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

Adenomatous polyposis coli gene is an important anti-oncogene of the Wnt signaling pathway. The promoter hypermethylation of APC gene can effect the expression of APC mRNA and APC proteinum, which can make Wnt signaling pathway anomalous. Recently. the promoter hypermethylation of APC Gene in gynecological tumors is found in many studies, and it is related to the aggravation level of tumor.This paper reviews the influencing factors and progress of promoter methylation of APC gene in Gynecological cancer.

ObjectiveTo develop the military acute stress scale and examine the reliability and validity of this scale.MethodsBased upon the previous acute stress researches and the rule of psychometrics,the military acute stress scale was compiled according to open-ended inventory survey.A total of 630 personnel were chosen by random cluster sampling,and tested with this scale,50 of them were tested by Chinese Military psychosomatic health Scale simultaneously,and 50 of them were retested after two week.The reliability and validity were examined by exploratory factor analysis,confirmatory factor analysis and correlation analysis.ResultsThe military acute stress scale was comprised of 9 factors and one lie sub-scale ; Main fit indexes of model were the following CMIN =1219.476,DF =593,P =0.000,CMIN/DF =2.056,IFI =0.927,TLI =0.902,CFI =0.924,RMSEA =0.059; The conrelation coefficients between subscales and subscales were 0.284-0.572.The correlation coefficients between subscales and total scale were 0.700 ～ 0.846 (P ＜ 0.05 or 0.01 ) ; The correlation coefficients was significant between this scale and Chinese military psychosomatic health scale.The correlation coefficients were 0.338-0.962 (P ＜ 0.01 ).The test-retest correlation coefficients of total scale and subscales were 0.379-0.909 (P ＜ 0.01 ).The Cronbaeh's α coefficients were 0.606-0.926 ; and the split-half correlation coefficients were 0.466-0.855.ConclusionThe military acute stress scale has acceptable psychometrics properties on reliability and validity.

The incidence of malnutrition among patients with chronic kidney disease (CKD) constantly increases despite the development of health care and dialysis techniques.New nutritional targets for CKD patients upon maintenance treatment have been developed.Before dialysis,evidences have shown that a long-term nutritional care plan,with a control of protein intake,can effectively correct metabolic disorders including proteinuria and acidosis.During the maintenance dialysis,the optimal protein and energy intakes have been recently challenged.The new classification of nutritional disorders in CKD patients may help the easily identification of protein-energy wasting.

Reading therapy in hospital libraries, academic libraries and public libraries was described in terms of its theoretical study and practical study,and its significance in hospital library was elaborated by comparative analysis.

Venous thrombotic disease is a serious disease,which impact on health and life-threatening.Pulmonary embolism and deep-vein thrombosis are the two components of a single disease called venous thromboembolism in obstetrics and gynecology.but it can be difficult to diagnose because clinical symptoms and signs are non-specific or absent in early venous thrombus embolism (VTE).It has great value that how to use the most economic,simple,efficient method for screened high-risk groups,timely and accurate laboratory diagnosis of VTE.

The clinical data and ultrasound findings of 185 patients with thyroid nodules undergoing thyroidectomy from June to December 2015 were retrospectively reviewed.Postoperative pathology confirmed malignant thyroid nodules in 86 cases and benign nodules in 99 cases.The ultrasonographic findings showed that there were significant differences in obscure boundary [51％ (44/86) vs.16％ (16/99)],hypoecho [(95％ (82/86) vs.27％ (27/99)],internal micro-calcification [63％ (54/86) vs.21％ (21/99)] and lymph node enlargement [33％ (28/86) vs.5％ (5/99)] between malignant and benign nodules (all P ＜ 0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of thyroid imaging reporting and data system (TI-RADS) in differentiation of malignant and benign thyroid nodules were 77％ (66/86),86％ (85/99),83％ (66/80),81％ (85/105) and 82％ (151/185),respectively.The positive rates of thyroid globulin antibody(TGAb) and thyroid peroxydase antibody (TPO-Ab) in malignant nodules [6％ (5/79) and 25％ (20/79)] were significantly higher than those in benign nodules [0 (0/94) and 12％ (11/94)] (both P ＜0.05).There was no significant difference in free T3 (FT3),free T4 (FT4) and TSH between the two groups [(4.91-± 0.78) vs.(4.93-± 1.98) pmol/L,(13.57 ±2.22) vs.(13.58 ±2.17)pmol/Land(1.78±1.40) vs.(1.88±2.36)mU/L] (allP＞0.05).The results indicate that TI-RADS grading and thyroid immunity index are valuable for differential diagnosis of thyroid nodules.

Objective:To investigate the clinical efficacy of loratadine combined with compositus mentholi cream in the treatment of infantile with external ear eczema and evaluate the safety .Methods:Totally 96 cases of infantile with external ear eczema were ran-domly divided into the observation group (n=48) and the control group (n=48) according to a random number table .Both groups were given the conventional treatment .The control group was treated with topical compositus mentholi cream , while the observation group was treated with loratadine additionally .Both groups were treated for 10 d.The clinical efficacy , the level changes of interleukin-4 (IL-4), interferon-γ(IFN-γ) and immunoglobulin-E (IgE) before and after the treatment, the incidence of adverse reactions during the treatment and the relapse after 6-month follow-up were compared between the groups .Results:The total effective rate of the obser-vation group (95.83%) was significantly higher than that of the control group (79.17%, P<0.05); the levels of IL-4, IFN-γand IgE in both groups were significantly decreased after the treatment (P<0.05), and those in the observation group were significantly lower than those in the control group (P<0.05);there was no significant difference in the incidence of adverse reactions between the groups (P<0.05); the recurrence rate in the observation group (8.33%) was significantly lower than that in the control group (22.92%, P<0.05).Conclusion:The clinical efficacy of loratadine combined with compositus mentholi cream in the treatment of infantile with external ear eczema is reliable with promising safety .

Objective To study the effect of reconbinant growrh hormone(rGH) on the tumor cell proliferation in the transplantation liver tumor models in rats,to explore the advantages and disadvantages of rGH in the treatment of liver carcinoma.Methods The male weaning rats were used to vaccinate and transgenerate by intraperitoneal injection of abdominal fluid contarning tumor cells from the celiar transplantation tumor rats, the others weaning rats were used to be the solid tumor rats by subcutaneous vaccination with abdominal fluid of tumor cells.The solid tumor were divided into pieces (2 mm?2 mm?3 mm),which were inserted into the liver of the 82 adult male rats to establish the transplantation liver tumor models.and then the models were divided into experimental group and control group randomly.After 3 days,experimental group were given rGH (0.5U/ kg?d)and control group were given via caudal vein NS for 5 days.All the rats were killed in 8d,10d,12d,respectively.The rats, tumors and livers were weighted,the number of hepatocytes,carcinoma cells and mitotic index were measured,the number of 3 H-TdR incorporation in vivo was measured in 8 days after operation. Results There were no significant difference in all the results between the two groups,except the rat's weight of 8days after operation and the tumor weight in different phase.Conclusions The rGH has no significant effect on the proliferation of tumor cell in transplantation liver models in rats.

Objective:To choose a best method of estimating the amount of blood loss after cesarean deliveryby comparing of three methods,to analyze the related factors of the amount of the blood loss more than 500ml after cesarean section.Methods:We collected the clinical data of the patients who were accepted cesarean delivery and treated in our hospital between January 2014 and December 2014.We estimate the amount of blood loss by different methods(including visually estimated,hematocrit (HCT) change and formula).Based on the formula method as the gold standard,we analyze the risk factors of the patients whose blood loss were more than 500 ml.Results:Among the 583 patients,using the method of visually estimated,there were 23 cases whose blood loss were more than 500 ml(3.95％),using the method of formula,there were 133 cases whose blood loss were more than 500 ml (22.81％),using the method of HCT change,there were 116 cases whose blood loss were more than 500 ml(19.90％).The incidence of patients whose blood loss were more than 500 ml between HCT change and formula method showed no significant difference(P ＞ 0.05),but the incidence by visually estimated method was less than the two other methods (P ＜ 0.05).We found the value of HCT change was a statistically significant positive correlation with the amount of blood loss more than 500ml.When the blood loss was more than 500 ml,the accuracy and sensitiveness of HCT method were significantly higher than those of visually estimated method(76.69％,87.93％ vs 12.78％,73.91％,respectively).Abnormal labor,uterine leiomyoma,placental factors,and macrosomia were risk factors of cases whose blood loss more than 500ml.Conclusions:HCT method is similar in accessing the blood loss after cesarean section with formula method,especially in the cases whose blood loss was more than 500 ml;HCT method is more convenient than formula method,and more accurate than visually estimated method.HCT method can be used as the standard for estimating blood loss initially,and formula method should be used as the method for estimating the blood loss accurately.Patients with macrosomia and abnormal labor are more likely to occur massive hemorrhage after cesarean section.