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 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.

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.

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 prepare voriconazole albumin nanoparticles and evaluate the characteristics of pharmacokinetics and tissue distribution in rats.Methods: Voriconazole albumin nanoparticles were prepared by a new ultra-high pressure microfluidization technology.The physicochemical properties of voriconazole albumin nanoparticles were studied, such as the particle size distribution, zeta potential and particle shape.The release of voriconazole from albumin nanoparticles was investigated in pH7.4 phosphate buffered saline.The concentrations of voriconazole in plasma and the other different tissues were determined after the tail-vein injection of voriconazole albumin nanoparticles in rats.Results: Voriconazole albumin nanoparticles were homogeneous small spheres as seen under a transmission electron microscope.The average particle diameter was (121.9±41.6) nm, the polydispersity index was 0.197, and the zeta potential was (-42.1±0.9) mV.In 0.5% Tween-80 phosphate buffered saline (pH7.4), the in vitro cumulative release of voriconazole albumin nanoparticles reached up to 67.5% in 24 h.AUC0-24 of voriconazole albumin nanoparticles and voriconazole injection was (98.27±1.42) and (105.32±1.45) g/L/h, and MRT0-24 was (4.48±0.38) and (4.86±0.51) h, respectively.Conclusion: Voriconazole albumin nanoparticles can prolong the circulation time, and exhibit promising targeting ability in liver, spleen and brain.

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.

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.

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.