目的:探讨低频脉冲联合水蛭预防下肢骨折术后深静脉血栓形成的临床疗效.方法:选取2017年12月～2018年12月我院收治的90例下肢骨折手术患者,随机分为三组,每组30例,术后分别给予低分子肝素钠(对照组)、低分子肝素钠+水蛭(水蛭组)、低分子肝素钠+水蛭+低频脉冲(低频脉冲+水蛭组)预防血栓治疗.比较各组术前、术后的凝血功能、血流动力学、彩超检查结果、下肢消肿时间、不良反应及并发症发生情况.结果:对照组和水蛭组下肢肿胀开始消退时间分别为(5.2± 1.4)d和(5.4±1.3)d,低频脉冲+水蛭组下肢肿胀开始消退时间为(3.6±0.9)d,低频脉冲+水蛭组下肢肿胀消退时间早于对照组和水蛭组(P＜0.05);术后第7天低频脉冲+水蛭组股静脉血流速度快于对照组和水蛭组(P＜0.05),对照组与水蛭组股静脉血流速度比较,差异无统计学意义(P＞0.05);三组术后第7天PT、APTT均短于术前(P＜0.05),但术后组间比较,差异无统计学意义;对照组2例术后发生下肢血栓,1例为肌间静脉血栓(未处理),另外1例为股静脉血栓(予介入治疗),余两组均无下肢深静脉血栓形成.所有患者最后顺利出院,治疗过程无明显药物不良反应及其他严重并发症发生.结论:低频脉冲联合水蛭能够安全、有效地预防下肢骨折术后深静脉血栓形成.

目的 探讨经皮椎体后凸成形术(pereutaneous kyphoplasty,PKP)术后发生邻近椎体骨折的相关因素.方法 217例行单侧穿刺PKP患者,术后有29例发生邻近椎体骨折,比较邻近椎体骨折与无邻近椎体骨折患者的年龄、性别、体质量指数(BMI)、初始骨折部位、术前骨密度、骨水泥注射量、骨水泥分布、骨水泥渗漏至椎间盘.结果 邻近椎体骨折与无邻近椎体骨折患者的性别、年龄、BMI、初始骨折部位、骨水泥注射量、骨水泥分布、骨水泥渗漏至椎间盘比较差异均无统计学意义(P>0.05);两组术前骨密度比较差异有统计学意义(P<0.05);65.5％的邻近节段骨折椎体初始骨折位于胸腰段(T10至L2),明显高于其他节段.结论 椎体成形术后发生邻近椎体骨折跟初始骨折部位及骨质疏松均有密切关系,其中骨质疏松的程度是主要因素.经皮椎体后凸成形术是治疗邻近椎体骨折的有效方法.

目的 研究益生菌制剂对绝经后骨质减少女性患者骨骼状态的改善作用.方法 选择2016年4月一2018年4月在本院就诊的绝经女性478例,其中骨质疏松患者103例.将患者分为对照组和益生菌组,两组患者均连续治疗6个月,定期进行随访.检测患者治疗前后骨密度(BMD)、骨代谢指标、骨折情况、肠道微生物情况.结果 治疗后益生菌组患者Ⅰ型胶原吡啶交联终肽(CTX)、骨特异性碱性磷酸酶(BALP)均明显低于对照组治疗后水平(CTX:P=0.004;BALP:P=0.011)和益生菌治疗前水平(CTX:P=0.008;BALP:P=0.024).对照组治疗前后丰度排列前三位的微生物均为Bacteroides plebeius,布氏瘤胃球菌(Ruminococcus bromii),普拉梭菌(Faecalibacterium prausnitzii);益生菌组治疗前后丰度排列前三位的微生物均为Bacteroides plebeius,普拉梭菌(Faecalibacterium prausnitzii),布氏瘤胃球菌(Rum inococcus bromii).结果显示益生菌组患者治疗后肠道甲醇拟无枝酸菌(Amycolatopsis methanolica),Burkholderia oklahomensis, Streptomyces turgidiscabies,Verrucosispora maris检出率明显低于治疗前(P=0.009,0.012,0.005,0.007).结论 益生菌可以改善骨代谢,对绝经后骨质减少女性具有骨保护作用,其机制可能与益生菌对肠道微生物分布的影响有关.

目的:观察电针配合定向透药疗法促进腰椎术后神经功能恢复的临床效果.方法:选取2014年1月～2015年12月于我科住院行腰椎术后仍残留坐骨神经根疼痛患者60例,将其随机分为电针配合定向药透治疗组与单纯西医治疗对照组,每组30例,比较两组患者疼痛的缓解程度(VAS评分)及治疗有效率.结果:电针配合定向药透治疗组的总体治疗有效率为93.3％,单纯西医治疗对照组的治疗有效率为86.7％,治疗组的治疗总体有效率显著高于对照组(P＜0.05).治疗组患者在治疗第7、10天时,其VAS评分均显著低于对照组相应评分,表明治疗组患者疼痛改善程度明显优于对照组(P＜0.05).结论:采用电针配合定向药透治疗腰椎术后腰腿痛疗效明显优于单纯西医治疗,值得临床推广.

Objective:To investigate the clinical effect of fixed point rotating neck method treating cervical spondylotic radiculopathy. Methods:100 patients with cervical spondylotic radiculopathy were randomly divided into treatment group and control group, treatment group was treated with fixed point rotating neck method, and control group with computer program-controlled tractor. Results:the total efficiency of treatment group was 100%, significantly higher than that of control group by 90%(P=0.000006<0.01);integral and SF-MPQ pain rating index scores of the two groups af-ter treatment were significantly higher than those before treatment, and treatment group significantly better than control group (P<0.01);both without adverse reactions. Conclusion:Fixed point rotating neck method treating cervical spondylotic radiculopathy is effective and without obvious adverse reaction, being worthy of promoting.

目的：观察定点旋颈手法对神经根型颈椎病疼痛的改善效果。方法神经根型颈椎病患者100例，随机分为观察组和对照组各50例。观察组予定点旋颈手法治疗，对照组予电脑程控牵引器牵引治疗，隔天1次，10 d为1个疗程，共治疗2个疗程。治疗前后分别采用疼痛等级计分和视觉模拟评分（ VAS）评估疼痛情况。记录两组治疗期间不良反应发生情况。结果两组治疗后疼痛等级评分均低于治疗前，且观察组治疗后疼痛等级评分低于对照组、治疗前后评分差值高于对照组（ P均＜0．01）。两组治疗后VAS均低于治疗前，且观察组治疗后VAS低于对照组（ P均＜0．01）。两组治疗期间均未出现不良反应。结论定点旋颈法治疗神经根型颈椎病可明显减轻患者疼痛，效果较好。

目的 对经皮椎体后凸成形术的术中疼痛进行相关临床研究.方法 选择68例椎体骨质疏松性压缩骨折患者,均为新鲜压缩骨折,完成72个椎体后凸成形术.手术均采用局麻下经皮椎体后凸成形术,均为单侧球囊穿刺.对术中穿刺、球囊扩张、骨水泥注射三个阶段患者疼痛进行评估和比较,同时观察术中的疼痛行为特征和生命体征.结果 59例(87%)患者术后疼痛出现明显改善,术中疼痛出现率为82%.手术前后VAS均值分别为8.1±1.2和3.1±1.4,穿刺VAS均值为7.6±1.2,球囊扩张VAS均值为8.7±0.9,骨水泥注射VAS均值为8.1±0.7.最疼痛比率:穿刺占18%,球囊扩张占53%,骨水泥注射占29%.球囊扩张时的疼痛程度与穿刺和骨水泥注射的疼痛程度相比有统计学差异(P<0.05).术中疼痛的发生对临床效果无影响.结论 对于椎体后凸成形术,多数患者会出现术中疼痛.尽管术中疼痛的出现不会影响椎体后凸成形术的临床疗效,但是我们还是应该对它给予足够的重视和处理.

The performance of the human-machine dialogue in a vehicle environment is greatly deteriorated by background noise. In this paper, the authors present an in-car speech enhancement method (ICSE), which can be employed to effectively improve quality of the in-car speech signals. This speech enhancement method was developed by means of the Ensemble Empirical Mode Decomposition (EEMD). Based on EEMD method, noise-contaminated speech signals can be decomposed into a set of intrinsic mode functions (IMFs). Next, nonlinear least squares estimation and signal-to-noise ratio (SNR) testing are employed to obtain optimal weighting coefficients of the dominant IMFs. Finally, by combining the weighted IMFs, the noise effect can be suppressed sufficiently and the in-car speech signals enhanced significantly. Experimental and simulative results show that the obtained weighting coefficients of IMFs are reasonable and the EEMD technology is effective for extracting clean speech from the noise-contaminated in-car speech.

<正>腰椎后关节滑膜嵌顿是引起腰痛的常见原因之一[1],常因搬提重物时姿势不正确、用力不协调而致病。该病属于中医"骨错缝"的范畴,目前随着研究的深入,越来越受到临床医生的重视,治疗方法包括手法复位、痛穴刺激法、电动牵引、[2]

Objective:To investigate the influence of the interspinous spacer implant on the kinematics of the lumbar spine.Method:Six cadaver spine functional units(L1-L5) were observed.The muscles were removed while the discs,ligaments and joint capsules were intact.The cranial portion of L1 and caudal portion of L5 vertebrae were secured in polymethylmethacrylate(PMMA).Specimens were initially tested by applying a 400N axial compression,followed by a ±7.5Nm bending moment in six directions(lexion and extension,left and right axial rotation,and left and right lateral bending) with a speed of 0.5°/s.The range of motion(ROM) at L2/3 and L3/4 of the intact group was measured,while the ROM at the L3/4 was measured after the Bullet interspinous device was placed.After the measurement,force was imposed with a frequency of 2Hz.Flexsion and extension were done 20000 time,lateral flexion was done 15000 times,and rotation was done 5000 times.X-ray was taken to see the positions of the implants,whether there was fracture of the spinous processes,whether the implants were deformed or broken.Result:The ROM in flexion-extension of L3/4 at intact state was 4.62°±2.26° and 4.07°±1.92° respectively.The ROM in flexion-extension at the instrumented level was 3.87°±2.06° and 2.57°±2.06°,the ROM of both groups in flexion-extension were significantly different(P<0.05),whereas there was no significant effect on the other directions.The novel device had the ability to resist fatigue.Conclusion:Similar to other interspinous implants,the novel percutaneously placed low profile inter-spinous device has an effect on the control of flexibility of the treated segments.It can provide spine stabilization while in extension,but has little effect on the range of motion in flexion,lateral bending and axial rotation.

退变性脊柱侧凸(degenerative scoliosis)是继发于椎间盘及椎间关节退变的成人结构性侧凸.随着社会老龄化的加速进展,退变性脊柱侧凸的发病率有明显上升趋势,Lonstein估计,在美国约有50万成人存在大于30°的脊柱侧凸[1];而由于人们对生活质量期望值的提高,越来越多的退变性脊柱侧凸患者选择外科手术作为治疗手段.尽管退变性脊柱侧凸的手术治疗效果令人满意,但术后出现的一系列近期和远期并发症仍是困扰大多数脊柱外科医生的问题.

Study Design. An in vitro laboratory study.Objective. (i) To evaluate the effect of osteoporotic degree in determining the strength of sacral screw fixation and (ii) to compare the strength of unaugmented bicortical pedicle screw and polymethylmethacrylate (PMMA) augmented unicortical pedicle screw in sacral fixation.Summary of Background Data. Screw loosening is a clinical problem in lumbosacral fusions, especially in osteoporotic patients. To improve the screw anchoring strength of sacrum, bicortical and PMMA augmented sacral pedicle screw fixation techniques are widely used in clinical practice. However, the biomechanical strength of the bicortical and PMMA augmented sacral screw fixations remains undetermined in different degrees of osteoporosis.Methods. Twenty-five fresh osteoporotic cadavers were used in this study. According to the value of lumbar bone mineral density (BMD) assessed by DEXA, specimens were divided into 3 groups: group A (N = 9): BMD - 0.7 to 0.8 g/ cm2, group B (N = 8): BMD = 0.6 to 0.7 g/cm2, and group C (N = 8): BMD = 0.6 g/cm(2). In each specimen, S1 pedicle screw was inserted bicortically on the left side, and S1 pedicle screw with PMMA augmentation was inserted unicortically on the right side of the sacrum. Following a dynamic cyclic loading from 30 to 250 N on the screw head for 2000 cycles, the subsidence displacement and axial pull-out strength of each screw were measured.Results. No anchoring failure (defined as the subsidence displacement exceeding 2 mm within 2000 loading cycles) occurred in group A and B. However, in group C, 6 cases (75%) in bicortical fixation and 5 cases (63%) in PMMA augmented fixation failed during cyclic loading. In group A, no significant difference between the bicortical and PMMA augmented fixations was detected in terms of the subsidence and maximal pull-out strength. In group B, significantly less subsidence and higher maximal pullout strength were demonstrated in the PMMA augmented technique than that in the bicortical fixation. Both techniques exhibited lower subsidence of the screw in group A than in group B. The bicortical technique exhibited higher maximum pull-out strength in group A than that in group B. However, statistical difference in terms of PMMA augmentation was not detected between group A and B.Conclusion. For BMD value more than 0.70 g/cm(2), bicortical sacral pedicle screw fixation could obtain sufficient anchoring strength comparable with the PMMA augmented technique. When BMD value is within 0.6 to 0.7 g/cm(2), the PMMA augmented technique would be more beneficial in improving the fixation strength than the bicortical fixation. For BMD values less than 0.6 g/cm(2), early screw loosening may occur in both bicortical and PMMA augmented fixations.

Study Design: An in vitro biomechanical cadaver study.Objectives: To compare the subsidence displacement after cyclic loading among 4 sacral pedicle screw fixations of bicortical, tricortical, standard polymethylmethacrylate (PMMA) augmentation, and sub-endplate PMMA augmentation in osteoporotic condition.Summary of Background Data: Implant failure caused by screw loosening is a clinical problem for lumbosacral fusions, especially in osteoporotic patients. To improve sacral screw anchoring strength, the main fixation techniques need to be evaluated biomechanically.Methods: For this study, 11 fresh osteoporotic cadaver sacra were harvested and bone mineral density was measured with dual-energy radiograph absorptiometry. A 7 mm diameter monoaxial pedicle screw (S1) was randomly assigned by side (left vs. right) and placed bicortically or tricortically. The 2 screws, followed 2000 cyclic compression loading of 30 to 250 N, were removed. The screw tracts were filled up with PMMA, then, screws 5 mm shorter than the bicortical or tricortical fixation were reinserted (defined as standard and sub-endplate PMMA augmented sacral screw fixations, respectively). The PMMA augmented screws were then retested as before. Screw subsidence displacement after 2000 cyclic loading was measured and compared.Results: The average bone mineral density of 11 specimens was 0.71 g/cm(2), ranged from 0.65 to 0.78 g/cm(2). No significant difference of subsidence displacement was detected between tricortical and standard PMMA augmented screws (P > 0.05), however, the 2 fixations exhibited markedly less subsidence than bicortical screw (P < 0.05). Sub-endplate PMMA augmented screw showed the least subsidence among all the screws (P < 0.05).Conclusions: PMMA augmentation can increase the bonding strength of sacral screw-bone interface and the sub-endplate PMMA augmented sacral screw could obtain the highest stability among the 4 fixation techniques in osteoporotic condition.

Study Design: Comparison of the biomechanical fixation strengths offered by 3 iliac screw fixation techniques: short screw, short screw augmented with cement, and long screw.Objective: Evaluate the effect of screw length and bone cement augmentation on the fixation strength of iliac screw upon fatigue loading.Summary of Background Data: Iliac screws have been used in treating spinal disorders such as spinal deformity, spondylolisthesis, and sacral tumor. In clinical practices, both short screws and long screws are being used. It has been reported that short iliac screws have a higher rate of loosening. Therefore, short iliac screws are being used with bone cement augmentation to improve fixation. To date, no biomechanical study has compared the strengths of these 3 different iliac screw fixation techniques.Method: Fresh, frozen human cadaveric pelvis specimens (n = 18, 12 males, 6 females, average age 61 y) were used. Bone density was measured to characterize bone quality. The specimens were randomly divided into 2 groups. In group 1 (n = 8), short screws of 7.0-mm diameter and 70 +/- 4 mm length (as the length of exceeding over ischial notch) and long screw of 7.0-mm diameter and 120 +/- 4 mm length were placed on either side of the pelvis (left and right). In group 2 (n = 10), short iliac screws were placed after augmentation with polymethyl methacrylate bone cement on 1 side of the pelvis and long iliac screw were placed on the other side (left and right). Cyclic loading ranging from 20 to 200 N was applied to each screw at a frequency of 2 Hz up to 5000 cycles. Pullout tests were then conducted at the rate of 5 mm/min after the fatigue test, and the maximum pullout strength for each screw was recorded and analyzed.Results: The maximum pullout strength of the long screw and short screw groups after fatigue conditioning were 2386 +/- 1470 and 833 +/- 681 N respectively. Significant difference was found between the 2 groups (P < 0.05). The short iliac screw had a higher loosening rate. The pullout force of the short screw fixation with augmentation and the long screw fixation after cyclic loading were 2436 +/- 915 and 2529 +/- 1055 N, respectively. No significant difference was found between the 2 groups (P > 0.05).Conclusions: Short iliac screws are susceptible to loosening after cyclic loading. Bone cement augmentation of short screws has demonstrated a significant increase in the fixation strength of short screws to an extent similar to that of long iliac screws. Thus, short iliac screw fixation after augmentation with bone cement will be a viable clinical option for spino-pelvic reconstruction.

Objective To compare the strength of long iliac screw and short iliac screw augmenting with PMMA fixations after a fatigue simulation and evaluate the biomechanical effect of the short iliac screw. Methods Eleven adult corpse embalmed pelves (7 males, 4 females, with the average age of 60.7 years, ranged from 41 to 78 years) were used. Using dual energy X-ray absorptiometry (DEXA), bone density was measured to characterize bone quality, the mean value of BMD was 0.68±0.17 g/cm2, long screw was difined as the length of 2 mm around anterior inferior iliac spine, and short screw was difined as the length of exceeding no more than 5ram over ischial notch. Long screw [7.0 mm diameter and (138±4) mm length] was randomly inserted in one side of each pelve, and short screw [7.0 mm diameter and (70±2) mm length] following augmentation with PMMA was inserted in the other side. The PMMA was inserted 2-5 ml (mean 3.6 ml). Cyclic loading from 30 N to 300 N was applied to each screw at a frequency of 2 Hz up to 2000 cy-cles. Pullout tests were conducted at 5 mm/min after completion of the fatigue tests, and the maximum pull-out strength was recorded. Results Initial stiffness of the long screw fixation and the short screw fixation with augmentation were (249±101) N/mm and (253±122) N/mm respectively. Pullout force of the short screw fixation with augmentation and the long screw fixation were (2436±915) N and (2529±1055) N respectively, no significant difference was found between the two groups. The pullout forces of two fixations following cyclic loading showed linear correlations with the bone mineral density of pelvis. Conclusion The short ili-ae screw fixation following augmentation with PMMA will be a viable clinical option for spino-pelvic recon-struction, especially in osteoporotic patients.

STUDY DESIGN:Comparison of feasibility and safety of the placement of short and long iliac screws by anatomic and biomechanical evaluations as they apply to lumbo-iliac fixation construct.OBJECTIVE:To compare the stability of the short and long iliac screw fixations for lumbo-iliac reconstruction by anatomic and biomechanical evaluations.SUMMARY OF BACKGROUND DATA:Spinopelvic reconstruction remains a challenge to spine surgeons. Despite the advent of many fixation methods, the use of iliac screws seems most favorable so far. Various lengths of iliac screws are applied in surgical treatments; however, no biomechanical comparison has been reported based on the screw length.METHODS:For anatomic observation, CT scan data of 60 Chinese adults were used to measure the details of the iliac spine structures. For biomechanical evaluation, 7 adult human cadavers (L3-pelvis) were observed. L4-S1 pedicle screw fixation was performed with posterior spinal fixation system. On the basis of the lengths of iliac screws, 2 groups were tested (short screw group using 70 mm screws and long screw group using 138 mm screws). In this study, short and long iliac screws were placed in the same specimen. Biomechanical testing was performed on a material testing machine under 800 N compression and 7 Nm torsion loading modes for stiffness evaluations. Finally, pullout testing was performed for all the iliac screws to measure the maximum pullout force.RESULTS:The length of the line between posterior superior iliac spine and anterior inferior iliac spine was 140.6 +/- 1.1 mm, and the distance between this line and the greater sciatic notch was 18.3 +/- 0.8 mm. The length of the line between posterior superior iliac spine and the second narrowest point was 67.1 +/- 0.62 mm in men and 70.1 +/- 1.4 mm in women. Insertion lengths of the short and long iliac screws were 70 +/- 2 mm and 138 +/- 4 mm, respectively. The lumbo-pelvic reconstruction using short and long iliac screws restored 53.3% +/- 13.6% and 57.6% +/- 16.2% of the initial stiffness in compression testing respectively. In torsion testing, the use of short and long iliac screws harvested 55.1% +/- 11.9% and 62.5% +/- 9.2% of the initial stiffness, respectively. No significant difference was detected between the 2 reconstructions in terms of compressive and torsional stiffness (P > 0.05). However, the maximum pullout strength of long iliac screw group was significantly higher than the short screw group (P < 0.05).CONCLUSION:The local stability is rather difficult to be restored to the original levels regardless the length of iliac screws. Obviously, long iliac screws resisted significantly greater axial pullout force. However, under physiologic, torsional, and compressive loading conditions, the mechanical stability of lumbo-pelvic fixation construct with short iliac screws was comparable with that of the long ones. Therefore, the use of short iliac screws, which are only about half the length of the long iliac screws, could reduce the implantation risk without significantly compromising on the stability of the construct.

Objective To compare the subsidence displacement following cyclic loading among 4 sacral pedicle screw fixations of bicortical,tricortical,standard polymethylmethacrylate(PMMA) augmentation and sub-endplate PMMA augmentation in osteoporotic condition.Methods For this study,11 fresh osteoporotic cadaver sacra were harvested,and bone mineral density was measured with dual energy X-ray absorptiometry.A 7 mm diameter monoaxial bicortical or tricortical pedicle screw(S1) was randomly assigned by side(left vs.right) and placed.The 2 screws which followed 2000 cyclic compression with 30-250 N pressure were removed.The screw tracts were filled up with PMMA,then,screws 5 mm shorter than the bicortical or tricortical fixation were reinserted(defined as standard and sub-endplate PMMA augmented sacral screw fixations,respectively).The PMMA augmented screws were then retested as before.Screw subsidence displacement following 2000 cyclic loading was measured and compared.Results The average bone mineral density of 11 specimens was 0.71 g/cm2,ranged from 0.65 to 0.78 g/cm2.No significant difference of subsidence displacement was detected between tricortical and standard PMMA augmented screws,however,the 2 fixations exhibited markedly less subsidence than bicortical screw.Sub-endplate PMMA augmented screw showed the least subsidence among all the screws.Conclusion PMMA augmentation can increase the bonding strength of sacral screw-bone interface,and the sub-endplate PMMA augmented sacral screw could obtain the most stability among the 4 fixation techniques in osteoporotic condition.

Objective:To evaluate the safety and efficacy of percutaneous balloon kyphoplasty in the treatment of vertebral compression fractures resulted from multiple myeloma.Method:From June 2005 to December 2006,a total of 29 vertebral compression fractures due to multiple myeloma were treated by balloon kyphoplasty in 12 patients.The average age of the patients was 58.2 years old with a range of 44 to 71 years. Symptomatic levels were identified by physical examination,magnetic resonance imaging(MRI) and radiograph. Outcome data were obtained by comparing visual analogue scale(VAS) and Oswestry disability index(ODI) score.Pre- and post-operative radiographs were analyzed to assess the restoration of vertebral height,Cobb angle and complications.Result:Operation was successfully performed on all patients with a mean operative time of 33min per vertebra.The average blood loss was 30ml per vertebra and the bone cement volume injected was 4.78ml per vertebra.The mean time of follow-up was 9.2 months(range,2.5-23 months).There were 7 cases died during the follow-up period.VAS decreased significantly from 8.9±1.2 points to 2.6±0.2 points one day post-treatment,3.6±0.1 points at the last follow-up(P0.05).ODI score was reduced from 74.5±6.2 to 27.4±3.6 points,and 31.2±4.2 points at the last follow-up(P0.05).The anterior and midline vertebral body heights were increased significantly(P0.05).The mean Cobb angle was improved 8.32°.Clinically asymptomatic cement leakage occurred at 4 fracture levels(13.8%).Conclusion:Percutaneous balloon kyphoplasty is proved to be safe and effective in the treatment of vertebral compression fractures and deformity resulted from multiple myeloma.

The performance of the human-machine dialogue at in-car environment is considerably deteriorated by background noises and other disturbances. In this paper, the authors present an in-car speech enhancement (ICSE) method to improve quality of speech signals suffering the in-car noises. The method is based on a novel signal processing technology called the ensemble empirical mode decomposition (EEMD). By using EEMD, the noisy speech signals are decomposed as a set of intrinsic mode functions (IMF). Then, the nonlinear least-square estimation and signal-to-noise ratio (SNR) are employed to find out the optimal weighting coefficients of those IMFs dominating the speech signals. Finally, the enhanced speech signals, where in-car noises are suppressed, are obtained by the reconstruction technique based on the weighting IMFs. Results of the work show that, EEMD is an effective technology of separating pure speech from in-car noises, and the weighting coefficients proposed in this study are also effective for noises reduction as considering the similarity of the signal waveform.

<正>椎间盘退变是人体的一种自然衰老过程,但它可引起一系列疾病如腰椎间盘突出症、腰椎管狭窄(尤其是椎间孔狭窄)、退变性腰椎体滑脱、节段性腰椎不稳定和退变