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.

The study of risk factors of nasal septal perforation in rats / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the risk factors and interaction of nasal septal perforation (NSP) in rats.@*METHOD@#Animals (n=120) that underwent unilateral nasal obstruction using Merocel nasal packing or gelfoam with/without standard staphylococcus aureus inoculation were observed for the formation of NSP at 2, 3, 5, and 7 days after operation by endoscope system. Following sacrifice at 7 days, the obtained nasal secretions were prepared for bacterial culture. Experimental interventions were compared with normal controls (n=10).@*RESULT@#Perforation of nasal septum was observed in 80% of the animals accepted nasal obstruction using Merocel nasal packing with standard staphylococcus aureus inoculation in 3 days (P 0.05). There was a weak region in anteroinferior nasal septum in rats, which the almost NSPs located in. The position of NSP does not overlap Merocel.@*CONCLUSION@#The interaction of risk factors contributes to NSP. The occurrence of NSP mainly depends on the construction of nasal septum, while dysaemia is also necessary. Obstruction of nasal drainage and infection promote the development of NSP.

Clinical study of the bone conduction thresholds before and after tympanoplasty in chronic suppurative otitis media / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the relative factors of the changes of preoperative and postoperative bone conduction thresholds in chronic suppurative otitis media.@*METHOD@#The preoperative and postoperative bone conduction thresholds were prospectively investigated in 45 patients with unilateral chronic suppurative otitis media after tympanoplasty. Preoperatively (within 3 days before operation), 10 dB or more depression of bone conduction threshold at least in consecutive 2 frequencies between 0.25 kHz and 8.00 kHz was considered to be significant. Similarly in the postoperative period (3 months after operation), 10 dB or more improvement or impairment of bone conduction threshold at least in consecutive 2 frequencies between 0.25 kHz and 8.00 kHz was regarded as significant.@*RESULT@#Thirty-five of 45 cases (77.8%) were found to have depressed bone conduction threshold before operation, 6 of 35 cases (17.1%) had improved bone conduction thresholds and 5 of 45 cases (11.1%) had depressed bone conduction thresholds after tympanoplasty.@*CONCLUSION@#In cases with chronic suppurative otitis media, successful results could be achieved after tympanoplasty disregarding air conduction threshold, the air-bone gap and deteriorated bone conduction threshold. Impairment of bone conduction thresholds could be induced by chronic suppurative otitis media itself and could also be induced by touching the ossicle chain crudely and by the noise of drilling during the operation.

A short term study on the efficacies of intratympanic prednisolone and dexamethasone injection for subjective tinnitus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the efficacies of intratympanic prednisolone and dexamethasone injection for the subjective tinnitus.@*METHOD@#A prospective study was designed to compare the efficacies of intratympanic prednisolone injection, intratympanic dexamethasone injection and carbamazepine by oral administration for subjective tinnitus. Seventy-three cases (78 ears) with subjective tinnitus for more than one month and treated by conservative therapy (such as vasodilator agent, Vitamin B, etc. by oral intake. ) were involved. The patients were randomized into 3 groups. Thirty-four cases (35 ears) were included in prednisolone group, 18 cases (18 ears) in dexamethasone group with intratympanic injection of prednisolone or dexamethasone, and 21 cases (25 ears) in carbamazepine group as a control group with oral administration of carbamazepine. All of the cases in intratympanic perfusion group were injected twice in the first week, then once a week consecutively. The patients were acupunctured 4-5 times in the whole course of treatment. All of the cases accepted Betahistine Mesylate, Mecobalamin and Vitamin B1 by oral intake at the same time. Pure tone audiogram and tinnitus matching were tested before the treatment immediately after the course of treatment, and were tested again after half a year's following up.@*RESULT@#All of the cases accepted the whole treatment and were followed up for half a year successfully. The effective rate of the prednisolone group, dexamethasone group and the carbamazepine group was 48.6%, 33.3%, 44.0%, respectively; the control rate half a year after the treatment was 45.7%, 27.8%, 36.0%, respectively. There was no statistically significant difference in the effective rate and control rate between intratympanic perfusion group and carbamazepine group. There is a statistically significant difference both in the effective rate and the control rate between the prednisolone group and the dexamethasone group. Prednisolone may be better than dexamethasone in intratympanic perfusion for subjective tinnitus.@*CONCLUSION@#Intratympanic steroid injection has a positive effect on subjective tinnitus and may be considered to be an alternative treatment to subjective tinnitus.