Objective To review the prenatal ultrasonographic evaluation on fetal midline facial defects of holoprosencephaly. Methods Twenty-four facial malformations of 14 cases with alobar/semilobar holoprosencephaly from August 2000 through April 2004 were reviewed to determine and classify the associated facial abnormalities detected with prenatal sonography. Results There were 24 facial abnormalities in 14 cases with alobar/semilobar holoprosencephaly. Facial abnormalities were present in all cases and were detected in 22 ( 91.7%) of 24 facial malformations on prenatal sonography. One or more extrafacial anomalies were present in 8 ( 57.1%) of 14 fetuses. Conclusions Prenatal sonographic evaluation of midline facial defect may allow more definitive diagnosis of alobar or semilobar holoprosencephaly.

Objective To explore the clinical characteristics and prognosis of apical hypertrophic cardiomy -opathy (AHCM).Methods A retrospective analysis was performed on the clinical data of 34 patients with AHCM, the clinical characteristic , ECG, imageology data and the cardiovascular morbidity were counted and analyzed . Results There was no specificity on the clinical characteristics of the patients with AHCM ,the high voltage of the left ventricular and the huge inverted T wave of the left precordial leads came into the characteristic change for the ECG,there were 21 patients of the total 34 patients were made a definite diagnosis after examined by the ultrasonic cardiogram,13 patients of them were made a definite diagnosis after examined by MRI .During the following-up,there were 4 patients occurred angiocardiopathy (the morbidity was 11.8%).The thickness of apex,apex cordis and poste-rior wall of the left ventricle examined during the last follow-up had significant differences compared with that during the first diagnosis(t=-3.73,-3.908,all P<0.05).The left ventricular ejection fraction ,interventricular septal thickness,left ventricular end diastolic diameter and thickness of the posterior wall of left ventricle had no significant differences compared with that during the first diagnosis (t =1.762,1.662, -1.857,2.015,all P >0.05). Conclusion AHCM has the benign prognosis effect , but the clinical misdiagnosis rate is high , clinicians should enhance their understanding level on the disease ,the characteristic ECG change ,ultrasonic cardiogram and MRI check can help to make a definite diagnosis .

Objective The deformed nasal bone is commonly seen in clinical practice of plastic surgery, and up to now, there is still lack of systemic classification to direct clinical treatment. Attempt was made in this study to classify the deformed nasal bone and present their plastic surgery treatment. Methods According to the orientation of the nasal bone deviation, the nasal bone deformities were divided into seven types, including the depressed, deviated, combination of the depressed and deviated, convex, widened, shortened ones and others. Of the 78 cases with the deformed nasal bone, 52 cases were corrected by the bone osteotomy techniques, and 26 cases by augmentation rhinoplasty. Results The satisfactory repair outcomes were achieved in 48 nasal bone deformities of the 52 cases (92%), and then secondary procedures were performed in 4 cases for further improvements (8%). Augmentation rhinoplasty in 26 cases showed good results. Conclusions Those types of classification are relatively simple and comprehensive, which is conducive to clinical treatment. The nasal bone osteotomy is effective to repair the deformed nasal bone.

Objective To discuss prognosis and relevant factors of the advanced age patients ( over 75 years old) with acute coronary syndrome two years after treated by percutaneous coronary intervene ( PCI ) and conservative treatment .Methods divided 134 cases of advanced age inpatients with acute coronary syndrome were into the obser -vation group and control group in accordance with the different therapies .To 71 inpatients in the observation group treated with standard PCI therapies and treated 63 inpatients in the control group with conservative treatment .Compare the clinical data and their cardiovascular event occurrence rate , case fatality rate and influencing factor of the two groups two years after they left the hospital .Results During the hospitalization ,there were 2 patients in the observa-tion group died,the case fatality rate was 2.82%(2/71),during 24 months follow-up visit,the cardiovascular event occurrence rate was 16.90%(12/71),and cardiac mortality was 5.63%(4/71).Well,in control group,there were 3 patients died,the case fatality rate was 4.76%(3/63),during 24 months follow-up visit,the cardiovascular event occurrence rate was 36.51%(23/63),and cardiac mortality was 11.11%(7/63).The fatality rate of the two groups during the hospitalization had no significant difference (χ2 =0.352,P=0.553),the cardiovascular event occurrence rate and cardiac mortality of the patients in the observation group was superior to that of the control group 24 months after they left hospital,the difference between the two groups was significant (χ2 =6.650,P=0.010).Conclusion PCI treatment to advanced age patients with ACS could reduce their myocardial infarction risk and case fatality rate and improve the symptom obviously ,effectively reduce the patients ’ cardiovascular event and cardiac death occurrence rate in two years .

Dysarthria is collective name for motor speech disorders resulting from disturbance in the speech control mechanism due to the damage to the central or peripheral nervous systems. The speech intelligibility (SI) and communication ability of dysarthric patient are affected, impacting quality of life. Evaluation of dysarthric speech involves subjective and objective measurement which contains electrolaryngoscope, glottograph, electropalatography, nasalance evaluation, acoustic analysis including sonogram，spectrogram, perturbation and noise measurements. Multi-Dimensional Voice Program (MDVP) is a commonly used quantitative acoustic analysis of dysarthric speech. However, in the mainland of China, it is applied in researches on voice of normal people and patients with laryngological diseases and researches on voice characteristics of patients with Parkinson disease or cerebral palsy. To date, no study on the acoustic analysis using MDVP for dysarthric patients with cerebrovascular disease or traumatic brain injury is reported.

Objective To observe the characteristics of acoustic parameter of mandarin vowels in patients with spastic dysarthria and to explore the optimal mandarin vowel sample for the evaluation of acoustic characteristics of spastic dysarthria patients.MethodsTwenty-two male and six female patients with the age range from 19 to 62 years were recruited to patient group from the department of hearing and speech, China Rehabilitation Research Center. Another 28 normal subjects with comparable characteristics were recruited to control group. Computerized Speech Lab MODEL 4500 was employed to sample and to analyze the characteristics of the acoustic parameter. The data of the two groups were compared to detect the difference between groups.ResultsNo significances were found both between groups and within group in the fundamental frequency when pronouncing all the selected vowels. Significant difference was noticed between groups in the variation of both frequency and amplitude. Within the patient group significant difference was only found in the variation of amplitude when pronouncing all the selected vowels. Between groups, a significant difference was found in HNR (harmonic to noise ratio) when pronouncing vowel ［a］, whereas no significance was noticed in ［i］ and ［u］. Significances were noticed within the patient group among the vowels.ConclusionThe patient demonstrated greater variations in frequency, amplitude and noise component compared to control group. The vowel ［a］ is an appropriate examination variable for mandarin in China.

A patient with pure alexia after occipital lobe and splenium infarction was investigated systematically in cognition and speech. It suggested that the damage of the route from orthographic processing to mental lexicon might cause reading disability, that meant the patient can not extract the phonological and semantic information from the mental lexicon. This patient presented some visual perception disorder, but the significance of visual perception still needs further research.

The studies of the pathogenesis of alexia in the west were based on the alphabetic writing system. Chinese is a meaningful writing system, which has its own characteristic of orthographic, semantic and phonological. In recent years, with the development of cognitive neuropsychology, the researchers have investigated the Chinese alexic patients, revealed the special clinical feature of Chinese alexia, and discussed the pathogenesis of it. This article would review the advance of Chinese alexia.

Objective To explore the characteristics and rehabilitation of Chinese dysarthria. Methods 31 patients and 63 normal controls were measured with maximum phonation time (MPT), pitch, intensity and mean airflow rate (MAR), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum midexpiratory flow (MMF), peak expiratory flow rate (PEFR); Nasalance was tested with Nasalance Acquisition System (NasalView); Speech intelligibility was tested with mandarin words card. And alternative movement rate (AMR) were also tested. All the patients were rehabilitated with physiologic approach, 16 patients who finished the course were tested again after rehabilitation. Results MPT, MAR, aspiratory function, AMR of the patients was remarkable lower than those of the control; the nasalance scores of vowel and nonnasal sounds, words, and sentence were remarkable higher than those of the control; the speech intelligibility was also lower. After intervention, MPT, aspiratory function, AMR, and speech intelligibility improved. In the index, only MPT and AMR were correlated with the speech intelligibility. The nasalance of /i/ and nonnasal sentence related with the listener perceptions of hypernasality. Conclusion The aspiratory and phonation function of the patients with dysarthria are impaired. The patients show hypernasality which is a type of resonance abnormity. AMR is declined. Speech intelligibility is much lower. Physiologic approach can improve their phonation, aspiration, articulation and communication ability, but can't for resonance. The longer the MPT, the more /pa、ta、ka/ in specific time, the higher the speech intelligibility. Nasalance could be used for evaluating the hypernasality.

This paper discussed the classification, performance, cerebral localization and the possible mechanism of agraphia in patientswith aphasia. Writing disorders include not only agraphia caused by the neurological dysfunction of the brain, but also mechanicalwriting disorders caused by the primary motor dysfunction. Agraphia is a damage or loss of writing capability caused by acquired brain damage.The study abroad on agraphia focuses on phonetic language. Chinese characters and alphabetic languages belong to different languagesystems. Therefore, foreign research methods are not suitable for us. Domestic studies on agraphia are mostly case reports, and researchmethods and the pathological mechanism of Chinese agraphia are not consistent.