Audiology ; Humans ; Speech-Language Pathology ; Voice

Objective To investigate the application and significance of aerodynamic parameters in voice function assessment. Methods The phonatory aerodynamic system (PAS) was used to collect aerodynamic parameters from subjects with normal voice,vocal fold polyp,vocal fold cyst,and vocal fold immobility.Multivariate statistical analysis was used to compare measurements across groups. Results Phonation threshold flow ( PTF),mean flow rate (MFR),maximum phonation time ( MPT),and glottal resistance (GR) in one hundred normal subjects were significantly affected by sex ( P ＜ 0.05 ),while phonation threshold pressure (PTP),subglottal pressure (SGP),and vocal efficiency (VE) were not (P ＞0.05). PTP,PTF,MFR,SGP,and MPT were significantly different between normal voice and voice disorders (P ＜ 0.01 ),and there were no significant differences among the three disorders ( P ＞ 0.05 ).Receiver operating characteristic (ROC) analysis found that PTP,PTF,SGP,MFR,MPT,and VE in one hundred thirteen voice dis orders had similar diagnostic utility (P ＜0.01 ),with PTP exhibiting the highest area under the curve.The aerodynamic parameters of the three degrees of voice dysfunction due to vocal cord polyps were compared and found to have no significant differences(P ＞0.05).PTP,PTF,MFR,SGP and MPT in forty one patients with vocal polyps were significantly different after surgical resection of vocal cord polyps (P ＜ 0.01 ).Conclusion The aerodynamic parameters can objectively and effectively evaluate the variations of vocal function,and have good auxiliarv diagnostic value.

Rapid Rural Appraisal (RRA) is a systematic, semi-structured activity carried out in the field by a multidisciplinary team that is designed to obtain new information and hypotheses about rural life. This article reports the results of an RRA conducted in Kampung Paris 1 (KGP1), Kinabatangan, Sabah under the Annual Health Promotion Program of the School of Medicine, Universiti Malaysia Sabah. A systematic random sampling was used to recruit the villagers and data was obtained through compilation of pre-existing data, field observation, structured interviews with key informants and villagers. Cardiorespiratory diseases were prevalent in KGP1. Common water sources such as rain water collected in dug wells in KGP1 were unhygienic. Dangerous toxic fumes were produced by the burning of municipal wastes nearby village houses. The villagers of KGP1 were exposed to various farm animals, which may harbor zoonoses. Health care services are limited in KGP1. Villagers who were not poor (>RM897) represented 48% of the population, followed by the poor (RM503-897), 20% and the hardcore poor (1.00 person per bedroom. Poor water hygiene, polluted air from open burning, exposure to farm animals, poverty, poor education, overcrowding and inadequate health care services were among the few possible factors affecting the health of villagers in KGP1. Formal rigorous research should be conducted in the future to facilitate specific health interventions in areas of need such as KGP1.
Rural Population ; Rural Health ; Rural Health Services ; Health Status ; Malaysia

Laryngeal diseases are closely related to the swallowing and speech function of the patients.Protecting and restoring laryngeal function, while curing lesions, is vital to patients′ quality of life.Photodynamic therapy (PDT) is a minimally invasive method which is widely used in the treatment of tumor, precancerous lesions, and inflammatory diseases.In recent years, it has been shown to have a protective effect on normal structures. This article reviews the clinical outcomes of laryngeal diseases treated with PDT since 1990 in order to evaluate its efficacy and significance. The complete remission rate of early-stage laryngeal tumors and precancerous lesions after PDT is 77.6%(249/321), and a promising effect on recurrent laryngeal papillomatosis has been observed thus far. The prolonged adverse effects of the first-generation photosensitizers have limited the application of PDT. With the improvement of photosensitizers and treatment strategies, PDT promises to be a safe, effective, and minimally invasive treatment method for laryngeal diseases.

Objective:To explore the dynamic changes of three-dimensional morphology of laryngeal soft tissue and its clinical value in the unilateral vocal fold paralysis (UVFP) patients through dynamic CT scanning during the process from inspiration to phonation.Methods:From October 2017 to July 2019, a retrospective study was performed in 18 patients with UVFP (10 males and 8 females with the range of age from 29 to 75 years old) and 10 normal subjects (5 males and 5 females with the range of age from 25 to 58 years old) in Department of Voice-Otolaryngology Head and Neck Surgery, Section Two, Zhongshan Hospital Xiamen University. The laryngeal dynamic computed tomography (CT) of cine mode was performed. Ten dynamic sequence images of vocal folds movements were obtained during the process from inspiration to phonation. Based on the dynamic changes of glottic area and the displacement of cricoid cartilage. The above dynamic sequence images were divided into inspiratory phase and phonation phase as well as open phase and closed phase. The soft tissue parameters were measured respectively, including vocal folds length, width, thickness and subglottal convergence angle. Independent-sample t test was used to analyze between UVFP group and control group. Results:During the process from inspiration to phonation, the morphology of vocal folds in control group was relatively stable at inspiratory phase and closed phase in phonation. When open phase and closed phase of phonation were switching, the morphology of vocal folds changed obviously. The length of vocal folds became longer (1.19±0.10) mm, the width became wider (2.19±0.17) mm, the thickness became thinner (2.66±0.56) mm, and the subglottal convergence angle decreased (31.45±4.78)°. Compared with the controll group, in the open phase, the thickness and width of the vocal fold on affected side in the UVFP group were thinner ( t=10.25, P<0.001) and wider ( t=5.25, P<0.001).While in the closed phase, the subglottal convergence angle was larger ( t=4.41, P=0.001).The width of the healthy side vocal fold in the UVFP was wider ( t=2.54, P=0.026) than that in the control group. The differences in other parameters were not statistically significant. Conclusions:Dynamic laryngeal CT scanning provides a simple and non-invasive method for the objective and quantitative measurement of the dynamic changes of laryngeal morphology from inspiration to phonation. Compared with the control group, the characteristic dynamic changes among UVFP were observed during this particular process, which included changes of subglottal convergence angle and thickness of vocal muscle due to denervation. In addition, in UVFP group, the width of the vocal fold healthy side in the closed phase may be used to assess its compensatory function.

BACKGROUNDOff-label application of drug-eluting stents (DES) during percutaneous coronary intervention (PCI) was not uncommon in daily practice, however DES in treating Chinese patients with complex lesion subset was under-investigated. The primary objective of the FIREMAN registry was to evaluate the long term efficacy and safety of the Firebird sirolimus-eluting stent (SES) in treating patients with complex coronary lesions. Here we report the mid-term of one-year clinical outcomes and eight-month angiographic follow-up results of FIREMAN registry.

METHODSThe FIREMAN registry was a prospective multi-center registry, which included 1029 consecutive patients undergoing PCI with Firebird SES implantation between September 2006 and July 2007 in 45 centers in China. The clinical follow-up was designed to be performed at 1, 6, 12, 18, 24, 30 and 36 months post index procedure, and non-mandatory angiographic follow-up at 8 months was planned. One hundred percent site monitoring was conducted.

RESULTSLong lesions (59.2%), multi-vessel disease (50.4%), and small vessel disease (31.6%) were mostly found in angiography. Major adverse cardiac events (MACE) occurred in 51 (5.1%) patients at 1 year clinical follow-up, including cardiac mortality in 6 (0.6%), non-fatal myocardial infarction in 11 (1.1%), and target lesion revascularization in 36 (3.5%) of the patients. Definite and probable stent thrombosis (ST) by Academic Research Consortium (ARC) definition occurred in 12 (1.36%) patients at one-year clinical follow-up. The 8-month binary restenosis rate was 5.7% in-segment and 4.3% in-stent, respectively. Late lumen loss was (0.21 ± 0.40) mm in-segment and (0.23 ± 0.36) mm in-stent, respectively. Furthermore, Cox regression analysis revealed that diabetes, small vessel diameter, and chronic total occlusion were independent predictors of ST.

CONCLUSIONSThe results showed that the Firebird SES was effective and safe in treating Chinese patients with complex coronary lesions and occurrence of ST rate at one-year clinical follow-up was acceptable, however further long-term follow-up was still necessary. (NCT00552656)

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; methods ; Asian Continental Ancestry Group ; Coronary Angiography ; Coronary Disease ; diagnostic imaging ; therapy ; Drug-Eluting Stents ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Sirolimus ; therapeutic use ; Treatment Outcome

Isshiki systematically developed thyroplasty in the 1970 s. Based on Isshiki′s classification of thyroplasty, laryngeal framework surgery was classified by the Phonosurgery Committee of the European Laryngological Society in 2001. Then laryngeal framework surgery became more systematic and standardized, and made new progress in clinical applications and basic theoretical research. This article mainly expounds new progress in laryngeal framework surgery over the last five years.