Efficacy of Sublingual Immunotherapy for House Dust Mite-Induced Allergic Rhinitis: A Meta-Analysis of Randomized Controlled Trials

PURPOSE: Allergic rhinitis (AR) has become a global issue for a large part of the general population. Sublingual immunotherapy (SLIT) has been used extensively to treat persistent allergic rhinitis (PAR). Although systematic reviews have confirmed the effectiveness of SLIT for the treatment of AR, a considerable number of studies using extracts of house dust mites (HDMs) for immunotherapy found no consensus on basic treatment parameters and questioned the efficacy of SLIT. METHODS: In this study, we evaluated SLIT for PAR by a meta-analysis of randomized controlled trials (RCTs). Medline, Embase, and Cochrane Library database searches were performed for RCTs on the treatment of PAR by SLIT that assessed clinical outcomes related to efficacy through May 2016. Descriptive and quantitative information was abstracted. An analysis was performed with standardized mean differences (SMDs) under a fixed or random effects model. Subgroup analyses were performed. Heterogeneity was assessed using the I2 metric. RESULTS: In total, 25 studies were eligible for inclusion in the meta-analysis for symptom scores and 15 studies for medication scores. SLIT was significantly different from the controls for symptom scores (SMD=1.23; 95% confidence interval [CI]=1.74 to 0.73; P<0.001). For medication scores, significant differences for SLIT were also observed versus the controls (SMD=-1.39; 95% CI=-1.90 to -0.88; P<0.001). CONCLUSIONS: Our meta-analysis indicates that SLIT provided significant symptom relief and reduced the need for medications in PAR. In this study, significant evidence was obtained despite heterogeneity with regard to the use of mite extract. Specifically, the mite extract used was provided by the patients with PAR. Furthermore, to confirm both the objective outcomes and the effective doses of HDM allergen extracts, experimental data should be obtained from large high-quality population-based studies.

Efficacy of intranasal corticosteroids-gelatin sponge in the treatment of nasal adhesion after nasal endoscopic sinus surgery / 中国耳鼻咽喉头颈外科

OBJECTIVE To compare the effect of intranasal corticosteroids-gelatin sponge and saline-gelatin sponge in the treatment of nasal adhesion.METHODS A total of 208 noses(170 patients) with nasal adhesions after receiving the endoscopic sinus surgeries from July,2012 to December,2015 were selected.All the cases were divided randomly into two groups:the treatment group and the control group.Both groups received separation treatments of the nasal adhesions.The intranasal corticosteroidsgelatin sponges were used as the separation material for the treatment group,while saline-gelatin sponges for the control group.The severity score and the time of treatment were evaluated as the indicators for curative efficacy of the treatment in each case.The differences of efficacy between two groups were analysed statistically.RESULTS The severity scores of the two groups after the treatment were both substantially lower than those before the treatment;The after-treatment severity scores of the treatment group were significantly lower than those of the control group;the times of treatment in the treatment group were substantially lower than those of the control group.The differences stayed for 3 months,and they became insignificant after 3 months.CONCLUSION The intranasal corticosteroids-gelatin sponge can be a quicker and more effective treatment of nasal adhesion in comparison with saline-gelatin sponge.

Correlation between the HPV type and clinical course of juvenile onset recurrent respiratory papillomatosis / 中国耳鼻咽喉头颈外科

OBJECTIVE To study on the influence of human papilloma virus(HPV) type on the clinical course of juvenile onset recurrent respiratory papillomatosis(JORRP).METHODS Fresh tumor specimens of 38 patients were collected and the HPV type of the specimens was detected by flow fluorescent hybridization method.According to the results,children were divided into HPV6 and HPVll positive groups.The clinical data of the two groups were compared.RESULTS Among 38 children with recurrent respiratory papillomatosis,21(55.2％) were infected with HPV6,14(36.8％) were infected with HPVll,and 3(7.9％) were negative for HPV 6 or HPV 11.The proportion of aggressive cases in HPV6 and HPV11 groups were similar.The age of onset,preoperative clinical symptom score,number of anatomic locations,anatomic Derkay/Coltrera score and Dikkers score were significant different between the two groups (P=0.002,0.040,0.023,0.001,0.005,respectively).CONCLUSION JORRP patients with HPV11 infection had the features of smaller onset age,more severe clinical symptoms and broader invasion compared with HPV6 infection.

Effect and postoperative reaction of nasal endoscopic low temperature plasma radiofrequency ablation on children with snoring / 中国内镜杂志

Objective To study the effect and postoperative reaction of nasal endoscopic low temperature plasma radiofrequency ablation on children with snoring. Methods 104 cases with snoring received surgical treatment from May 2013 to May 2015 were divided into experimental group and control group. The experimental group patients re-ceived nasal endoscopic low temperature plasma radiofrequency ablation, the control group received adenoidectomy curettage combined with tonsillectomy. Then the surgery condition, postoperative pain, stress response and ventila-tion function were compared between the two groups. Results Operation indicator: the experimental group operation time, postoperative pain time, symptoms remission time, intraoperative blood loss were significantly lower than the control group ( < 0.05); Pain degree: 6 h, 24 h, 48 h, 72 h after surgery, the experimental group VAS score were significantly lower than that in control group ( < 0.05); Stress reaction: 24 h after surgery, the experimental group patients serum MDA, 8-isoPG, 3-NT content were significantly lower than that in control group, SOD, GSH content were significantly higher than that in control group ( < 0.05); Ventilation function: 6 months after surgery, the ex-perimental group AHI, ODI, SLT90%, LAT were significantly lower than that in control group, LSaO2 were signifi-cantly higher than that in control group ( <0.05). Conclusion Nasal endoscopic low temperature plasma radiofre-quency ablation can reduce surgical trauma and relieve postoperative pain and stress reaction, improve ventilation function, it's an ideal operative method for the treatment of children with snoring.

Clinical observation and esophageal dynamical analysis of esomeprazole combined with itopride in the treatment of gastroesophageal relfux disease / 中国耳鼻咽喉头颈外科

[ABSTRACT]OBJECTIVETo study the changes of symptoms, signs and esophageal dynamics characteristics of laryngopharyngeal reflux diseases(LPRD) before and after treatment with esomeprazole and itopride.METHODS The suspected LPRD patients were took the diagnostic treatment with esomeprazole and itopride. Reflux finding score(RFS), reflux symptoms index(RSI) score and high-resolution esophageal pressure were evaluated before and after treatment. The patients were divided into pure LPRD group and LPRD with GERD group according to gastroesophageal reflux disease(GERD) questionnaire scores.RESULTS There were 38 patients confirmed with LPRD(pure LPRD group:12 cases, LPRD with GERD group:26 cases). The BMI, age, gender ratio had no statistical difference between the two groups(P>0.05). In LPRD group, RSI had significant difference before and after treatment(Z=-3.009,P0.976). In LPRD with GERD group, the RSI and RFS had significant difference before and after treatment(P0.05), but in LPRD with GERD group, esophageal dynamic parameters of UESP, LESP, DCI, DL had significant difference before and after treatment(P<0.05).CONCLUSIONIn pure LPRD group, the reflux symptoms improved obviously after treatment, but the signs may need treatment for more time. Esomeprazole combined with itopride can improve the esophageal dynamics in LPRD with GERD group, but can not improve that in pure LPRD group. The results suggested that the LPRD and GERD have different pathogenesis.

Juvenile onset respiratory papillomatosis: risk factors for severity / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#This study was designed to explore the risk factors associated with severity of juvenile onset recurrent respiratory papillomatosis.@*METHOD@#A retrospective study was conducted to study determinants of severe forms of juvenile recurrent onset respiratory papillomatosis. The patients were separated into different groups based on the onset age, the first recurrence of age, the first recurrence of period, gender and incision of tracheal respectively. The relationship among the lesion severity score,the involvement of the subregion, operation period and the next operation period were also explored.@*RESULT@#It was observed that some children who recurred before 4 years old required more surgery, shorter operation period(the average, longest or shortest operation period) than those elder children, the differences were statistically (P=0. 029, 0. 003, 0. 010, 0. 039, respectively). The severity score of lesion was correlated positively with the involvement of the subregion and negatively with operation period (r=0. 914, -0. 451, respectively). Some children who diagnosed before 4 years old had to endure more severity score and shorter operation period than those older children, the differences were statistically (P= 0. 036, 0. 000, respectively). 8 cases accepted incision of tracheal, they accepted more surgery too. But the differences in the onset age, the first recurrence of age, and the operation period were not statistically.@*CONCLUSION@#The results showed that the clinical course of juvenile onset recurrent respiratory papillomatosis was closely related to the first recurrence age and period, while the severity of disease was associated to the onset age and the involvement of the subregion.

Function study of non-syndromic deafness associated mitochondrial 12S rRNA A839G mutation / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the correlation between nonsyndromic deafness and mitochondrial 12s rRNA A839G mutation.</p><p><b>METHODS</b>According to the clinical manifestations of mitochondrial DNA sequencing and analysis to find and determine family containing mitochondrial 12s rRNA A839G mutation. Harvested its family members blood and transferred their lymphocytes into lymphoblastoid cell lines, followed by cells cultured, cell doubling experiment, susceptibility testing, cellular oxygen consumption rate experiment, ROS and mitochondrial membrane potential experimental tests were progressed to explore the correlation between the A839G mutation and nonsyndromic deafness.</p><p><b>RESULTS</b>The mitochondrial 12s rRNA A839G mutation pedigrees were determined through the full sequence detections of the Mitochondrial DNA, further phylogenetic analysis showed that 839 point conservative index (CI) up to 78.6%; in RPMI-galactose medium containing A839G gene mutant cell line, the doubling time was significantly longer than the control group, and the difference was significant (P = 0.033). The effect to cell lines containing the A839G mutation of aminoglycoside drugs was not obvious. When compared with the control group, cell lines containing the A839G mutation significantly reduced cellular oxygen consumption rate(P = 0.033); compared with the control group, the ROS levels of cell lines containing the A839G mutation appeared more substantial elevated with significan difference (P < 0.01). The mitochondrial membrane potential of cells of experimental group was significantly reduced than the control group.</p><p><b>CONCLUSION</b>The present study proved that the mitochondria 12s rRNA A839G mutations affect the function of the mitochondrial respiratory chain at the cell level, which might reduce the growth rate of the mutant cell lines, result in hearing.</p>

Levels of serum IL-4, IFN-gamma, IL-32 in children with juvenile-onset recurrent respiratory papillomatosis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the relationship between serum IL-4, IFN-gamma, IL-10 levels and the aetiology of juvenile-onset recurrent respiratory papillomatosis.@*METHOD@#Serum IL-4, IFN-gamma, IL-32 levels of 15 JORRP children were detected by use of enzyme-linked immunosorbent assay (ELISA) and compared with those of healthy control group.@*RESULT@#Serum IL-4 levels were significantly higher in the JORRP children (P<0.01): (524.65 +/- 147.77)pg/ml in the JORRP children and (213.27 +/- 87.48) pg/ml in the healthy control group. Serum IFN-gamma levels were significantly lower in the JORRP children (P<0.01): (2.87 +/- 0.84) pg/ml in the JORRP children and (10.63 +/- 5.09) pg/ml in the healthy control group. Serum IL-32 levels were significantly lower in the JORRP children (P< 0.01): (2.47 +/- 1.60) pg/ml in the JORRP children and (9.08 +/- 2.66) pg/ml in the healthy control group.@*CONCLUSION@#1) While the concentration of Th2 like cytokine IL-4 in children with JORRP was higher than that in control group, the concentration of Th1 like cytokine IFN-gamma in children with JORRP was lower than that in controls, indicating that the polarization of Th1 /Th2 T cell in children with JORRP; 2) The polarization of Th1/Th2 T cell may cause the reduction of the serum IL-32 as a proinflammatory role in host immunity system that could not eradicate HPVs because of lacking enough inflammatory stimulation.