By analyzing the mechanism of pronunciation, traditional acoustic parameters, including fundamental frequency, Mel frequency cepstral coefficients (MFCC), linear prediction cepstrum coefficient (LPCC), frequency perturbation, amplitude perturbation, and nonlinear characteristic parameters, including entropy (sample entropy, fuzzy entropy, multi-scale entropy), box-counting dimension, intercept and Hurst, are extracted as feature vectors for identification of pathological voice. Seventy-eight normal voice samples and 73 pathological voice samples for /a/, and 78 normal samples and 80 pathological samples for /i/ are recognized based on support vector machine (SVM). The results showed that compared with traditional acoustic parameters, nonlinear characteristic parameters could be well used to distinguish between healthy and pathological voices, and the recognition rates for /a/ were all higher than those for /i/ except for multi-scale entropy. That is why the /a/ sound data is used widely in related research at home and abroad for obtaining better identification of pathological voices. Adopting multi-scale entropy for /i/ could obtain higher recognition rate than /a/ between healthy and pathological samples, which may provide some useful inspiration for evaluating vocal compensatory function.
Acoustics ; Humans ; Sound ; Speech Acoustics ; Voice Disorders ; Voice Quality

Objective To evaluate the effect of morphine on synaptic long-term potentiation (LTP) in the spinal dorsal horn evoked by electric stimulation of sciatic nerve in rats. Methods Twenty-seven healthy male SD rats aged 60-90 d weighing 180-200 g were randomly divided into 4 groups: group Ⅰ control (group C, n=7), group Ⅱ morphine (group M, n=7), group Ⅲ naloxone (group N, n=6), and group Ⅳ morphine + naloxone (group MN, n=7). The animals were anesthetized with intraperitoneal 10% urethane 1 g/kg, intubated and then mechanically ventilated. The bipolar insulated stainless steel recording electrode (impedance 0.5-1 MΩ, diameter 0.1 mm) was inserted into the left side of the spinal dorsal horn at T13-L1 to stimulate the left side of the sciatic nerve. Single square pulses (15 V, 0.5 ms, 1/60 Hz for 30 min) was applied to evoke spinal field potentials. Normal saline 10 μl, morphine 10 μl (15 μg/μl), naloxone 10 μl (2.5 μg/μl), and the mixture 10 μl of naloxone 5 μl (2.5 μg/μl) and morphine 5 μl (15 μg/μl) was gradually instilled over 2 rain in the 4 groups respectively. Five minutes later, high-frequency and intensity tetanic stimulation (30-40 V, 0.5 ms, 100 Hz, given in 4 trains of 1-s duration at 10-s intervals) was used to induce LTP. Then single square stimuli (15 V, 5 ms, 1/60 Hz) were applied to the sciatic nerve for 210 min. The amplitude and latency period of the field potential were recorded 30 min before tetanic stimulation, and 0-30, 35-60, 65-120 and 125-210 min after titanic stimulation. Results Compared with group C, the amplitude of the field potential was significantly decreased and the latency period prolonged in group M and MN, but there was no significant difference in the above indices between group N and C. Compared with group M, the amplitude of the field potential was significantly increased and the latency period shortened in group MN. Compared with those 30 min before the tetanic stimulation, the amplitude of the field potential was significantly increased and latency period shorted at the time points after the tetanie stimulation in group C and N, the amplitude of the field potential was significantly decreased and latency period prolonged at the time points after the tetanie stimulation in group M, and the amplitude of the field potential was significantly increased 0-30 and 35-60 min after the tetanic stimulation and latency period shortened 0-30 min after the tetanie stimulation, the amplitude of the field potential was significantly decreased and latency period prolonged 65-120 and 125-210 min after the tetanic stimulation in group MN. Conclusion Morphine can inhibit synaptic LTP in the spinal dorsal horn evoked by electric stimulation of sciatic nerve in rats, and it may be one of the mechanisms of the central sensitization inhibition.

Objective To explore the outpatients′experience of caring and provide references for improving their experience of medical care.Methods The phenomenology research method was adopted in this study,and twenty-one outpatients were subject to an in-depth interview to learn their outpatient experiences.Results Ten themes of experience with caring were extracted as follows:passionate and patient,careful and considerate,respect for others,offers to help,encouraging and comforting,apologies and courteously,humor,truthful considerations,conscientious and responsible,and a caring environment setup.Five themes of experience without caring were extracted as follows:impatient communication, careless seeing of outpatients,delayed service,passive reminders,and facilities without enough details. Conclusions The outpatients may have abundant experiences of caring at the outpatient clinic,also lack of caring sometimes as well.Outpatient managers should keep an eye on outpatients′needs and satisfaction of caring from time to time,to improve the quality of outpatient service.

Objective To observe the changes of coagulation function in patients with acute lowerlimb deep venous thrombosis(DVT)and evaluate the risk factors for DVT. Methods Plasma APTT.PT,TT,D-dimer and fibrinogen(Fbg)were detected by an automated coagulation analyzer in 62 acute lower-limb DVT patients and 70 controls:Retrospective studies on the clinical data of all patients were done by binary logistic regression analysis.Results (1)In DVT group,plasma APTT,PT and TT,the levels of D-dimer and fibrinogen.and D-dimer/fibrinogen ratio(D/F ratio)were higher when compared with control group(au P＜0.01);(2)There were positive correlations between D-dimer and fibrinogen both in DVT and control groups(r=0.475,P＜0.01;r=0.564,P＜0.01,respectively);(3)Logistic analysis indicated that acute lower-limb DVT was associated with the presence of hypertension and increased plasma level of fibrinogen(OR=24.99,P＜0.01: OR=4.346.P＜0.01,respectively).Conclusions Hypertension and elevated plasma level of fibrinogen are independent risk factors for acute lower-limb DVT.

Objective To explore the methods of the standardized management used in humanistic nursing care and to assess its effects.Methods Measures of the standardized management began to be used in such care at the hospital since January 2013.Questionnaires of patient satisfaction with nursing care for inpatients and those discharged were used to assess the effects of the standardized management measures periodically and synthetically.Results The patient satisfaction with humanistic nursing care keeps increasing year by year from 2013 to 201 5.The differences among three sets of data are statistically significant(P < 0.05 ).Conclusions Humanistic nursing care calls for promotion of standardized management.It is high time to build such a standardized management system at the hospitals.

Objective To investigate the diagnosis and surgical treatment of intracaval venous tumors. Methods Clinical data of 6 cases were retrospectively analyzed, including signs and symptoms diagnostic means such as type-B ultrasound, CTA, MRA, surgical procedures and prognosis. Results All six cases received type-B ultrasonic examination, final definite diagnosis was achieved by CTA exam in 2 cases and through MRA in 4 cases. Heart involvement was found in 3 cases. All patients underwent a surgery. According to the extent of the tumor,3 cases had thoraco-abdominal incision,3 cases with extracorporeal circulation and right atrium opening. All of the tumors were completely resected. Pathological exam revealed that 4 cases were of leiomyomatosis and 2 cases were of leiomyosarcoma. One case with leiomyosarcoma died of liver disfunction postoperatively.The other 5 cases recovered without major complications. An average 51 months of follow-up found no recurrence. Conclusions CT and MRI are the mainstay for the diagnosis,and MRI can provide clear anatomy image to the surgeons, help choose the surgical procedures. The one-stage operation is effective. During the operation, the main branches of the vena cava system should be detected, and the attachment of the tumor should be found and removed thoroughly to prevent the recurrence of the tumor. When the attachment point is lower than the iliac vein level, ligation of the involved iliac vein should be mandatory.

On the analysis of world suicide prevention day theme throughout the years and its basic connotation, the article elucidates the core idea of "suicide, can be prevented" from different angles. And it enlightens the nurses should combine clinical practice, according to the specific situation of the hospitalized patients to carry out suicide prevention nursing work, mainly includes: think globally, make life full of hope, diversified social support, promote understanding, focus on high-risk age bracket, attach great importance to the cultural background, strengthen the cause of survival, eliminate discrimination, psychological intervention and continuous human care.

Objective To understand the probability of suicide and demographic characteristics of cancer inpatients and to analyze the correlation between depression and probability of suicide.Methods From June to October 2017, we selected 310 inpatients in oncology department of two hospitals in a province as subjects by convenience sampling. The questionnaire survey was carried out in patients with the general information questionnaire, Patient Health Questionnaire-9 (PHQ-9) and Suicide Probability Scale (SPS). Pearson correlation was used to analyze the correlation between depression and probability of suicide. We also compared the differences of probability of suicide among patients with different characteristics.Results Among 310 cancer inpatients, the score of PHQ-9 was (3.96±3.46) with 7.1％ (22/310) for the incidence of depression;the score of SPS was (57.35±8.38) with 11.0％ (34/310) for the incidence of suicide idea. Depression of patients had a positive correlation with the probability of suicide (r=0.381,P<0.001). There were statistical differences in the probability of suicide among cancer inpatients with different sexes, ages, education levels, marital status and living conditions (P<0.05).Conclusions When evaluating the probability of suicide of cancer inpatients, we should pay attention to high-risk population according to different demographic characteristics. Clinical nursing workers should show solicitude for patients with depressive symptoms and provide timely medication and mental regulation for patients diagnosed with depression.

Objective To analyze the coding quality of multiple primary malignant tumors in a tertiary hospital,identify existing problems,and improve the accuracy of coding for multiple primary malignant tumors.Methods We collected 393 medi-cal records from a tertiary hospital from June 1,2021,to June 30,2023,with ICD-10 code C97 for the discharge diagnosis.By carefully reading the medical records,we analyzed the reasons for coding errors in multiple primary malignant tumors with code C97.Results Among the 393 medical records,there were 34 cases with coding errors in C97,including 11 cases where meta-static malignant tumors were erroneously coded as multiple primary malignant tumors,9 cases where malignant tumors of the same organ system with non-adjacent sites and the same histological type were erroneously coded as multiple primary malignant tumors,7 cases where distant metastasis or local invasion was erroneously coded as multiple primary malignant tumors,4 cases where be-nign tumors were mistakenly coded as malignant tumors,and 3 cases where suspected malignant tumors were coded as confirmed cases.Conclusion To improve the quality and efficiency of C97 coding,coders need to have a clear understanding of the defini-tion of multiple primary malignant tumors,read the medical records carefully and completely,determine the location and histolog-ical type of the tumors accurately,and strengthen communication with clinical physicians.

Coding malignant tumors in multiple sites within the digestive system involves some coding rules.When more than two malignant tumors present various pathologic types,they should be included in the code of C97,which indicates multiple primary malignancies,and should be categorized into a specific code under the category of C97 upon corresponding treatment pur-poses.For those malignant tumors in the digestive system presenting with the same pathological results but unidentified primary sites,which are diagnosed as more than two types of tumors and recorded on the first page of a medical record,they are coded ac-cording to their specific locations.The coding principles are as followed:① If a malignant tumor spans two or more adjacent sites with an unidentified primary origin,it should be classified as a cross-site malignant tumor and coded based on the tumor's ana-tomical location.② If more than two malignant tumors are located in the separate parts of the same location,they should be co-ded with".9"as a subheading of the three-digit category specific to the right location.③If more than two malignant tumors are not adjacent to each other in the digestive system,they should be classified to the code of C26.9.In the process of coding,cod-ers should review case data thoroughly,enhance the accumulation of clinical knowledge,and strengthen communications with doc-tors,thereby enhancing coding precision.