OBJECTIVE: To use the maximum loudest phonation time (MLPT) on evaluation of unilateral vocal fold paralysis. METHOD: The MLPT, maximum comfortable phonation time (MCPT) and maximum phonation time (MPT) were tested and collected in 17 patients with unilateral vocal fold paralysis. The data of ratio value of MLPT to MCPT also was collected. The stroboscopy, perceptual measures and self-questionnaire also were used in evaluation of vocal fold and voice in all patients. Correlation coefficients were used as measures of agreement. RESULT: MLPT was (5.0 +/- 4.0)s, MCPT was (5.4 +/- 4.1)s, and MPT was (6.1 +/- 4.5)s in patients. The MPT was composed of MLPT in 4 patients and MCPT in 13 patients. The MLPT/MCPTa was 1.08 +/- 0.47. MLPT was positively correlated with MCPT and MPT, respectively (r = 0.679, P < 0.01; r = 0.878, P < 0.01), and MCPT also was positively correlated with MPT (r = 0.993, P < 0.01). MLPT, MCPT and MPT was negatively correlated with G value which was from GRBAS scale, respectively (r = -0.620, P < 0.05; r = -0.564, P < 0.05; r = -0.665, P < 0.05). The MLPT/MCPTa was positively correlated with the value of question 4 from self-questionnaire (r = 0.534, P < 0.05). MLPT, MCPT or MPT had no correlation with self-questionnaire, GRBAS perceptual evaluation or stroboscopy measures significantly. CONCLUSION MLPT, MCPT or MPT can be used for evaluation of aerodynamic measures in unilateral vocal fold paralysis. The MLPT may be easiest to operate in clinic. The MLPT/MCPTa ratio can assess dysphagia in unilateral vocal fold paralysis patients.
Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Phonation ; Vocal Cord Paralysis ; pathology ; physiopathology ; Vocal Cords ; pathology ; Voice Quality ; Young Adult

Objective :To analyze and explore influence of hyperuricemia (HUA ) on intracranial atherosclerosis . Methods : A total of 250 patients with non—cardiogenic cerebral infarction treated in our hospital from May 2014 to Jul 2016 were enrolled .Digital subtraction angiogrophy was performed in all patients .According to level of serum uric acid (SUA) ,patients were divided into HUA group (n＝84) and normal UA group (n＝166).Age ,percentages of hypertension ,coronary heart disease ,diabetes mellitus (DM) , hyperlipodemia ,smoking history and recurrence rate of cerebral infarction were compared between two groups ,and influencing factors of atherosclerotic intracranial artery stenosis were analyzed using single—and multi—factor regression analysis .Results : Compared with normal UA group ,there was significant rise in recurrence rate of ischemic stroke (25.30% vs.45.24%) in HUA group , P＝0.001. Single factor analysis indicated that hypertension ,DM and HUA were influencing factors for intracranial ar—tery stenosis , P＝0.001 all ;multi—factor regression analysis indicated that hypertension ,DM and HUA were inde—pendent risk factors for atherosclerotic intracranial artery stenosis (OR＝0. 960～4.957 , P＝0.001 all).Conclusion :Hyperuricemia is an independent risk factor for intracranial atherosclerotic stenosis .Monitor on HUA patients should be enhanced in clinic in order to prevent intracranial atherosclerosis .

Objective:To investigate the role of plasma neurofilament light chain (NfL) in diagnosing and differentiating Parkinson's disease (PD) and multiple system atrophy-Parkinsonian subtype (MSA-P).Methods:Forty PD patients and 23 MSA-P patients admitted to Department of Neurology, Henan Provincial People's Hospital from June 2019 to December 2021 were recruited; 27 healthy subjects accepted physical examination during the same period were selected as controls. Ultrasensitive Simoa technology was used to measure the plasma NfL. Differences in clinical data and plasma NfL were compared among all subjects. Correlations of plasma NfL with clinical characteristics, such as disease course, Hoehn-Year (H-Y) staging, Unified Parkinson's Disease Rating Scale (UPDRS), Montreal Cognitive Assessment (MoCA), Scale for Outcomes in Parkinson's Disease for Autonomic Symptoms (SCOPA-AUT) and levodopa equivalent daily dosage (LEDD), were analyzed with Pearson correlations. Receiver operating characteristic (ROC) curve was used to analyze the value of plasma NfL in diagnosing and differentiating PD and MSA-P.Results:Compared with MSA-P group, PD group had significantly longer disease course and statistically lower scores of UPDRS-II and SCOPA-AUT ( P<0.05). The plasma NfL in MSA-P group, PD group and healthy control group was decreased successively ([37.69±10.47] pg/mL, [17.85±4.23] pg/mL, [12.86±3.14] pg/mL, respectively), with statistical differences ( P<0.05). In MSA-P patients, Pearson correlations showed positive correlation between plasma NfL and age ( r=0.442, P=0.035); and Partial correlations showed positive correlations between plasma NfL and scores of UPDRS-I and UPDRS-III ( P<0.05), and plasma NfL showed no significant correlation with H-Y staging, UPDRS-III, MoCA, LEDD or SCOPA-AUT scores ( P>0.05). In PD patients, Pearson correlations showed that plasma NfL was positively correlated with age ( r=0.342, P=0.031); partial correlations showed that plasma NfL was positively correlated with H-Y staging and UPDRS-III, and negatively correlated with MoCA scores ( P<0.05); plasma NfL showed no significant correlation with disease course, scores of UPDRS-I and UPDRS-II, LEDD, and SCOPA-AUT scores ( P>0.05). ROC curve showed that the area under the curve (AUC) of plasma NfL in diagnosing PD was 0.814 (95% CI: 0.712-0.920, P<0.001); AUC of plasma NfL in differentiating and diagnosing PD and MSA-P was 0.980 (95% CI: 0.954-1.000, P<0.001); AUC of plasma NfL in diagnosing MSA-P was 0.998 (95% CI: 0.993-1.000, P<0.001). Conclusions:Plasma NfL is correlated with severity of motor symptoms in MSA-P patients; plasma NfL is correlated with cognitive function and disease course in PD patients. Besides, plasma NfL has high sensitivity and specificity in differentiating PD and MSA-P, therefore, plasma NfL could serve as a biomarker to diagnosis and differentiate PD.

Objective:To explore the current status and influencing factors of alexithymia among elderly stroke patients.Methods:From August 2017 to April 2018, we investigated 200 elderly stroke inpatients in Neurology Department at a ClassⅢ Grade A hospital in Henan with the self-designed General Information Questionnaire, Toronto Alexithymia Scale 20 (TAS-20) , Social Support Rate Score (SSRS) and Hamilton Depression Scale (HAMD) .Results:Among those stroke patients, the score of alexithymia was (67.42±9.13) and the incidence rate was 51%, which was mainly manifested in extroverted thinking and recognition emotional disorders. Multiple stepwise regression analysis showed that the main influencing factors of alexithymia in elderly stroke patients were the age, hemiplegia, aphasia, social support and depression, which could explain 50.6% of the variation in alexithymia.Conclusions:Alexithymia of elderly stroke patients needs to be improved. While providing nursing care for elderly stroke patients, clinical nursing workers and family members of patients should pay attention to patients' emotional expression, thinking style and depression, especially for patients with advanced age, hemiplegia, aphasia, loss of self-care ability and so on. On the other hand, social support can also be used to improve patients' alexithymia so as to reduce complications, improve clinical outcomes and their quality of life.