Objective To investigate the clinical characteristics,diagnosis and treatment of ileal injury secondary to percutaneous nephrolithotomy percutaneous nephrolithotomy(PCNL).Methods The diagnosis and treatment of a patient were reviewed,and relevant literature were retrieved.Results The patient was a 41-year-old male,who underwent stage PCNL(initial percutaneous nephrostomy,followed by secondary PCNL)due to right ureteral calculi with severe hydronephrosis.On postoperative day 1,he developed abdominal distension and pain.Abdominal X-ray revealed subdiaphragmatic free gas,and CT showed pelvic and abdominal fluid and gas accumulation,suggesting peritonitis due to intestinal perforation.Emergency exploratory laparotomy identified a 3 mm×3 mm ileal perforation approximately 30 cm from the ileocecal valve,which was repaired surgically.The patient recovered well and was discharged after one week,with no discomfort reported during a 6-month follow-up.Conclusion The clinical features of ileal injury secondary to PCNL include early postoperative abdominal distension,pain and peritonitis.Diagnosis relies on clinical manifestations,abdominal X-ray and CT,with surgical exploration if necessary.Conservative management under vigilant observation can be cautiously adopted for localized injuries,while surgical repair is required for peritonitis or failed conservative therapy.

Objective To investigate the clinical characteristics,diagnosis and treatment of ileal injury secondary to percutaneous nephrolithotomy percutaneous nephrolithotomy(PCNL).Methods The diagnosis and treatment of a patient were reviewed,and relevant literature were retrieved.Results The patient was a 41-year-old male,who underwent stage PCNL(initial percutaneous nephrostomy,followed by secondary PCNL)due to right ureteral calculi with severe hydronephrosis.On postoperative day 1,he developed abdominal distension and pain.Abdominal X-ray revealed subdiaphragmatic free gas,and CT showed pelvic and abdominal fluid and gas accumulation,suggesting peritonitis due to intestinal perforation.Emergency exploratory laparotomy identified a 3 mm×3 mm ileal perforation approximately 30 cm from the ileocecal valve,which was repaired surgically.The patient recovered well and was discharged after one week,with no discomfort reported during a 6-month follow-up.Conclusion The clinical features of ileal injury secondary to PCNL include early postoperative abdominal distension,pain and peritonitis.Diagnosis relies on clinical manifestations,abdominal X-ray and CT,with surgical exploration if necessary.Conservative management under vigilant observation can be cautiously adopted for localized injuries,while surgical repair is required for peritonitis or failed conservative therapy.

Objective To summarize and analyze the clinical phenotypes,hereditary features and treatment and follow-up strategies of different hereditary pheochromocytoma/paragangliomas(PCC/PGL)and related syndromes.Methods Forty-four clinically diagnosed PCC/PGL patients admitted in our hospital from January 2000 to August 2022 were enrolled,and the clinical data of them and their family members were collected.Second-generation sequencing was performed on 43 patients for genetic detection,and Sanger sequencing was applied to verify the mutation of the probands and family members.Results There were 15 patients diagnosed with hereditary PCC/PGL,including 7 cases of von Hippel-Lindau(VHL)syndrome,3 cases of multiple endocrine neoplasia type 2(MEN2),and 5 cases of familial paraganglioma syndrome.Seven VHL syndrome families were diagnosed as VHL2A(c.500G＞A),VHL2B(c.239G＞T and c.444_457del),and VHL2C(c.293A＞G)according to their clinical manifestations.All probands received surgical treatment,and 2 cases of recurrent PCC and the patients with multiple renal cancer also received targeted therapy with sunitinib.Three MEN2 families carried c.1901G＞C,c.1832G＞A,and c.1901G＞A missense mutations,respectively,and were diagnosed with MEN2A clinically.All of them underwent adrenalectomy and thyroidectomy,including one for preventive thyroidectomy.Among the 5 familial paraganglioma syndrome families,4 patients carried SDHB mutations(SDHB:c.343C＞T,c.541-2A＞G,c.575G＞A,c.268C＞T)and 1 patient carried an SDHD mutation(SDHD:c.337_340del).Sporadic retroperitoneal PGL were most common.Conclusion More than 1/3 of PCC/PGL patients carry germline gene mutations,showing obvious genotype-phenotype correlation.Genetic diagnosis technology plays an important guidance role for clinical precision treatment and follow-up,and genetic counseling.

Objective To investigate acoustic characteristics of VC coarticulation for males in Mandarin . Methods This study compared nasal flow of 32 male adults'production which include /an/,/in/,/?n/,/a?/,/i?/,/??/,/a/,/i/,/?/.Results Whether /a /,/i/or /?/,the nasal flow of vowels before /n/was greater than the na-sal flow of vowels before /?/was greater than the nasal flow of vowels themselves .When produced solely ,the na-sal flow of /i/was greater than the nasal flow of /a/,/?/ .Before nasal consonants /n/,/?/ ,the nasal flow of /i/was greater than the nasal flow of /?/which was greater than the nasal flow of /a/.Conclusion Vowels before nasal consonants can be nasalized .The nasalization of /n/to vowel is greater than that of /?/to vowel .When nasals is produced around ,the nasalization of vowel depends on the height of the tongue .The nasal flow of vowels can be used as an effective measure and monitor the indicators before and after nasal coarticulatin .

Objective This study is to analyze the fundamental frequencies of different speech materials . Methods 60 normal subjects (22 males ,38 females) were studied .When pronouncing /a/,/i/,/u/and the short paragraphs ,the fundamental frequencies were measured using Praat software .Results The analysis of the funda‐mental frequencies for different materials indicates that /i/and /u/were the highest while /a/was the next and the paragraphs were the lowest .For males ,the fundamental frequencies from high to low were:148 .47 Hz ,146 .77 Hz ,136 .33 Hz ,and 132 .85 Hz ;for females ,they were:257 .39 Hz ,250 .52 Hz ,239 .43 Hz and 222 .16 Hz .The experimental results showed that there was no significant difference between the fundamental frequencies of vowels between the two genders but there were significant differences when pronouncing different vowels among the female subjects .Conclusion When measuring fundamental frequencies ,reading short paragraphs can be more accurate and the vowel /a/is more useful in this purpose .

Objective To analyze implanted children's production of vowels and to investigate the features of vowels production .Methods Thirty CI children averaged 32 .65 ± 5 .97 months were enrolled in this study .Using 19 Chinese vowels as test materials ,accuracy rates were statistically analyzed to get the difficulty gradient and main error patterns .Results /a/and /e/were the easiest vowels and /üe/,/uai/,/ü/were the most difficult vowels for CI children .From the mouth shape of vowels ,the difficulty gradients from easy to difficult were open -mouths →e-ven-teeth → close-mouths → pursed -mouths .From the structures of vowels ,triphthongs were the most diffi-culty ,while single vowels and diphthongs shared the same difficulty level .High vowel's nasalization ,the deletion of diphthongs and triphthongs ,the separation of diphthongs and triphthongs and the substitution of /o/,/ü/,and /ai/were the main error patterns .Conclusion The difficulty levels of vowels'production for CI children at average age of 31 months are rather obvious .Compared with aided children ,they show some common developmental sequences and error patterns ,but also reflect their own characteristics .When in vowel articulation therapy for little CI children ,we should provide targeted training according to error patterns on the basis of following their sequences of difficulty level to fa-cilitate their efficiency .