Global, regional and national burdens of Nasopharynx cancer in the adolescents and young adults from 1990 to 2019 and its predictions.

PURPOSE: To use data from the Global Burden of Disease (GBD) Study 2019 to report the global, regional and national rates and trends of deaths incidence, prevalence, disability-adjusted life years (DALYs) for Nasopharynx cancer (NPC) in adolescents and young adults (AYAs). METHODS: Data from the GBD 2019 were used to analyze deaths incidence, prevalence and DALYs due to NPC at global, regional, and national levels. Joinpoint regression analysis was used to calculate the average annual percentage changes (AAPC). The association between incidence, prevalence and DALYs and socioeconomic development was analyzed using the GBD Socio-demographic Index (SDI). Finally, projections were made until 2030 and calculated in Nordpred. RESULTS: The incidence, prevalence, death and DALYs rates (95%UI) due to NPC 0.96 (0.85-1.09, 6.31 (5.54-7.20),0.20 (0.19-0.22), and 12.23(11.27-13.29) in 2019, respectively. From 1990 to 2019, the incidence and prevalence rates increased by 1.79 (95% CI 1.03 to 2.55) and 2.97(95% CI 2.13 to 3.82) respectively while the deaths and DALYs rates declined by 1.64(95%CI 1.78 to 1.49) and 1.6(95%CI 1.75 to 1.4) respectively. Deaths and DALYs rates in South Asia, East Asia, North Africa and Middle East decreased with SDI. Incidence and prevalence rates in East Asia increased with SDI. At the national level, the incidence and prevalence rates are high in China, Taiwan(China), Singapore, Malaysia, Brunel Darussalam, Algeria, Tunisia, Libya and Malta. Meanwhile, the deaths and DALYs rates are still high in Malaysia, Brunel Darussalam, Greenland and Taiwan(Province of China). The deaths and DALYs rates are low in Honduras, Finland and Norway. From the 2020 to 2030, ASIR、ASPR and ASDR in most regions are predicted to stable, but DALYs tends to decline. CONCLUSION: NPC in AYAs is a significant global public problem. The incidence, prevalence, and DALYs rates vary widely by region and country. Therefore different regions and countries should be targeted to improve the disease burden of NPC.

The relationship between prebiotic intake and allergic rhinitis.

Objectives: Exploring the relationship between intake of probiotics and the prevalence of allergic rhinitis. Methods: Based on data from the National Health and Nutrition Examination Survey, dietary supplement labels were examined to identify products containing probiotics and prebiotics. Statistical methods were used to analyze the factors influencing the prevalence of allergic rhinitis, and further stratified analysis was conducted to control for confounding factors. Results: The proportion of individuals not consuming probiotics was significantly higher in the allergic rhinitis (AR) group than in those consuming them, suggesting a correlation between probiotics and AR. In the male subgroup with probiotic intake, the adjusted odds ratio (95% confidence interval) was 0.28 (0.10-0.75), p = .02, indicating that probiotic intake was a protective factor for AR in the male population. In the probiotic-intake group, the odds ratio for age < 65 was 0.26 (0.07-0.94), p = .04, and for age ≥ 80 was less than 1 with p < .0001, suggesting that probiotic intake was a protective factor for AR in age < 65 and age ≥ 80 populations, both with statistical significance. Conclusion: Intake of probiotics is associated with a reduced prevalence of allergic rhinitis, particularly in the male population and individuals aged <65 years and ≥ 80 years. Level of Evidence: Level 4.

[Clinical significance and expression of periostin in chronic rhinosinusitis with nasal polyps].

Objective:To investigate the clinical significance and expression of periostin in chronic rhinosinusitis with nasal polyps（CRSwNP） . Method:In this study, we collected 30 CRSwNP patients' nasal polyps（NPs） and 18 control subjects' normal nasal mucosa of uncinate process. The expressions of periostin and IL-5 were examined using immunohistochemistric staining, immunostaining and /or quantitative RT-PCR and the eosinophil infiltration were evaluated as well. Result:Periostin was mainly expressed in the subdermal area of nasal mucosa. The number of periostin positive cells in nasal polyps was significantly higher than that in normal control group（P<0.01）. The mRNA and protein expressions of periostin in NPs were significantly higher than that of the control nasal mucosa（all P<0.01）. The expression of priostin mRNA were positively correlated with IL-5 expression in NPs（r=0.731 5, P<0.01）. Conclusion:Our findings indicate periostin may participate in the formation of nasal polyps by means of chemostaxis and activation of eosinophils.

Changes of TNF-α, PDGF and HA in nasal secretions and olfactory function of patients with chronic sinusitis before and after endoscopic sinus surgery.

This study aimed to investigate the changes of tumor necrosis factor-α (TNF-α), platelet-derived factor (PDGF), hyaluronic acid (HA) in nasal secretions and olfactory function in patients with chronic sinusitis before and after endoscopic sinus surgery. A total of 94 patients with chronic sinusitis treated at Xiangyang No.1 People's Hospital, Hubei University of Medicine (Xiangyang, China) from May 2016 to April 2017 were randomly divided into the control and observation groups, with 47 patients in each group. The observation underwent endoscopic sinus surgery, while the control group were treated with traditional extranasal surgery. The treatment efficacy of the two groups were compared 3 months after the treatment. A self-designed symptom questionnaire was used to evaluate the symptom scores. Enzyme-linked immunosorbent assay (ELISA) was used to detect the TNF-α, PDGF and HA levels in nasal secretions. The olfactory function of the patients was evaluated by the standard T&T olfactometry test. The life quality before and after the treatment was compared by using the SNOT-20 questionnaire. The treatment efficacy of the observation group was significantly higher than that of the control group (P<0.05). Both groups showed improved symptom scores after the treatment, while improvement in the observation group was more obvious (P<0.05). The observation showed significantly lower TNF-α level than the control group (P<0.05). One, four and eight weeks after treatment, the levels of PDGF and HA were significantly higher in the observation group than in the control group (P<0.05). Both groups exhibited significantly improved olfactory function scores after treatment, and improvement in the observation group was more than that in the control group (P<0.05). After treatment, decreased scores of SNOT-20 in the observation group was more significant (P<0.05). Compared with traditional surgery, endoscopic surgery resulted in lighter postoperative inflammatory responses, better nasal mucosa repair, and more improved postoperative olfactory function.

[The mechanism and onset time of single dermatophagoides farina sublingual immunotherapy in patients with allergic rhinitis sensitized to dermatophagoides farina and dermatophagoides pteronyssinus].

OBJECTIVE: To evaluate the efficacy and onset time of single dermatophagoides farina sublingual immunotherapy in patients sensitized to dermatophagoides farina (Df) and dermatophagoides pteronyssinus (Dp), discuss the mechanism of single allergen immunotherapy in polysensitized patients and provide evidence for clinical applications. METHOD: This is a retrospective study, we screen 50 patients with allergic rhinitis sensitized to Df and Dp in our department. The average age of those patients is 28.98 +/- 2.41 years old. The nasal symptom scores of sneezing, itching, obstruction and runny nose are recorded after three to six months. SPSS 20.0 software is used to analyze the data. RESULT: After treatment for 3 months with sublingual immunotherapy, the TNSS (P < 0.05), score of sneezing (P < 0.01) and runny nose (P < 0.01) is significantly decreased comparing with that before treatment. The scores of obstruction and itching are increased, but the differences are not statistically significant. After treatment for 6 months, the TNSS (P < 0.01), score of sneezing (P < 0.01), itching (P < 0.01), obstruction (P < 0.05) and runny nose (P < 0.01) are all decreased, the difference between the scores of 6 month after treatment and that before treatment is statistically significant. And all of the scores (Z = -5.749, P < 0.01, sneezing; Z = -5.353, P < 0.01, runny nose; Z = -3.476, P < 0.01, congestion; Z = -3.824, P < 0.01, itching; Z = -5.746, P < 0.01, TNSS) at 3 month after treatment are significant higher than that after 6 month treatment. CONCLUSION: The onset time of single Df sublingual immunotherapy for patients sensitized to Dp and Df with allergic rhinitis is 12 weeks, and the efficacy is enhanced as time of the treatment.

[Fourth branchial pouch sinus of children: from diagnosis to techniques and technology of surgical operation].

OBJECTIVE: To clarify the correct diagnostic methods of FBPS of children, and to explore techniques and technology of surgical operation aim to complete excision of sinus tract and preservation of the recurrent laryngeal nerve through analyzing the clinical characteristics and the characteristics of open neck surgery in FBPS of children. METHOD: Clinical materials of 6 children FBPS with internal pyriform sinus were retrospectively analyzed, and literatures were studied to explore the appropriate surgical management of children FBPS; lesions of 6 patients were completely dissected by open neck surgery with the help of di-direction catheterization revealing the tract of fistula, and the openings of the fistula to pyriform apex were cauterized by monopolar coagulation at the end of the procedure; all 6 cases were with systematic endoscopic follow-up. RESULT: All cases of 6 children patients were cured by open neck surgery, no recurrence of clinical symptoms were observed during a mean follow-up of 14 months (1-3 years); 2 cases were diagnosed with an "anatomical" relapse (persistence of the sinus tract orifice without clinical symptoms) at the follow-up endoscopy(at 3 and 4 months after surgery); all 6 cases had no complication of laryngeal paralysis. CONCLUSION: The children patients presenting recurrent acute suppurative thyroiditis and deep neck abscess of anterior area in the lower part of neck, especially locating left neck, should be considered as the diagnosis of FBPS. also the same as confirmed by enhanced neck CT scan and direct laryngoscopy. Patients with identification of internal pyriform sinus and Betz fold by direct laryngoscopy, and with identification of fistula which passes through the cricothyroid membrane beneath the superior laryngeal nerve can be confirmed FBPS. Completely dissection of sinus tract by open neck surgery was the effective management of children FBPS and di direction catheterization aids to reveal and identify the tract of fistula. Resection of the posterior part of the thyroid cartilage ala can be useful to aid exposure and preservation of the recurrent laryngeal nerve; but co-excision of a portion of the upper of the thyroid gland aids to the entire dissection of lesions. In addition, cauterizing the opening of the fistula to pyriform apex may be useful to obliterate the internal opening of pyriform sinus.