Prevalence of cigarette use and addiction among Chinese females by age and province: Findings from nationwide China Health Literacy Survey during 2018-19.

BACKGROUND: The prevalence of cigarette smoking among women is significantly different from that of men, however, cigarette use by women is little known. The study aims to describe cigarette use prevalence and patterns among Chinese females by age and province. METHODS: This study was based on the 2018 China Health Literacy Survey (2018 CHLS), a nationally representative cross-sectional study, and our analysis included 43,319 female participants aged 20-69 with valid data. The prevalence of cigarette use was estimated overall by sociodemographic factors and weighted based on the census population data. The logistic regression model was conducted to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the risk factors associated with cigarette use and dependency. RESULTS: In China, the estimated female current cigarette use prevalence was 1.85%, with over half of the population suffering from tobacco dependence (7.34 million). Jilin Province has the highest cigarette prevalence among women (10.59%), while Fujian Province has the lowest (0.27%). Participants over 60 years old (aOR=1.61, 95%CI=1.20-2.14), single (aOR=1.54, 95%CI=1.07-2.21), with primary education (aOR=1.93, 95%CI=1.47-2.52) were more likely to smoke. The age of smoking initiation among women intergenerational advanced, and compared to the cigarette users without tobacco dependence, those who have tobacco dependence start smoking earlier in all age groups (25.69 years vs. 19.36 years, p<0.001). CONCLUSIONS: The cigarette use prevalence among Chinese women was 1.85%, and there are significant differences among provinces. We noted a trend of women initiating smoking at increasingly younger ages, particularly among those with tobacco dependence.

Association of Comorbid Asthma and the Efficacy of Bioabsorbable Steroid-eluting Sinus Stents Implanted After Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis with Nasal Polyps.

OBJECTIVE: To identify factors affecting the efficacy of steroid-eluting sinus stents implanted after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). METHODS: We performed a post-hoc analysis of a randomized self-controlled clinical trial on post-operative implantation of bioabsorbable steroid-eluting stents in patients with CRSwNP. Univariate logistic regression analysis was conducted to identify which of the following factors affect the response to post-operative stent implantation: sex, serum eosinophil levels, history of prior surgery, endoscopic scores, and comorbid conditions (asthma and allergic rhinitis). The primary outcome was the rate of post-operative intervention on day 30, and the secondary outcome was the rate of polypoid tissue formation (grades 2-3) on days 14, 30, and 90. RESULTS: A total of 151 patients with CRSwNP were included in the post-hoc analysis. Asthma was identified as the only risk factor for a poor response to steroid-eluting sinus stents on post-operative day 30, with an odds ratio of 23.71 (95% CI, 2.81, 200.16; P=0.004) for the need for post-operative intervention and 19 (95% CI, 2.20, 164.16; P=0.003) for moderate-to-severe polypoid tissue formation. In addition, the asthmatic group showed higher rates of post-operative intervention and polypoid tissue formation than the non-asthmatic group on post-operative day 30. Blood eosinophil levels were not identified as a risk factor for poor outcomes after stent implantation. CONCLUSION: Comorbid asthma, but not blood eosinophil level, impairs the efficacy of steroid-eluting sinus stents in the short term after ESS in patients with CRSwNP.

Comparison of airflow characteristics after Draf â ¢ frontal sinus surgery and normal person by numerical simulation.

Draf III frontal sinus surgery is confirmed as an effective surgical treatment for refractory sinusitis and frontal sinus tumors, etc. Although it has been reported to improve symptoms and reduce the recurrence rate of polyps significantly, the study of airflow characteristics in frontal sinus after Draf III is still rare, especially compared with normal person. This study was designed to describe the airflow characteristics of frontal sinus after Draf III procedure and differences compared with normal subject. One patient with refractory sinusitis received Draf III procedure15 months ago, and one normal person were selected retrospectively. The two subjects reported no discomfort and no abnormalities in their paranasal sinus within computed tomography scans. Computational fluid dynamics and numerical simulation calculation was performed with the finite volume method. The quantitative indexes of airflow in the frontal sinus of Draf III and normal subjects were achieved. Areas of relatively high-pressure and high wall shear stress located in a posterior part of frontal sinus ostium in both models. Inside frontal sinus, pressure and velocity of flow between Draf III and normal models were statistically significant differences (p < 0.01) after analyzed by Mann-Whitney U test. But airflow pattern of each section in frontal sinus was basically the same. Draf III sinus surgery is able to achieve nasal airflow patterns similar to those of normal person. Although values of airflow pressure and velocity were different from normal person, patients could have no subjective discomfort after surgery. "Frontal T" structure is a key anatomical site interacted with airflow to be an important cause of postoperative edema after Draf III procedure.

Preoperative and postoperative medical therapies for chronic rhinosinusitis: National surveys among Chinese otolaryngologists.

OBJECTIVE: The aim of this study was to evaluate clinical practice patterns of preoperative and postoperative medical therapies immediately surrounding sinus surgery for chronic rhinosinusitis (CRS) by Chinese otolaryngologists. METHODS: Two anonymous web-based surveys of preoperative and postoperative medical therapies were performed. These surveys assessed the frequency of prescription of oral corticosteroids, intranasal corticosteroid sprays, oral antibiotics, nasal saline irrigation, oral antihistamines, nasal antihistamines, anti-leukotriene agents, topical decongestants and oral mucolytics. RESULTS: A total of 304 (17.5%) preoperative and 143 (23.5%) postoperative questionnaires were completed and returned. Seventy-eight percent, 63% and 56% of respondents used preoperative intranasal corticosteroid sprays, oral antibiotics and oral mucolytics "always or often", respectively. Ninety-four percent, 93%, 72% and 69% of respondents used postoperative intranasal corticosteroid sprays, nasal saline irrigation, oral antibiotics and oral mucolytics "always or often", respectively. Oral antihistamines, nasal antihistamines, anti-leukotrienes and topical decongestants were not commonly used preoperatively or postoperatively. CONCLUSIONS: Our study demonstrated that current practice patterns of preoperative medical therapies among otolaryngologists are not uniformly based on evidence-based outcomes research. Postoperative oral antibiotics, intranasal corticosteroid sprays, nasal saline irrigation and oral mucolytics are commonly used by a majority of Chinese otolaryngologist for CRS. Practice patterns of postoperative medical therapy reflect recent guidelines.

The Lung Function Impairment in Non-Atopic Patients With Chronic Rhinosinusitis and Its Correlation Analysis.

OBJECTIVES: Chronic rhinosinusitis (CRS) is common disease in otorhinolaryngology and will lead to lower airway abnormality. However, the only lung function in CRS patients and associated factors have not been much studied. METHODS: One hundred patients with CRS with nasal polyps (CRSwNP group), 40 patients with CRS without nasal polyps (CRSsNP group), and 100 patients without CRS were enrolled. The difference in lung function was compared. Meanwhile, CRSwNP and CRSsNP group were required to undergo a bronchial provocation or dilation test. Additionally, subjective and objective outcomes were measured by the visual analogue scale (VAS), 20-item Sino-Nasal Outcome Test (SNOT-20), Lund-Mackay score, Lund-Kennedy endoscopic score. The correlation and regression methods were used to analyze the relationship between their lung function and the above parameters. RESULTS: The forced expiratory volume in 1 second (FEV1) and forced expiratory flow between 25% and 75% of forced vital capacity (FEF25-75) of CRSwNP group were significantly lower than other groups (P<0.05). On peak expiratory flow, there was no difference between three groups. In CRSwNP group, FEV1 was negatively correlated with peripheral blood eosinophil count (PBEC) and duration of disease (r=-0.348, P=0.013 and r=-0.344, P=0.014, respectively), FEF25-75 negatively with VAS, SNOT-20 (r=-0.490, P=0.028 and r=-0.478, P=0.033, respectively) in CRSsNP group. The incidence of positive bronchial provocation and dilation test was lower in CRSwNP group (10% and 0%, respectively), with both 0% in CRSsNP group. The multiple linear regression analysis indicated that change ratio of FEV1 before and after bronchial provocation or dilation test were correlated with PBEC in CRSwNP group (ß=0.403, P=0.006). CONCLUSION: CRS leading to impaired maximum ventilation and small airway is associated with the existence of nasal polyp. Lung function impairments can be reflected by PBEC, duration, VAS, and SNOT-20. In CRSwNP patients, PBEC is independent predictor of FEV1 change ratio.

Expression of Innate Immunity Genes in Epithelial Cells of Hypertrophic Adenoids with and without Pediatric Chronic Rhinosinusitis: A Preliminary Report.

BACKGROUND: Adenoid hypertrophy (AH) is associated with pediatric chronic rhinosinusitis (pCRS), but its role in the inflammatory process of pCRS is unclear. It is thought that innate immunity gene expression is disrupted in the epithelium of patients with chronic rhinosinusitis (CRS), including antimicrobial peptides and pattern recognition receptors (PRRs). The aim of this preliminary study was to detect the expression of innate immunity genes in epithelial cells of hypertrophic adenoids with and without pCRS to better understand their role in pCRS. METHODS: Nine pCRS patients and nine simple AH patients undergoing adenoidectomy were recruited for the study. Adenoidal epithelium was isolated, and real-time quantitative polymerase chain reaction (RT-qPCR) was employed to measure relative expression levels of the following messenger RNAs in hypertrophic adenoid epithelial cells of pediatric patients with and without CRS: Human ß-defensin (HBD) 2 and 3, surfactant protein (SP)-A and D, toll-like receptors 1-10, nucleotide-binding oligomerization domain (NOD)-like receptors NOD 1, NOD 2, and NACHT, LRR and PYD domains-containing protein 3, retinoic acid-induced gene 1, melanoma differentiation-associated gene 5, and nuclear factor-κB (NF-κB). RT-qPCR data from two groups were analyzed by independent sample t-tests and Mann-Whitney U-tests. RESULTS: The relative expression of SP-D in adenoidal epithelium of pCRS group was significantly lower than that in AH group (pCRS 0.73 ± 0.10 vs. AH 1.21 ± 0.15; P = 0.0173, t = 2.654). The relative expression levels of all tested PRRs and NF-κB, as well as HBD-2, HBD-3, and SP-A, showed no statistically significant differences in isolated adenoidal epithelium between pCRS group and AH group. CONCLUSIONS: Down-regulated SP-D levels in adenoidal epithelium may contribute to the development of pCRS. PRRs, however, are unlikely to play a significant role in the inflammatory process of pCRS.

[Influence of recombinant lentiviral vector encoding miR-15a/16-1 in biological features of human nasopharyngeal carcinoma CNE-2Z cells].

OBJECTIVE: To study the influence of recombinant lentiviral vector encoding miR-15a/16-1 on biological features of human nasopharyngeal carcinoma CNE-2Z cells and underlying mechanisms. METHODS: GFP-positive CNE-2Z cells transfected with recombinant lentiviral vector were selected. The experiment was divided into control group, transfected group, radiotherapy group, transfected-radiotherapy group. Cell proliferation was analyzed by MTT. Apoptosis was detected by flow cytometry. Radiotherapy sensitivity of the cells in control group and transfected group was evaluated by colony forming experiment. The expressions of miR-15a, miR-16-1 and bcl-2 mRNA were detected by real-time quantitative polymerase chain reaction (RT-qPCR). The expression of bcl-2 protein was detected by Western blot. The activation of Caspase-2 and Caspase-3 was evaluated by spectrophotometry. RESULTS: Relative expression quantities of miR-15a and miR-16-1 in infected group were 524.80 ± 40.79 (t = 494.611, P = 0.000) and 466.11 ± 40.96 (t = 386.8, P = 0.000), respectively. The proliferation of the cells in transfected-radiotherapy group was the most obvious, followed by the cells in radiotherapy group and transfected group (F = 424.3, P = 0.000). The apoptosis rates of control group, transfected group, radiotherapy group and transfected-radiotherapy group were (2.2 ± 1.4)%, (9.6 ± 0.8)%, (2.9 ± 1.1)%, and (18.6 ± 0.7)% respectively(F = 158.5, P = 0.000). Clonogenic assay showed that the values of SF2, Do (1.473) and Dq (1.581) in transfected group were lower than those in control group. The relative expression levels of bcl-2 mRNA in transfected group, radiotherapy group, and transfected-radiotherapy group had no significant difference (P > 0.05). Decrease in the expression of bcl-2 protein in transfected-radiotherapy group was most significantly, followed by that in transfected group. The percentages of activated Caspase-2 in control group, radiotherapy group, transfected group and transfected -radiotherapy group were 0.12 ± 0.01, 0.24 ± 0.04, 0.35 ± 0.02, and 0.44 ± 0.04, respectively (F = 115.500, P = 0.000). The percentages of activated Caspase-3 in the groups were 0.13 ± 0.01, 0.27 ± 0.01, 0.43 ± 0.02, and 0.83 ± 0.06, respectively (F = 439.921, P = 0.000). CONCLUSIONS: Recombinant lentiviral vector LV-miR15a/16-1 could improve the expression of miR-15a and miR-16-1 in CNE-2Z cells, inhibit the proliferation of CNE-2Z cells, promote apoptosis and enhance the sensitivity of the cells to radiotherapy probably by inhibiting bcl-2 expression, activating Caspase-2 and Caspase-3.

[Clinical implication of global osteitis score system and its role in evaluation of osteitis of chronic rhinosinusitis].

OBJECTIVE: To investigate the clinical application of Global Osteitis Score System (GOSS). To determine the association between GOSS, Lund-Mackay scores and Lund-Kennedy scores and to investigate the incidence of osteitis in patients with chronic rhinosinusitis (CRS). METHODS: Three hundreds and thirty-four patients with CRS were enrolled prospectively in a large tertiary referral center. The paranasal sinus bone Hounsfield unit (HU), thickness, scope were measured by PHILIPS MxLiteView software. Nasal endoscopy Lund-Kennedy score was analyzed in all patients. Sinus CT scans of all patients were analyzed for Lund-Mackay score and for osteitis using the GOSS. Association between GOSS and Lund-Mackay, Lund-Kennedy was examined. RESULTS: The incidence of osteitis in patients with chronic rhinosinusitis was from 33.83% to 53.89%. Average GOSS score of osteitis was 7.51 ± 7.27. The highest incidences of osteitis were in the maxillary and anterior ethmoid sinuses. The left anterior ethmoid sinuses was 37.2%. The right anterior ethmoid sinuses was 32.8%. The left maxillary sinuses was 46.1%. The right maxillary sinuses was 42.2%. Global osteitis score were significantly correlated with Lund-Mackay and Lund-Kennedy scores (r value were 0.497 and 0.409 respectively, all P < 0.001). CONCLUSIONS: GOSS can define and evaluate the extent and the severity of osteitis in patients with CRS by using CT, and can also reflect the extent and the severity of CRS.

[Analysis of follow-up outcomes of endoscopic modified Lothrop procedure].

OBJECTIVE: To sum up the follow-up outcomes of endoscopic modified Lothrop procedure (EMLP) and retrospectively analyze the indications, methods and prognostic factors of EMLP. METHODS: The collected data of 73 cases who received EMLP with frontal sinus diseases were analyzed in this paper. The mean age was 45.6 (ranging from 14 to 72 years). There were 52 males and 21 females. Only patients with follow-up time greater or equal to 6 months were included. Paranasal sinus CT scan was adopted for all cases and MRI for tumor patients. All patients were followed under endoscope. RESULTS: There were 21 inverted papilloma in the frontal sinus, 16 chronic sinusitis with asthma, 12 frontal sinusitis, 9 chronic sinusitis with or without polyps, 7 osteoma of the frontal sinus, 4 frontal mucocele, 3 allergic fungal sinusitis and 1 congenital encephalocele. Sixty-one cases had prior surgical history (1.8 times on the average). Their mean follow-up was 25.0 months, (ranging from 6 to 122 months). At the end of follow-up, 44 cases (60.3%) had well opened frontal drainage pathway. Twenty-five (34.2%) was re-stenosed and 4 (5.5%) closed. Seven cases (9.6%) underwent revision surgeries. There were no surgical complications. CONCLUSIONS: EMLP is an effective and salvage procedure in dealing with tumor of frontal sinus and recurrent frontal sinusitis. Combined with medical treatment, EMLP will have a better results for chronic sinusitis with or without polyps and asthma. The degree of diseases, mucosal loss, anatomic variability and prior surgeries are important prognostic factors.

[Clinical application of Draf IIb frontal sinusotomy and it's modified procedures].

OBJECTIVE: To summarize the follow-up outcomes of Draf IIb frontal sinusotomy and it's modified procedures, and to discuss the surgical indications and prognostic factors. METHODS: Thirty-two patients treated between 2004 and 2010 were enrolled in this study. There were 15 patients for recurrent frontal inverted papilloma (IP), 6 for mucocele, 4 for recurrent frontal sinusitis, 3 for osteoma, 2 for meningoencephalocele with cerebrospinal fluid rhinorrhea, 1 for meningoencephalocele alone and 1 for acute frontal sinusitis. All patients underwent preoperative paranasal sinus computed tomography (CT) scans. Patients with tumor accepted magnetic resonance imaging (MRI). The patients with meningoencephalocele and cerebrospinal fluid rhinorrhea received magnetic resonance cisternography (MRC). The Draf IIb frontal sinusotomy and it's modified Draf IIb-1-3 procedures were applied endoscopically under general anesthesia mainly by high speed bur and power system. The postoperative CT scan was obtained as a base line for follow-up 1 week after the operation. Postoperative follow-up was performed under endoscope. RESULTS: Among 19 cases of Draf IIb, 12 were recurrent IP of frontal sinus, 4 were mucocele, 2 were recurrent frontal sinusitis and 1 were osteoma. Five cases received Draf IIb-1, 2 for each recurrent IP of frontal sinus and recurrent frontal sinusitis and 1 for osteoma. Six cases received Draf IIb-2, 3 for meningoencephalocele, 1 for each IP, acute frontal sinusitis and osteoma. Two cases received Draf IIb-3 were mucocele. The follow-up ranged from 8 to 73 months. Twenty-two cases of the frontal nepostium were widely opened, 7 were stenosis and 3 were closed. Revision surgery was seen in 2 cases with IP. All of them had no complications. CONCLUSIONS: The Draf IIb frontal sinusotomy and it's modified procedures are suitable for complex frontal sinus disease, which can be selected according to pathological and anatomical features, and have a good prospect for clinical application.

[Identification of differentially expressed genes in recurrent nasopharyngeal carcinoma and analysis of their chromosomal location].

OBJECTIVE: To identify differentially expressed genes in recurrent nasopharyngeal carcinoma (rNPC) by DNA microarrays, and analyze chromosomal localizations and molecular function by bioinformatics. METHODS: The primary nasopharyngeal carcinoma (pNPC) tissue samples and rNPC tissue samples were selected, and Affymetrix Gene1.0 ST gene chips were used to identify differential expressed genes in rNPC, and the bioinformatics was used to analyze their chromosomal localizations as well as molecular functions. RESULTS: A total of 44 genes were identified to be differential expressed in rNPC. Thirty-six genes were down regulated, 8 genes were up regulated. Functional classification of down-regulation genes showed that most genes (10 genes, 27.8%) belonged to the enzyme activity genes, followed by calcium ion binding genes (7 genes, 19.4%), protein binding genes (5 genes, 13.9%), receptor activity genes (4 genes, 11.1%), ATP binding genes (2 genes, 5.6%), transcription factor genes (2 genes, 5.6%), extracellular matrix binding and growth factor binding have 1 gene respectively (each accounted for 2.8%). In addition, the functions of 4 genes (11.1%) were unknown. Functional classification of up-regulation genes showed most genes (3 genes, 37.5%) were unknown, followed enzyme activity genes (2 genes, 25.0%), receptor activity, calcium ion binding and voltage-gated ion channel activity genes have 1 genes respectively (each accounted for 12.5%). These genes were localized randomly on the most the chromosomes, with a majority of them localized on chromosomes 1, 17. Chromosome 1 contained the most differentially expressed genes (10, 22.7%), followed by chromosomes 17 (5, 11.3%). CONCLUSIONS: The differential expressed genes in rNPC were supposed to be randomly distributed on most chromosomes, but the majorities were found on chromosomes 1, 17. Abnormality in three groups of genes, including in enzyme activity, calcium ion binding and protein binding associate genes, might play important roles in rNPC. Those genes need to be further studied.