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 .

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.

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 .

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.

In this experiment, Animal model of guinea pig's experimental Autoimmune sensorineural hearing Loss was established by injecting crud inner ear antigen (CIEAg), Dexamethason was used to tret the deaf guinea pigs for one week, the ABRT(Acoustic Brain—stem Reaction Threshold) of guinea pigs was measured and the morphological change of the guinea pigs inner ear, tissue was observd. We found that the deaf guinea pig's ABRT rose distinctly to 60. 8?5.31 dBspl and inner ear hair cell showed severe damage. The number of the hair cell of the third cochlear turn lost 111?55.8. After one week treatment with Dexamethason,the treated group's ABRT reduced to 48. 8?6. 69dBspl, the number of the outer—hair—cell of the third cochlear turn is only 57. 254?18. The results indicate that Dexamethon has effect on the AISNHL,it can clearly lighten the damage of inner ear tissue and significantly improve the ABRT. The mechanism still remains unknown.

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.

This paper discussed the performance and cerebral localization of tone error occurred in patients with aphasia. The definition and characteristics of tone and aphasia were introduced briefly, while focusing on the brain lateralization of the tone. Tone is a language signal, but also has characteristics of melodic acoustic. The dual nature affects the cognitive process of tone languages. Therefore studies at home and abroad about tone showed that the conclusion of advantage of lateralization was inconsistent. In this paper, by summarizing the advantage of lateralization of listening perception with different languages, and generalizing the brain damage localization in aphasia patients with voice disorders, the dominant side of the tone in the brain was discussed. This paper also summarized and discussed the characteristics of voice disorder in aphasia.

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 explore the evaluation for apraxia of speech (AOS) with Chinese. Methods 20 Chinese cases with AOS were assessed with Chinese material referred from Motor Speech Evaluation (MSE) using. Results The subtest of multiple repetitions of multisyllabic words was the most difficult and single repetitions of monosyllabic words was the easiest for AOS patients (P<0.05). The score of the short sentences negatively correlated with both the scores of repetition ability (r=-0.865) and the fluency of speech (r=-0.614) (P<0.001).Conclusion Chinese material referred from MSE can be used for evaluation of AOS with Chinese.