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Objective To investigate the application of fiberoscope on upper airway compliance in OSAHS patients with MSMSMS. Methods From May 2014 to December 2015,93 patients with OSAHS in Jinhua Central Hospital were detected by MSMSMS[including 32 mild cases (MI),31 moderate cases (MO),and 30 severe cases (SE)] underwent electronic nasopharyngeal examination combined with the Muller test. The course of 93 OSAHS patients were recorded,including body mass index (BMI),sleep apnea index (AHI),mean oxygen saturation. The degree of collapse in the patients' soft palate area,tongue,epiglottis after area were calculated by the software. The results were analyzed by SPSS15. 0 statistical software. Results The disease courses between the mild group and moderate group [(4. 93 ± 2. 91)years,(8. 91 ± 4. 87)years],as well as between the moderate group and severe group [(4. 93 ± 2. 91)years,(9. 27 ± 4. 75) years],had statistically significant differences (t = - 3. 97,P = 0. 001;t =- 4. 33,P < 0. 001). The pairwise intergroup comparison of AHI among the three groups[(7. 75 ± 2. 49) times, (23. 24 ± 3. 74)times,(53. 27 ± 13. 59)times] showed statistically significant differences(t = 15. 49,P = 0. 000;t =- 45. 52,P = 0. 000;t = - 30. 02,P = 0. 000). The differences of MSaO2 between the mild group and severe group [(94. 25 ± 1. 11)％ vs. (94. 45 ± 0. 72)％ ],as well as between the moderate group and severe group[(94. 45 ± 0. 721)％ vs. (91. 40 ± 3. 17)％ ] had statistically significant differences ( t = 2. 85,P = 0. 000;t = 3. 05,P =0. 000). In the SE,there was a positive correlation with mean oxygen saturation (r = 0. 45,P = 0. 007). The collapse of soft palate area among the three groups had statistically significant differences (t = 3. 74,P = 0. 005;t = - 8. 39, P = 0. 000;t = - 4. 65,P = 0. 001). The collapse of posterior tongue area between the moderate group and mild group [(72. 65 ± 1. 56)％ vs. (66. 69 ± 8. 64)％ ],the mild group and severe group[(66. 69 ± 8. 64)％ vs. (74. 33 ± 10. 96)％ ] had statistically significant differences (t = 5. 96,P = 0. 008;t = - 7. 65,P = 0. 001). There was no statistically significant difference between the moderate group and severe group in the collapse of posterior tongue area (P > 0. 05). There were statistically significant differences between the mild group and moderate group[(63. 84 ± 8. 81)％ vs. (75. 06 ± 5. 07)％ ],the mild group and severe group[(63. 84 ± 8. 81)％ vs. (76. 40 ± 7. 94)]in the collapse of epiglottic area (t = 11. 22,P = 0. 000;t = - 12. 56,P = 0. 000). There was no statistically significant difference between the moderate group and severe group in the collapse of epiglottic area(P > 0. 05). Conclusion Fiberoscope combined with Müller test can respond better upper airway compliance in OSAHS patients with MSMSMS. It is worth to promote in clinic.
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Objective To evaluate the efficacy of low-dose and long-term clarithromycin in treatment of chronic rhinosinusitis with positive bacterial biofilms.Methods Seventy-seven patients with chronic rhinosinusitis and positive bacterial biofilms underwent functional endoscopic sinusitis surgery between January 2008 and December 2009 in department of otolaryngology of Jinhua Central Hospital.Fortytwo patients were treated with clarithromycin 250 mg/d orally for at least 3 months (trial group).At the end of 3 months patients received endoscopic examination,for patients with mucosal epithelialization the clarithromycin therapy was stopped; for those with mucosal edema,granulation or polyoid formations the clarithromycin treatment was continued,but no longer than 5 months.Thirty-five patients in control group were not given clarithromycin.All patients were assessed by visual analogue scale (VAS) and nasal endoscopic examination (Lund-kennedy score) 6 months after surgery,the results were compared between two groups.Results Two patients in the trial group did not complete the protocol.VAS score and Lundkennedy score in trial group were 8.0 ± 0.8 and 3.6 ± 1.3 at 6 month after surgery respectively,while those in the control group were 7.3 ± 0.7 and 4.5 ± 1.7,and the differences were of statistical significance (t =5.311 and-3.187,P ＜ 0.01).Conclusion Low-dose and long-term oral administration of clarithromycin has positive impact on the prognosis of bacterial biofilms positive patients with chronic rhinosinusitis.
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Objective To observe the bacterial biofilm in patients with chronic rhinosinusitis (CRS), and to investigate the possible relationship between biofilm and clinical factors. MethodsSixtynine patients with CRS ( study group), 15 patients with nasal septum deviation and 10 patients with nasal bone fracture (control group) were enrolled in the study. Mucosa specimens of uncinate process or ethmoid near the ostium of the maxillary sinus were obtained during endoscopic sinus surgery. The specimens were subjected to scanning electron microscopy. All patients were evaluated by questionnaire of chnical factors based on sino-nasal outcome test-20. SPSS 10. 0 was used for statistical analysis, and the relationship between bacterial biofilm and clinical factors was evaluated by Chi-square test. ResultsBacterial biofilms were found in 49 patients ( 71.0％ ) with CRS. A marked destruction of the epithelium and cilia was observed in all samples of study group. No bacterial biofilm was found in the control group, and scanning electron microscopy showed normal epithelium and cilia in those specimens. Chi-square test showed that bacterial biofilm was not associated with clinical factors (gender, staging, course, nasal obstruction, phlegm, nasal discharge with stinking smell, headache, bloody nasal discharge and olfactory degeneration) in CRS. ConclusionsBacterial biofilms and destruction of the epithelium and cilia can be obscrved in CRS patients, which may be involved in the pathogenesis of CRS, but the formation of bacterial biofilm is not correlated with the clinical factors in CRS.
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<p><b>OBJECTIVE</b>To explore the presence of bacterial biofilms (BF) in patients with CRS and the effect of BF on clinical symptoms and postoperative outcomes.</p><p><b>METHODS</b>Seventy-two patients with chronic sinusitis were enrolled in this study. The control group included 15 patients with deviation of the nasal septum and 10 patients had a fracture of the nasal bone. Mucosa of the uncinate process or ethmoid near the ostium of the maxillary sinus was obtained during endoscopic sinus surgery. The specimens were subjected to scanning electron microscopy. Patients were followed for 1 year and observed by the Lund-Kennedy endoscopy, and the Haikou standard classification (ESS-1997). Statistical analysis was performed by t-test or chi-square test.</p><p><b>RESULTS</b>Three patients were lost to follow-up. The scanning electron microscopy analysis showed bacterial biofilms in 49 of the 69 patients with chronic sinusitis. A marked destruction of the epithelium and cilia was observed in samples positive for bacterial biofilms. No bacterial biofilms were detected in the control group, and scanning electron microscopy showed normal epithelium and cilia in those specimens. There was no significant difference in gender, classification or duration of disease between the BF(-) and BF(+) groups. At six months and one year postoperative, the Lund-Kennedy endoscopy scores for CRS patients with BF (4.78 +/- 1.67; 4.55 +/- 1.61) were significantly higher than those without BF (3.65 +/- 1.39; 3.65 +/- 1.18) (t = -2.654, P < 0.01; t = -2.264, P < 0.05). Based on the Haikou standard classification, there was a significantly difference between patients with BF and those without BF (chi2 = 18.014, 22.063, P < 0.001, respectively).</p><p><b>CONCLUSIONS</b>Different life stages of bacterial biofilms were demonstrated to be present in CRS. Gender, classification or duration of disease did not affect the presence of bacterial biofilms in patients with CRS. There is a correlation between bacterial biofilms and an unfavorable outcome in patients with CRS after ESS.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Biofilms , Case-Control Studies , Chronic Disease , Follow-Up Studies , Microscopy, Electron, Scanning , Nasal Mucosa , Microbiology , Nasal Polyps , Microbiology , Rhinitis , Microbiology , Sinusitis , MicrobiologyABSTRACT
Objective To investigate the relationship between bacteria biofilm and bacterial culture in patients with chronic rhinosinusitis (CRS). Methods Ninety patients with CRS were enrolled in the study. Five patients with deviation of nasal septum and 10 healthy subjects served as controls. Mucosa of uncinate process or near the ostium of the maxillary sinus was obtained during endoscopic sinus surgery. All specimens were processed for bacterial culture and scanned by electron microscopy. Pearson test was performed to analyze the relationship between the presence of bacterial biofilm and the results of bacteria culture. Results The scanning electron microscopy showed bacterial biofilms in 64 (71.1%) out of 90patients with CRS, while the positive rate of bacteria culture in the study group was 66.7% (60/90). No bacterial biofilm and bacterium was detected in the control group and 26 culture-negative individuals in study group. Pearson correlation analysis showed a statistically association between bacterial biofilm and bacterial culture in CRS ( r = 0. 901, P = 0. 000). Conclusion Positive results of bacteria culture are highly correlated with the presence of bacterial biofilm in CRS patients.