Objective To propose an effective objective acoustic voice assessment method for detecting vocal fold nodules in children.Methods Continuous vowel sounds/a/from 48 children with vocal fold nodules and 40 healthy chil-dren were analyzed using multi-band cepstral analysis.Thirteen Mel-frequency cepstral coefficients(MFCC),five cepstral peak values,and six cepstral distances were extracted as subband features.An independent sample t-test was conducted to compare the acoustic feature parameters between the two groups.Features with statistically significant differences were fur-ther analyzed using the receiver operating characteristic(ROC)curve to identify the optimal acoustic features with the high-est discriminative power for detecting vocal fold nodule disorders.Results The MFCC2,MFCC3,MFCC5,MFCC11,MFCC12,DQP,EP1,and EP2 feature values were significantly higher in the vocal fold nodule group compared to the nor-mal children group(P＜0.05,P＜0.001),while MFCC1,MFCC6,MFCC8,MFCC13,and EEP were significantly lower(P＜0.05).ROC curve analysis of these features showed that the combined ROC curve area under the curve(AUC)for MFCC1,MFCC2,MFCC3,MFCC5,MFCC6,MFCC8,MFCC11,MFCC12,MFCC13,DQP,EP1,EP2,and EEP was 0.98.The individual AUCs for MFCC1,MFCC2,MFCC3,MFCC5,MFCC6,MFCC8,MFCC11,MFCC12,DQP,and EP2 were all greater than 0.7,indicating a certain level of accuracy.Among these,MFCC2 and MFCC3 had AUCs of 0.85 and 0.87,respectively,indicating that these features have high diagnostic value for vocal fold nodule-related voice seg-ments in children.Conclusion The specific combination of acoustic parameters derived from multiband cepstral features of sustained vowels,including Mel-frequency cepstral coefficients(MFCC1,MFCC2,MFCC3,MFCC5,MFCC6,MFCC8,MFCC11,MFCC12,MFCC13)and cepstral peak values(DQP,EP1,EP2,EEP),can enhance the accuracy of detecting vocal fold nodule-related voice disorders in children.Particularly,MFCC2 and MFCC3 demonstrate high sensitivity and specificity,enabling more accurate identification of vocal fold nodule-related voice disorders in children.

Objective To investigate the characteristics of laryngeal diadochokinesis(LDDK)in children with functional articulation disorder(FAD)using different corpus.Methods A total of 23 children with FAD and 21 typically developing(TD)children,aged 4-6,from Shanghai's general kindergartens were recruited.Five types of acoustic parameters were collected:average rate and jitter(％)of LDDK(/?a/,/ha/,/??/,/h?/),the diadochoki-nesis rate(/pataka/),the jitter and shimmer of the vowel/a/,maximum phonation time(MPT).Differences across different corpora of the LDDK were analyzed between the two groups.Results ① Between-group compari-son:the rate of/?a/was significantly lower in FAD children than in TD children(P＜0.05).② Different corpora comparison:the LDDK speed of/?a/-/ha/was significantly different for both groups,/?a/-/??/was significantly different in TD children,and/ha/-/h?/was significantly different in FAD children.The LDDK jitter of/ha/-/h?/was significantly different among FAD children.Conclusion The LDDK of children with FAD is weaker than the TD children,and both groups exhibiting varying abilities across different corpora.

Military training represents one of the most essential activities for troops during peacetime,of which the prevention and treatment of training-induced injuries are a very important part.Recent findings of research suggest that cold atmospheric plasma(CAP)exhibits a distinctive and multifaceted superiority in terms of broad-spectrum sterilization,rapid blood coagulation and healing promotion for wounds.Consequently,CAP has good prospects of applications in diverse fields such as clinical medicine,emergency rescue and military medicine.Based on a review of the research progress in plasma medicine,the applicability of CAP in the prevention and treatment of military training injuries was discussed in this paper by focusing on the urgent issues related to military training injury,including the typical application scenarios and methods for CAP,the safety and effectiveness of plasma trauma prevention and treatment,and the key issues facing the prevention and treatment of military training injuries.

Objective To investigate the effects of different contrast injection schemes on the image quality of triple-rule-out com-puted tomography angiography(TRO-CTA).Methods A total of 691 patients with acute chest pain who underwent TRO-CTA exami-nation from multiple centers were prospectively selected and randomly divided into mixed group and unmixed group according to dif-ferent contrast injection methods.The image quality of aorta,pulmonary artery and coronary artery in the two groups was evaluated subjectively and objectively and the radiation dose was calculated.Results There were no significant differences in subjective image quality scores,aorta and coronary CT values,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)between the two groups(P>0.05),while there were significant differences in pulmo-nary CT values,SNR,CNR and radiation dose between the two groups(P<0.05).Conclusion The utilization of a mixed contrast injection scheme in TRO-CTA can satisfy diagnostic require-ments while ensuring a low proportional dosage and reduced radiation dose,which has clinical application value.

Objective:To investigate the clinical efficacy of fixation with a modified double-pulley anchor suture in the treatment of Rockwood type Ⅱ patella fractures.Methods:A retrospective study was conducted to analyze the 60 patients with Rockwood type Ⅱ patellar fracture who had been admitted to Department of Joint Surgery, The Hospital Affiliated to Qingdao University between November 2021 and November 2023. The cohort included 31 males and 29 females, with an age of (53.5±10.4) years. According to the treatment methods, the patients were divided into a study group (28 cases) which was treated by traction reinforcement of the terminal anchor suture in addition to fixation with a double-pulley anchor suture, and a control group (32 cases) which was treated by the traditional Kirschner wire tension band technique. The operation time, intraoperative blood loss, incision length, reoperation rate, complication rate, fracture healing, and visual analog scale (VAS) pain scores and Bostman scores at postoperative 1 month, 3 months, and 6 months and at the last follow-up were compared between the 2 groups.Results:No statistically significant differences were observed in the preoperative general data between the 2 groups, indicating that the 2 groups were comparable ( P>0.05). All patients were followed up for (12.8±1.4) months postoperatively. The study group demonstrated significantly lower intraoperative blood loss [(25.9±6.8) mL] than the control group [(40.5±11.6) mL], and a significantly lower reoperation rate (0) than the control group [53.1% (17/32)] ( P<0.05). There was no statistically significant difference between the 2 groups in operation time, incision length, incidence of complications, as well as in VAS pain scores or Bostman scores at postoperative 1 month, 3 months, or 6 months or at the last follow-up (all P>0.05). Fractures healed in both groups at 6 months postoperatively. Conclusions:For patients with Rockwood type Ⅱ patellar fracture, fixation with modified double-pulley suture anchor can achieve good clinical efficacy. Compared to the traditional Kirschner wire tension band technique, the modified mothed significantly reduces intraoperative blood loss and avoids secondary trauma caused by a second surgery for implant removal.

Objective To study the objective changes and effects of speech characteristics in patients with nasal endoscopic surgery,and to analyze the relationship between surgery and changes in vocal tract structure.Methods A prospective study was conducted on 45 patients who underwent nasal endoscopic surgery from June 2023 to December 2023.Among them,13 patients underwent nasal septum deviation correction surgery and/or nasal polypectomy and/or turbinate shaping surgery group(G1 group),11 patients underwent simple sinus opening surgery group(G2 group),and 21 patients underwent nasal sinus opening+nasal septum deviation correction surgery and/or nasal polypectomy and/or nasal turbinate shaping surgery group(G3 group).Spectrogram detection was completed before and 1 month after surgery.Nasal resistance(Refft value),acoustic indicators resonance peak frequency(F1-F4),bandwidth(B1-B4),difference between F1 amplitude and nasal murmur resonance peak amplitude(A1-P0),and difference between F1 and nasal murmur resonance peak amplitude(A1-P1)under different sound tasks(oral vowels,nasal vowels,and phrases and short sentences containing nasal vowels)were analyzed.Results After surgery,there was no significant change in the acoustic indicators in any of the groups,and the Refft value significantly decreased.The change in the resonance peak of oral vowels was not significant,but the bandwidth significantly decreased.A1-P1 in each group showed an upward trend after surgery,while A1-P0 showed a downward trend after surgery.Among them,A1-P1 in G1 group showed a significant increase compared to preoperative levels in/ma/,/na/,/mi/,and/ni/,and A1-P0 showed a significant decrease in/ma/and/na/compared to preoperative levels.There were statisti-cally significant differences in A1-P0 between G2 group and preoperative group in both/ma/and/na/.The A1-P1 levels in G3 group showed significant differences compared to preoperative levels in/mi/and/ni/,and A1-P0 showed significant differences compared to preoperative levels in/ma/and/na/.Conclusion Nasal endoscopic surgery may have a measurable impact on the patient's speech.The spectrogram can be used to evaluate the postoperative pronuncia-tion characteristics of nasal endoscopy,with A1-P1 being a better measurement indicator for high vowels/i/and A1-P0 being a better measurement indicator for non high vowels/a/.

Objective To investigate the occurrence of dysphagia in patients with congenital esophageal atre-sia(EA)after surgery and study the associated risk factors.Methods A retrospective analysis was conducted on clinical data of 103 children who underwent surgery for congenital EA at Beijing Children's Hospital,Capital Medi-cal University,from July 2016 to August 2023.Results A total of 103 eligible cases of congenital EA were includ-ed in this study,among which 74 cases experienced dysphagia,with an incidence rate of 71.8％.Single-factor anal-ysis revealed that primary surgery(x2=4.017,P=0.045),endoscopic surgery(x2=8.315,P=0.004),long-seg-ment defects(x2=10.975,P＜0.001),gastroesophageal reflux(x2=16.973,P＜0.001),vocal cord paralysis(x2=4.017,P=0.045),tracheomalacia(x2=5.778,P=0.016),and arytenoid movement disorder(x2=10.420,P=0.001)were significantly associated with postoperative dysphagia.Further binary logistic regression analysis indi-cated that endoscopic surgery(OR=24.373,P=0.016),tracheomalacia(OR=17.556,P=0.010),and anasto-motic stenosis(OR=20.453,P=0.032)were independent risk factors for increased incidence of postoperative dys-phagia.Moreover,stratified analysis of dysphagia duration using unordered multinomial logistic regression revealed that tracheomalacia(OR=16.883,P=0.007;OR=4.337,P=0.045),long-segment defects(OR=0.040,P=0.049;OR=0.040,P=0.036),and arytenoid movement disorder(OR=0.127,P=0.039;OR=0.510,P=0.028)were closely associated with dysphagia duration.Conclusion Dysphagia is a common symptom in children with congenital EA after surgery across all age groups.Endoscopic surgery,long-segment defects,tracheomalacia,and anastomotic stenosis are independent factors contributing to postoperative dysphagia.Additionally,tracheoma-lacia,long-segment defects,and arytenoid movement disorder are closely related to the duration of dysphagia.

Objective To evaluate the intra-rater and inter-rater consistency of GRBAS and CAPE-V in Chi-nese context.Methods Five experts used the"Voice Assessment Assistant"APP to evaluate voice samples extrac-ted from The Sixth Medical Center of Chinese PLA General Hospital Pathological Voice Database V1.0.Fifty-two cases were used for inter-rater consistency analysis,and 38 cases were used for intra-rater consistency assessment.Intraclass correlation coefficient(ICC)was used for intra-rater and inter-rater consistency analysis of CAPE-V,while Cohen's Kappa method was applied for intra-rater consistency analysis of the five features of GRBAS.Inter-rater consistency analysis for GRBAS used Fleiss Kappa method,and Spearman's correlation analysis was conducted for the same features in both scales.Results The results of intra-rater consistency analysis showed that all six fea-tures of CAPE-V exhibited high consistency,with ICC coefficients of overall severity(OS)=0.80,roughness(R)=0.69,breathiness(B)=0.77,strain(S)=0.75,pitch(P)=0.74,and loudness(L)=0.78.For GRBAS,ex-cept for the features G(0.48)and S(0.45)which showed weaker intra-rater consistency,the rest of the features had poor intra-rater consistency.The results of inter-rater consistency analysis showed that the ICC correlation coef-ficients for all features of CAPE-V were greater than 0.85,indicating a high degree of consistency in the scoring of each feature by different raters.For GRBAS,except for the feature G(correlation coefficient=0.48),the rest of the features had correlation coefficients less than 0.40,indicating that the inter-rater consistency was poor for all features except G.When evaluating the same sample with both GRBAS and CAPE-V,the Spearman correlation co-efficients for the overall voice quality OS/G,roughness R,breathiness B,and strain S were 0.89,0.85,0.91,and 0.91,respectively,suggesting a high degree of correlation between the scoring results of the four features in the two scales.Conclusion In the auditory perceptual assessment of Chinese voice samples,the CAPE-V scale has higher intra-rater and inter-rater consistency compared to the GRBAS scale and is more suitable for clinical practice.

Objective To study the objective changes and effects of speech characteristics in patients with nasal endoscopic surgery,and to analyze the relationship between surgery and changes in vocal tract structure.Methods A prospective study was conducted on 45 patients who underwent nasal endoscopic surgery from June 2023 to December 2023.Among them,13 patients underwent nasal septum deviation correction surgery and/or nasal polypectomy and/or turbinate shaping surgery group(G1 group),11 patients underwent simple sinus opening surgery group(G2 group),and 21 patients underwent nasal sinus opening+nasal septum deviation correction surgery and/or nasal polypectomy and/or nasal turbinate shaping surgery group(G3 group).Spectrogram detection was completed before and 1 month after surgery.Nasal resistance(Refft value),acoustic indicators resonance peak frequency(F1-F4),bandwidth(B1-B4),difference between F1 amplitude and nasal murmur resonance peak amplitude(A1-P0),and difference between F1 and nasal murmur resonance peak amplitude(A1-P1)under different sound tasks(oral vowels,nasal vowels,and phrases and short sentences containing nasal vowels)were analyzed.Results After surgery,there was no significant change in the acoustic indicators in any of the groups,and the Refft value significantly decreased.The change in the resonance peak of oral vowels was not significant,but the bandwidth significantly decreased.A1-P1 in each group showed an upward trend after surgery,while A1-P0 showed a downward trend after surgery.Among them,A1-P1 in G1 group showed a significant increase compared to preoperative levels in/ma/,/na/,/mi/,and/ni/,and A1-P0 showed a significant decrease in/ma/and/na/compared to preoperative levels.There were statisti-cally significant differences in A1-P0 between G2 group and preoperative group in both/ma/and/na/.The A1-P1 levels in G3 group showed significant differences compared to preoperative levels in/mi/and/ni/,and A1-P0 showed significant differences compared to preoperative levels in/ma/and/na/.Conclusion Nasal endoscopic surgery may have a measurable impact on the patient's speech.The spectrogram can be used to evaluate the postoperative pronuncia-tion characteristics of nasal endoscopy,with A1-P1 being a better measurement indicator for high vowels/i/and A1-P0 being a better measurement indicator for non high vowels/a/.

Objective To propose an effective objective acoustic voice assessment method for detecting vocal fold nodules in children.Methods Continuous vowel sounds/a/from 48 children with vocal fold nodules and 40 healthy chil-dren were analyzed using multi-band cepstral analysis.Thirteen Mel-frequency cepstral coefficients(MFCC),five cepstral peak values,and six cepstral distances were extracted as subband features.An independent sample t-test was conducted to compare the acoustic feature parameters between the two groups.Features with statistically significant differences were fur-ther analyzed using the receiver operating characteristic(ROC)curve to identify the optimal acoustic features with the high-est discriminative power for detecting vocal fold nodule disorders.Results The MFCC2,MFCC3,MFCC5,MFCC11,MFCC12,DQP,EP1,and EP2 feature values were significantly higher in the vocal fold nodule group compared to the nor-mal children group(P＜0.05,P＜0.001),while MFCC1,MFCC6,MFCC8,MFCC13,and EEP were significantly lower(P＜0.05).ROC curve analysis of these features showed that the combined ROC curve area under the curve(AUC)for MFCC1,MFCC2,MFCC3,MFCC5,MFCC6,MFCC8,MFCC11,MFCC12,MFCC13,DQP,EP1,EP2,and EEP was 0.98.The individual AUCs for MFCC1,MFCC2,MFCC3,MFCC5,MFCC6,MFCC8,MFCC11,MFCC12,DQP,and EP2 were all greater than 0.7,indicating a certain level of accuracy.Among these,MFCC2 and MFCC3 had AUCs of 0.85 and 0.87,respectively,indicating that these features have high diagnostic value for vocal fold nodule-related voice seg-ments in children.Conclusion The specific combination of acoustic parameters derived from multiband cepstral features of sustained vowels,including Mel-frequency cepstral coefficients(MFCC1,MFCC2,MFCC3,MFCC5,MFCC6,MFCC8,MFCC11,MFCC12,MFCC13)and cepstral peak values(DQP,EP1,EP2,EEP),can enhance the accuracy of detecting vocal fold nodule-related voice disorders in children.Particularly,MFCC2 and MFCC3 demonstrate high sensitivity and specificity,enabling more accurate identification of vocal fold nodule-related voice disorders in children.