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 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 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 .

ObjectiveTo investigate the changes of lymph flow by microwave heating whichhad achieved an excellent result in the management of lymphedema of extremities. Methods26 caseswith lymphedema of the extremities had been evaluated by means of lymphoscintigraphy using 99mTc －Dextran and SPECT to examine the lymph flow speed and half－ time(T1/2)clearance of the injection siteas well as lymphatic images of the affected limbs before and after treatment. Results The averagelymph flow speed in the affected limbs was significantly lower than that of the contralateral normal limbswith 7.82cm/min and 10.41cm/min respectively before treatment, and they increased significantly from7.82 to 9.36cm/min after two courses of treatment; in contrary, T1/2 was higher in the lymphedema-tous limbs with an average value of 154.21 min in comparison with 91.55 min contralaterally, and de-creased significantly to 115.38 min after treatment. In addition, lymphatic image disturbances improvedmarkedly in 22/26 cases(84.6% ) after treatment, especially in the patients with infectious lymphede-ma, and showed no changes in two cases. ConclusionThe results demonstrated that there was evi-dent lymph flow stasis in lymphedematous limbs, based on the preliminary calculation of lymph flow in-dexes; microwave heating could promote the lymph flow in lymphedema of extremities.

Articulation disorders that inhibit the communicative ability in children can be classified into three types. In the past, we have done much work in dysarthria and organic articulation disorders. Now we begin to explore the treatment of functional articulation disorders. In this paper, we described 10 patients between four to ten years old with functional articulation disorders and approached from different angles. We have positive answers in definition, diagnose standard and treatment procedure. We also find that the cure effect is very good, 9 of 10 patients have regained normal communlcative ability after speech therapy of one to three months.We hope to do much more work in the etiology and incidence of functional articulation disorders of children in China in the future.

目的探讨980nm半导体激光经皮椎间盘减压术(PLDD)治疗腰椎间盘突出症的疗效。方法286例患者局麻后在C型臂X射线机透视下确定病变椎间盘平面,以每个椎间盘600～800J激光能量行PLDD。参照Choy评分法评价疗效。结果经1年以上随访,0～2分者(优)188例(65.8%),;3～5分者(良)41例(4.1%),6～10分者57例(20%);无椎间盘炎及其他并发症发生。结论PLDD能有效缓解椎间盘源性疼痛。

Naming refers to broad nerve network, the cerebral location of naming is not clearly so far. It is a main measure to study the mechanism of naming by combining the symptoms and the imaging examination of aphasic patients. Meanwhile, it is also a focus of research in the field of neuropsychology. Many models on naming were produced. In this article, the authors reviewed the previous research fruits on naming and summarized some useful neuroanatomical pathways, cortex areas related to naming such as fusiform gyrus, angular gyrus, etc., and the most influential theories in the field of neuropsychology: namely lexicon system and lexical access theories.

This article would review the general symptoms of anomia and the classification of anomia based on the clinical characteristics, including word production anomia, word selection anomia, semantic anomia, category-specific anomia, modality-specific anomia.

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.