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

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.

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

ObjectiveTo explore the effect of hysterescopy on the diagnosis and treatment of abnormal uterine bleeding. MethodsHysteroscopy was used in 120 cases of abnormal uterine bleeding, 98 cases with abnormal uterine cavity lesions were found. According to the different diseases, different treatments were unde~aken. ResultsThe use of hysteroscopy could make a clear diagnosis to variety of intrauterine abnormalities, and could treat many diseases at the same time directly. ConclusionUsing hysteroscopy to diagnose and treat abnormal uterine bleeding is a reliable method.

BACKGROUND:The function was poor in middle aged and elderly patients with total knee replacement. If there was no ideal anesthesia during the operation, the prognosis of patients would be poor. Therefore, it is necessary to explore the analgesic drugs for artificial knee joint arthroplasty. OBJECTIVE:To investigate clinical analgesic efficacy of tramadol and paracetamol in total knee arthroplasty and the drug safety. METHODS:200 cases undergoing unilateral total knee arthroplasty in the Department of Orthopedics of Huaian First Hospital Affiliated to Nanjing Medical University from December 2013 to January 2015 were enroled in this study. According to the different methods of analgesia, patients were divided into control and experimental groups, with 100 cases in each group. Control group received intravenous patient controled analgesia. Experimental group received paracetamol and tramadol oraly. Clinical analgesic efficacy and safety of tramadol paracetamol in total knee arthroplasty were analyzed. RESULTS AND CONCLUSION: No significant difference in visual analogue scale score was detected immediately, 4 and 5 days after replacement in both groups. Visual analogue scale score was significantly lower in the experimental group than in the control group at 1-3 days after replacement. Hospital for Special Surgery scores at 7 and 12 months after replacement and Special Surgery scores at 24 and 72 hours after replacement were significantly higher in the experimental group than in the control group. The twice doses of tramadol and paracetamol were significantly lower at 24 and 48 hours after replacement in the experimental group than in the control group. The incidence of complications was significantly lower in the experimental group than in the control group. These data verify that during perioperative analgesia, the effects of tramadol and paracetamol were ideal, could lessen patient’s pain, contribute to the recovery of knee function, have less adverse reactions, and have a certain clinical application value.

Objective To analyze clinical value of enteral nutrition via a nasojejunal feeding tube placed endoscopically and total parenteral nutrition in severe acute pancreatitis( SAP) .Methods 35 patients with SAP were received nasojejunal enteral nutrition endoscopically(NENE),while other 35 patients were received total parenteral nutrition(TPN).After nutrtion support for 4 weeks the nutrition index,Ranson score,APACHE score and CT score and complications and mortality rate of occurrence between the two groups were compared.Results After nutrition support of 4 weeks,the levels of hemoglobin and serum albumin of NENE group were (108 ±21) g/L,(38.7 ±9.5) g/L, which were significantly higher than those of TPN group( t=3.928,3.684,all P<0.05),while the fasting blood glucose of(5.1 ±1.2)mmol/L was significantly lower than that of TPN group(P<0.05),the level of CRP,TNF-α, IL-1 and IL-6 in patients of NENE group were (32.1 ±12.3)mg/L,(34.4 ±12.3)ng/L,(22.4 ±11.3)ng/L, (32.4 ±11.3)ng/L,which were significantly lower than those of TNP group(t=3.927,4.925,4.258,4.825,all P<0.05);the incidence of multiple organ dysfunction,hyperglycemia of NENE group were 17.14%,8.57%,5.71%, 5.71%,which were significantly lower than those of TPN group(χ2 =4.167,4.529,5.082,4.926,all P<0.05). Conclusion Nasojejunal enteral nutrition endoscopically is safe in clinical application.Compared with TPN,NENE results in better control of the incidence of complication, and decreased the length of stay in hospital and the cost enteral nutrition were more beneficial than total parenteral nutrition.

"Triple-negative"breast cancer patients who have special clinicopathological characteristics are defined by a lack expression of oestrogen,progesterone,and HER-2 receptors.Triple-negative patients usually metastasize early with worse prognosis,and have a higher incidence of visceral metastases than bony metas tases.This subgroup has no chance of hormone treatment and targeted therapy for HER-2,and chemotherapy is the main therapy.We discuss the predominant proliferative signals,molecular features of triple-negative breast cancer,and some basic studies and clinical trials.Furthermore,targeted therapy against EGFR,C-kit,and BRCA1 may show preferable anticancer activity.However,recent research is still unable to identify the biological characteristics of triple-negative Cancer,and special treatment is still not available.

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.

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.