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.

Efficient evaluation of standardized specific immunotherapy in personalized maintenance phase to patients of allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the efficacy of individualized subcutaneous immunotherapy (SCIT) in allergic rhinitis(AR) maintain phase.@*METHOD@#Compare nasal symptom scores (VAS) and special disease scale--nasal conjunctivitis quality of life questionnaire(RQLQ) score after 3 years treatment to evaluate the therapeutic effect of each group and the level of improving patients quality of life. Take patients' blood to detect the serum level of IL-10 by enzyme linked immunosorbent test (enzyme linked immunosorbent assay).@*RESULT@#After 3 years treatment, there was no difference of VAS between the conventional SCIT group and the individualized SCIT group. ELISA results showed that the level of IL-10 was significantly higher in the drug symptomatic treatment group than that in the healthy group, the levels of IL-10 were significantly lower in the conventional SCIT group and the individualized SCIT group than that in the healthy group, but there was no difference between the conventional SCIT and the individualized SCIT group.@*CONCLUSION@#After 3 years treatment, there was no difference between conventional and individualized SCIT groups. But the efficacy of the conventional and individualized SCIT groups were significantly better than that in the drug symptomatic treatment group.

The role of glucocorticoids in the treatment of chornic rhinosinusitis / 临床耳鼻咽喉头颈外科杂志

Glucocorticoids (GC) are increasingly being used to treat chronic rhinosinusitis, its efficacy and safety are the focus of attention. This article will be divided into chronic rhinosinusitis with nasal polyps and without nasal polyps two subtypes discussed nasal and oral glucocorticoids in the clinical therapeutic efficacy and medication safety.

The role of sinomenine in treatment of allergic rhinitis mice model and its mechanism / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the role of sinomenine in treatment of allergic rhinitis mice model and its possible mechanism.@*METHOD@#We used ovalbumin (OVA) to make allergic rhinitis model of BALB/c mice. Saline was used in the control group. When we challenged the mice with OVA intranasally, the mice in sinomenine treatment group were feed by the food containing sinomenine. Mice were then killed 24 h after the last OVA challenge. The noses of mice from each group were removed en bloc and fixed, then each section was stained with hematoxylin and eosin. ELISA assay was used to measure the concentration of anti-OVA IgE, IL-4 and IFN-gamma. The proteins expressive level of T-bet and GATA3 were examined.@*RESULT@#Nasal mucosa of the mice in sinomenine treatment group were not hyperplasia and without obvious infiltration of eosinophils. The concentration of anti-OVA IgE, IL-4 and IFN-gamma in the serum and T-bet and GATA3 expression levels of sinomenine treatment group were lower than those of allergic rhinitis group.@*CONCLUSION@#The sinomenine can be used to treat allergic rhinitis mice, and the mechanism may rely on the improvements of the Th1/Th2 imbalance.

Observation on morphology and nerve growth factor expression in nasal mucosal of depression rats / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To establish the rat model of depression and observe its morphological changes and nerve growth factor (NGF) expression in nasal mucosal.@*METHOD@#Thirty SD rats were divided into depression model group and normal controls with 15 rats in each group. The rat depression model were made by application of chronic unforeseeable medium stress stimulating. Behavior change were observed with open box experiment(open field) and humoral consumption-experiments (sucrose consumption), After being sacrificed, the nasal mucosal were taken for HE and NGF immunohistochemical study. The difference of nasal mucosal NGF protein between two groups were examined with medical digital image analysis technology.@*RESULT@#There were no swelling and inflammatory cells infiltrating in nasal mucosal of normal group, but 53% nasal mucosal of depression model were observed such morphological changes. Th NGF immunohistochemical staining were negative in normal group but positive in 53% depression model group. There were significant differences between two groups (P < 0.01).@*CONCLUSION@#Depression rats may appear rhinitis symptoms under long-term stress stimulating. NGF may exert immunoregulatory effects, stimulate the immune cell proliferation and gathering, induce various media release, increase the sensitivity of nerve fibers itself and the producing of neuropeptide, promote the formation of nerve source inflammation and increase the reactivity of nasal mucosa.

The analysis of AllergyScreen results among allergic patients of different age groups / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the positive rates of some allergens in different age groups of allergic rhinitis patients, and to analyze the relationship between serum specific immunoglobulin E(sIgE) and total immunoglobulin E(IgE).@*METHOD@#Six hundred and fifty-three patients with allergic rhinitis, tested by AllergyScreen system, were enrolled in our research.@*RESULT@#The positive rate of sIgE in all patients was 85.5%. The positive rate of dust mite was the highest with the result of 76.3%, and the positive rate of feline or dogs hair was the lowest of 20.3%. The statistical significance of different positive rate of some allergens were found in the different age groups. All the patients were divided into two groups, one was younger than 18 years old group, which including 18 years old and another was older than 18 years old group. Except Mx, the positive rate of other allergens existed statistical difference. The level of serum total IgE could not reflect the positive rate of sIgE completely.@*CONCLUSION@#It is an effective and reliable method of the diagnosis of allergic rhinitis to combine the analysis of total serum IgE and sIgE levels with patients clinical manifestations. Different strategies should be employed for the prevention and treatment of allergic rhinitis according to their ages.

The relationship between job stressors,mental health and intention to quit of pediatric nurses / 中国实用护理杂志

Objective To explore the relationship between job stressors,montal health and intention to quit of pediatric nurses by comparing with nurses in internal medicine department. Methods Job stressors, mental health,intention to quit of pediatric nurses and their relationship were investigated among nurses in above mentioned wards from three third-level and first-class hospitals by using questionnaires. Results The scores of some factors of job stressors and nine factors of SCL- 90 of pediatric nurses were much higher than those of internal medicine nurses. There was a significantly positive correlation between some factors of job stressors, mental health and intention to quit of pediatric nurses. Conclusions Working pressure is a factor of low mental health level and intention to quit of pediatric nurses. Effective management strategies should be imple-mented to protect the mental health of pediatric nurses and decrease the loss of nurses.

Clinical significance of CT examination in 197 cases of sinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the characteristic of chronic paranasal sinusitis CT scans and discuss the relationship between the anatomic variations in ostiomeatal complex (OMC) and the incidence of chronic sinusitis.@*METHOD@#One hundred and ninety-seven cases diagnosis as sinusitis were selected and analyzed,whose age ranged between 4 and 74 years old. Several common anatomical abnormalities in ostiomeatal complex were evaluated through the observation of the coronal and axial plane CT scans of the paranasal sinusitis.@*RESULT@#The incidence of anatomic variations in OMC concentrated in the age between 11-20. The incidence of chronic sinusitis also concentrated in the age between 11-20. Deviation of nasal septum, uncinate variations, inferior-turbinate hypertrophy were observed between the chronic sinusitis group and the none chronic sinusitis group,the correlation between deviation of nasal septum, uncinate variations, inferior-turbinate hypertrophy and chronic sinusitis were significant (P<0.05).@*CONCLUSION@#The occurrence of OMC variation is common. The anatomic variations may be one of the causes of chronic paranasal sinusitis, especially deviation of nasal septum, uncinate variations and inferior-turbinate hypertrophy. If these abnormalities were altered,it will have a great significance for the preservation and treatment of chronic paranasal sinusitis.

Expression and significance of SP-A in nasal mucosa of allergic rhinitis and nasal polyp / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Surfactant protein A (SP-A) is protein that appears to play an important role in mammalian first-line host defense. The objective of this study was to immunolocalize SP-A in human sinonasal tissue.@*METHOD@#Eleven cases of allergic rhinitis, fifteen cases of polyp and seven cases of normal middle turbinate were studied with immunohistochemistry and immunofluorescence method to detect the expression of SP-A.@*RESULT@#The expression of SP-A in allergic rhinitis and polyp were dramatically higher than that in controls (P 0.05). The result demonstrated that SP-A was positively correlated with eosinophils within the basement membrane of epithelium (R = 0.81, 0.55). In the result of immunofluorescence, there was significantly higher expression SP-A in nasal mucosa of allergic rhinitis and nasal polyp than that in control group (P < 0.05).@*CONCLUSION@#SP-A is likely to play key roles in the inflammatory reaction process of allergic rhinitis and polyp. Its secretion in the upper airway indicates that future studies may allow manipulation of this protein and development of novel treatments for sinonasal pathology.

Expression and significance of SP-A in nasal mucosa of allergic rhinitis and nasal polyp / 临床耳鼻咽喉头颈外科杂志

Objective: Surfactant protein A (SP-A) is protein that appears to play an important role in mammalian first-line host defense. The objective of this study was to immunolocalize SP-A in human sinonasal tissue. Method:Eleven cases of allergic rhinitis, fifteen cases of polyp and seven cases of normal middle turbinate were studied with immunohistochemistry and immunofluorescence method to detect the expression of SP-A. Result:The expression of SP-A in allergic rhinitis and polyp were dramatically higher than that in controls(P0.05). The result demonstrated that SP-A was positivly correlated with eosinophils within the basement membrane of epitheli-um(R=0.81,0.55). In the result of immunofluorescence, there was significantly higher expression SP-A in nasal mucosa of allergic rhinitis and nasal polyp than that in control group(P<0.05). Conclusion:SP-A is likely to play key roles in the inflammatory reaction process of allergic rhinitis and polyp. Its secretion in the upper airway indicates that future studies may allow manipulation of this protein and development of novel treatments for sinonasal pathology.

Analysis about the results of allergy screen in 134 cases of allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the results of serum in allergic rhinitis and investigate the specific clinic allergen and serum immunoglobulin E (IgE) levels.@*METHOD@#Allergy Screen method was used to detect the specific allergen and total serum IgE level of 134 cases of Allergic rhinitis.@*RESULT@#The dust mite was the most common allergen in inhalation group in 134 cases of allergic rhinitis, the positive rates was 90%; then were donly, feline and scurfy fungus, the positive rates were 16%, 9%. The positive rates of total IgE was 54%. The serum IgE levels between 100 to 200 kU/L, there was 21 cases together, but there existed 7 negative cases. There were 51 cases' IgE levels more than 200 kU/L, the rates was 70.8%, but there still existed 4 negative cases.@*CONCLUSION@#Allergy screen method can find relevant allergen and provide basis for the prevention and treatment of allergic disease.

Expression and significance of Eotaxin and Eotaxin-2 in nasal polyposis and nasal polyp tissue / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the expression of Eotaxin and Eotaxin-2 in nasal polyposis and nasal polyp and explore the different mechanism between polyposis and polyp.@*METHOD@#Fifteen cases of nasal polyposis, thirteen cases of polyp and eight cases of normal middle turbinate were studied with immunohistochemical SP method to detect the expression of Eotaxin and Eotaxin-2.@*RESULT@#There were significant differences between either two groups about the expression of Eotaxin-2 (P 0.05).@*CONCLUSION@#Both of Eotaxin and Eotaxin-2 likely play key roles in the inflammatory reaction process of nasal polyposis and polyp. The different expression of Eotaxin-2 between nasal polyposis and polyp demonstrates it may be one of the main causes in the different mechanism of the two diseases.

Expression of human protection of telomeres1 (POT1) and telomeric repeat binding factor-2 (TRF2)in laryngneal squamous cell carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To study the significance by analyzing the expression of human protection of telomeres1(POT1)and telomeric repeatbinding factor-2(TRF2)in the tissues of laryngneal squamous cell carcinoma(LSCC)and in polyp of vocal cord tissues. METHODS The expression of POT1 and TRF2 in 20 tumor samples and 19 polyp of vocal cord were determined by the indirect immunofluorescence method. The results were scored and analyzed statistically. RESULTS The positive expression rates of POT1 and TRF2 in tumor samples was 65.00% and 70.00% respectively. There were no positive expression of POT1 and TRF2 in polyp of vocal cord. The positive expression of POT1 was higher in poorly differentiated laryngeal carcinoma than that in well-differentiated and moderately differentiated laryngeal carcinoma(Chi-square test with contingency table, P0.05). CONCLUSION The expression of POT1 and TRF2 in laryngneal squamous cell carcinoma were remarkable, POT1 and TRF2 may play a critical role in tumorigenesis of laryngneal squamous cell carcinoma. There was statistical significant difference for degrees of POT1 expression in different tumor histological grades.