In vitro diagnosis of chronic nasal inflammation

BACKGROUND: Differential diagnosis of chronic nasal inflammation is insufficient when based solely on clinical examination and radiography of paranasal sinuses. Patients complain about more or less similar symptoms. Activation of mast cells and eosinophils is pivotal in nasal inflammation. OBJECTIVE: To compare tryptase and eosinophilic cationic protein (ECP) in nasal secretions in different forms of chronic nasal inflammation and to establish norm values. METHODS: The study included 1710 patients presenting with nasal complaints. Nasal secretions were gained by the cotton wool method and analysed for tryptase, as a marker of mast cell activation, and for ECP, as a marker of tissue eosinophilia and activation. Patients were grouped according to their diagnosis: chronic, non-allergic rhinosinusitis (sinusitis, n=194), non-allergic nasal polyposis (polyposis, n=138), non-allergic rhinitis with eosinophilia syndrome (NARES, n=198), isolated perennial allergic rhinitis (AR) (n=126), isolated seasonal AR (n=132), and patients allergic to both, seasonal and perennial allergens (n=193). Seven hundred and twenty-nine patients with nasal complaints due to a deviated septum and without any nasal inflammation served as controls. RESULTS: Nasal tryptase was highly significantly (P<0.001) elevated in polyposis, NARES, and in AR. ECP was highly significantly (P<0.001) elevated in all groups of patients suffering from chronic nasal inflammation. Based on our data and method we established norm values (95% confidence interval of mean value) for nasal tryptase in healthy adults, ranging from 12.0 to 18.7 ng/mL and for ECP ranging from 84.4 to 102.6 ng/mL. CONCLUSION: Mast cells and eosinophils are involved in non-allergic and allergic forms of chronic nasal inflammation. We established an in vitro assay for tryptase and ECP in nasal secretions and defined norm values based on our data and method. In vitro measurement of biological markers in nasal secretions provides important information for differential diagnosis and therapeutic strategies of chronic nasal inflammation.     

贝克曼4代和5代总β亚单位人绒毛膜促性腺激素测定试剂的分析性能验证及比较

目的 对Beckman第5代化学发光法检测总β亚单位人绒毛膜促性腺激素(total β-human chorionic gonadotropin,total βhCG)试剂分析性能进行评估.方法 参照CLSI EP15-A、EP6-A、EP9-A2方案,使用Beckman UniCel Dxi-800全自动免疫分析仪评估Beckman第4代和第5代Total βhCG试剂盒的精密度、分析测量范围、稀释回收率、携带污染率及第4代和第5代试剂的可比性.选择335名表观健康女性建立5代βhCG的参考区间(年龄19～ 84岁,其中绝经后162名).结果 第4代和第5代试剂检测低、中、高水平质控物的批内CV分别为2.2％～5.0％和2.0％～2.5％,总CV分别为3.5％ ～5.1％和2.4％～2.6％;定量下限分别为0.337和0.275 IU/L;2种试剂携带污染率均小于3％;分别使用wash buffer、蒸馏水、生理盐水对样本进行1∶1～1∶199倍稀释后,使用第4代和第5代试剂分别测定,稀释回收率分别为92％～ 114％和99％～ 113％.第5代与第4代试剂比对试验的回归方程为Y=1.144X+ 10.61 (R2 =0.990),百分偏差为-10.34％ ～ 35.62％.绝经后女性的βhCG水平显著高于绝经前女性(P＜0.01),第95百分位数分别为2.10和5.60 IU/L.结论 第5代试剂的各项指标能够满足临床需求,但两种试剂之间存在一定的系统偏差,实验室应重新建立和使用新的参考区间,并做好临床沟通.     

Medicolegal liability in laboratory medicine

The laboratory testing process, including the preanalytic, analytic, and postanalytic phases, is an area where errors frequently occur. These errors may impair the diagnostic process and compromise patient safety. Delay in diagnosis and failure to diagnose are common reasons for a medicolegal action. It is estimated that over 70% of medical decisions are made using laboratory data. For this reason, the laboratory is often involved either directly or indirectly in medical liability cases. The laboratory and hospital need to design systems that reduce the possibility of error and to rapidly identify and resolve the errors that do occur. Because the pre- and postanalytic processes extend into the clinical operations of the hospital, the laboratory can play an important role in promoting patient safety by assisting clinicians with test ordering, communicating test results appropriately, and aiding in the interpretation of results.     

Austrian height and body proportion references for children aged 4 to under 19 years

Abstract

Background: Previous studies have demonstrated differences between national and the WHO reference curves in children older than 5 years. Moreover, reference curves for body proportions (sitting height, subischial leg length and their ratio) based on state-of-the-art statistics are not available.

Aim: To develop reference curves for height and body proportions for use in Austria and compare the curves with WHO reference curves. To estimate and statistically investigate extreme percentiles.

Subjects and methods: A sample of ～14?500 children between 4–19 years of age was drawn via schooling institutions, stratified by provinces according to age- and sex-specific population proportions. GAMLSS models were used for a flexible estimation of percentile curves.

Results and conclusions: After the age of 5 years national reference curves are more suitable than the WHO reference curves for clinical use in Austria. These height curves are very similar to the German reference curves published recently. Therefore, these reference curves for criteria of body proportions are recommended for use in other populations. Further validation studies are needed to establish whether the recently recommended ?2.5 and ?3.0 SD for height are a sensitive and specific cut-off in the diagnostic work-up for children with a suspected growth disorder using this new Austrian height chart.     

初中生青春期性心理健康状况调查

目的了解初中生青春期性心理健康状况,为早期心理干预提供依据。方法整群抽取285名初中生施测青春期性心理健康量表,以SPSS17.0进行统计分析。结果①初中生总体性心理健康状况分量表均分高于4.0分的是自身适应、性态度,低于3.0分的是性知识;②不同性别初中生性心理健康状况比较,初中女生生理知识、性知识、性观念均分显著高于男生,差异有统计学意义(t=2.442,2.138,3.080,P<0.05或<0.01);③不同成长环境初中生性心理健康状况比较,农村学生性观念均分显著高于城市学生,差异有统计学意义(t=2.289,P<0.05);④是否是独生子女、不同家庭状况初中生性心理健康状况各分量表均分比较,差异均无统计学意义。结论初中生的自身适应较好,性态度较积极,性知识较欠缺。女生生理知识、性知识、性观念优于男生,农村学生性观念优于城市学生。     

Values as Moderators of the Association between Interpersonal-Psychological Constructs and Suicidal Ideation among Veterans

This study examined whether valuing relationships, achievement, and security moderated the association between interpersonal-psychological constructs (Joiner, 2005 Joiner, T. E. Jr. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.[Crossref] , [Google Scholar]) and suicidal ideation (SI). A total of 122 veterans completed the Interpersonal Needs Questionnaire, Survey of Life Principles, and Beck Scale for Suicide Ideation. Valuing relationships moderated the association between thwarted belongingness and SI. Specifically, thwarted belongingness predicted SI among veterans who reported moderate and high, but not low, levels of valuing relationships. The estimated impact of perceived burdensomeness on SI was stronger at higher levels of valuing relationships, but only approached statistical significance. Valuing achievement and security did not moderate the association between perceived burdensomeness and SI. Future research should continue to examine specific values as they relate to interpersonal-psychological constructs and suicidal behavior.     

氚相对生物效应的实验研究及遗传危害的估计

本研究采用指数下降剂量和相对恒定剂量照射小鼠,以显性致死突变、显性骨胳突变、精母细胞染色体畸变率,初级卵母细胞和精原细胞存活率,外周血淋巴细胞和骨髓有核细胞微核细胞率为生物终点,并⁶⁰Coy射线作为参考辐射,研究了氚的相对生物效应(RBE)值.结果表明:在剂量率为0.02～0.06Gy/d,连续照射10天的情况下,观察到氚的平均RBE值约为3.6～2.7之间,以外周血琳巴细胞微核细胞率为终点对RBE值最高,而初级卵母细胞存活率为终点时,RBE值最低,如果考虑到氚的遗传危害,如以显性骨胳突变为终点,则RBE值约大于3.     

18F-FDG PET/CT显像正常腹部消化器官的标准摄取值分析

目的分析^18F-脱氧葡萄糖（FDG）PET/CT显像正常腹部消化器官标准摄取值（SUV）的变化范围.方法60例要求行PET/CT检查的健康人,按体重7.77 MBq/kg静脉注射^18F-FDG,PET采集为三维模式,每个床位3 min.对腹部肝、胆囊、脾、胰腺、胃、盲肠、结肠和直肠进行半定量分析,各器官的SUV由横断面测量,准确定位时参考同机CT.结果正常腹部消化器官^18F-FDG摄取有较大差异,其中摄取较高者SUV平均值（SUVavg）依次为直肠、肝、乙状结肠、回盲部和脾、升结肠,SUV最大值（SUVmax）依次为直肠、乙状结肠、肝、回盲部、升结肠、脾.结论PET/CT显像能较好地识别腹部消化器官;熟悉正常腹部消化器官^18F-FDG摄取的差异,对判读图像十分重要.     

Monte Carlo estimates of absorbed dose rate in various tissues and organs

A computer program based on the Monte Carlo technique was developed for calculation of absorbed dose rate in various tissues and organs. The accuracy of the program was tested by reproducing Berger's values of the specific absorbed fractions for point isotropic sources in water, and a good agreement with those obtained by the moments method was found within an error of several percent. In comparing with experiment and other Monte Carlo results, good agreement was also obtained within the range of statistical error. The absorbed dose rate for an ¹²³I, ¹²⁴I, ¹²⁵I, ¹²⁶I and ^99mTc point source and their specific dose constants in various tissues and organs were calculated using this program. This computer program has the mass energy absorption and attenuation coefficients for 69 tissues and organs as a database file, and can be extended to various radionuclides used in nuclear medicine by adding their nuclear data to the program.     

Extrapolation of Normative KOOS,JR Data for the Young Patient Population Undergoing Knee Arthroplasty Procedures

Background

The Knee Injury and Osteoarthritis Outcome (KOOS), JR is a patient-reported outcome measure that is validated for patients undergoing total knee arthroplasty. The objective of this study was to provide normative data for the KOOS, JR in a relatively healthy US population visiting an outpatient orthopedic setting. This study is a cross-sectional study.