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 promote the implementation of essential medicine system by combining drug utilization research with national essential medicine system. METHODS:The importance of information monitoring in the implementation of essential medicine system was analyzed and the application of drug utilization research in the implementation of essential medicine system was also discussed. RESULTS & CONCLUSIONS:It is suggested that the indicators for example DDDs are used in the monitoring of clinical drug utilization,and conditions also should be created to carry out further research of drug utilization so as to promote the implementation of essential medicine system in China.

[ABSTRACT]OBJECTIVETo diagnose laryngopharyngeal reflux (LPR) by using two methods: 24h pH monitoring and RSI combined with RFS scales. To research the voice characteristics of patients with LPR and changes of voice parameters before and after PPIs therapy, and to use voice parameters to help diagnosing and evaluating treatment effect of LPR.METHODSThe patients visited department of Otolaryngology head & neck surgery of Peking University Third Hospital from August 2012 to August 2013 were included in this study. There were 26 LPR patients diagnosed by 24 hr pH-MII monitoring (pH group) and 26 LPR patients diagnosed by RSI combined with RFS (questionnaire group). Another 52 subjects without laryngeal or pharyngeal symptoms were as control group. All subjects underwent MDVP examination. The patients from pH group and questionnaire group took esomeprazole 20 mg bid for one month, afterwards MDVP was examined again. The voice related parameters were compared before and after medication therapy.RESULTSComparing data between LPR patients and normal subjects, Jitter, Shimmer, NHR had significant difference (P<0.05), and F0, MPT had no significant difference (P>0.05) before treatment. After PPIs therapy there was no significant difference between each group (P>0.05).CONCLUSIONAbnormal voice parameters were existed in LPR patients. After PPIs treatment, voice related parameters improved apparently.

Objective:To study the related factors of severe acute radiation-induced lung injury (SAR) caused by IMRT and concurrent chemotherapy for non-small cell lung cancer. Methods:We retrospectively analyzed the data of 2 323 non-small cell lung cancer pa-tients who underwent IMRT radiotherapy and concurrent chemotherapy at the Department of Radiotherapy of Tianjin Medical Univer-sity Cancer Institute and Hospital from January 2010 to January 2014. We analyzed the clinical factors and parameters that affect dose by univariate and multivariate analysis. Results:A total of 2 323 patients enrolled and 1 241 cases suffering from acute radiation-in-duced lung injury with the rate of 53.4%. Only 185 cases suffered from SARP with a rate of 7.96%. Univariate analysis showed that the gender, histopathological type, total radiation dose, V5 (%), and average dose rate are not related to SARP (P>0.05). By contrast an age of>60 years, 1%predicted FEV, docetaxel+carboplatin/cisplatin chemotherapy, V20 (%), V30 (%), and mean lung dose (MLD) are sig-nificantly related to SARP (P<0.05). Multivariate analysis showed that a patient age of>60 years, docetaxel+carboplatin/cisplatin che-motherapy, V20 (%), and V30 (%) are the independent risk factors of SARP. Conclusion:Among the non-small cell lung cancer patients undergoing IMRT radiotherapy and concurrent chemotherapy, further attention should be given to elderly patients, patients receiving docetaxel and platinum chemotherapy, as well as V20 and V30 with high doses. The necessary preventive treatment should be given to reduce the incidence of SARP, improve the quality of life of patients, and reduce the incidence of respiratory failure and mortality.

Objective To evaluate the effects of Taoist cognitive psychotherapy on depression of aged patients with cerebral stroke hemiplegia convalescence. Methods Seventy-seven hemiplegia convalescence patients with depression were divided into general treatment group (38 patients, received general back-up psychology therapy) and combined treatment group (39 patients, received general back-up psychology therapy and Taoist cognitive psychotherapy) by random digits table. All patients were treated for 8 weeks and followed up for 6 months. Two groups were evaluated with HAMD and SS-QOL before treatment and at the end of the 2 weeks,4 weeks, 8 weeks and 6 months after treatment. The results were analyzed with statistics. Results In general treatment group, the HAMD scores were gradually decreased, and the HAMD scores of patients after 8 weeks' treatment were significantly lower than those before treatment[(22.35 ± 4.69)scores vs. (29.62 ± 5.95 ) scores,t = 6.425 ,P ＜ 0.01]. At the end of 6 months after treatment, the scores increased [(24.48 ± 4.12 ) scores vs. (22.35 ± 4.69 ) scores, t = 2.014, P ＜ 0.05], but they were lower than those before treatment(t = 4.836, P ＜ 0.01 ). At the end of 6 months after treatment, the SS-QOL scores were lower than those after 8 weeks' treatment (t =2.543,P ＜0.05),but they were higher than those before treatment (t = 2.790,P ＜ 0.05 ). In combined treatment group, the HAMD scores decreased continuously,and the scores after 8 weeks' treatment [(20.08 ± 4.60) scores] and 6 months' treatment [( 15.21 ± 3.42)scores] were significantly lower than those before treatment [( 30.14 ± 4.92 ) scores] (t = 8.341,15.443, P ＜0.01). Meanwhile,the HAMD scores after 6 months'treatment were significantly Iower than those after 8 weeks' treatment (t =4.724,P ＜ 0.01 ). The SS-QOL scores after 8 weeks' treatment [( 117.56 ± 26.22)scores] and 6 months' treatment [(126.57 ±21.82) scores] were significantly higher than those before treatment[(86.54 ± 23.90) scores] (t = 6.716,8.916,P ＜ 0.01 ) ,and there was significantly difference(t=2.378,P ＜ 0.05). The HAMD scores of combined treatment group after 8 weeks' and 6 months' treatment were significantly lower than those of general treatment group at the same time(t = 2.118, P ＜ 0.05 ;t = 8.405,P＜ 0.01 ) ,and SS-QOL scores were significantly higher than those of general treatment group at the same time (t = 3.123,P ＜ 0.05 ;t = 6.580,P ＜ 0.01 ). Conclusions General back-up psychology therapy combined with Taoist cognitive psychotherapy can improve depression and life quality of cerebral stroke hemiplegia convalescence in aged patients. The effects of Taoist cognitive psychotherapy is slower, but it is more beneficial in the long time.

To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months (range 12-30 months). The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation (P < 0. 01), the total excellent and fine rate was 91.86%. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.

Objective The present study investigated the expression of heat shock cognate protein 70 (Hsc70) in the synovial tissues and blood samples of patients with rheumatoid arthritis (RA) to determine the pathological role of this protein in the pathogenesis of the disease.Methods The expression of Hsc70 in synovial membranes was quantitatively analyzed by immunohistochemistry,real-time quantitative PCR and western blotting.The samples from osteoarthritis (OA) and ankylosing spondylitis (AS) were used as controls.The levels of Hsc70 in blood of patients with RA were determined using enzyme linked immunosorbent assay (ELISA) with the samples of the healthy subjects as controls.Statistical analysis was conducted with one-way ANOVA,LSD test and Spearmen's correlation.Results Immunohistochemistry showed that Hsc70 had significantly increased expression in synovial tissues of RA than in the samples of OA and AS.Real-time PCR and western blotting confirmed the above findings.ELISA detected significantly elevated level of Hsc70 in blood of patients with RA as compared with samples from the controls (P＜0.01).Conclusion The study suggests that the up-regulation of Hsc70 may be involved in the pathogenic process of RA.

Objective To observe the effect of scalp-body acupuncture plus psychological intervention in treating post-stroke depression.Method Seventy-eight patients with post-stroke depression were divided into a treatment group (40 cases) and a control group (38 cases). In addition to ordinary neurological treatments, the treatment group also received scalp-body acupuncture plus psychological intervention while the control group also received Fluoxetine hydrochloride (Prozac). The interventions were given once a day, 4 weeks as a treatment course, for 2 courses in total. Hamilton Rating Scale for Depression (HAMD) and neurological impairment severity scale (NISS) were observed before intervention, after 1 treatment course and at the end of the intervention.Result After intervention, the HAMD and NISS scores dropped significantly in both groups, and the treatment group was markedly better than the control group (P＜0.05). The total effective rates of anti-depression and recovery of neurological function in the treatment group were significantly higher than those in the control group (P＜0.05).Conclusion Scalp-body acupuncture plus psychological intervention can produce a content efficacy in improving depression and recovering neurological function.

Objective To study the clinical distribution and detection of the efflux pump gene in multiple drug-re?sistant acinetobacter baumannii. Methods The clinical distribution of 96 strains of multiple drug-resistant acinetobacter baumannii was analyzed. K-B method was used to detect 96 strains of multi resistant bauman resisted to 15 kinds of antibiot?ics. PCR amplification was used to detect the efflux pump gene. Results Ninety-six strains of multiple drug-resistant aci?netobacter baumannii mainly distributed in intensive care unit (ICU, 54.2%) and respiratory department (18.8%). The drug resistance rates to quinolone, cephalosporins, amino glucoside, tetracycline were above 70%. The 52 strains of multiple drug-resistant acinetobacter baumannii detected in ICU included 18 strains of adeB (34.62%), 16 strains of adeR (30.77%), 18 strains of adeS (34.62%), 18 strains of adeJ (34.62%), 0 strain of adeE and18 strains of adeM (34.62%). The18 strains of multiple drug-resistant acinetobacter baumannii detected in respiratory department included 9 strains of adeB, 8 strains of adeR, 8 strains of adeS, 8 strains of adeJ, 0 strain of adeE and 8 strains of adeM. Conclusion Efflux pump genes are impor?tant factors for multiple drug-resistant acinetobacter baumannii distributed in ICU and respiratory department.

BACKGROUND:Present studies mainly focused on in vitro culture of bone marrow mesenchymal stem cells(BMSCs)and cell transplantation for treating intracalvarium diseases.However,the understanding of survival,differentiation,migration and structure of transplanted cells in the damaged spinal cord is limited.OBJECTIVE:To explore effects of local BMSC transplantation in repair of spinal cord damage and feasibility of replacement therapy of BMSCs.METHODS:Adult healthy female Sprague-Dawley rats were randomly assigned to cell transplantation and control groups.Rat models of spinal cord transection damage were established.Rat BMSC suspension or calcium and magnesium phosphate buffer were transplanted immediately after injury to the damage zone.At 1 day,1,2,3,4 and 8 weeks before and after transplantation,BBB score motor function was observed in rats,and at 1 week after transplantation,immunohistochemical staining was utilized to observe BrdU-labeled BMSC survival in the spinal cord damaged site.At 4 weeks after transplantation,the general observation and histological detection were observed.RESULTS AND CONCLUSION:At 1-8 weeks after transplantation,BBB scores were higher in the cell transplantation group than in the control group.At 1 week following surgery,immunohistochemical staining showed that BrdU-positive cells were detected in the distal end of rat spinal cord in the cell transplantation group.At 4 weeks following surgery,nerve fibers were found in the damaged spinal cord.These verified that BMSCs were transplanted into rat damaged spinal cord immediately following damage,and the transplanted cells could survive.Living BMSCs can differentiate into neurons,and formed neuron pathway in the local region of damage,which will promote the recovery of conduction function of spinal nerve fibers,and contribute to the recovery of rat hindlimb motor function following high-level spinal cord injury.