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Objective@#To investigate the correlation between postoperative recurrence and clinical parameters in patients with chronic rhinosinusitis with nasal polyps (CRSwNP), and to study predicitve value of total scores of eosinophils (EOS) and sinus CT for postoperative recurrence.@*Methods@#A retrospective analysis of 264 patients with CRSwNP who were admitted to the First Affiliated Hospital of Wenzhou Medical University from June 2013 to December 2015 was performed. The patient was subjected to a visual analogue scale (VAS) score, a skin prick test, a peripheral blood cell count, a sinus CT score, and a nasal polyp EOS count. All patients underwent endoscopic surgery and were followed up for at least 2 years. The demographic characteristics of the nasal polyps recurrence group and the non-recurrence group were compared with other clinical indicators. Quantitative data were compared by t test or Mann-Whitney U test, qualitative data were compared by chi-square test, and Logistic regression analysis was used for Logistic regression analysis. The risk factors for recurrence were assessed. The best cut-off value was determined by using the receiver operating characteristic (ROC) curve. The predictive value of the parameters was determined by area under curve (AUC). The difference was statistically significant at P<0.05.@*Results@#The recurrence rate of the study patients was 43.56% (115/264). Sex, olfactory VAS score, total sinus CT score, peripheral blood neutrophil ratio, peripheral blood EOS absolute value and proportion, and tissue EOS absolute value and proportion were associated with postoperative recurrence of nasal polyps (χ2=5.241, t=-3.146, t=-7.441, χ2=180.617, t=-5.313, χ2=100.067, t=-7.471, χ2=258.916, all P<0.05), and the tissue EOS ratio and total sinus CT scores have higher predictive value for recurrence of nasal polyps (AUC values were 0.793, 0.767, respectively, all P<0.001). With the EOS ratio of nasal polyps >0.032, the sensitivity of predicting recurrence was 83.48%, the specificity was 56.38%. With the total score of sinus CT>15, the sensitivity of predicting recurrence was 51.30% and the specificity was 87.25%. The combined sensitivity of predictive recurrence was 92.00% and the specificity was 49.20%.@*Conclusion@#The percentage of EOS in nasal polyps and the total score of sinus CT in patients with CRSwNP have better predictive diagnostic value for recurrence of nasal polyps.
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Objective@#To evaluate the efficacy of treatment at 1 year after completing the 2-year specific sublingual immunotherapy in patients with allergic rhinitis (AR).@*Methods@#A retrospective analysis of 124 patients with AR who were allergic to dust mite and treated in the First Affiliated Hospital of Wenzhou Medical University since 2012 was performed. All patients achieved sublingual immunotherapy (SLIT) for 2 years and had a regular follow-up over 1 year. Efficacy evaluation index such as VAS score, total nasal symptom score and total medication score were compared between the time of SLIT for 2 years, and 1 year after termination of SLIT. Paired t test was used for the comparison of scores.@*Results@#Compared with those before treatment, the VAS score, total nasal symptom score and total medication score at the time of SLIT for 2 years were significantly decreased in all patients with AR [(9.40±5.96) vs (24.78±6.36), (4.53±2.06) vs (9.51±2.02), (0.42±0.87) vs (3.02±0.41), t value was 17.627, 24.600, 5.331, respectively, all P<0.01]. Compared with 2 years SLIT treatment, VAS score and total nasal symptom score were significantly increased than 1 year after termination of immunotherapy [(12.52±6.92) vs (9.40±5.96), (5.30±2.36) vs (4.53±2.06), t=5.199, 3.744, respectively, all P<0.01], but the total medication score showed no significant difference [(0.34±0.84) vs (0.42±0.87), t=-1.043, P>0.05].@*Conclusions@#The symptoms after 2 years SLIT in patients with AR have been well controlled. One year after the termination of SLIT, there is a certain rebound in symptoms, 2 years SLIT may not be the ideal treatment cycle for AR.
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OBJECTIVE To investigate the correlation between eosinophils(Eos) and CT findings in patients with chronic rhinosinusitis(CRS).METHODS The clinical data of 355 CRS patients who were treated at the First Affiliated Hospital of Wenzhou Medical University from January 2013 to June 2015 were studied.Friedman stage and Lund score and pathophysiological Eos count were recorded in all cases.The results were divided into eosinophilic CRS(ECRS) group and non-eosinophilic CRS(non-eosinophilic CRS,NECRS) group.The scores of CT findings of the two groups were compared and analyzed,and the correlation of the results of CT scores and the number of Eos in the tissue were explored.RESULTS There was a significant difference in total CT scores between ECRS and NECRS groups(Z=1.674,P＜0.01),but there was no significant difference in CT scores among T1,T2,T3 and T4 stages(Z=1.011,0.892,0.612,0.80,P＜0.01).And CT scores were positively correlated with Eos counts and percentages in the tissues (correlation coefficients r were 0.216,0.223,P＜0.01).CONCLUSION 1.The difference of Eos in the tissue of the CRS is the cause of different CT manifestations.2.The more Eos count or the percentage,the higher the CT scores of patients with chronic sinusitis,which means the more severe of the CT imaging.
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OBJECTIVE To evaluate the difference of efficacy of sublingual immunotherapy on different age patients with allergic rhinitis. METHODS 229 patients with dermatophagoides farina drops allergic rhinitis who have finished SLIT at least 2 years were enrolled and analyzed by retrospective analysis. All patients were divided into different age groups: pre-adolescence(n=107), adolescence(n=53), adulthood(n=69). Indexes for therapeutic effects of SLIT visual analogue scale(VAS) score, rhinitis symptom scores, medication scoreintra- and inter groups were assessed during different stage of treatment(3 months, 1 year and 2 years). Data were analyzed with SPSS 19.0 software. RESULTS Compared with prior treatment, after the SLIT for 3 months, 1 year, 2 years, VAS scores, rhinitis symptom scores, medication scoresof all the patients with allergic rhinitis are significantly decreased; Differences of rhinitis symptom scores(H=0.844, 4.153, 2.669, P>0.05), VAS score(H=1.356, 3.720, 0.313, P >0.05), medication scores(H=1.044, 5.841, 3.399, P>0.05) between groups had no statistical significance at different stage after treatment(3 months, 1 year and 2 years); The differences between 2 years and 1 year of SLIT treatment showed statistical significance in the VAS scores(Z=1.635, P =1.635). CONCLUSION SLIT with dust mites drops had good curative effect and security in patients with allergic rhinitis, which hadno obvious difference between different age groups.