Validation of the Chinese version of Hull airway reflux questionnaire and its application

groups．The morphological indices in coronary lesions as-sessed by QCA had no differences between the two groups．During a median of24months of follow-up，58 patients（11．2%）had clinical endpoints events．Age，smoking history，hypertension history，TC，TG，HDL-C，white blood cell count，levels of OPG above-median，hs-CＲP，SBP，DBP，and BMI were used as the inde-pendent variables，and the clinical and events as the de-pendent variable．Forward stepwise logistic regression a-nalysis showed that HDL-C，levels of OPG above-medi-an，hs-CＲP were the independent risk factors in elderly patients．The risk of cardiovascular events in patients with levels of OPG above-median was2．510fold higher than those with levels of OPG below-median．Conclu-sion High levels of OPG and hs-CＲP are the independent risk factors for the occurrence of coronary heart disease in the elderly with intermediate coronary lesions．（Authors）9Ｒespiratory System2016314Gene typing and antibiotic resistance of methicillin-resistant Staphylococcus aureus isolated from lower respiratory tract at two hospitals in Shanghai．WANGＲen（王仁），et al．Dept Pulmon Med，Ｒuijin Hosp，Shanghai Jiaotong Univ Med Sch，Shanghai200025．Chin J TubercＲespir Dis2016；39（4）：286-290．Objective To study the genotyping characteristics and antibiotic resistance of methicillin-resistant Staphylo-coccus aureus（MＲSA）isolated from lower respiratory tract at2different level hospitals in Shanghai．Methods The subjects included155patients atＲuijin Hospital and Tongren Hospital between January2013and June2014，including108males and47females，with a mean age of 67．8ʃ16．5．The155MＲSA strains were isolated from lower respiratory tract specimens and multilocus sequence typing（MLST）and spa typing were analyzed by the PCＲmethod．The antimicrobial resistance of MＲSA was test-ed by VITEK-32．Fisher's exact test was used for statisti-cal analysis．Ｒesults Among the155strains，28MLST-spa molecular types were identified，of which ST764-t002（41．29%），ST239-t037（17．42%）and ST239-t030（10．32%）were the most predominant types．The MＲSA strains were susceptible to linezolid，vancomycin and teicoplanin，and also had a lower resistance to trime-thoprim-sulfamethoxazole and rifampin，with a suscepti-ble rate of83．9%and83．2%respectively，but were highly resistant to other antibiotics．The resistance rate of ST239-t037to trimethoprim-sulfamethoxazole was higher than that of other types，and the resistance rate of ST239-t030to rifampin was higher than that of other types，the differences being significant（P＜0．001）．The mean length of hospital stay of the155patients was （97ʃ84）days，and mechanical ventilation was used in 78（50．3%）patients，while108（69．7%）patients re-ceived invasive procedures．Broad-spectrum antibiotics were used in136（87．1%）patients．There were differ-ences in age，hospitalization days，smoking history，his-tory of COPD，mechanical ventilation，and operation be-tween the2hospitals（P＜0．05）．Conclusion Most of the MＲSA strains atＲuijin Hospital and Tongren Hospi-tal between January2013and June2014were multi-drug resistant，and the susceptibility spectrum of different genotypes was different．（Authors）2016315Validation of the Chinese version of Hull airway reflux questionnaire and its application in the evaluation of chronic cough．HUANG Yun（黄芸），et al．DeptＲespir Med，Tongji Hosp，Tongji Univ Med School，Shanghai20065．Chin J TubercＲespir Dis 2016；39（5）：355-361．Objective To validate the effectiveness，repeatabili-ty and treatment responsiveness of the Chinese version of Hull airway reflux questionnaire（HAＲQ），and to deter-mine its clinical value．Methods A standard Chinese version of HAＲQ was developed by an established trans-lation procedure and its repeatability was assessed in a preliminary study involving55untreated patients with stable chronic cough．Thereafter，a total of132patients with chronic cough referred to our respiratory clinic were recruited into the study between May2014and April 2015．After their cough was evaluated with the HAＲQ，cough symptom score or cough reflex sensitivity to in-haled capsaicin and the correlations among them were an-alyzed，and the causes of chronic cough in all the pa-·851·China Medical Abstracts（Internal Medicine）tients were presumptively determined according to an es-tablished diagnostic protocol and finally confirmed with the subsequent therapy specific to the etiologies．After two weeks of effective treatment，HAＲQ，cough symptom score and cough reflex sensitivity to inhaled capsaicin were measured once more，and treatment responsiveness was calculated．The score of the HAＲQ in132patients with chronic cough was compared with that in104health-y volunteers．Ｒesults The repeatability of the Chinese version of the HAＲQ was validated at a week interval with the intraclass correlation coefficients of0．96（95% CI：0．93－0．98，P=0．00）for total score（n=55）．No correlation was found between the HAＲQ and cough symptom score，and the HAＲQ showed a weak negativecorrelation with cough threshold C2（rIgC2=－0．23，P=0．01）but not with C5．The value of HAＲQ was signifi-cantly higher in patients with chronic cough than in healthy volunteers［20．00（14．00，28．00）vs4．00（2．00，6．00），Z=－12．89，P=0．00］，but no differ-ence of HAＲQ in gender or age existed in chronic cough．Although all the patients with various etiologies of chronic cough had an increased value of HAＲQ，cough due to gastroesophageal reflux showed the highest HAＲQ score among them［28．50（25．00，32．25）vs18．50（14．00，26．25），Z=4．43，P0．00］．After two weeks of effec-tive treatment，the HAＲQ score decreased from20．00（14．00，28．00）pre-treatment to10．00（4．25，17．75）post-treatment（Z=－6．06，P=0．00），with52．04% of score change ratio，1．38of effect side and1．97of standard response mean respectively．Conclusion HAＲQ is a reliable and valid tool for the management of chronic cough with good treatment responsiveness，and may be used as an easy way to predict cough due to gastroesoph-ageal reflux．（Authors）2016316The distribution characteristics of etiology of chronic cough in Lanzhou．LIU Weiying（刘维英），et al．DeptＲespir Med，1st Hosp，Lanzhou Univ，Lanzhou730000．Chin J TubercＲespir Dis2016；39（5）：362-367．Objective To explore the distribution characteristics of etiology and clinical feature of chronic cough in Lanzhou．Methods Based on the guidelines of the diag-nostic process of chronic cough in China，data of medical history and physical examinations were collected，and chest X-ray，pulmonary function plus airway hyperre-sponsiveness，induced sputum eosinophils，sinus X-ray or CT，24h esophageal pH monitoring，chest high-reso-lution CT and bronchoscopy were performed accordingly for outpatients with chronic cough．The cause of chronic cough was identified by the test results and treatment re-sponse．The results were compared with those reported previously in other areas of China．Ｒesults A total of173 patients with completed data were collected，including90 males and83females．The causes were as follows：45ca-ses（26．01%）of cough variant asthma，35（20．23%）upper airway cough syndrome，20（11．56%）allergic cough，17（9．83%）chronic pharyngitis，14（8．09%）gastroesophageal reflux，14（8．09%）postinfectious，13（7．51%）eosinophilic bronchitis，8（4．62%）chronic bronchitis，4（2．31%）cough associated with ACEI，3（1．73%）bronchial tuberculosis，2（1．16%）pulmona-ry fibrosis and bronchiectasis repectively．The causes of the remaining14patients（8．09%）were unknown．The cuases of chronic cough were identified in159patients （91．91%），of whom141（88．68%）with a single cause and18（11．32%）with more than2etiological fac-tors．The percentage of cough variant asthma in our se-ries was significantly higher than that reported in Guang-zhou（13．6%，χ2=5．60，P=0．018，P＜0．05），but lower than that reported in Shenyang（39．4%，χ2= 7．91，P=0．004，P＜0．01）．The percentage of allergic cough was higher than that reported in Beijing（3．3%，χ2=6．66，P=0．010，P＜0．05），and that of eosino-philic bronchitis was lower than those reported in Guang-zhou（22．4%，χ2=22．38，P=0．000，P＜0．01）and Shenyang（12．5%，χ2=8．09，P=0．005，P＜0．01）．The percentage of esophageal reflux cough was lower than that reported in Beijing（20．3%，χ2=9．40，P=0．002，P＜0．01）but higher than that reported in Shenyang （1．9%，χ2=3．98，P=0．036，P＜0．05）．Conclu-sion In Lanzhou，cough variant asthma，upper airway cough syndrome，allergic cough，chronic pharyngitis and gastroesophageal reflux were the main causes of chronic cough，and the etiological distribution was different from Guangzhou，Beijing，Shenyang and other areas．（Authors）·951·2016Vol33No3。