ABSTRACT
Objective At present,there are relatively few studies on the application of pepsin in the diagnosis of laryngopha -ryngeal reflux disease(LPRD)in China.This paper aimed to evaluate the application value of Peptest in the diagnosis of LPRD by measuring saliva/sputum pepsin in patients with chronic pharyngitis. Methods From January to June 2017,35 patients with chronic pharyngitis treated in our department were selected to undertake electronic laryngoscopy and evaluated by reflux finding score(RFS) and reflux symptom index(RSI)scoring.The patients'saliva/sputum samples were collected three times for pepsin concentration de-tection(PEPTEST).The first collection was before mouthwash in the morning,the second was 1h after lunch,and the third was the time of evident symptoms.Comparative research was carried out on the above results. Results The average RSI score and RFS score were11.31±6.21 and 5.97±1.98.The pepsin content in morning saliva/sputum[26.80(0,109.80)ng/mL]was significantly lower than that at 1 h after lunch[89.00(16.0,254.8)ng/mL]and that at the time of obvious symptoms[105.70(34.3,254.8)ng/mL](P<0.05).The area under ROC of Peptest in the morning[0.759(0.602, 0.917)],1h after lunch[0.824(0.670,0.978)], at the time of ob-vious symptoms were all greater than the combination of RSI and RFS, representing significant statistical differences(P<0.05). Conclusion Compared with traditional method(a combination of RSI and RFS),Peptest has more important clinical value in the diag-nosis of LPRD.
ABSTRACT
OBJECTIVE@#To compare the symptoms and lower airway inflammatory factors of patients with allergic rhinitis (AR), and to observe the effect of nasal irrigation in the treatment of allergic rhinitis.@*METHOD@#Sixty-one cases diagnosed as AR after skin prick test (SPT)were selected and randomly divided into three groups: 17 patients in group A used nasal steroid spray; 21 cases in group B used nasal irrigation; 23 patients in group C combined ir rigation with nasal steroid. Before and after 3 months treatment, nasal visual analogue scale (VAS) score, rhino conjunctivtis quality of life questionnaire (RQLQ) score, fractional exhaled nitric oxide (FENO) values were observed and compared in each group.@*RESULT@#Before treatment, there is no statistically difference between three groups (P > 0.05). After 3 months of treatment, VAS, RQLQ, FENO of all patients was significantly decreased (P 0.05), FENO value has no statistically significant difference between group A and group B (P > 0.05), but were less than that in group C (P < 0.05).@*CONCLUSION@#Nasal irrigation can ameliorate nasal symptoms, improve quality of life, decrease lower airway inflammation of allergic rhinitis patients. Nasal irrigation is an effective treatment of allergic rhinitis. Nasal irrigation combined with nasal steroid can achieve more significant efficacy.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Nasal Lavage , Quality of Life , Rhinitis, Allergic , Therapeutics , Treatment OutcomeABSTRACT
<p><b>BACKGROUND</b>Epinephrine infiltration of the nasal mucosa causes hypotension during functional endoscopic sinus surgery (FESS) under general anesthesia. A prospective randomized-controlled study was designed to determine whether relatively light general anesthesia is superior to fluid expansion in reducing epinephrine-induced hypotension during FESS.</p><p><b>METHODS</b>Ninety patients undergoing elective FESS under general anesthesia were randomly assigned to three groups with 30 patients in each. Each patient received local infiltration with adrenaline-containing (5 microg/ml) lidocaine (1%, 4 ml) under different conditions. For Group I, anesthesia was maintained with propofol 2 microg/ml and rimifentanil 2 ng/ml by TCI. Group II (control group) and Group III received propofol 4 microg/ml and rimifentanil 4 ng/ml, respectively. In Groups I and II, fluid expansion was performed with hetastarch 5 ml/kg within 20 minutes; hetastarch 10 ml/kg was used in Group III. Mean arterial pressure (MAP) and heart rate (HR) were recorded at 30-second-intervals for 5 minutes after the beginning of local infiltration. Simultaneously, the lowest and the highest MAP were recorded to calculate the mean maximum increase or decrease percent in MAP for all patients in each group. Data analysis was performed by chi(2) test, one-way analysis of variance, or one-way analysis of covariance.</p><p><b>RESULTS</b>Hemodynamic changes, particularly a decrease in MAP accompanied by an increase in HR at 1.5 minutes (P < 0.05), were observed in all groups. The mean maximum decrease in MAP below baseline was 14% in Group I, 24% in Group III and 26% in Group II. There were statistically significant differences between Group I and Groups II and III (P < 0.05). The mean maximum increase in MAP above baseline was 9% in Group I, 6% in Group III and 2% in Group II.</p><p><b>CONCLUSION</b>Relatively light general anesthesia can reduce the severity of epinephrine-induced hypotension more effectively than fluid expansion during FESS under general anesthesia.</p>