Objective To compare the resonance acoustic characteristics between 7~16 years old Down syn-drome children and normal children .Methods A total of 29 cases of 7~16 years old Down syndrome children and 90 cases of 7~16 years old normal children pronuanced /a/,/u/,/i/,each sound for 3 times ,every time 1 to 2 sec-onds .The oral resonance acoustic parameters ,including F1 (a) ,F2 (a) ,F1 (i) ,F2 (i) ,F1 (u) ,F2 (u) ,the distance of tongue and the distance of jaw ,were recorded by real analysis .Analysis of variance was used for the voice acous-tic .Results With age ,there was a significant decrease tendency of the value of F2 (a) and a very significant growth tendency of the values of F2 (i) and the distance of tongue in normal children .The value of F2 (i) inrcreased signifi-cantly in Down syndrome children .The values of every oral resonance acoustic parameters were not different signifi-cantly on sex in normal children .The values of F1 (i) and F1 (u) in Down syndrome boys were significantly less than those of in the Down syndrome girls ,but the the distance of jaw in Down syndrome boys were significantly greater than those of in the Down syndrome girls .The values of F2 (u) and F1 (i) in Down syndrome children were signifi-cantly greater than those of in normal children ,but the distance of tongue was significantly less than those of in nor-mal children .Conclusion With age ,in normal children ,the amplitude of the tongue forward movement and the range of tongue back and forward movement were increased significantly ,the oral focus moved forward gradually .In Down syndrome children ,the amplitude of the tongue back movement ,and the range of tongue back and forward movement ,were poor than those of in normal children .The Down syndrome children were easier to suffer from oral resonance disorder than normal children .

Objective To study the causes of rehematomas after operations of traumatic hematomas of perisylvian area.Methods The causes of 50 cases of rehematoma after operation were analyzed retrospectively.Results The big hematoma in primary contusion and laceration of brain happened in 19 cases(38%),delayed epidural hematoma in opposite side in 15 cases(30%),increased intracerebral hematoma in 9 cases(18%),epidural hematoma in primary area in 3 cases(6%),subdural hematoma caused by postoperative lumbaropuncture in 3 cases(6%),hematoma in encephalonecrosis in 1 case(2%).Conclusion Insuitable operation and hemostasis are the main causes of rehemorrhage,and fracture line in the opposite side,and thrombocytopenia are high risk factors of rehematoma.

Objective To explore a time series based meta-analysis of randomized clinical trials (RCTs) and observational studies which examined differences in mortality in acute-on-chronic liver failure (ACLF) patients treated with artificial liver support system(ALSS) or not.Methods Medline,Embase,Ovid,and Cochrane library database was systemically searched up to December 2014.The outcome measure was mortality at different follow-up endpoints.Relative risks (RRs) were pooled for analysis.Results Ten studies,involving a total of 1682 ACLF patients,among whom 842 were treated with ALSS.ALSS was found to reduce the risk of 1-month and 3-month mortality for patients with ACLF by nearly 16.4％ and 13.2％,respectively.Randomized trials and observational studies provided good internal and external validity,respectively.Conclusions ALSS therapy could reduce short-term mortality in patients with ACLF.Clinical utility of this system for survival benefit may be implied.

Objective To explore the correlation between speech fluency and diadochokinetic rate in children aged 7～11 years with cochlear implant.Methods Speech samples were collected from 62 children aged 7～11 years with cochlear implant using language retelling task and diadochokinetic rate test task.Their speech rate,articulation rate,syllable duration and pause duration were analyzed.The data were input into ICF converter to obtain the im-pairment limit of each parameter and analyze the speech fluency and diadochokinetic rate characteristics.Partial cor-relation analysis was performed for speech rate,articulation rate,syllable duration and pause duration by two tasks.Results ① For children with cochlear implant,the mean ICF impairment limit of diadochokinetic rate was 1.3± 0.1,the mean ICF impairment limit of fluency in retelling was 1.0±0.3,with various degree of impairment in both tasks.② There was a moderate or low correlation between speech rate,articulation rate,syllable duration in retell-ing task and those in diadochokinetic rate task(0.3＜|r |≤0.8).There was a low correlation between pause dura-tion in retelling task and speech rate and pause duration in diadochokinetic rate task(0.3＜|r |≤0.5).Conclusion The speech fluency and diadochokinetic rate of children aged 7～11 years with cochlear implant is underdeveloped,and the poor articulation movement ability limits their development of speech fluency.

Objective:To explore the reasonable timing of radiotherapy for epidermal growth factor receptor ( EGFR) mutation-positive non-small cell lung cancer patients with brain metastasis in the era of third-generation targeted drugs. Methods:Clinical data of EGFR mutation-positive non-small cell lung cancer patients with brain metastasis who received first-line treatment with third-generation targeted drugs and stereotactic radiotherapy at Shanghai Armed Police Corps Hospital from September 2019 to May 2022 were retrospectively analyzed. According to the timing of radiotherapy before / after targeted drug resistance, all patients were divided into the early and salvage radiotherapy groups. The proportion of brain metastasis, physical fitness, complete response rate, objective response rate, delaying the progression of brain metastasis and overall survival (OS) were compared between two groups. Kaplan-Meier method was used for survival analysis, log-rank test was used for univariate prognostic analysis, and factors with P <0.1 were included in Cox multivariate analysis. Results:A total of 85 patients were included, including 51 (60%) cases receiving early radiotherapy. Patients who participated in early radiotherapy had a higher proportion of symptomatic brain metastasis (82% vs. 56%, P=0.013) and poorer physical fitness (Kanofsky performance score <70: 61% vs. 26%, P=0.002) compared to patients who underwent salvage radiotherapy. Early radiotherapy significantly improved the complete response rate of intracranial lesions (35% vs. 12%, P=0.015) and objective response rate (88% vs. 71%, P=0.041), delayed the progression of brain metastasis (median intracranial progression free survival: 23.0 months vs. 16.0 months, P=0.005; median intracranial secondary progression free survival: 31.0 months vs. 22.0 months, P=0.021), and improved OS (median OS: 44.0 months vs. 35.0 months, P=0.046). In multivariate analysis, diagnosis-specific graded prognostic assessment score <2.5, mutation of EGFR exon 21, and salvage brain radiotherapy were adverse prognostic factors for OS. Conclusion:In the era of third-generation targeted drugs therapy, early involvement of stereotactic radiotherapy in non-small cell lung cancer patients with brain metastasis can bring greater clinical benefits.