Evaluation of measurement uncertainty in routine coagulation assays in medical laboratory / 国际检验医学杂志

Objective To explore the application of evaluation of measurement uncertainty in routine coagulation assays based on the data of internal quality control (IQC) and results of external quality assessment (EQA) .Methods Data of clinical coagulation assays of clinical laboratory of Xiangyang city hospital were collected ,Which came from six months of IQC and 3 times of EQA of ministry of health clinical laboratory center from 2012 to 2013 .The combined and expanded uncertainties of 3 measurements(PT , APTT and Fbg) were evaluated according to CNAS top-downapproach .Results When PT were in 12 .72 s and 21 .04 s ,its ex-panded uncertainty were 1 .06 s and 1 .96 s ,and APTT in 36 .6 s and 50 .6 s were 2 .59 s and 5 .30 s ,and Fbg in 3 .32 g/L was 0 .30 g/L .Conclusion Evaluation of measurement uncertainty by using internal quality control data and EQA results for routine coagula-tion detection index is economical and practical and acceptable way ,with good clinical practice .

The relevance of leukotriene D4 synthase gene A(-444)C polymorphism to clinical responsiveness of leukotriene receptor antagonist in patients with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the leukotriene D4 synthase gene A (LTD4S A)-444 C polymorphism in persistent allergic rhinitis (AR) of Chinese Han nationality and to evaluate its relevance to clinical responsiveness of leukotriene receptor antagonist.@*METHOD@#There were 150 patients [87 males, 63 females, average age (38 +/- 14)] diagnosed with persistent AR in Allergy clinic in our hospital from March 2010 to March 2012; 146 healthy controls (78 males, 68 females, mean age (39 +/- 12)). We detected LT D4SA-444C polymorphism and allele frequencies with Polymerase Chain Reaction (PCR) and-Restriction Fragment Length polymorphism (RELP). The treatment group received monotherapy leukotriene receptor antagonist (montelukast) for 4 weeks. Urinary leukotriene D4 (LTD4) levels were detected by enzyme-linked immunosorbent assay (ELISA) before and after treatment, respectively. We evaluated anti-leukotriene treatment response according to the changement of symptoms, signs PTS and urinary LTD4. We tested correlation between LT D4S gene-444C allele frequency and the treatment response by multivariate analysis of variance.@*RESULT@#(1) LTD4S gene-444 genotype AA/CC, AC/CC frequency is 70.7% (106/150) and 29.3% (44/150), allele A, C frequencies is 67.3% (101/150) and 32.7% (49/150) in AR group, and LTD4S gene-444 genotype AA/CC, AC/CC frequency is 76.7% (112/146) and 23.3% (34/ 146), allele A, C frequencies is 74.0% (108/146) and 26.0% (38/146) in healthy control group, there is not statistically significant difference between two groups. (2) Among 150 AR patients, compared to patients with AA/CC genotype, the genotype AC/CC patients are younger [average age (35 +/- 9), and (50 +/- 18) respectively, F = 5.891, P < 0.05], with earlier age of onset [(31 +/- 4), and (46 +/- 6) respectively, F = 6.985, P < 0.05], longer course of disease [(8.7 +/- 2.1), and (3.1 +/- 2.0) respectively, F = 11.43, P < 0.05], higher symptom scores (8.2 +/- 0.2; 4.8 +/- 0.3), higher signs score (7.3 +/- 3.3; 3.4 +/- 5.1), and the difference was statistically significant. (3) After 4 weeks of montelukast treatment in AR patients, treatment response of anti-leukotriene in genotype AC/ CC patients is better than those in AA/CC genotype patients (F = 11.01, P < 0.05), the differences of treatment response between two groups were correlated with LTD4 levels in vivo, clinical symptoms and signs of patients.@*CONCLUSION@#In a Chinese Han population the LTD4SA-444B polymorphism might be one of the factors in the clinical response to leukotriene receptor antagonists in persistent AR patients.

Relationship between eosinophils in nasal discharge and responses to treatment of inhaled glucocorticosteroid in patients with persistent allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the treatment responses of persistent allergic rhinitis with and without eosinophils (EOS) in nasal discharge to inhaled glucocorticosteroid (CS), and therefore to verify whether low eosinophil level in nasal discharge can predict poor response to treatment with CS.@*METHOD@#Forty-two symptomatic allergic rhinitis patients, who had not received CS therapy in three months preceding the study, were examined before and 2 month, 4 months and 6 months after treatment with CS. At each visit, all patients underwent symptom scoring and physical sign scoring. The level of eosinophil cationic protein (ECP) in the nasal discharge supernatants was measured by radioimmunoassay. The patients were divided into 2 groups according to nasal discharge EOS percentages, an EOS group (EOS > or = 3%) and a non-EOS group (EOS 0.05), but the ECP level did improve (F = 3.78, P < 0.05). The average daily dose of CS was not different between the two groups at any visits.@*CONCLUSION@#In persistent allergic rhinitis with low EOS in nasal discharge, CS therapy for 6 months failed to improve symptoms and physical signs.

Study of three-grade preventive health education and lifestyle intervention in the treatment of allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Investigate the effect of three-grade preventive health education and lifestyle intervention in the treatment of allergic rhinitis (AR).@*METHOD@#Two hundred and ten selected cases needed for triple prevention were randomly divided into three groups, each group included 70 cases were undertaken for a three-year randomized controlled study. Group A, treated with Budesonide nasal spray. Group B, combined Budesonide nasal spray with Hydrochloric acid left Kabbah Sting nasal spray. Group C, taking health education management and lifestyle intervention on the basis of group B's therapy. A health lecture or health problems counseling and the dissemination of health education information were undertaken, quarterly. It was mainly for health knowledge awareness, and healthy behaviors formation rate guidance. Lifestyle intervention included a balanced diet, avoiding the allergens of living environment and aerobic exercise (daily 0.5-1.0 h). The score of the signs and symptoms in each group were obtained respectively at the beginning of study, 1 year after intervention and 3 years after intervention, as well as the comparison of patient compliance of follow-up.@*RESULT@#The improved score of the signs and symptoms, endoscopy and radiological results were used to evaluate the treatment effect. There was no significant difference among the score of signs and symptoms in three groups. Comparing in group, before intervention,1 year after intervention and 3 years after intervention, the signs and symptoms of patients in three groups had improvement at different degree. The score of four symptoms (rhinobyon, rhinorrhoea, rhinocnesmus, sneezing) and signs were significant lower than before the intervention, there were a significant difference (P < 0.05). There were 8 patients in group A (11.43%), 6 patients in group 13 (8.57%) and 1 patient in group C (1.43%) lost to follow-up at 3 years after the intervention. The patient compliance of group C was significantly higher than groups A and B.@*CONCLUSION@#Triple prevention health education for AR can significantly improve the treatment compliance of AR patients for treatment, while ensuring clinical efficacy.

Changes of leukotriene D4 in nasal discharge and plasma of patients with persistent allergic rhinitis and the effects of antihistamine / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the changes of leukotriene D4 (LTD4) in nasal discharge and plasma of patients with persistent allergic rhinitis (AR) and the effects of antihistamine.@*METHOD@#The investigation was a prospective, randomized controlled trial. Forty AR patients (group C) were divided randomly into two subgroup. One group received oral antihistamine 10 mg everyday for one week (group CA) and another group received no loratadine tablets 10 mg everyday for one week (group CB). Fifteen age matched healthy (group D) people were enrolled as control. The level of LTD4 and interleukin-5 (IL-5) in both nasal discharge and plasma by using enzyme linked immunosorbent assay (ELISA) and enzyme immunoassay (EIA), cell counts and cell differentials in nasal discharge, were measured before and after three month. The clinical symptom and life quality scores of group C were also investigated.@*RESULT@#The concentrations of LTD4 in nasal discharge [(794 +/- 305) pg] and plasma [(5219 +/- those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P 1185) ng/L] in group C were significantly higher than those in group D [(347 +/- 169) pg, (2283 +/- 489) ng/L, all P 0.05).@*CONCLUSION@#The results suggested that LTD4 was involved in airway inflammation in AR. Antihistamine was not effective enough in decreasing the levels of LTD4 in both nasal discharge and plasma of AR patients.

Clinical research of Ibudilast on treating the steroid resistant allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the efficacy and safety of histamine H1 receptor antagonist loratadine with Leukotriene receptor antagonist Ibudilast in steroid resistant allergic rhinitis in a randomized controlled clinical trial.@*METHOD@#Thirty-five cases were treated by Ibudilast, and 34 cases by loratadine. Score system was used to compare the therapeutic effect of these two drugs on clinical symptoms and signs.@*RESULT@#Ibudilast shows a better curative effect than loratadine in the improvement of the total scores on clinical symptom and signs(P<0.05). Scores of symptoms and signs in Ibudilast group after 3, 7, 14 days decreased significantly by means of square analysis of single factor (P<0.01). No complication was observed.@*CONCLUSION@#Ibudilast can effectively alleviate the clinical symptoms and signs of steroid resistant allergic rhinitis with confirmed efficacy and safety, thus is recommended in steroid resistant allergic rhinitis. Increased doses or prolonged treatment of steroid is inappropriate.

Effects of long term use of beclomethasone dipropionate nasal spray on bone density with perennial allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the effects of long term use of beclomethasone dipropionate (BDP) nasal spray on bone density with perennial allergic rhinitis (AR) in adults.@*METHOD@#A 5-year randomized study was conducted on the effects of BDP nasal spray on serum calcium, phosphorus, alkaline phosphatase, and bone density determined before and after the treatment in 36 adult patients with perennial AR. 20-45 years of age, were randomly divided into 3 groups. That is group A (nasal spray 1 - or =5 year). The data were analyzed by paired t test.@*RESULT@#The perennial AR were followed up for more than > or =1 year, > or =3 year and > or =5 year to observe the influences of nasal spray BDP. There were no significant difference between the data examined before and after the treatment (P > 0.05). Bone development is not influenced by nasal spray BDP < or =400 microg/d within 5 years.@*CONCLUSION@#Long term use of BDP nasal spray in adult patients does not lead to osteoporosis if the lowest effective steroid dose is given.

Effect of Ibudilast on the quality of life of patients with steroid resistant allergic rhinitis:a randomized,double blind,controlled study / 中国耳鼻咽喉头颈外科

OBJECTIVE To assess the effect of Ibudilast on the quality of life (QOL) of patients with steroid resistant allergic rhinitis.METHODS A randomized,double-blind,placebo-controlled study was carried out with Ibudilast in 66 patients with the steroid resistant allergic rhinitis.QOL was measured with Short-Form Health Survey (SF-36) questionnaire (Chinese version).Ibudilast (10rag twice daily,34 patients),placebo (32 patients) was given for 3 weeks. The SF-36 questionnaire was administered at the start of treatment and after 3 weeks of treatment.Sings and Symptom-medication scores were measured daily during the study.RESULTS There were no significant differences between the Ibudilast and placebo group in terms of sings and symptoms or QOL scores before study.After 3 weeks of treatment,symptoms scores were significantly decreased and QOL scores significantly improved in the Ibudilast group compared with those in placebo group (both P