Objective To compare the effects on voice of endolaryngeal microsurgery(EMS)with cold instruments and a new method,"carbon dioxide laser(CO_(2)Laser)"for vocal fold polyps.Methods Twenty-five patients with v...Objective To compare the effects on voice of endolaryngeal microsurgery(EMS)with cold instruments and a new method,"carbon dioxide laser(CO_(2)Laser)"for vocal fold polyps.Methods Twenty-five patients with vocal fold polyps suffering from dysphonia who were treated in Macao Kiang Wu Hospital,Department of Otolaryngology Head and Neck Surgery were included in the study.Voice analysis was performed in a soundproof room,holding the microphone 15 cm away from the patients mouth and by recording a sustained[a,e,i,o,u]vowel for at least 5 seconds.Fundamental frequency(F0),Jitter and Shimmer parameters were evaluated in terms of vocal analysis.All patients were asked to fill in a questionnaire,to discuss the voice handicap index(VHI)after adequate explanation.EMS was performed with a carbon dioxide laser and cold knife on 15 and 10 patients,respectively.Patient follow-up was performed 1 week,2weeks and 4weeks after surgery.Changes in F0,Jitter and Shimmer values were measured and recorded.VHI was also completed and reassessed.Results Postoperatively,there was no significant difference in VHI scores between two groups(P>0.05).There was no significant difference in voice analysis values between two groups postoperatively,(P>0.05).Conclusion In the treatment of vocal polyps,EMS with both CO_(2)laser and traditional cold knife is effective.展开更多
文摘目的:探讨归因研究下认知干预对老年肺癌患者心理韧性及癌因性疲乏的影响。方法:选取宁波市第九医院2018年1月至2020年1月收治的老年肺癌患者88例作为研究对象,根据随机数字表法将其分为研究组( n=44例)与对照组( n=44例),对照组给予常规护理干预,研究组使用归因研究下的认知干预,为期6个月。观察两组患者干预前后心理韧性变化及癌因性疲乏症状改善情况,并使用应对方式评定量表(CSQ)评价两组患者干预前后应对方式变化,比较两组干预前后依从性。 结果:干预6个月后,研究组中文版心理韧性量表(CD-RISC)各维度评分分别为(7.74±1.36)分、(23.67±1.94)分、(41.28±1.47)分,均高于对照组[(6.92±1.12)分、(12.45±2.76)分、(32.34±1.69)分],差异均有统计学意义( t=3.08、22.06、26.47,均 P < 0.05)。研究组Piper疲乏修订量表(PFS)各维度评分分别为(4.85±1.15)分、(4.71±1.05)分、(4.85±1.05)分、(5.24±1.05)分,均低于对照组[(6.33±1.25)分、(6.21±1.52)分、(6.39±1.17)分、(6.72±1.23)分]( t=5.78、5.38、6.49、6.07,均 P < 0.05)。研究组患者积极应对方式评分为(28.51±2.65)分,高于对照组[(24.84±2.52)分]( t=6.65, P < 0.05),消极应对方式评分为(12.39±2.53)分,低于对照组[(14.81±2.12)分]( t=4.86, P < 0.05)。研究组用药、复查、饮食及体育锻炼依从率分别为100.00%、90.91%、90.91%、81.82%,均高于对照组的81.81%、68.18%、75.00%、61.36%(χ^(2)=6.73、6.98、3.93、4.52,均 P < 0.05)。 结论:归因研究下的认知干预能够增强老年肺癌患者心理韧性,改善其癌因性疲乏症状,促进其应对方式向积极转变,提高治疗依从性。
文摘Objective To compare the effects on voice of endolaryngeal microsurgery(EMS)with cold instruments and a new method,"carbon dioxide laser(CO_(2)Laser)"for vocal fold polyps.Methods Twenty-five patients with vocal fold polyps suffering from dysphonia who were treated in Macao Kiang Wu Hospital,Department of Otolaryngology Head and Neck Surgery were included in the study.Voice analysis was performed in a soundproof room,holding the microphone 15 cm away from the patients mouth and by recording a sustained[a,e,i,o,u]vowel for at least 5 seconds.Fundamental frequency(F0),Jitter and Shimmer parameters were evaluated in terms of vocal analysis.All patients were asked to fill in a questionnaire,to discuss the voice handicap index(VHI)after adequate explanation.EMS was performed with a carbon dioxide laser and cold knife on 15 and 10 patients,respectively.Patient follow-up was performed 1 week,2weeks and 4weeks after surgery.Changes in F0,Jitter and Shimmer values were measured and recorded.VHI was also completed and reassessed.Results Postoperatively,there was no significant difference in VHI scores between two groups(P>0.05).There was no significant difference in voice analysis values between two groups postoperatively,(P>0.05).Conclusion In the treatment of vocal polyps,EMS with both CO_(2)laser and traditional cold knife is effective.
文摘建立模块化多电平变流器(modular multilevel converter,MMC)内部动态数学模型,模型以上下桥臂储能和环流电流为状态变量,分析直接调制和间接调制方式下桥臂电容电压储能的稳定性,考虑数学模型中存在的时变参数均为工频周期变量,采用线性周期时变(linear time periodic,LTP)系统分析方法,通过计算庞加莱(poincare)算子判断系统稳定性。进一步推导MMC内动态误差状态方程,基于此判断出系统阻尼完全由桥臂损耗和等效电阻提供,属于弱阻尼特性,对此,提出基于直流电流反馈的阻尼控制方法,经PSCAD仿真验证所设计控制方法正确,有效。
