The effect research of specific immunotherapy of allergic rhinitis and allergic rhinitis combined bronchial asthma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the therapeutic effects of the specific immunotherapy (SIT) on allergic rhinitis and allergic rhinitis combined bronchial asthma. METHED: All patients were classified into allergic rhinitis group (AR group) with 32 patients and allergic rhinitis combined bronchial asthma group (AR+BA group) with 32 patients. Another health control group with 32 cases was designed as well. The allergens,symptom scores and therapeutic effects of the former two-group patients were analysis, and the serums of all three-group cases were extracted to evaluate the specific Immunoglobin E(sIgE), Interleukin-4 (IL-4). The SPSS13. 0 package was applied to conduct t-test and chi-square test, and the difference of P<0. 05 was regarded as statistical significance.@*RESULT@#The main allergens of 64 patients were dermatophagoides farinae and dermatophagoides pteronyssinus. The improvement of symptom scores before and after SIT was statistical significant with P<0. 05. Although total effective rate reached 100% , AR group was superior than AR+BA group in term of the efficacy comparison, and P<0. 05 indicated the statistical significance. The serum sIgE, IL-4 values of three groups were brought into comparison, and P<0. 05 indicated the statistical significance of the difference.@*CONCLUSION@#The SIT on the AR, AR+BA is a safe and effective treatment, but different disease responds diversely. The long-term treatment course is recommended.

Research on the efficacy and mechanism of standardized house dust mite allergen vaccine to allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The study was designed to analyze the efficacy of standardized house dust mite allergen vaccine to allergic rhinitis by subcutaneous injection and investigate the possible mechanism of specific immunotherapy (SIT).</p><p><b>METHODS</b>From January 2011 to December 2011 a prospective study was performed in the Department of Otorhinolaryngology Head and Neck Surgery, the Affiliated Hospital of Nantong University, involving 90 patients with perennial AR, of whom 60 patients received Der p - SIT + pharmacotherapy after their approval and 30 received only pharmacotherapy. All patients were allergic to house dust mites. Symptom and medication scores were recorded three times: before the treatment, at the middle of treatment and at the end of treatment. Over a period of 1 yr. prior to and at the end of treatment, CD4⁺ CD25⁺ Foxp3⁺ Treg cells and Th17 cells were measured by flow cytometry. SPSS 21.0 software was used to analyze the data.</p><p><b>RESULTS</b>The symptom scores using VAS and medication scores in AR patients treated with SIT and medication were reduced, the differences were significant (14.25 ± 6.40, 1.00 ± 0.84 vs. 32.18 ± 7.78, 3.12 ± 1.54, t value was 19.65, 10.71, both P < 0.05). The symptom of VAS score in medication group was reduced after treatment (30.30 ± 5.97 vs. 20.30 ± 5.79, t = 10.09, P < 0.05), but the medication score had not significant difference (P > 0.05). The frequency of Th17 cells in peripheral blood mononuclear cells were decreased in patients treated with SIT, whereas the frequency of Treg cells were increased (χ² value was 2.81, 2.80, both P < 0.05), but not in medication group.</p><p><b>CONCLUSIONS</b>Both SIT and pharmacotherapy can improve symptoms of allergic rhinitis, but SIT can also reduce medication use. The effect of immunotherapy is better than drug treatment alone. The frequency of blood Th17 cells in peripheral blood mononuclear cells were decreased in patients treated with SIT, whereas the frequency of Treg cells were increased.</p>

Quality of life assessment of 80 cases of persistent allergic rhinitis in adults before and after treatment / 重庆医学

Objective To explore the health-relate quality of life(QOL) status of adult persistent allergic rhinitis (PAR);the change of QOL of pro-post specific immunotherapy (SIT) and pharmacotherapy .Methods Skin prick tests(SPT) were performed on PAR patients .According to the results ,80 adult cases that were allergic to dermatophagoides were enrolled in ENT outpatient clinic of affiliated hospital of Nantong University from April to August 2011 .The patients were randomly allocated to receive either specific immunotherapy(n=40) or pharmacotherapy (n=40) ,all of them were given RQLQ before and after half-year treatment ;40 cases without any allergic diseases were chosen from ENT in-patient department ,and were given RQLQ .The scores of previous treatment of the PAR group were compared with health control group ,then compared with the scores of post-treatment ,and also compared the scores of post-treatment between the immunotherapy group and pharmacotherapy group .Results The scores of the PAR patients were higher than that of health control patients in all dimensions of RQLQ (P< 0 .05) ,and the most troublesome problems were nasal symptoms .The scores of the patients who received SIT were evidently lower than that of pro-treatment in all dimensions of RQLQ(P<0 .05) ,the scores of the patients who received medical treatment were also lower than before (P<0 .05) , and the scores of the SIT group were lower than the pharmacotherapy group (P<0 .05) .Conclusion The QOL of adult patients with PAR was improved after SIT or drug treatment ,and QOL improvement is more obvious treat by SIT .

The molecular epidemiology analysis of heavy-profound hearing loss in Nangtong / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the etiology of deafness and the common disease-causing genes among patients with sensorineural hearing loss in Nangtong and to explore the proportion of genetic factors in this region.@*METHOD@#One hundred and fifty cases with hearing loss from three schools for deaf-mutes in Nangtong received sequence analysis of GJB2, GJB3, SLC26A4, mtDNA12SrRNA and mtDNA tRNASer(UCN), and individuals carrying SLC26A4 mutation were given further temporal bone CT scan. We investigated the etiology of deafness by analyzing the genes testing results and questionnaires.@*RESULT@#GJB2 mutations were responsible for approximately 19.33% of the cases in Nangtong area. Nineteen cases (12.67%) were diagnosed with EVA (enlarged vestibular aqueduct) by screening SLC26A4 followed by temporal bone CT scan. The aminoglycoside-related mtDNA 1555A > G mutation accounted for 2.67% (4/150) of the cases in this area. In addition, 27 cases (18%) may relate to genetic factors in this group.@*CONCLUSION@#By genetic screening we find that genetic deafness occupies a large proportion in deaf community. Our data demonstrate that gene testing has important role in clarifying etiology for hearing loss population.

Clinical application of uvulopalatopharyngoplasty with resection of the musculus uvulae and preservation of uvulae mucosa / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the effect of modified uvulopalatopharyngoplasty with partial resection of the musculus uvulae and preservation of the mucosa of uvulae for obstructive sleep apnea hypopnea syndrome (OSAHS).@*METHOD@#Thirty-six patients with OSAHS were enrolled and determined by physical examination, Muller's Test, and cephalometry whose obstructive plane were in oropharynx. One group (n = 18) only received uvulopalatopharyngoplasty with uvulae preservation, while the other group (n = 18) received uvulopalatopharyngoplasty with partial resection of the musculus uvulae and preservation of the mucosa of uvulae. Polysomnography (PSG), Epworth Sleepiness Scale (ESS) and Level of Snore were measured one day before operation and seix months after operation.@*RESULT@#The apnea hypopnea index (AHI), lowest SaO2 (LSaO2), ESS and Level of Snore have changed in both groups (P 0.05) in validity ratio between two groups. Postoperative Level of Snore were significantly different between two groups while AHI, LSaO2, ESS were not significantly different between two groups.@*CONCLUSION@#Uvulopalatopharyngoplasty with partial resection of the musculus uvulae and preservation of uvulae mucosa is an effective surgical method for patients with OSAHS which obstructive plane is in oropharynx. It can decrease not only the level of snore but also the limited ratio of shrink in uvulae after routine surgery.

Diagnostic function of SLC26A4 hot spot mutations screening to enlarged vestibular aqueduct syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the frequencies of SLC26A4 hot spot mutations by genetic testing method in non-syndromic hearing loss children. The feasibility of genetic screening method in finding enlarged vestibular aqueduct syndrome was confirmed by temporal bone CT scan.@*METHOD@#Ninety-two children with moderate-profound hearing loss were enrolled and DNA were extracted from peripheral blood. SLC26A4 IVS7-2A > G and H723R mutations were analyzed by direct sequencing. The individual with homozygous, compound heterozygous or heterozygous SLC26A4 mutations was given further temporal CT scan.@*RESULT@#The sequencing results revealed 11 (12.0%) cases carrying SLC26A4 mutations, including 5 cases of bi-allelic mutation and 6 cases of single allelic mutation.@*CONCLUSION@#The SLC26A4 mutations has a high carrying rate in non-syndromic hearing loss children. The screening for the SLC26A4 gene mutations is useful in the diagnosis of EVAS.