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.

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.

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.

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.

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.

The minimally invasive surgery means treatment that can remain homeostasis, reduce tissue damage, benefit body recovery and prognosis. The typical techniques of minimally invasive surgery in gynecology are laparoscope and hysteroscope, which can replace nearly all kinds of traditional gynecology surgery and have superior curative effect. After 10 years clinical practice, we found that reasonable application of laparoscope play a significant role in ensuring the surgery quality and postoperative living quality, on account of the greater risk by new surgery instruments and various sorts of energy. The popularization of gynecology minimally invasive surgery is influenced by the regional economic development and update of doctor's ideology, so it is important to train the surgeons and change their ideas.

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.