后吞咽障碍的评价,观察其与口腔癌患者早期吞咽障碍预后的相关性.方法 选取2016年9月至2019年9月于辽宁中医药大学附属医院确诊并手术治疗的口腔癌患者124例,经口腔修复后进行洼田饮水试验评估及电视X线透视吞咽功能(VFSS)检查,比较两种方法评价吞咽障碍效果.根据成功随访3个月的95例患者是...     

口腔癌患者红细胞免疫粘附功能的初步研究

通过酵母多糖检测法对３５例口腔癌患者和２５例正常人的红细胞免疫粘附（ＲＣＩＡ）功能进行了检测,并比较了口腔癌患者颈淋巴结转移阴阳性两组的ＲＣＩＡ功能。结果显示：口腔癌患者红细胞表面的Ｃ３ｂ受体活性下降,粘附的免疫复合物含量上升。颈淋巴结转移并不会改变这种结果。     

Effects of high-frequency speech therapy on speech-related quality of life and objective speech intelligibility of oral cancer patients

To analyze objective and subjective progression of speech intelligibility in oral cancer patients undergoing high-frequency speech therapy during early rehabilitation.Oral cancer patients in the Department of Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Kiel, Germany, participated in the study from March 2016 to November 2017. Speech intelligibility was analyzed preoperatively (t1), post radiation (t2), and post speech therapy (t3). Objective measures were the Munich Intelligibility Profile (Online) and the Frenchay Dysarthria Assessment-2 (FDA-2). Subjective measures were the Speech Handicap Index (SHI), the speech subscale of the EORTC QLQ-C30&HN35, and the WHO-5 Index II.For nine patients with complete data, progression analyses showed a non-existent-to-low intelligibility impairment at t1 (means/SDs: e.g. FDA-2: 8.96/0.11, SHI: 17.5/15.15), increasing towards t2 (means/SDs/p-values for difference from t1: e.g. FDA-2: 7.40/0.80/0.000, SHI: 21.7/14.24/0.213), and then decreasing towards t3, without ever reaching the initial level (means/SDs/p-values for difference from t1: e.g. FDA-2: 8.22/0.60/0.005, SHI: 23.5/15.85/0.481). The objective changes in intelligibility were significant; the subjective changes were not.Overall, the ability to speak intelligibly after oral cancer treatment follows a typical pattern. Therefore, high-frequency speech therapy in the early rehabilitation phase might be recommendable. It might help patients to adapt to their situation after surgery, and facilitates compensating for possible functional deficits.     

Development of the German Speech Intelligibility Index for the treatment of oral cancer patients

ObjectivesThis study aimed at 1) adapting the well-established Speech Handicap Index (SHI) to German, 2) testing the suitability of the instrument for assessing speech-related quality of life, 3) comparing it to the German Voice-Handicap-Index (VHI), in order to support treatment of oral cancer patients who experience posttreatment speech difficulties that affect their quality of life.Material and methodsParticipants completed a web-based survey that employed a 2 (experienced problem: speech/articulation-related vs. voice-related) x 2 (SHI vs. VHI) between-subject experimental design, enabling it to distinguish between the experiences of voice and intelligibility impairments, and to determine the discriminatory ability of the two instruments.ResultsThe German SHI reliably assessed speech intelligibility and articulation-related Quality of life. While voice impairments were equally well assessed by both, VHI: M 2.48, SD 0.65; SHI: M 2.52, SD 0.63; only the latter appropriately registered intelligibility handicap in speech impairments (VHI: M 2.05, SD 0.70; SHI: 2.68, SD 0.73). The responsivity of the SHI in capturing the experienced handicap was significantly greater in the speech/articulation-impairment condition (p = .001).ConclusionThe German SHI is a reliable and responsive measure for speech intelligibility and articulation-related quality of life that should be chosen in preference to the VHI.     

早期系统化康复训练在口腔癌术后游离皮瓣修复患者中应用效果的meta分析

目的:系统评价早期系统化康复训练在口腔癌根治伴游离皮瓣修复术后患者中的应用效果。方法:计算机检索Cochrane Library、Web of Science、PubMed、Embase等英文数据库以及中国知网、维普和万方等中文数据库,获取国内外关于早期系统化康复训练在口腔癌根治术后患者中应用的随机对照试验。由2名研究者按照纳入和排除标准筛选文献并提取资料,参考Cochrane Handbook 5.1质量评价标准进行文献质量评价,使用Review Manager 5.3软件进行meta分析。结果:共纳入12篇符合标准的文献,meta分析结果显示,试验组术后2周洼田饮水试验评分显著低于对照组[SMD=-1.22,95%CI（-1.55,-0.90）,Z=7.41,P<0.001],试验组术后语言清晰度有效率显著优于对照组[RR=1.44,95%CI（1.16,1.78）,Z=3.33,P<0.001],试验组术后3个月、6个月语音清晰度评分显著高于对照组,差异均有统计学意义[MD=13.01,95%CI（6.78,19.24）,Z=4.09,P<0.001;MD=7.90,95%CI（3.19,12.61）,Z=3.29,P<0.01]。结论:早期系统化康复训练有助于口腔癌切除伴游离皮瓣修复术后患者吞咽功能和语音功能的恢复。     

Statistical analysis on oral cancer patients related to radiotherapy

Summary Sixty nine patients with carcinoma of the oral cavity, especially those treated by radiotherapy during the 5 year period from 1982 through 1987 were reviewed. Sixty three of 67 patients (94%) had received radiation therapy with curative, adjunctive or palliative intent. In the cases when external irradiation was applied, the antitumor agents were combined in most cases. As the curative therapy for tongue cancer, 23 of 33 patients were treated with radiotherapy alone, i.e., interstitial implants alone or in combination with external irradiation. The 5-year cumulative survival rate for all cases was 55.4%; for stage I and II was 84%, and for stage III and IV it was 22.7%.     

Patterns of referral of patients undergoing surgical management for oral cancer

BACKGROUND: Oral cancer is most often diagnosed by dentists or dental specialists. We were interested in analyzing demographic and referral data for a cohort of patients referred for the management of oral cancer to our unit. METHODS: A consecutive review of all patients treated by oral and maxillofacial surgery at the Austin and Repatriation Medical Centre over the last 10 years. Inclusion criteria included those patients with malignant oral and perioral disease that underwent surgical management. Exclusion criteria included those patients who did not have malignant oral disease, who did not have surgical management and those patients who were not treated by our unit as the primary surgeon. RESULTS: A total of 113 patients were identified. The mean age for presentation for the group was 61.6 years and the male to female ratio was 1.2:1. Approximately 70 per cent of patients were smokers or had smoked in the past. Over the last 10 years there has been a steady increase in referrals to our unit. Over half of all patients referred were from the Royal Dental Hospital of Melbourne while the majority of the remainder of the referrals were from private oral and maxillofacial surgeons. A significantly increased number of referrals from other sources were identified. Surveillance techniques that can be used in general dental practice are also described. CONCLUSIONS: A high proportion of referrals from dental sources highlights the importance of the dentist and dental specialist in the diagnosis and referral of patients with suspected oral cancer. Patients can either be referred to a dental hospital, private oral and maxillofacial surgeons or directly to a public hospital oral and maxillofacial surgery unit treating oral cancer, such as the one at the Austin and Repatriation Medical Centre.     

Galvanic skin response of oral cancer patients during speech

Severe speech difficulty is often caused after surgery of an oral cancer. Prosthetic treatment with a removable obturator prosthesis is generally provided for such patients. Although some speech ability is recovered with prosthetic treatment, patients sometimes complain of continued dissatisfaction with their speech. However, it is difficult to evaluate the dissatisfaction. Therefore, a new method for evaluation is desirable. In this study, such a new method using the galvanic skin response as the index for the dissatisfaction of the patient was developed, and its objectivity was investigated. Eleven patients with maxillary bone defects were selected. Prior to the evaluation, improvement of speech with the removable prosthesis was confirmed using the speech intelligibility test and the visual analogue scale. The electrical resistant value at pronunciation was measured with the measuring system composed with the apparatus (galvanic skin response (GSR) measuring apparatus), the personal computer program. The changes for the electrical resistant value after pronunciation were evaluated by calculating the decrease ratio at pronunciation [(the mean electrical resistance before pronunciation - the mean electrical resistance after pronunciation)/the mean electrical resistance before pronunciation]. This decrease ratio at pronunciation was defined as the index of the speech dissatisfaction of the subject. The mean values for the decrease ratio with prosthesis were significantly smaller than the values without prosthesis (P < 0.05). From the results of this study, it is suggested that the measurement of the electrical resistance change of the skin during speech could be a new method for evaluating the speech dissatisfaction of the post-oral-cancer patient.     

基于德尔菲法构建老年口腔癌患者围术期口腔护理方案

目的 构建老年口腔癌患者围术期口腔护理方案。方法 在前期指南内容分析、医护患相关人群深入访谈的基础上,根据老年口腔癌患者的临床特点、治疗阶段,结合PDCA循环,构建老年口腔癌患者围术期口腔护理方案初稿,采用德尔菲法对16位相关领域专家进行2轮函询,以确定方案。采用Excel 2016、SPSS 25.0软件包进行统计描述和统计分析。结果 2轮专家咨询回收率均为100%,整体专家权威系数为0.84。经过2轮专家咨询,各指标的变异系数为0~0.240,整体协调系数为0.171,形成了术前、术后、放化疗时期3个阶段的口腔护理方案。术前阶段包括4个维度,12个一级条目,56个二级条目;术后阶段包括4个维度,18个一级条目,102个二级条目;放化疗阶段包括4个维度,13个一级条目,35个二级条目。结论 老年口腔癌患者围术期口腔护理方案符合老年口腔癌围术期患者特点,能够满足该群体的口腔护理需求,方案构建具有可靠性,能为临床实践提供参考。     

平阳霉素化疗对口腔癌患者端粒酶活性的影响

目的 :测定平阳霉素化疗的口腔癌肿瘤组织中的端粒酶活性 ,以探讨平阳霉素化疗效果。材料与方法 :取35例口腔癌患者的病案为资料 ,并依是否术前接受平阳霉素化疗分为用药组及对照组。分别测定两组的端粒酶活性 ,并进行统计分析。结果 :用药组端粒酶活性检出率及强阳性表达率明显比对照组的端粒酶活性检出率及强阳性表达率低 ,有显著性差异。结论 :平阳霉素化疗是一种有效的治疗鳞癌的药物。通过测定端粒酶活性变化来评估平阳霉素化疗的疗效可能是一种较为客观的方法。