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 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.

Objective To explore the performance of meningiomas in MRI dynamic enhancement and DWI sequence,and to improve the accuracy of differential diagnosis of benign and malignant meningiomas.Methods Meningioma MRI data,which were pathology proved by the Guilin medical college affiliated hospital at different levels(Ⅰ,Ⅱ and Ⅲ),were retrospectively analyzed.The enhancement of meningiomas at all levels and the extent of edema were summarized,at the meantime the dynamic enhancement perfusion parameters and ADC values of meningioma MRI meningioma were contrastively analyzed.Results There were 30 cases of meningioma located in the brain falcus,27 cases of meningioma located in the sagittal sinus,10 cases of meningioma located in the cerebellopontine angle and 6 cases of meningioma located in other parts.The difference of ADC value between grade Ⅰ meningiomas and grade Ⅲ meningiomas was statistically significant different[(1.253±0.123)×10-3 mm2/s vs.(0.891±0.103)×10-3 mm2/s,P<0.05].The relative blood flow(rCBF)and relative blood volume(rCBV)of grade Ⅰ meningiomas were significantly lower than those of grade Ⅲ meningiomas(P<0.05).Conclusion MRI dynamic enhancement combined with DWI can accurately identify grade Ⅰ meningiomas and grade Ⅲ meningiomas,and it is necessary that the assessment of its classification should be appropriately considered to the higher level for patients who do not have a characteristic manifestation of meningioma in the preoperative.

Objective By investigating the actualities of career development potential of eight-year program medical students, to explore a direction of training mode innovation aiming to improve career development potential. Methods Eight-year program medical graduates, their tutors, and di-rectors of their clinical department in a university hospital were the subjects of the current study. Questionnaire method was applied to evaluate professional competence including clinical skills, re-search capabilities and integrative ability . Anonymous questionnaires were dispensed to eight-year program medical graduates for self-evaluation. Distinct anonymous questionnaires were dispensed to tutors directors for evaluation. Traditional doctoral graduates (professional degree or academic degree) were set as standard for comparison of specific ability of eight-year program medical students. Results 74 out of 85 (87%) questionnaires for Eight-year program medical graduates were available. 53 out of 63 (84%) questionnaires for tutors were available. 21 out of 26 (81%) questionnaires for directors of clinical departments were available. In clinical capabilities, according to 43 percent (32 persons) of the eight-year MD graduates' self-assessment and the evaluation of 94%(50 persons) mentors and 81%(17 people) department directors, eight-year program medical graduates were regarded as lower-skilled clinicians compared with doctoral graduates with professional degree . Eight-year program medical graduates were also considered with worse research capabilities than doctoral graduates with profes-sional degree by themselves (76%, n=56), their tutors (91%, n=48), and their department directors (86%, n=18). Conclusions The survey shows that to some extent, the current eight-year clinical doctoral graduates lack of career development potential, reflecting the current training mode cannot lead to the given training goals. We suggest that both clinical skills and research capabilities should be enhanced to make sure that eight-year program medical graduates deserve the title of academic physicianorphysician scientists.

This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) by using dynamic 3-Dimensional (3-D) CT imaging. A total of 41 male patients who presented with 2 of the following symptoms, i.e., daytime sleepiness and fatigue, frequent snoring, and apnea with witness, were diagnosed as having OSAHS. They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller's maneuver. The soft palate length (SPL), the minimal cross-sectional area of the retropalatal region (mXSA-RP), and the vertical distance from the hard palate to the upper posterior part of the hyoid (hhL) were compared between the two breathing states. These parameters, together with hard palate length (HPL), were also compared between mild/moderate and severe OSAHS groups. Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index (AHI) and the lowest saturation of blood oxygen (LSaO(2))] was examined. The results showed that 31 patients had severe OSAHS, and 10 mild/moderate OSAHS. All the patients had airway obstruction at soft palate level. mXSA-RP was significantly decreased and SPL remarkably increased during Muller's maneuver as compared with the quiet breathing state. There were no significant differences in these airway parameters (except the position of the hyoid bone) between severe and mild/moderate OSAHS groups. And no significant correlation between these airway parameters and the severity of OSAHS was found. The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group. The patients in group with body mass index (BMI)≥26 had higher collapse ratio of mXSA-RP, greater neck circumference and smaller mXSA-RP in the Muller's maneuver than those in group with BMI<26 (P<0.05 for all). It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients. All the OSAHS patients had airway obstruction of various degrees at soft palate level. But no correlation was observed between the airway change at soft palate level and the severity of OSAHS. The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI<26.

The enzymatic synthesis of endomorphins were carried out by immobilized papain on sodium alginate-chitosan (IPSAC). The reaction has been carried out in two steps. First, Trp-Phe-NH2 was obtained by Boc-Trp-OH coupling with Phe-NH2 using IPSAC catalyst in microaqueous acetonitrile system with a 27.8 % yielding as determined by high performance liquid chromatography (HPLC). The catalytic properties of IPSAC were examined by studying the dependence of pH, ionic strength, solution content, reaction temperature,enzyme loading and reaction time over the yields. The results of orthogonal experiments indicated that pH was the most significant factor that influenced this synthesis. Second, Boc-Tyr-Pro-OMe and Trp-Phe-NH2 were suspended into the microaqueous acetonitrile to produce Tyr-Pro-Trp-Phe-NH2 (endomorphin-1) with a 35.2% yield.

To explore the effect of estrogen on pathogenesis of osteoporosis in women with maintenance hemodialysis. One hundred and twenty women aged 18-45 years had been undergoing maintenance hemodialysis for ≥ 3 months were included. Of them ,60 women without osteoporosis served as control group and the other 60 women with osteoporosis as observation group. Serum concentrations of estradiol, tumour necrosis factor-α (TNF-α), parathyroid hormone (PTH), and calcium were determined, meanwhile bone mineral density (BMD)was measured by quantitative computed tomography. Serum estradiol levels in the observation group were lower while TNF-α level were higher than those in control group (all P<0. 05). PTH and calcium levels were not significantly different (P= 0.567 and P = 0. 588). In the observation group, linear correlation analysis revealed positive correlation (r = 0. 865 ,P<0. 01)between estradioi and BMD,while multiple linear regression analysis showed that serum estradiol and calcium levels were positively correlated with BMD, and the concentrations of TNF-α and PTH were negatively correlated with BMD (F= 140.32 ,P<0.01). Estradiol levels were found to have greater effect on BMD(t=5. 386, P<0. 01). Lowered serum concentration of estradiol in women with maintenance hemedialysis seems to be a major factor related to osteoporosis,it accelerates the pathogenesis of osteoporosis by modulating TNF-α.

Objective To investigate the effects of internal and external biliary drainage on liver regeneration of the obstructive jaundice rats after partial hepatectomy.Methods The rat models of obstructive jaundice with 70％ liver resection were successfully constructed.All the 120 rats were randomly divided into the control group:rats received middle and left hepatic lobectomy; internal drainage group:a drainage tube was placed between the dilated bile duct and the duodenum; external drainage group:a drainage tube was placed in the dilated bile duct.There were 40 rats in each group.Rats in the internal and external drainage groups received middle and left hepatic lobectomy at postoperative day 7.The blood and hepatic tissues were collected at postoperative day 0,1,2,4,12,24,48,72 hours after operation,and the rate of liver regeneration and mitotic index were determined.The expression of proliferating cell nuclear antigen (PCNA) and signal transducer and activator of transcription 3 (STAT3) in the hepatic tissues were detected by immunohistochemistry,and the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected by ELISA,and the mRNA expressions of TNF-α and IL-6 were detected by RT-PCR.All data were analyzed using the one way analysis of variance or SNK test.Results Within 72 hours after partial hepatectomy,the rate of liver regeneration of the internal drainage group was 94.86％± 12.72％,which was significant higher than 62.39％±8.01％ of the external drainage group and 45.77％ ± 5.41％ of the control group (F =33.62,P ＜ 0.05).The mitotoic index and PCNA levels of the 3 groups had obvious increase at postoperative hour 12,and the mitotoic index and PCNA levels of the external drainage group reached peak at postoperative hour 24,which were 24.47％ ± 4.01％ and 88.1％ ± 9.2％,respectively,the mitotoic index and PCNA levels of the control group and the external drainage group reached peak at postoperative hour 48,which were 15.80％ ± 1.08％,58.3％ ± 5.8％ and 18.40％ ± 1.12％,70.2％ ± 6.9％,respectively.The mitotoic index and PCNA levels of the internal drainage group were significantly higher than those of the control group and the external drainage group (P ＜ 0.05).The expression of STAT3 expression of the internal drainage group reached peak at postoperative hour 4,which was 42.6％ ± 3.6％ ;the expression of STAT3 expression of the control group and the external drainage group reached peak at postoperative hour 12,which were 22.9％ ± 2.0％ and 29.2％± 3.7％.The peak level of STAT3 of the internal drainage group was significantly higher than those of the control group and the external drainage group (P ＜0.05).The levels of TNF-α and IL-6 of the internal drainage group reached peak at postoperative hour 12,which were (227 ±23)U/L and (256 ± 32)U/L; the levels of TNF-α and IL-6 of the control group and the external drainage group reached peak at postoperative hour 24,which were (309 ± 41) U/L and (388 ± 40) U/L,(287 ± 30)U/L and (346± 33)U/L,respectively.The levels of TNF-α and IL-6 of the internal drainage group at postoperative hour 0,1,2,4,12,24,48,72 were significantly lower than those of the control group and the external drainage group (P ＜ 0.05).The expressions of TNF-α mRNA of the control group,internal drainage group and external drainage group reached peak at postoperative hour 4,which were 0.92 ±0.14,0.39 ±0.05,0.80 ±0.15,respectively.The expressions of IL-6 mRNA reached peak at postoperative hour 12,which were 0.79 ± 0.07,0.38 ± 0.06,0.63 ±0.10,respectively.The expressions of TNF-α mRNA and IL-6 mRNA of the internal drainage group at postoperative hour 0,1,2,4,12,24,48,72 were significantly lower than those of the control group and the external drainage group (P ＜ 0.05).Conclusions Both internal and external drainage can improve liver regeneration of obstructive jaundice rats following partial hepatectomy,while the effect of internal drainage is superior.Internal biliary drainage has influence on the expression of STAT3 by decreasing the levels of TNF-α and IL-6,and help to improve liver regeneration of obstructive jaundice rats following partial hepatectomy.

Objective To study the effects of exogenous phosphocreatine (CP) on brain injury after cardiopulmonary resuscitation (CPR) in rats.Methods A total of 160 male adult SD rats were randomly ( random number) divided into 4 groups:sham-operation control group ( group A),CPR group ( group B),low-dose CP group ( group C),high-dose CP group ( group D),and each group was further divided into 5 subgroups (n =8) as per study at different intervals,0.5,3,6,12 and 24 h after restoration of spontaneous circulation (ROSC) in groups B,C and D or after tracheotomy in group A.Cardiac arrest (CA) was induced by using asphyxia to establish CPR model in group B,C and D.The CP0.5 g/kg used in group C or CP 1.0 g/kg used in group D was injected into femoral vein at beginning of ROSC.Rats in each subgroup were sacrificed and the tissues of frontal lobe of brain of rats were taken at different intervals.The levels of adenosine triphosphate (ATP),adenosine diphosphate (ADP) and adenosine monophosphate (AMP) in cerebral cortex were measured by high performance liquid chromatography (HPLC),and values of total adenine nucleotides ( TAN ) and energy charge ( EC ) were detected.The activities of Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase in cerebral cortex were assayed by spectrophotometric method. The pathological changes of cerebral cortex were observed under optical microscope.The experimental data were processed with analysis of variance by using SPSS 16.0 package. Results Compared with group A,the levels of ATP,TAN,EC,Na + -K + -ATPase,Ca2+ -Mg2+ -ATPase were lower ( P ＜ 0.05 or P ＜ 0.01 ) at each interval in groups B and C,and at intervals of 0.5,3,6,12 h in group D,and the levels of AMP were higher (P ＜ 0.01 ) at each interval in group B and at intervals of 0.5 h and 3 h in groups C and D.Compared with group B,the levels of ATP,TAN,EC,Na + -K + -ATPase,Ca2 + -Mg2+ -ATPase were higher ( P ＜ 0.05 or P ＜ 0.01 ),and the levels of AMP were lower ( P ＜ 0.05 or P ＜ 0.01 ) at intervals of 6,12 and 24 h in groups C and D.Compared with group C,the levels of ATP at interval of 24 h and TAN,Na +- K + -ATPase,Ca2 + -Mg2 + -ATPase at intervals of 6,12 and 24 h were higher in group D ( P ＜ 0.05 or P ＜ 0.01 ).There were severe pathological changes in cerebral cortex in group B,and mild changes in groups C and D. Conclusions There was obvious energy metabolism disorder after CPR in rats.Treatment with exogenous CP could increase the levels of ATP and activities of ATPase,alleviate pathological changes,especially in high-dose,and mitigate injury in cerebral cortex after CPR in rats.

Objective To observe the expression changes in apoptosis-related microRNA(miRNA) in cerebral cortex after cardiac arrest-cardiopulmonary resuscitation(CA-CPR)in rats and explore the factors that may affect the mechanism of CPR. Methods 24 clean male Sprague-Dawley(SD)rats were randomly divided into three groups,the normal control group,sham operation group and CA-CPR group(each n=8). The animal model of CA induced by asphyxia was established and CPR was performed. In the normal control group,no special management was performed. In the sham operation group,only abdominal cavity anesthesia,tracheotomy,vascular puncture and electrocardiogram(ECG)were performed without clamping the trachea and resuscitating. Normal feeding in normal control group and 24 hours after tracheotomy in sham operation group,at 24 hours after recovery of spontaneous circulation(ROSC)in CA-CPR group,cerebral cortex specimens were obtained for detection of the expression of miRNA by using real time fluorescence quantitative reverse transcription - polymerase chain reaction(RT-PCR). Flow cytometry(FCM)was used to detect the neurocyte apoptotic rate. Results Compared between normal control and sham operation groups,there were no significant differences in the expression of apoptosis-related miRNA and neurocyte apoptosis rate of cerebral cortex(both P>0.05). Compared with sham operation group,in CA-CPR group, 16 miRNA expressions were up-regulated,including Let-7c,miR-15a,miR-21,miR-24,miR-29,miR-29b, miR-34a, miR-103, miR-200a, miR-200b, miR-200c, miR-210, miR-326, miR-338-3p, miR-494 and miR-497,and there were 22 down-regulated,being Let-7a,Let-7b,Let-7d,Let-7e,miR-19a,miR-19b-1, miR-20a,miR-20b,miR-23a,miR-23b,miR-25,miR-98,miR-107,miR-122a,miR-125a,miR-125b, miR-145,miR-181a,miR-181c,miR-335,miR-384-5p and miR-422a. Eight miRNA had significant changes at 24 hours after ROSC,in which miR-15a,miR-21,miR-34a,miR-497 were up-regulated respectively for 6.831±2.625,8.122±3.442,5.349±2.010,6.590±3.689 times,and miR-125b,miR-145,Let-7a,Let-7e were down-regulated respectively for 0.122±0.039,0.199±0.096,0.191±0.069,0.160±0.082 times. The apoptosis rate of cerebral cortex was increased significantly in CA-CPR group〔(32.23±5.31)%〕compared with that in normal control group〔(3.66±1.34)%〕and sham operation group〔(4.98±1.84)%,both P<0.01〕. Conclusions In early period after CA-CPR,obvious neurocyte apoptosis may be found in brain tissue of rats,and in the mean time, changes in apoptosis-related miRNA expression in cerebral cortex occur. The various types of miRNA with significant changes possibly play important roles in cerebral protection after CA-CPR in rats.
down-regulated respectively for 0.122±0.039,0.199±0.096,0.191±0.069,0.160±0.082 times. The apoptosis rate of cerebral cortex was increased significantly in CA-CPR group〔(32.23±5.31)%〕compared with that in normal control group〔(3.66±1.34)%〕and sham operation group〔(4.98±1.84)%,both P<0.01〕. Conclusions In early period after CA-CPR,obvious neurocyte apoptosis may be found in brain tissue of rats,and in the mean time, changes in apoptosis-related miRNA expression in cerebral cortex occur. The various types of miRNA with significant changes possibly play important roles in cerebral protection after CA-CPR in rats.