Objective To investigate the effect of voice training therapy on the voice improvement in patients with vocal nodules .Methods Twenty one patients with vocal nodules were recruited and were evaluated by the GRBAS perpetual evaluation ,voice handicap index (VHI)-30 subjective assessment ,vocal laryngostroboscopy , maximum phonation time (MPT) and acoustic analysis pre- and post-therapy .These patients completed 5 cour‐ses of voice training .Results The VHI value(29 .48 ± 21 .21) of post-therapy was less than the value (52 .95 ± 24 . 30)of pre -therapy (P< 0 .01) .There were significantly differences in voice perpetual evaluation between pre -training and post-training ,especially for G (grade) (P<0 .01) and R (roughness) (P<0 .01) .The post-training laryngostrobescopy vocal vibration improved comparing with pre-therapy in the closure of vocal cords ,symmetry of vibration ,the mucosal wave and vibration regularity of the vocal cords .After therapy ,three patient nodules dis‐appeared ,thirteen patient nodules became smaller ,and five patient nodules remained the same .The maximum pho‐nation time (MPT) (12 .54 ± 3 .68)of post-therapy was longer than MPT(8 .87 ± 3 .75) of pre-therapy MPT(P<0 .01) .The jitter value (0 .18% ± 0 .08% ) of post -therapy was less than that of pre-therapy(0 .43% ± 0 .31% ) (P<0 .01) .The shimmer of post -therapy (2 .10% ± 0 .98% ) was less than that of pre -therapy (4 .55% ± 1 .80% )(P<0 .01) ,The ratio of noise to harmonic(NHR)(0 .0034 ± 0 .0022 dB) of post-therapy was significantly less than NHR(0 .0184 ± 0 .028 dB)(P<0 .05) of pre-therapy .Conclusion The voice therapy could significantlyimprove voice of patients with vocal nodules .

OBJECTIVE: To investigate the characteristics of adductor spasmodic dysphonia phonatory break in mandarin Chinese and select the stimuli phrases. METHOD: Thirty-eight patients with adductor spasmodic dysphonia were involved in this study. Standard phrase " fù mŭ xīn" and a speech corpus in mandarin Chinese with 229 syllables covering all vowel and constant of mandarin Chinese were selected. Every patient read the phrases above twice in normal speed and comfortable voice. Two auditory perpetual speech pathologists marked phonatory break syllables respectively. The frequency of phonatory break syllables and their located phrases were calculated, rated and described. The phrases including the most phonatory break syllables were selected as stimuli phrases, the phonatory break frequency of which was also higher than that of standard phrase "fù mŭ xīn". RESULT: Phonatory break happened in the reading of all patients. The average number of phonatory break syllables was 14 (3-33). Phonatroy break occurred when saying 177 (77.3%) syllables in the speech corpus. The syllables "guŏ, rén, zāng, diàn, chē, gè, guăn, a, bā, ne, de" broke in 23.1%-41.0% patients. These syllables belonged to the phrases "pĭng guŏ, huŏ chē, shì de, nĭ shì gè hăo rén, wŏ mén shì yŏu zŏng shì bă qĭn shì nong dé hĕn zāng, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a,wŏ yīng gāi zài xìn lĭ xiĕ yī xiē shén mē ne?". Thirty-seven patients (97.3%) had phonatory break in above mentioned words. Ratios of these words phonatory break also were more than "fù mŭ xīn". CONCLUSION Adductor spasmodic dysphonic patients exhibited different degrees of phonatory break in mandarine Chinese. The phrases" shì de, pĭng guŏ, huŏ chē, nĭ shì gè hăo rén, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a" were recommended as stimuli phrases for adductor spasmodic dysphonia evaluation.
Dysphonia ; diagnosis ; physiopathology ; Female ; Humans ; Language ; Male ; Phonation ; Spasm ; diagnosis ; physiopathology ; Voice

Objective To analyze the clinical features of patients with sporadic adult-onset neuronal intranuclear inclusion disease (NIID),and raise awareness of the disease among medical workers.Methods The clinical data of two patients with pathologically confirmed adult sporadic NIID,admitted to our hospital in February 2018 and October 2018,were collected.The clinical manifestations,head MR imaging,cutaneous pathological features,treatments and prognoses were retrospectively analyzed.Results Both patients were characterized with slow progressive dementia,accompanied with diverse clinical manifestations involving the central and autonomic nervous systems.Acute encephalopathic signs occurred in both patients.Head MR imaging showed extensive leukoencephalopathy mainly in the frontal and parietal lobes;these white matter abnormalities showed hyperintensity in T2-weighted imaging and liquid attenuated inversion recovery sequences,and equal or low signal in T1-weighted imaging.Remarkably,specific curve-like high-intensity signals along the corticomedullary junction in the bilateral frontal lobe were both observed in diffusion-weighted imaging.Patient 2 with seizures showed unilateral cerebral cortical edema on head MR imaging.In both patients,skin biopsy revealed specific eosinophilic inclusion bodies in the nucleus of some sweat gland cells,adipocytes and fibroblasts.Patient one was treated with dexamethasone intravenous drip to relieve headache and vision loss,and cognitive therapy was given.The acute encephalopathy of patient two was relieved by intravenous gamma globulin.Conclusions NIID has various clinical manifestations of central,peripheral,and autonomic nerve systems.Head MR imaging characteristic changes and skin pathological biopsy contribute to the diagnosis.Immunomodulatory therapy may be effective for acute encephalopathic symptoms in NIID.

Objective To investigate the changes in serum levels of angiopoietin-like protein 4(ANGPTL4)and ubiquitin carboxyl terminal hydrolase-1(UCH-L1),and CHA2DS2-VASc score in patients with non-valvular atrial fibrillation(NVAF)and acute cerebral infarction(ACI),and their diagnostic value.Methods A total of 162 NVAF patients treated in our hospital from Janu-ary 2021 to January 2023 were enrolled and divided into a combined group(45 cases)and a non-combined group(117 cases)according to having ACI or not.General clinical information,CHA2DS2-VASc scores,and serum levels of ANGPTL4 and UCH-L1 were collected and detected.Spearman correlation analysis was applied to evaluate the correlation of ANGPTL4,UCH-L1 and CHA2DS2-VASc score.Multivariate logistic regression analysis was performed to identify the in-fluencing factors of NVAF combined with ACI.ROC curve was plotted to evaluate the diagnostic value of serum ANGPTL4,UCH-L1,and CHA2DS2-VASc score for NVAF combined with ACI.Results The ANGPTL4 level was significantly lower,and the UCH-L1 level and CHA2DS2-VASc score were obviously higher in the combined group than the non-combined group(P＜0.05).In the patients with NVAF combined with ACI,serum ANGPTL4(r=-0.548,P＜0.05)and UCH-L1(r=0.400,P＜0.05)levels were negatively and positively correlated with CHA2DS2-VASc score,respectively.ANGPTL4,UCH-L1 and CHA2DS2-VASc were the risk fac-tors for ACI in NVAF patients(P＜0.05,P＜0.01).The AUC value of combined serum ANGPTL4 and UCH-L1 levels and CHA2DS2-VASc score for diagnosing NVAF complicated with ACI was 0.926(95％CI:0.874-0.961).Conclusion Combined detection of serum AUCH-L1 and NGPTL4 levels and CHA2DS2-VASc score can significantly improve the diagnostic value of NVAF patients with ACI.

Objective     To investigate the combined effects of digastric muscle low frequency modulated medium frequency electro-acupuncture therapy and voice training for dysphagia in patients who underwent aortic arch surgery. Methods     Forty-two consecutive patients with dysphagia after aortic arch surgery between October 2014 and November 2017 were divided into two groups including an observation group and a control group. There were 21 patients in each group. There were 17 males and 4 females at age of 51.0±6.5 years in the observation group, while 18 males and 3 females at age of 49.8±7.3 years in the control group. The patients in the observation group underwent electroacupuncture therapy and voice training (20 min per day for each therapy, 2 weeks), while the patients in the control group only received safe swallowing education and rehabilitation guidance (2 weeks). The test results, such as fibrolaryngoscope and functional oral intake scale (FOIS) score, and the data of computer phonatory detection, before and after the intervention were  compared. Results     The fibrolaryngoscope of vocal cords significantly decreased and the FOIS score significantly increased after digastric muscle low frequency modulated medium frequency electro-acupuncture therapy and voice training in the observation group(6.30 vs. 4.60, P<0.05). Bucking was obviously reduced. The indicators of hoarse degree, such as median pitch, fundamental frequency, jitter (0.60%±0.96% vs. 1.99%±1.86%, P=0.033), shimmer (2.47%±4.26% vs. 5.89%±3.66%, P=0.043), maximum phonation time (15.31±9.10 s vs. 3.72±8.83 s, P=0.006), maximum and loud phonation time (9.30±5.73 s vs. 2.32±2.99 s, P=0.039), mean noise-to-harmonics ratio (23.99±10.17 vs .9.98±9.37, P=0.006) and mean harmonics-to-noise ratio (0.03±0.02 vs. 0.17±0.23, P=0.019) improved after the treatment in both groups. But the improvement in the observation group was significantly better than that in the control group. Conclusion     The combination of digastric muscle low frequency modulated medium frequency electro-acupuncture therapy and voice training on dysphagia in patients who underwent aortic arch surgery can significantly improve the swallowing function of patients. Meanwhile, it also helps the recovery of phonic function and improves the ability of feeding and communication in these patients.

In order to overcome the difficulty in lung parenchymal segmentation due to the factors such as lung disease and bronchial interference, a segmentation algorithm for three-dimensional lung parenchymal is presented based on the integration of surfacelet transform and pulse coupled neural network (PCNN). First, the three-dimensional computed tomography of lungs is decomposed into surfacelet transform domain to obtain multi-scale and multi-directional sub-band information. The edge features are then enhanced by filtering sub-band coefficients using local modified Laplacian operator. Second, surfacelet inverse transform is implemented and the reconstructed image is fed back to the input of PCNN. Finally, iteration process of the PCNN is carried out to obtain final segmentation result. The proposed algorithm is validated on the samples of public dataset. The experimental results demonstrate that the proposed algorithm has superior performance over that of the three-dimensional surfacelet transform edge detection algorithm, the three-dimensional region growing algorithm, and the three-dimensional U-NET algorithm. It can effectively suppress the interference coming from lung lesions and bronchial, and obtain a complete structure of lung parenchyma.
Algorithms ; Neural Networks, Computer ; Tomography, X-Ray Computed