Research progress in the establishment of allergic rhinitis mouse model / 中华耳鼻咽喉头颈外科杂志

The number of patients with allergic rhinitis (AR) have been increasing in the world. Establishment of AR model in mice is an important method for the study of this disease. However, there is still no consensus standard for the modeling methods, selection of allergens and adjuvants, and evaluation parameter of AR modeling. Here, we introduce the advancement of AR mouse model in recent years from the above, and provide evidence of references for the standardized process of AR mouse model establishment.

Long non-coding RNA XIST modulates cisplatin resistance by altering PDCD4 and Fas-Lexpressions in human nasopharyngeal carcinoma HNE1 cells / 南方医科大学学报

OBJECTIVE@#To explore the role of long non-coding RNA (lncRNA) X inactive specific transcript (XIST) in modulating cisplatin (DDP) resistance of human nasopharyngeal carcinoma cells and investigate the possible mechanism.@*METHODS@#Realtime PCR was performed to detect the expression of XIST in cisplatin-resistant human nasopharyngeal carcinoma cell line HNE1/DDP. The effects of up-regulation and down-regulation of XIST on DDP resistance, proliferation and apoptosis of HNE1/ DDP cells were assessed using MTT assay, EdU assay and flow cytometry. Western blotting was used to detect the changes in the expressions of programmed cell death 4 (PDCD4) and Fas ligand (Fas-L) proteins in the cells in response to up-regulation or down-regulation of XIST.@*RESULTS@#The expression of XIST was significantly up-regulated in HNE1/DDP cells in comparison with HNE1 cells (0.57±0.06 0.1±0.02, < 0.05). Down-regulation of XIST significantly decreased while up-regulation of XIST obviously increased DDP resistance of HNE1/DDP cells ( < 0.05). Down-regulation of XIST significantly reduced the proliferation (6.17 ± 1.93 16.59 ± 4.86, < 0.05) and enhanced apoptosis [(18.04 ± 4.72)% (4.22 ± 1.65)%, < 0.05], while upregulating XIST enhanced the proliferation (25.40±7.21 13.16±3.95, < 0.05) and inhibited apoptosis [(2.82±0.88)% (6.46± 1.75)%, < 0.05] in HNE1/DDP cells. Down-regulation of XIST significantly increased the protein expressions of PDCD4 and Fas-L ( < 0.05) in HNE1/DDP cells, and up-regulation of XIST resulted in reverse changes in PDCD4 and Fas-L expressions ( < 0.05).@*CONCLUSIONS@#XIST is up-regulated in HNE1/DDP cells, and down-regulation and up-regulation of XIST expression reduce and increase DDP resistance of the cells, respectively, possibly as a result of changes in the expressions of PDCD4 and Fas-L.

Tracheal sleeve resection and end-to-end anastomosis in management of severe tracheal stenosis / 中国耳鼻咽喉头颈外科

OBJECTIVE To review the clinical and image features of the patients with grade III-IV tracheal stenosis, and the surgical outcomes of tracheal sleeve resection and end-to-end anastomosis in the treatment of severe tracheal stenosis. METHODS Between July 2008 and July 2016, 20 patients with grade III-IV tracheal stenosis underwent tracheal sleeve resection and end-to-end anastomosis. RESULTS Postoperative decannulation was achieved in 17 patients(85.0％), and restenosis developed in 3 patients(15.0％). Postoperative complications were: 1 case wound infection, 4 cases subcutaneous emphysema, 3 cases temporary unilateral vocal fold palsy. Suture dehiscence, irreversible injury of the recurrent laryngeal nerves was not observed in our patients. No perioperative mortality occurred. CONCLUSION The tracheal sleeve resection and end-to-end anastomosis represent a viable treatment for severe tracheal stenosis. Long segment stenosis should not be considered as a contraindication. This surgical method should be considered cautiously in patients with diabetes.

Chinese Society of Allergy Guidelines for Diagnosis and Treatment of Allergic Rhinitis

Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.

Study on the situation regarding endoscope cleaning and disinfection in the department of otolaryngology in Hunan hospitals / 中南大学学报(医学版)

OBJECTIVE@#To investigate the situation regarding the cleaning and sterilization of endonasal endoscopes in department of otolaryngology in Hunan Province, and to provide strategy for improving the level of sterilization and management of endonasal endoscopes.
@*METHODS@#A total of 100 medical institutions were investigated by spot assessment, check and sampling. Data was analyzed by multivariate analysis.
@*RESULTS@#The qualified rate of rules and regulations for endoscopy was 28.8% in the second-class hospitals and 45% in the top-class hospitals. The qualified rate of environment for endoscopy cleaning and sterilization was 36.3% in the second-class hospitals and 85% in the top-class hospitals. The main problems include lack of independent disinfection room, the space not large enough, and/or lack of ventilation system. The qualified rate of bacterial detection for post-sterilized endoscopes and biopsy forceps was 93.8% in the second-class hospitals and 95.0% in the top-class hospitals, and the main pathogenic bacteria was gram-positive cocci and gram-negative bacilli. The multivariate analysis showed that the influencial factors for endoscope cleaning and disinfection are as follows: staffs responsible for the cleaning and sterilization of otolaryngology endoscopes, the standard for cleaning and disinfection process, and the frequency of endoscope use.
@*CONCLUSION@#The present situation of cleaning and sterilization for otolaryngology endoscopes is better in the top-class hospitals than that in the second-class hospitals. The sterilization and management of otolaryngology endoscopy are needed to be improved, and the staff training is needed, especially in the primary hospitals.

Long-term efifcacy of standardized speciifc subcutaneous immunotherapy on pediatric persistent allergic rhinitis / 中国耳鼻咽喉头颈外科

OBJECTIVETo observe the long-term therapeutic efficacy of standardized specific subcutaneous immunotherapy on persistent allergic rhinitis in children. METHODSFrom Jan. 2007 to Aug. 2009, 236 children with persistent allergic rhinitis were divided into two groups, which 120 cases underwent standardized house dust mite allergen subcutaneous specific immunotherapy (SCIT), another 116 cases accepted a serious of steroids nasal spray and oral antihistamine (control group). The efficacy of the patients was evaluated by using the visual analog scale (VAS) and Rhino conjunctivitis quality of life questionnaire (RQLQ).RESULTSAfter patients underwent 3-years SCIT, the VAS score was 2.3±0.7, 2.4±0.6, 1.6±0.4, 1.9±0.5, and the RQLQ score was 7.7±1.6, 7.4±1.1, 4.3±0.7, 4.1±0.9, respectively, at the follow-up period of 3 month, 1 year, 3 years and 5 years, and both scores were significantly lower than the score of pre-treatment (P0.05). No serious adverse events occurred in all treatments.CONCLUSIONThe standardized specific immunotherapy has the long-term efficacy for dust mite positive children with persistent allergic rhinitis. It demonstrated a similar effect in both single dust mite positive patients and multiple allergens positive patients.

Risk factors and intervention strategies for the elementary and middle school students with allergic rhinitis in Changsha / 中南大学学报(医学版)

OBJECTIVE@#To analyze the risk factors for allergic rhinitis and provide the scientific basis for disease control and intervention through investigation of the elementary and middle school students with allergic rhinitis in Changsha.@*METHODS@#From January to April 2012, we randomly enrolled the elementary and middle school students aged at 10-17 years old in Changsha. We explored the risk factors for allergic rhinitis by using stratified and cluster sampling survey, questionnaire investigation, physical examination, skin pricking needling experiment and statistical analysis.@*RESULTS@#A total of 814 students were investigated in cluster sampling survey. The result of the incidence of allergic individual was 26.3% and the prevalence of allergic rhinitis was 17.2%. Analysis of Visual Analog Scale Questionnaire (VAS) showed that allergic rhinitis exerted significant effect on student's character, memory, sleep quality, etc.@*CONCLUSION@#The prevalence of allergic rhinitis in the elementary and middle school students aged in Changsha is 17%-20%. The incidence and development is related to environment, genetic and living habits, which affects people's character, memory and sleep quality significantly.

Potential risk factors of excessive epistaxis after endoscopic endonasal surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the potential risk factors and management of excessive epistaxis after endoscopic endonasal surgery (EES).@*METHOD@#Six hundred and forty-one patients who underwent EES in our hospital from December 2011 to December 2012 were reviewed retrospectively. Factors which potentially affect the incidence of excessive epistaxis after EES were analyzed with univariate and multivariate logistic regression model.@*RESULT@#The incidence rate of excessive epistaxis after EES was 8.4% in our study. Multivariate logistic regression analysis revealed that history of previous EES, along with other four factors, correlated significantly with the occurrence of excessive epistaxis after EES.@*CONCLUSIONS@#Previous EES, along with other three factors, may increase the chance of excessive epistaxis after EES, while pre-operative corticosteroid therapy may reduce the risk to some extent.

Epidemiological investigation and related risk factors analysis of allergic rhinitis in primary and middle school students in Changsha / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the epidemiological characteristics and related risk factors of allergic rhinitis in primary and middle school students in Changsha so that to provide the scientific basis for the disease control and intervention.@*METHOD@#From June 2011 to April 2012, we randomly chose primary and middle school students aged from 10 to 17 years old in Changsha as our research objects. Through stratified sampling and cluster sampling, we carried out epidemiological investigation using questionnaire investigation, physical examination and skin prick test. After statistical analysis of the data,we explored the related risk factors.@*RESULT@#(1) 7,023 copies of questionnaire were sent out and 6,407 copies of valid questionnaire were received in the stratified sampling survey. The prevalence of complaining about having got allergic rhinitis is 44.6% while the real rates is 20.5%; (2) 814 research objects were investigated in cluster sampling survey. The result of the incidence of allergic rhinitis is 26.3%, and the prevalence of allergic rhinitis is 17.2%. Analysis of Visual Analog Scale Questionnaire showed significant influence of allergic rhinitis on students character, memory, sleep quality, etc.@*CONCLUSION@#The prevalence of allergic rhinitis in primary and middle school students aged at 10-17 years old in Changsha is 17%-20%. The occurrence and development of allergic rhinitis is related to environment, genetic background and living habits. Allergic rhinitis influenced the students' character, memory and sleep quality significantly.

Evaluation of quality-of-life and therapeutic effects of endoscopic sinus surgery in patients with chronic rhino-sinusitis using the SNOT-20 questionnaire / 中南大学学报(医学版)

OBJECTIVE@#To explore the therapeutic effects of endoscopic sinus surgery on symptoms and quality of life of patients with chronic rhino-sinusitis (CRS).@*METHODS@#A survey of symptoms and quality of life was conducted using Sino-nasal Outcome Test-20 (SNOT-20) questionnaire with 76 patients before and after endoscopic sinus surgery. The overall effect of endoscopic sinus surgery on CRS was subjectively self-evaluated by patient.@*RESULTS@#After 6 months following-up, the total SNOT-20 score of patients was significantly decreased from the baseline (P<0.001). The most important 5-items were found to be "thick nasal discharge", "need to blow nose", "dizziness", "frontal pain", and "lack of a good sleep". Other items, related to sleep and emotion, were also significantly improved: the proportion of responses of "much improved", "improved" and "no-improved" were 56.3%, 33.3%, 10.4%, respectively.@*CONCLUSION@#Endoscopic sinus surgery demonstrated positive effects on symptoms and quality of life of CRS patients.

Differential expression of taxol resistance and taxol resistance reversal related genes in nasopharyngeal carcinoma by cDNA microarray / 中南大学学报(医学版)

OBJECTIVE@#To compare the difference in gene expression profiles between parental cell line and drug resistant cell line (CNE-1 and CNE-1/taxol) pre-treated or treated by drugs, and search for genes related to taxol resistance and reversal of taxol resistance phenotype.@*METHODS@#cDNA microarray was used to detect the difference in gene expression profiles between 6 groups of cells. Combination of multiple filtering genes and detailed analysis of documented resistance genes were used to analyze the data.@*RESULTS@#Through multiple filtering, 297 differentially expressed genes were screened. The expression of 17 genes was increased or decreased more than 5 folds in CNE-1/taxol compared with CNE-1.Through analyzing documented drug-resistant genes, MDR1 expression was not detected in each group. CYP1A1, one of P450 family members, was not expressed in CNE-1, but significantly increased expressions was found in CNE-1/taxol and these increased expressions were restored by cisplatin. The expression level of some members of tumor necrosis factor family was decreased in CNE-1/taxol and restored by cisplatin, including TNFAIP1, 3 and TNFRSF12A, 21. The differentially expressed members in the caspase family were caspase-4 and caspase-6. The expression of β-tubulin II was down-regulated in CNE-1/taxol. TSP1 was obviously down-regulated in CNE- 1/taxol compared with CNE-1, and a more significant down-regulation of TSP1 was found when treated by taxol. However, it was greatly up-regulated after cisplatin treatment in CNE-1/taxol.@*CONCLUSION@#Some genes are probably related to taxol resistance and reversal of taxol resistance in NPC cells: 297 differentially expressed genes detected by multiple filing, CYP1A1, some members of TNF family and another 17 genes whose differential expression is more than 5 folds between parental cell line and drug resistant cell line. Combination of multiple filtering genes and detailed analysis of documented resistance genes is a good method to study drug resistance and reversal of drug resistance in carcinoma cells.

Management of postoperative complications of basicranial tumor resection under nasal endoscopy / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore medical and nursing management of postoperative complications of basicranial tumor resection through nasal endoscopy.@*METHOD@#Retrospective analysis was carried out in 178 patients with skull base tumors who underwent nasal endoscopic resection of basicranial tumors under general anesthesia, and controlled hypotension was conducted during the surgery. Different surgical approaches were applied in terms of anatomical regions which the tumor involved.@*RESULT@#Postoperative complications occurred in 87 of 178 patients, including cerebrospinal fluid rhinorrhea, intracranial infections, diabetes insipidus, etc. Eighty-five cases with complications recovered through proper medical and nursing care, except for 2 cases of death.@*CONCLUSION@#Because there is a higher risk for nasal endoscopic basicranial procedure, doctors and nurses are required to master multidisciplinary skills and experiences. Careful and rigorous nursing care of postoperative complications is quite important for successful management of basicranial operative patients.

Aeroallergen spectrum of patients with child allergic rhinitis in Changsha area of China / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate aeroallergen spectrum and allergy positive rates of patients with child allergic rhinitis and analyze its related factors.@*METHOD@#Skin prick test was carried out in 562 cases with child allergic rhinitis using 13 inhaled allergens, and detailed history was collected in all cases.@*RESULT@#Four hundred and fifty-seven (81.3%) of 562 cases showed positive reaction to at least one allergen out of 13 allergens. The most common allergens found in patients was Dermatophagoides farinae and Dermatophagoides pteronyssinus, and positive reaction was 93.1% in child allergic rhinitis, followed by tropical mite, Periplaneta americana, Blattella germanica and dog hair. The pollen allergen, most common in American and European, was pretty rare in this study. The prevalence of child allergic rhinitis was significantly higher in urban than in rural (P<0.01). There was no adverse effect appeared in children with allergic rhinitis underwent skin prick test.@*CONCLUSION@#The major allergen of allergic rhinitis is mite for child allergic rhinitis, and relates to housing enviroment. Most of patients with child allergic rhinitis can be treated by the mite specific immunotherapy. The skin prick test is a safe technique for diagnosis of children with allergic rhinitis.

Nasal endoscopic-assisted surgery for adults cleft palate repair / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the efficacy of nasal endoscopic-assisted surgery for adults cleft palate repair.@*METHOD@#We designed and made two suitable nasal mucoperiosteal flaps in nasal cavities, then released the nasal mucoperiosteal flaps to the level of hard palate and sewed up two flaps on the midline of oral cavity to repair the nasal side of cleft palate.@*RESULT@#Nine of 11 patients were healed after three months following-up. The bilateral palatal mucoperiosteal flap were separated in the front of hard palate in 2 patients, however they were not perforated due to well-healing of nasal mucoperiosteal flaps and second stage surgery was not necessary.@*CONCLUSION@#The cleft palate could be repaired using the tensionless nasal mucoperiosteal flap with good blood supply, and'procedures could be carried out under nasal endoscopy. Endoscopic-assisted surgery for cleft palate repair was simple to perform, and its effect was satisfactory.

Study on biocompatibility of hydroxyapatite/high density polyethylene (HA/HDPE) nano-composites artificial ossicle / 生物医学工程学杂志

This study was aimed to evaluate the biocompatibility of Hydroxyapatite/High density polyethylene (HA/ HDPE) nano-composites artificial ossicle. The percentage of S-period cells were detected by flow cytometry after L929 cells being incubated with extraction of the HA/HDPE nano-composites; the titanium materials for clinical application served as the contrast. In addition, both materials were implanted in animals and the histopathological evaluations were conducted. There were no statistically significant differences between the two groups (P >0.05). The results demonstrated that the HA/HDPE nano-composite artificial ossicle made by our laboratory is of a good biocompatibility and clinical application outlook.

Aeroallergen spectrum of 387 patients with allergic rhinitis in Changsha area / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate aeroallergen spectrum of patients with allergic rhinitis in Changsha area and analyze its related factors.@*METHOD@#Skin prick test was carried out in 463 cases with allergic rhinitis using 13 inhaled allergens, and detailed history was collected in all cases.@*RESULT@#Three hundred and eighty-seven cases (83.6%) showed positive reaction to at least one allergen of 13 allergens. The most common allergens found in patients were Dermatophagoides farinae and Dermatophagoides pteronyssinus, followed by tropical mite, Periplaneta americana, Blattella germanica and dog hair. The rate of positive reaction to only one specie allergen were 51.9%, and most of them were positive reaction to mites (49.6%). The degree of positive reaction was significantly related to family history, asthma, age and housing environment.@*CONCLUSION@#The major allergen of allergic rhinitis is mite, and the degree of positive reaction relates to genetics, asthma, age and housing environment.