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

"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.

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.

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.

Molecular biology is an important course for the postgraduate in medical school which includes both theoretic class and experimental class.This article described the setting and organization of molecular biology course of postgraduate in Nantong University,and some thoughts and experiences about the training of the research competence of students were introduced as well.

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

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 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.

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.