Objective To investigate the phonological characteristics of patients with functional speech problems. Methods Ninety patients with functional speech problems were classified by speech analysis. All types of speech problems were analyzed. Results The functional speech problems can be categorized as unaspiration, palatalization, lateralization, fronting of tongue, backing of tongue, plosion, omission of consonants, glottal stop, affrication and backing of tongue and nasalization. Backing of tongue and nasalization was only related to the consonant l, and the unaspiration was often related to such consonants as p, t, k, q, c, ch. Conclusion The functional speech problems were related to consonants. There was regularity with the involvement of the consonants in different types of functional speech problems.

Objective To compare the oxygen saturation between the blood of superior vena cava and mixed venous in lung transplantation and provide reference for monitoring method in anesthesia. Methods 30 patients who received lung transplantation were placed central venous catheter into superior vena cava and flotation catheter into the pulmonary artery in turn. The blood samples were collected from the superior vena cava and pulmonary artery for blood gas analysis simultaneously at the time of just followed the catheter placement (T1), before the resection of the first bad lung (T2), after the reperfusion of the first donor lung (T3), before the resection of the second bad lung (T4), after the reperfusion of the second donor lung (T5), before the end of the operation (T6). The oxygen saturation were compared between the blood of the superior vena cava and mixed venous. Results From T1 to T6, Bland-Altman analysis showed that the mean of deviation between the SpO2 measured in blood of superior vena cava and mixed venous were 0.5, 3.4, 2.3, 0.5, 0.27,-2.9, respectively, and the incidence beyond the upper and lowed limits of consistency zone was 3.3%, 0%, 0%, 3.3%, 3.3%, 0%respectively. The incidence of SpO2 within the consistent limits was 96.7%, 100%, 100%, 96.7%, 96.7%, 100% respectively. Conclusions The SpO2 of superior vena cava may be approximately reference as SpO2 of mixed venous during lung transplantation.

Objective To assess the application value of disposable syringe of low resistance (SLR) in epidural puncture.Methods One hundred and thirty-two patients scheduled to undergoing selective operation under epidural or combined epidural-spinal anesthesia were divided into glass syringe (GS) group and SLR group with 66 cases each by random digits table method.GS was applied in local anesthesia and epidural puncture with loss of resistance in GS group.While SLR was used in SLR group.The defect of the syringes' appearance was evaluated.The fastness between each sub-unit during the procedure was observed.The rupture,dropping,leakage,air leakage and blockage were also estimated.The heart rate,blood pressure,oxygen saturation and other adverse events were also observed.Results In SLR group,syringe excepted 1 case of slight resistance but did not affect the use,the rest of the components connected firmly,surface without defects,clear scale uniform color,not observed rupture,air leakage,leakage and blockage phenomenon,pump liquid and air resistance was small.In GS group,syringe surface without defects,clear scale uniform color,3 cases had loose connection,1 case with rupture when using,5 cases with air leakage and leakage,3 cases of pumping liquid or dry air resistance to 0.9％ sodium chloride and moist after use.There was significant difference in appearance and usage between two groups (x2 =10.324 5,P =0.001 3).There was no significant difference in a puncture success,first three puncture success and inject air negative pressure sensitivity between two groups (P ＞ 0.05).Conclusion SLR is worth to be applied in epidural puncture.

Objective To explore the clinical role and value of detailed target management on patients with diabetic ketoacidosis (DKA) complicated with acute pancreatitis (AP).Methods The clinical data of patients with DKA complicated with AP admitted to the Department of Emergency of Linyi City People's Hospital from January 2013 toDecember 2016 were retrospectively analyzed. The patients managed by detailed target management (from January 2015 to December 2016) were served as the observation group (detailed target management group), and those managed by routine management (from January 2013 to December 2014) were set as the control group (traditional management group). The gender, age, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, Ranson score, underlying disease, blood glucose, glycemic excursion [including: standard deviation of blood glucose (SDBG) level, the largest amplitude of glycemic excursions (LAGE), mean amplitude of glycemic excursion (MAGE), and absolute means of daily difference (MODD) in blood glucose], remission time of DKA, the incidence of MODS and mortality were compared between two groups.Results There were no significant differences in sex, age, APACHE Ⅱ score, Ranson score, blood glucose and the distribution of underlying disease between the two groups (allP > 0.05). Compared with the traditional management group, the level of blood glucose in the detailed target management group was decreased steadily, blood glucose excursions of within-day and day-to-day were significantly reduced on the 2nd and 3rd day (the 2nd day: SDBG was 3.01±1.38 vs. 4.27±1.89, LAGE was 4.14±1.52 vs. 5.62±2.54, MAGE was 0.61±0.35 vs. 1.01±0.57, the 3rd day: SDBG was 2.94±0.91 vs. 3.83±1.29, LAGE was 3.81±1.05 vs. 5.02±2.13, MAGE was 0.58±0.32 vs. 0.96±0.52), MODD: 0.82±0.81 vs. 1.59±1.12, allP < 0.05]. Remission time of DKA and the staying time at emergency department after the implementation of the detailed target management was significantly reduced [remission time of DKA (days): 1.73±0.88 vs. 2.57±1.09, the staying time at emergency department (days): 6.13±0.99 vs. 7.29±1.38, bothP < 0.05], and no hypoglycemic events occurred. There was no significant difference in the incidence of MODS and mortality between the two groups (bothP > 0.05).Conclusions Detailed target management can help the salvage and treatment of patients with diabetic ketoacidosis complicated with acute pancreatitis, control the blood glucose steadily, and significantly shorten the remission time of DKA and the stay time at emergency department.

Objective:To evaluate the changes of nasalance when cleft palate patients examined using nasometer and nasopharyngeal fiberscopy simultaneously.Methods:A total of 33 cleft palate patients from August 2004 to August 2010 were examined by nasopharyngeal fiber endoscopy and nasometer simultaneously. The nasalance of 33 voice samples was compared under two situations only nasometer and nasometer with nasopharyngeal fiberscopy.Results:The statistics showed that the nasalance value of 33 voice samples of 33 participants under different situations were no significant difference through paired t-test ( P>0.05). Conclusions:Nasopharyn fiber endoscopy had no influence to the results of the nasalance value under simultaneous condition. The nasometer and nasopharyn fiber endoscopy can be applied to evaluate the velopharyngeal function of cleft palate patients simultaneously.

Objective:To investigate the influence of glottal stops for the relationship between nasalance and velopharyngeal closure status of cleft palate patients after surgery.Methods:A total of 71 patients with postoperative cleft palate speech disorders treated in the Department of Oral and Maxillofacial surgery, School of Stomatology, Peking University from August 2004 to August 2010 were included. The compensated speech evaluation of cleft palate with or without glottic occlusion was performed in 50 males and 21 females with an average age of (15.9±6.2) years old. The nasal sound meter and nasopharyngeal fiber endoscope were used to record the nasal phonation rate and the score of nasopharyngeal fiber endoscopic visual analog scale (VAS) of the patients. According to the results of glottic plug speech evaluation, the patients were divided into three groups: whole group (without glottic plug), glottic plug group and silent glottic plug group. The nasal phonation rate values and VAS values of 11 speech samples (unit vowel No. 1-3, continuous syllable No. 4-9, sentence 10-11) of the three groups were compared by Pearson analysis.Results:There were 71 patients in the whole group, 34 patients in the glottic plug group and 37 patients in the silent glottis group. There was a negative correlation between nasal phonetic rate and VAS of 11 speech samples in the whole group, however there were no significant difference ( r>-0.179 and<-0.017, P>0.017) and no significant correlation between nasal phonetic rate and VAS in glottic occlusion group ( r>-0.196 and<-0.017, P>0.05). There was a significant negative correlation between nasal phonetic rate and VAS value of all but No. 1, 3 and 11 speech samples in silent door plug group ( P<0.05), among which No. 7 speech sample was the most sensitive sample ( r=-0.557, P<0.05). Conclusions:The present study showed the glottal stops could affect the evaluation of the velopharyngeal closure function by using nasometer. Glottal stops should be considered as one important factor for the nasalance.