The predicting role of postoperative changes in self-reported symptoms in patients with recurrence eosinophilic chronic sinusitis with nasal polyps / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate whether changes in postoperative symptoms and signs in patients can predict the recurrence of ECRS after nasal endoscopic sinus surgery. Methods:A total of 70 adult patients with ECRS were enrolled for ESS surgery from June 2020 to March 2022 in a single center. There were 50 males and 20 females, with an average age of （46.9±14.5） years. Follow-up after ESS was at least 52 weeks. Patients undergo peripheral blood tests, CT of the sinuses, olfactory T&T test, visual analogue scale of symptoms（VAS）, and endoscopic scoring. Results:VAS scores and endoscopic scores were analyzed at preoperative and 6th week, 12th week, 24th week and 52th week postoperative. After 12th week postoperatively, there was a clear correlation between symptom scores and endoscopic scores. Moreover, olfactory disorder and nasal discharge were the two most obvious symptoms. There were differences in the expression of multiple preoperative clinical inflammatory indicators between the symptom-controled group and the symptom-uncontrolled group（previous surgical history, concomitant asthma, nasal smear eosinophil, serum EOS%, total IgE, CT score, olfactory score, and symptom score, all with P<0.05）, while there was no difference in baseline endoscopic score（P>0.05）. At 12th week postoperative, the two groups of patients showed significant differences in both symptom scores and endoscopic scores. The symptoms and endoscopic score at the 12th week point of follow-up were used as predictive indicators for recurrence, with sensitivity and specificity of 62.5% and 83.3%, respectively. Conclusion:The changes in postoperative symptom score and endoscopic score in ECRSwNP patients indicated that the recurred ECRS. In the symptom-uncontrolled group, symptomatic and endoscopic scores showed consistent increased scores; In the symptom-controlled group, conflicting results between increased endoscopic scores and stable symptoms suggest that the presence of asymptomatic recurrence must be considered. The changes in symptoms and signs at the 12th week point of follow-up can serve as clinical indicators for preventing disease recurrence.

Study of fractional exhaled nitric oxide concentrations in healthy school children of Beijing, Tianjin, Hebei province / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the normal range of fraction exhaled nitric oxide(FeNO) in healthy schoolchildren in Beijing, Tianjin and Hebei Province. METHODS A total of 337 schoolchildren(161 males and 176 females) in Beijing, Tianjin and Hebei Province were selected randomly in our outpatient clinic and met the health standards. FeNO values were measured using NIOX. Age, height, weight and body mass index(BMI) were investigated. At the same time, skin prick tests were performed on children with suspected atopy. RESULTS Geometric mean of FeNO value in healthy schoolchildren in Beijing, Tianjin and Hebei Province was 13 ppb(part per billion, ppb), and the 95％ Confidence Interval(CI, bias distribution) was 5-23 ppb, which was related to the gender of schoolchildren(P ＜0.001). There was no signif icant cor relation between age, height, weight, body mass index(BMI) and regional differences(P all＞0.05). FeNO values were no significant difference among the three regions(P ＞0.05); the geometric mean of FeNO values were 13 ppb in Beijing, 13 ppb in Tianjin, and 14 ppb in Hebei; 95％CI was 5 to 21 ppb, 5 to 21 ppb, 5 to 23 ppb, respectively. CONCLUSION FeNO values of healthy schoolchildren in Beijing, Tianjin and Hebei provinces are only significantly correlated with gender. However, FeNO values are highest among schoolaged girls in Hebei, and 23 ppb is the 95％ normal range of FeNO in healthy schoolchildren in Beijing, Tianjin and Hebei province. Gender and regional factors must be considered when FeNO values are evaluated.

Establishment and evaluation of secretory otitis media model induced by endotoxin / 中国耳鼻咽喉头颈外科

OBJECTIVE To establish secretory otitis media(SOM) model induced by endotoxin and evaluate its reliability. METHODS Healthy 50 Sprague-Dawley rats of either sex( 250-300g)were randomly divided into experimental group(ET group) and control group(NS group),with 30 and 20 rats respectively. 35ul volume of 1mg/ml endotoxin from Pseudomonas aeruginosa and same amount of saline(NS) were transbullaly injected into the right tympanic bullas of the two groups. Six rats of ET group and four rats of NS group were killed postoperative on 6h,1d,3d,7d,14d respectively. The temporal bones were harvested for histological study. The left tympanic bullas served as control. Another four rats(each group 2 rats) were used for SEM study with the same method. One rat was killed and harvested for SEM observation of mucocilliary transporting system on the tympanic ostium of Eustachian tube. RESULTS ①LM(light microscope):The epithelial layer and subepithelial space(SES) were thicked mildly in ET group at 6 hours,and more heavily at 1 day with inflammatory cells infiltration (mostly polymorphonuclear leukocytes,PMNs). At 3 days,the same changes were observed most severely. By 14 days,the mucosal lining returned to normal. No obvious changes were observed in the NS group. ②SEM(scan electrical microscope):In ET group,the impairment of mucociliary transport system such as lodging,shedding of cilias were observed at 3 days and returned to normal at 14 days. No abnormal changes were observed in NS group. CONCLUSION Endotoxin can induce SOM with inflammatory changes peak at day 3 and return to normal by day 14.

An explant outgrowth culture system for airway ciliated cells / 中国耳鼻咽喉头颈外科

OBJECTIVE To develop an explant outgrowth culture system for airway ciliated cells and explore the usefulness of the system.METHODS Mucosal specimens from rabbit tracheal epithelium were seeded into collagen-coated cover-slips. After 7 days,the specimens were characterized by Photo- contrast microscopy,transmission and Scanning electron microscope. They were also examined with hematoxylin-eosin staining and mucin-5AC immunohistochemistry. Ciliary beat frequency was measured with high-speed digital microscopy. RESULTS Many ciliated cells with good viability and goblet cells were found in the culture system. Immunohistochemistry analysis revealed that mucin- 5AC antibody labeled mainly in the goblet cells.The ciliated cells were differentiated well detected by electron microscope. At (30?1)℃,the basal ciliary beat frequency was (13.2?0.9) Hz. CONCLUSION The method may be useful in establishing a culture system for ciliated cells and the system will be suitable for the long-term studies of mucociliary transport system.