Laryngopharyngeal reflux (LPR) is gaining extensive attention in recent years because of the high incidence. But because of the complex symptoms and signs, there exist no diagnostic consensus. In this paper, the available objective diagnostic methods so far are reviewed, in the purpose of discussing the approach of objective and accurate diagnosis of LPR.
Humans ; Laryngopharyngeal Reflux ; diagnosis

Objective To investigate the characteristics of distribution of adverse event(AE)associated with human papillomavirus(HPV)vaccine by analysis of data on AE collected from the Vaccine Adverse Event Reporting System(VAERS).Methods The data on AE reported in VAERS from January 1st,2006 to December 31st,2021 were analyzed and compared by using Pearson Chi-square test and Mann-Whitney U test.Results A total of 53 571 cases of AE were included in the study,in which the ratio of male to female was 0. 25∶1,and the median age of vaccinees was 15 years. A portion of 36. 1%of AE occurred after the first dose,while 90. 7% occurred within 3 d after vaccination. Both the gender ratios(χ~2=72. 570,P < 0. 001) and the median ages(Z = 4. 255,P < 0. 001)of vaccinees in non-serious and serious adverse event(SAE)showed significant difference. In terms of classification of SAE,hospitalization,prolonged hospitalization and disability were more common in females than in males,of which the percentages decreased with the increasing age. Among the AE,syncope was the most common clinical symptom. In the SAE,the highest proportion of deaths was caused by HPV2 vaccine,which was 19. 0%. The proportion of prolonged hospitalization caused by HPV4 vaccine was higher than that by HPV9vaccine. In general,HPV4 vaccine was more prone to cause SAE than HPV9 vaccine(χ~2=183. 267,P < 0. 001).Conclusion In all the AE,the largest proportion occurred in the age group of 9 ～ 17 years,followed by those in the groups of 18 ～ 26 and 27 ～ 45 years. Most of the AE occurred after the first dose. The clinical symptoms of AE caused by three vaccines were different. The analysis of distribution characteristics of AE may provide a reference for the study on clinical safety of HPV vaccine and optimization of vaccination.

Objective To study the effect of cognitive behavior intervention on negative self-concept and life quality of chronic heart failure patients. Methods 128 cases of patients with chronic heart failure were divided into the observation group (63 cases) and the control group (65 cases).The control group were treated with cardiology common nursing, the observation group received cardiology common nursing with cognitive- behavioral therapy. Negative self-concept and life quality of the two groups were compared. Results Compared with the control group, the negative self-concept alleviated and life quality improved in the observation group. Conclusions Cardiology common nursing with cognitivebehavioral therapy can alleviate the negative emotion and improve the quality of life in patients with coronary heart disease.

Objective To analyze clinical process and therapy means of drug induced liver disease(DILD).Methods The retrospectively study on the clinical data 40 patients of DILD was used.Results(1)18 patients with DILD are more 60 year(45.0%); 17 patients have chronic dease(42.5%); 3 patients are sensitive to drug.10 patients have unite using drug(25%); 4 patients have bibulosity; 20 patients had not cease drug when DILD happened with al- imentary tract symptom(50%);(2)72.7% DILD with antibiotics happened in 2 weeks,most cases are acute bile de- posit type.95.2%DILD with Chinese traditional medicine happened after 2 weeks,is are chronic hepatotoxicity,it is obvious that liver cell damage type and bile deposit type.and commix-type.Very few Chinese traditional medicine also lead to acute hepatotoxicity.By protect liver of therapy:6 patients cure,32 patients mend,2 have patients no change. Conclusion DILD is very normal in clinical,must be in advance know and guard for DILD,the key is to cease drug when DILD happened.

Objective: To study self-efficacy and locus of control in s tudents under stress Method: 489 students including 138 colleg e students, 222 high school students and 129 high school students facing national examination for college (exam group) were collected SEI (self-judgement inven t ory) and ASLEC (adolescent life event scale) were applied to college students an d high school students Scale for Self-efficacy in Mathematics, ICP (inner cont r ol potential) and TAS (test anxiety scale) were applied to exam group R esult: Only in male students, there was significant negative correlation between general self-efficacy and stress The stress level of female was highe r than male There was significant negative correlation between stress and self- e fficacy in mathematics and between stress and internality While positive corre l ation existed between stress and powerful others, and between stress and chance In multiple regression, the main factors influence stress were gender, self-e fficacy and chance

The minimally invasive surgery means treatment that can remain homeostasis, reduce tissue damage, benefit body recovery and prognosis. The typical techniques of minimally invasive surgery in gynecology are laparoscope and hysteroscope, which can replace nearly all kinds of traditional gynecology surgery and have superior curative effect. After 10 years clinical practice, we found that reasonable application of laparoscope play a significant role in ensuring the surgery quality and postoperative living quality, on account of the greater risk by new surgery instruments and various sorts of energy. The popularization of gynecology minimally invasive surgery is influenced by the regional economic development and update of doctor's ideology, so it is important to train the surgeons and change their ideas.

Dilated cardiomyopathy (DCM) is the most common type of cardiomyopathy in children.It is associated with gene mutation,viral infection,autoimmunity,nutritional deficiency,drug induced,endocrine and metabolic abnormalities,et al.Through the balance of the calcium content,the negative control of renin-angiotensin-aldosterone system and the reduction of the formation of inflammatory mediators,vitamin D can reduce the occurrence of DCM.This paper elaborates the latest research advances of the DCM pathogenesis and treatment,especially focusing on the mechanism and prognosis of vitamin D deficiency and gene mutation.

Master of Translation and Interpretation in medicine aims at cultivating professional translators and interpreters in medicine.This paper makes a discussion of the construction of academic degree granting schools from curriculum setting,teaching group and evaluating model,proposing to increase the proportion of medical class and practical translating class,integrate teachers in school and strengthen their teaching training,and utilize professional evaluation mechanism for students' translating ability.

There are many causes of proteinuria in children.Because proteinuria is mainly caused by glomerular diseases,renal tubulopathies are often ignored.Dent's disease is an hereditary renal tubulopathy characterized by low-molecular-weigh proteinuria,hypercalciuria,nephrocalcinosis,nephrolithiasis,and progressive renal failure.Dent's disease is mainly caused by mutations in CLCN5 and OCRL1 genes.Current treatments of the disease are still mainly symptomatic and supportive therapy,including reducing urinary calcium excretion,lightening nephrocalcinosis,and delaying the occurrence of renal insufficiency.

Government Subsidized Student Loan is a policy adopted by the government,which aims to help the poor students to go to college.However,the result turns out that the policy doesn't achieve the expectant target for many reasons.This paper analyses the reasons and introduces three methods for promoting the healthy development of the Government Subsidized Student Loan.They are: establishing the personal credit system for college students,ensuring the remedy right of loan and designing reasonable procedure of Government Subsidized Student Loan.