Surgical approach analysis of endoscopic resection of juvenile nasopharyngeal angiofibroma / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the surgical approach for the resection of juvenile nasopharyngeal angiofibroma（JNA） under nasal endoscopy. Methods:The clinical data of 87 patients undergoing endoscopic resection of nasopharyngeal fibroangioma were retrospectively analyzed. We classified JNA according to tumor site, size, invasion scope and anatomic position relationship between tumor and midline of pupil. Three endoscopic surgical approaches were selected according to the classification, and the postoperative symptoms, complications and recurrence were investigated and analyzed. Results:The tumor resection rate of 87 cases by nasal endoscopic surgery was 100%. Thirty-five cases were approached through the middle nasal passage（small tumors located in the nasal sinuses and pterygopalatine fossa）, forty-five cases were approached through the lateral wall of the nasal cavity（tumor invaded the pterygopalatine fossa but did not exceed the midline of the pupil） , and seven cases were approached via the lateral wall of nasal cavity + ipsilateral anterior wall of maxillary sinus（tumor invaded the infratemporal fossa beyond the midline of pupil or invaded the cavernous sinus and the middle cranial fossa epidural）, Postoperative patients with nasal congestion, nasal bleeding, headache, dizziness, vision loss and other symptoms showed varying degrees of improvement. No surgical death or intracranial infection occurred. The postoperative follow-up was 6-78 months, and the recurrence rate was 3.44%. Conclusion:Endoscopic resection of nasopharyngeal fibroangioma is the main treatment method for JNA. Selecting suitable endoscopic approach to resect JNA, To maximize the advantage of nasal endoscopic equipment according to the inherent anatomical space of the human nasal cavity, In order to achieve the purpose of JNA resection, reduce intraoperative and postoperative complications, reduce the recurrence rate and improve the prognosis.

Research progress in the role of mesenchymal stem cell sheets and their derivatives in bone defect repair / 中华创伤杂志

Bone defects are mostly caused by severe trauma, infection, tumor resection and congenital malformations, which adversely affect their health and quality of life. So far, the bone defects are mainly filled with autologous or allogeneic bone grafting, which has problems such as donor shortage, secondary bone injury and scarring. In recent years, the rise of bone tissue engineering has provided a new way for repair of bone defects, in which mesenchymal stem cell (MSC) sheets prepared by using the principle of tissue engineering can well solve the above problems of autologous or allogeneic bone grafting. With the development of preparation technology, new bone defect repair materials such as decellularized extracellular matrix (ECM) sheets and MSC/ECM clumps have been derived on the basis of MSC sheets. Therefore, the authors reviewed the preparation and the role of MSC sheets and their derivatives in bone defect repair, hoping to provide a reference for basic research and clinical treatment related to bone defect repair.

A study on the targeted nanoparticles of isosorbide mononitrate on reducing the levels of inflammatory factors in rabbit models of rhinosinusitis / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the effect of isosorbide mononitrate (ISMN) targeted nanoparticles on inflammatory factors of sinusitis by establishing a rabbit model of rhinosinusitis.@*Methods@#Thirty healthy rabbits, male and female, weighing 2.5-3.5 kg, were randomly divided into 6 groups with 5 rabbits in each group. Group A was the control group. The model of rabbit sinusitis was established in group B to F, and CT was used to confirm the model was successful. After placing tubes into the maxillary sinus in the group C to F, saline, 45 mg/ml ISMN, 45 mg/ml ISMN nanoparticles and 45 mg/ml ISMN targeted nanoparticles were used to wash the maxillary sinus, respectively. Blood samples were collected from the ear vein of rabbits on day 7, 14, 21, 28, 35 and 42 after modeling respectively. Changes in the expression levels of inflammatory factors in rabbits during the modeling process and after drug washing were detected by ELISA. After the drug intervention, the maxillary sinus mucosa was taken for real-time quantitative PCR to detect the changes in the mRNA level of inflammatory factors. SPSS 22.0 software was used to process the data.@*Results@#Rabbit model of sinusitis was successfully established. ELISA showed that after the action of ISMN targeted nanoparticles of 1 week (42th day after modeling), the levels of (interleukin, IL) 4, IL-8, IL-17A and interferon γ (IFN-γ) in the blood were lower compared with that of 35th day after modeling, the difference was statistically significant (5.57±1.20 vs 19.73±0.68, 66.41±11.87 vs 154.68±13.13, 17.96±1.87 vs 28.23±0.80, 53.56±5.66 vs 111.93±7.29, all P<0.05). Compared with the ISMN nanoparticles and ISMN, the ISMN targeted nanoparticles reduced the levels of IL-4, IL-8, IL-17A and IFN-γ more obviously, the differences were statistically significant (13.26±1.43 vs 8.81±1.33 vs 7.14±2.16, 89.47±17.80 vs 41.07±7.77 vs 15.84±3.72, 10.28±2.07 vs 3.06±1.62 vs 1.82±0.90, 62.16±6.18 vs 35.12±4.62 vs 27.89±10.18, all P<0.05). Real-Time PCR showed that after the flushing of ISMN targeted nanoparticles, the levels of IL-4, IL-8, IL-17A and IFN-γ mRNA were lowest compared with that of the model group, ISMN nanoparticles and ISMN group.@*Conclusion@#ISMN targeted nanoparticles can reduce the level of inflammatory factors in rabbit sinusitis model.

Creation and validation of three-dimensional printed models for basic nasal endoscopic training.

BACKGROUND: Three-dimensional (3D) printed models have been shown to be promising in surgical training in rhinology. The objectives of this study were to develop a set of 3D-printed models including the pediatric and adult nasal cavity, and the postsurgical paranasal sinuses, and to assess the face and content validity in endoscopic training. METHODS: The computed tomography (CT) data of a pediatric patient without nasal disorders and an adult patient with nasal septal deviation were selected to produce the models of the pediatric and adult nasal cavity, and the CT data of an adult patient who underwent endoscopic sinus surgery 4 months ago was chosen to create the paranasal sinus model. After the models were printed by our desktop-level 3D printer, 5 rhinologists used the 5-point Likert scales to evaluate the fidelity and utility. Additionally, a group of prespecified tasks were completed by the rhinologists and 5 residents respectively for supplementary content validation. The difference of time used in completing each task was analyzed by Mann-Whitney U test. RESULTS: All the models were prototyped in 24 hours, and the total cost for each model was less than 100 CNY (15 USD). The overall scores for fidelity and usefulness in endoscopic training were above 4.0. The experts accomplished all tasks using significantly less time than the residents (all p < 0.05). CONCLUSION: The models of nasal cavities and paranasal sinuses made by our desktop-level 3D printer are high-fidelity, low-cost, and useful in training basic endoscopic skills.

IL-25-regulated type 2 innate lymphoid cells activation promote allergic fungal rhinosinusitis / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the regulation of IL-25 on type Ⅱ innate lymphoid cells (ILC2s) activation in the pathogenesis of allergic fungal rhinosinusitis (AFRS).@*Methods@#Nasal mucosa tissues were collected from 16 AFRS patients and 12 patients, who underwent nasal endoscopic surgery for cerebrospinal rhinorrhea or skull base benign tumor during the period from June 2016 to June 2017 in Department of Rhinology, the First Affiliated Hospital of Zhengzhou University. Firstly, flow cytometry was used to detect ILC2s in nasal mucosa of both groups. Secondly, the expression of IL-25, IL-5 and IL-13 in nasal mucosa was detected by immunofluorescence and/or Western Blot assay. Finally, fungal extracts, IL-25 and glucocorticoids were used to stimulate nasal mucosal epithelial cells and tissues in vitro respectively to detect the regulatory effect of IL-25 on ILC2s. SPSS 16.0 software was used to analyze the data.@*Results@#The prevalence of ILC2s in nasal tissues was higher in patients with AFRS than those of the control group ((3.85±1.52)%(Mean±SD) vs (0.32±0.10)%, U=9.00, P<0.05). There was a positive correlation between the prevalence of ILC2s and the number of eosinophils in nasal mucosa of patients with ARFS (r=0.80, P<0.05). The expression of IL-25, IL-5 and IL-13 in nasal mucosa epithelium of AFRS group was significantly higher than that of the control group (0.49±0.13 vs 0.23±0.09, 0.23±0.05 vs 0.10±0.04, 0.31±0.08 vs 0.14±0.07, t value was 5.90, 7.21, 5.69, respectively, all P<0.05). Fungal stimulation enhanced the expression of IL-25 protein in nasal epithelial cells of both groups (0.67±0.19 vs 0.25±0.12 (AFRS group), 0.62±0.17 vs 0.27±0.16 (control group), q value was 8.65, 9.26, respectively, all P<0.05). In the IL-25 stimulated nasal mucosa at a concentration of 1, 10 and 100 ng/ml, the expression level of retinoid acid-related orphan receptor α (RORα) mRNA was 2.07±1.53, 5.06±0.93, 7.38±2.30, respectively; the expression level of GATA binding protein 3 (GATA3) mRNA was 3.58±1.29, 6.14±1.55, 7.64±2.28, respectively; the expression level of IL-5 protein was 0.21±0.06, 0.32±0.06, 0.38±0.10, respectively; the expression level of IL-13 was 0.52±0.13, 0.69±0.22, 0.82±0.21, respectively, which were significantly higher than that in the unstimulated nasal mucosa (1.00±0.00, 1.00±0.00, 0.11±0.05, 0.35±0.15, F value was 63.45, 59.27, 49.35, 20.20, respectively, all P<0.05). The up-regulation could be inhibited by dexamethasone (F value was 89.20, 92.47, 99.63, 49.82, respectively, all P<0.05).@*Conclusions@#Epithelial-derived IL-25 up-regulates the expression of IRC2s-dependent transcription factors RORα and GATA3 mRNA, which are positively correlated with elevated IL-13 and IL-5 expression levels in tissues, may be involved in AFRS inflammatory response, and are inhibited by glucocorticoids.

Fabrication and verification of three-dimensional prototyped models of nasal cavities and paranasal sinuses / 中华耳鼻咽喉头颈外科杂志

Objective@#To make three-dimensional prototyped models of nasal cavities and paranasal sinuses for endoscopic skills training and teaching and to verify and evaluate the fidelity of the models.@*Methods@#Imaging data of a patient with nasal septum deviation was selected for prototyping the nasal cavities model, and the imaging data of a patient with chronic rhinosinusitis who underwent the endoscopic sinus surgery 4 months ago was selected for the paranasal sinuses model. Both patients came from the Department of Rhinology, the First Affiliated Hospital of Zhengzhou University. The models were printed by the desktop-level printer based on the fused deposition modeling (FDM). The evaluations of anatomical structures and prespecified tasks on the simulators were completed by 5 residents and 5 experts of Rhinology.The models were evaluated by survey ratings based on a 5-point Likert scale. The average time to complete each task was calculated.Mann-Whitney nonparametric test was used to assess the differences between experts and residents groups. The statistical significance level was set at P<0.05.@*Results@#All the components of the two models were prototyped in 24 h. For the nasal cavities model, the scores of each anatomical structure were more than 4.0. As to the paranasal sinuses model, except for the frontal sinus (3.6), the scores of each anatomical structure were more than 4.0. All the participants who performed the prespecified tasks evaluated the models well (>4.0). With the nasal cavity simulator, the experts completed the tasks (nasal cavity and nasopharyngeal endoscopy, removal of nasal foreign body, nasal packing, pledget insertion), and the other tasks (the nasal cavity and nasopharyngeal endoscopy, identification of ostiums of paranasal sinuses, maxillary sinus debridement with 70° nasal endoscopy) were completed with paranasal sinus model. The average time to complete each task by experts group and residents group (M (P25, P75)) were 10.3 (10.0, 10.7) s vs 17.1 (14.6, 20.7) s, 2.1 (2.0, 2.2) s vs 3.4 (2.6, 4.7) s, 30.1 (27.8, 32.8) s vs 59.2 (52.0, 65.4) s, 54.8 (50.1, 63.2) s vs 92.2 (79.3, 106.9) s, 9.3 (8.7, 9.9) s vs 14.5 (13.3, 14.9) s, 20.1 (19.3, 21.2) s vs 41.9 (35.5, 45.1) s, 31.1 (28.8, 35.2) s vs 52.8 (47.7, 56.3) s, respectively, and the average time to complete each task was shorter for the experts group than for the residents (U value was 0, 1.000, 0, 0, 0, 0, 0, respectively, all P<0.05).@*Conclusion@#The models of nasal cavities and paranasal sinuses made by our desktop-level FDM 3D-printer are useful for endoscopic training skills.

Clinical analysis of 14 cases of acute sinusitis in children complicated with orbital cellulitis / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the clinical characteristics and treatment methods of acute sinusitis in children with orbital cellulitis. Method:Fourteen cases in our hospital of acute sinusitis in children which causes orbital cellulitis were collected. The history, physical examination, imaging examination, and surgical records were analyzed to understand the clinical characteristics and treatment of the disease. Result:Thirteen cases had poor efficacy after been treated with antibiotics. Excepted 1 case automatic left the hospital, the rest were cured by surgical treatment. The cure rate was 100%. An 8 years old child transfered in department of rhinology from department of ophthalmology with his eye blind. Inspite of surgury, the vision didn't improve. Conclusion:Acute sinusitis in children with orbital cellulitis has a rapid onset and is rapidly spreading. Early diagnosis, active treatment can effectively prevent disorders of ocular movement, visual impairment and can improve the cure rate.

Staphylococcus aureus biofilm influences the expression of lysozyme, SLPI and gp340 in a human sinonasal explant model / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the influences of staphylococcus aureus in planktonic and biofilm forms on the expression of lysozyme, SLPI and gp340 in the human sinonasal explant model.@*METHOD@#Mucosa samples from ethmoid sinus were collected from ten patients of cerebrospinal fluid leak and were cultured with and without S. aureus biofilms and planktonic cells. After the infection, the explant model was confirmed by CLSM, and the secretion of lysozyme, SLPI and gp340 was detected by enzyme-linked immunosorbent assay (ELISA) at 8, 16, and 24 h after S. aureus challenge. Expressions of lysozyme, SLPI and gp340 in mRNA and protein levels after 24 h S. aureus challenge were detected using RT-PCR, immunohistochemistry and Western bolt assay respectively.@*RESULT@#The secretion of lysozyme, SLPI and gp340 in the explant model was observed with a trend to increase in a time-dependent manner. At 8 and 16 h after S. aureus challenge, the secretion of lysozyme, SLPI and gp340 in biofilms group was significantly higher than these in planktonic cells group and control group (P 0.05), the biofilms enhanced the expressions of lysozyme, SLPI and gp340 significantly compared with planktonic cells and controls (P < 0.05).@*CONCLUSION@#S. aureus biofilm induced the expressions of lysozyme, SLPI and gp340 to a higher level than planktonic cells, indicating that S. aureus biofilm was an influencing factor on the innate immune system.

Clinical analysis of 249 cases of children with foreign bodies in the nasal cavity and paranasal sinus / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#Insertion of a foreign body in the nasal cavity is a very common incident in children. It is easily diagnosed, but the type of foreign body varies and the extraction can sometimes be difficult with risk of complications. The present study reported nasal foreign bodies diagnosed in emergency in our ENT department, with an update on the state of knowledge.@*METHOD@#A prospective study between Feb 2013 to Sept 2015 included patients admitted to the ENT emergency unit for nasal foreign body. Data comprised age, gender, circumstances of discovery, symptoms, type of foreign body, extraction method and complications. Many patients required anterior rhinoscope for the diagnosis and removal (179/249, 71. 9%), and 170 cases were directly removed and 9 cases were into alimentary canal; Most irregularly shaped objects were removed by a endoscope under general anesthesia (70/249, 28.1%), including button batteries (n= 65), nasal calculi (n = 2) and chopsticks (n = 3).@*RESULT@#The main types of foreign body were vegetal forms (61.8%). The incident was discovered following nasal symptoms in 24.9% (n = 62). Extraction was easy by using forceps, micro-hooks or suction in 71.9% of qn:Nasal sinuses foreign body on prevention, detailed history and make the necessary inspection, can improve the correct diagnostic rate.

The impact and mechanisms of ursolic acid on Hep-2 cells invasion / 重庆医学

Objective To study the effect of ursolic acid on human laryngeal carcinoma Hep‐2 cells invasion and to explore its mechanism .Methods Methabenzthiazuron(M TT ) was used to observe the proliferation of Hep‐2 cells treated with various con‐centrations of ursolic acid at different time .Boyden chamber was used to compare ursolic acid effect on cell invasion .Western blot was used to the measure the NF‐κB protein expression .Gelatin zymography was used to the activity of MMP‐9 and MMP‐2 .Results Ursolic acid inhibited human laryngeal carcinoma Hep‐2 cells growth ,its effect showed dose dependent and time dependent (P <0 .01) .Boyden chamber results revealed that after the ursolic acid treatment Hep‐2 cells ,invasion ability showed a concentration de‐pendent decreased (P< 0 .01) .Western blot results revealed that ursolic acid showed a concentration dependent decreased on human laryngeal Hep‐2 cells NF‐κB protein expression(P< 0 .01) .Gelatinases spectrum revealed that ursolic acid a concentration depend ‐ent decreased on human laryngeal Hep‐2 cells MMP‐9 and MMP‐2 cells activity (P< 0 .01) .Conclusion Ursolic acid inhibit human laryngeal cancer Hep‐2 cell proliferation and invasion ,its mechanism is related to down‐regulate MMP‐9 and MMP‐2 activity and the NF‐κB protein expression .

One case of human nasal myiasis / 临床耳鼻咽喉头颈外科杂志

Human myiasis is caused by the parasitic maggots of flies. We report a case of nasal myiasis in a 37-year-old woman in Henan. The patient presented with nasal foreign-body sensation, nansal itching sneezing, snuffle and such allergic symptoms in nasal cavity. Based on maggots that were bowed from the right nasal cavity, a detailed endoscopic examination, sinus CT scan and identification of the maggot's species done by parapsychologists of the parasitology teaching and reseach section of the Zhengzhou University School of Medicine, the diagnosis of human nasal infestation by oestrus ovis was definited.

Expression and significance of NLRP3 inflammasome and its downstream factors IL-1β/IL-18 in rat model of allergic rhinitis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To detect the expression and explore the role of the innate immune NLRP3 inflammasome and its downstream factors interleukin-1β (IL-1β)/ interleukin-18 (IL-18) in rat model of allergic rhinitis (AR).</p><p><b>METHODS</b>Forty Sprague Dawley (SD) rats were randomly divided into control group (A group), AR model group 1 (B group), AR model group 2(C group), AR model group 3 (D group). Every group contained 10 rats. After the rats in the model group were sensitized by ovalbumin (OVA) and alum, B, C and D groups were separately stimulated with 5% OVA for 10 days, 20 days and 30 days (once a day). The control group did not add OVA in the process of sensitization and excitation. All rats were executed after excitation.Eosinophil granulocyte (EOS) infiltration were observed in nasal mucosa by hematoxylin-eosin (HE) staining, the expression of NLRP3 and cysteinyl aspartate-specific protease-1 (Caspase-1) were observed in nasal mucosa by immunohistochemical staining. The concentrations of ovalbumin specific IgE (OVA-sIgE), IL-18 and IL-1β in peripheral blood and the concentrations of IL-18 and IL-1β in nasal fluid were tested by enzyme-linked immunosorbent assay (ELISA). The data were processed by SPSS 17.0 software.</p><p><b>RESULTS</b>EOS cell counted, the behavioral score and the concentrations of OVA-sIgE in AR model group were obviously higher than those in control group (P < 0.05), and the difference of which had statistical significance between the AR model groups (P < 0.05). The expression of NLRP3 in AR model group (The expression of NLRP3 in group of B, C and D were 48.80 ± 10.75, 71.80 ± 16.98 and 100.32 ± 13.91, respectively) were obviously higher than those in control group (17.47 ± 5.59), the difference of which had statistical significance (F = 78.399, P < 0.05). The expression of Caspase-1 in AR model group (The expression of Caspase-1 in group of B, C and D were 36.33 ± 4.71, 50.87 ± 11.18 and 73.10 ± 14.77, respectively) were obviously higher than those in control group (11.48 ± 2.70), the difference of which had statistical significance (F = 71.727, P < 0.05). The concentrations of IL-1β in AR model group [The concentrations of IL-1β in group of B, C and D were (56.46 ± 10.13), (82.37 ± 11.93), (112.01 ± 22.91) pg/ml, respectively] were obviously higher than those in control group [(38.26 ± 4.66) pg/ml], the difference of which had statistical significance (F = 51.981, P < 0.05). The concentrations of IL-18 in AR model group [The concentrations of IL-18 in group of B, C and D were (177.92 ± 23.63), (194.33 ± 20.78), (234.06 ± 31.70) pg/ml, respectively] were obviously higher than those in control group [(89.71 ± 5.56) pg/ml], the difference of which had statistical significance (F = 73.295, P < 0.05). And the difference of which had statistical significance between the AR model groups (P < 0.05). The expression of NLRP3 was significantly positively correlated with the behavioral score, the concentrations of OVA-sIgE and EOS cell counted in rat model of allergic rhinitis (r value were 0.833,0.873 and 0.868, respectively, all P < 0.01).</p><p><b>CONCLUSION</b>NLRP3 inflammasome and its downstream factors IL-1β/IL-18 play a role in the pathogenesis of allergic rhinitis, which may be correlated with the degree of inflammation.</p>

Analysis of allergens spectrum in children with allergic rhinitis in Zhengzhou district / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the main allergens in children with allergic rhinitis and provide scientific basis for prevention and treatment in Zhengzhou district.@*METHOD@#Twenty standardization allergens were used to perform skin prick test in 412 children with AR, and the results were statistically analyzed.@*RESULT@#Three hundred and twenty-nine of 412 cases (79.85%) showed positive reaction. The positive rate of dermatophagoides farina (87.54%) was the highest in inhaled allergens, followed by dermatophagoides pteronyssinus (86.32%), cat hair (62.31%), fungus I (47.72%) and dog hair (43.16%). The positive rate of shrimp (13.68%) was the highest in ingestive allergens, then egg (5.17%), carp (4.56%), meat I (3. 04%) and milk (3.04%).@*CONCLUSION@#Dust mites, cat hair, fungus,dog hair were the most common allergens in children in Zhengzhou district. Improving living environment of children with AR and avoiding contacting with allergens were pretty important.

Suppression of T-type Ca2+ channels inhibited human laryngeal squamous cell carcinoma cell proliferation running title: roles of T-type Ca2+ channels in LSCC cell proliferation.

BACKGROUND: Despite the tight correlation between T-type Ca2+ channels and a great variety of tumors, the roles of alpha1G subunit of T-type Ca2+ channels in laryngeal squamous cell carcinoma (LSCC) have not yet been investigated. METHODS: In the present study, we examined the expression of alpha1G subunit of T-type Ca2+ channel in human LSCC tissues and cell lines. One human laryngeal squamous cell carcinoma cell line, Hep-2, was also examined for T-type channels using voltage-clamp recordings. Cell proliferation assays were performed in the presence or absence of T-type channel blocker mibefradil and alpha1G subunit sepcific siRNA. The cell cycle was determined by flow cytometry. RESULTS: Our results indicated that the a1G subunit of T-type Ca2+ channel is highly expressed in human laryngeal squamous cell carcinoma tissues and cell lines. alpha1G siRNA significantly down-regulated the protein expression of the alpha1G subunit. Both alpha1G siRNA and mibefradil inhibited Hep-2 cell proliferation and arrested cell cycle progression. CONCLUSIONS: Together, these findings suggest a functional role of T-type channels in certain laryngeal carcinomas, and that inhibition of T-type channels reduces cell proliferation via cell cycle arrest, suggesting that the alpha1G subunit of T-type Ca2+ channel may be used as a therapeutic target for treating LSCC.

Correlation between bacterial biofilms and osteitis in patients with chronic rhinosinusitis.

OBJECTIVES/HYPOTHESIS: Bacterial biofilms (BBF) and osteitis are potential contributors to the local inflammatory load in chronic rhinosinusitis (CRS). This study investigated the relationship between BBF and osteitis status in CRS patients. STUDY DESIGN: Prospective cohort study. METHODS: Eighty-four CRS patients undergoing endoscopic sinus surgery and 22 control patients were enrolled in this study. Mucosal and bony samples from ethmoid sinus were obtained for confocal scanning laser microscopy and microscopic examination. Biofilm volume (BV), biofilm score (BS), histopathologic bony grade, Global Osteitis Scoring Scale (GOSS) score, and Hounsfield unit (HU) value on computed tomography were recorded. Associations between these parameters describing BBF and osteitis were assessed. RESULTS: The histopathologic bony grade 2 (0-3) versus 0 (0-3) (P < 0.001), GOSS score 4.5 (0-31) versus 0 (0-26) (P = 0.014) and HU value 431.5 (310-509) versus 354 (288-499) (P < 0.001) in patients with BBF were greater than those without BBF. The bony grade (r = 0.683, P < 0.001 and r = 0.664, P < 0.001), GOSS score (r = 0.314, P = 0.004 and r = 0.312, P = 0.004), and HU value (r = 0.539, P < 0.001 and r = 0.520, P < 0.001) were significantly increased with higher BV and BS. CONCLUSION: A total of 84.8% of the bone underlying mucosa with BBF had some form of osteitis in ethmoid sinus, and approximately 46.4% of CRS patients were from a subgroup with both BBF and osteitis. The volume of BBF correlated well with severity of osteitis in CRS patients.

Enhanced expressions of lysozyme, SLPI and glycoprotein 340 in biofilm-associated chronic rhinosinusitis.

Lysozyme, secretory leukocyte proteinase inhibitor (SLPI) and glycoprotein 340 (gp340) are important effectors of the innate immune system in sinonasal mucosa. Bacterial biofilms (BBF) are highly organized bacterial communities resistant to host defense systems. The aim of this study was to investigate the expression of lysozyme, SLPI and gp340 in sinus mucosa from chronic rhinosinusitis (CRS) patients with different BBF status. In this prospective cohort study, 63 CRS patients undergoing endoscopic sinus surgery and 20 controls were enrolled and their mucosal samples from ethmoid sinus were obtained. Biofilms were examined by confocal scanning laser microscopy (CSLM), and the expressions of lysozyme, SLPI and gp340 in mRNA and protein levels were detected using reverse transcription polymerase chain reaction (RT-PCR), immunohistochemistry and Western blot assay, respectively. As a result, 35/63 (55.6%) of the patients were BBF positive in the CRS group and none in controls. Both mRNA and protein levels of lysozyme, SLPI and gp340 in patients with CRS were significantly higher than those in controls. When sub-classified according to BBF status, the CRS patients with BBF revealed the significantly enhanced mRNA and protein levels of lysozyme, SLPI and gp340. In conclusion, our study demonstrates that lysozyme, SLPI and gp340 are constitutively expressed in sinus mucosa and their up-regulated expressions on both the mRNA and protein levels are associated with BBF in CRS patients. These findings may offer an insight into the interaction between BBF and the innate immune system.

Development of the Chinese nasal obstruction symptom evaluation (NOSE) questionnaire / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To develop the Chinese version of the nasal obstruction symptom evaluation (NOSE) questionnaire.</p><p><b>METHODS</b>After introduction, forward and backward translation, synthesis, expert committee review, pretest, adaptation and validation followed the international guidelines, the Chinese version of NOSE scale was tested among 223 nasal septal deviation patients and 80 health volunteers to further assess its psychometric and clinical properties. SPSS 19.0 software was used to analyze the data.</p><p><b>RESULTS</b>The Chinese version demonstrated satisfactory evaluation results. The acceptance rate of the questionnaire was 97.6% and 94.1% in the patient group and control group respectively, and the completion time was (1.5 ± 0.5)min and (1.0 ± 0.5)min. Internal consistency reliability (Cronbach's α) was calculated to be 0.869. Test-retest reliability coefficient was adequate at rs = 0.996. Content validity was approved by our expert committee. Criteria validity (Spearman correlation coefficient) between NOSE Chinese version and SF-36, as well as VAS was -0.837 and 0.725 separately. Construct validity of Chinese version was similar to that of the original edition. The standardized response mean and the effect size at three months postoperatively was respectively 1.34 and 1.21, indicating high responsiveness. Calculated by Mann-Whitney U test, the instrument showed excellent sensitivity to discriminate the subjects with or without nasal obstruction (P < 0.01). The NOSE scores were also correlated with nasal resistance by rhinomanometry.</p><p><b>CONCLUSIONS</b>The NOSE Chinese version was successfully cross-cultural adapted and validated. It therefore can be recommended as a robust tool for future measuring subjective severity of nasal obstruction in China.</p>

The effect of two surgical method on treatment of allergic rhinitis complicated with nasal septum deviation / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the effect of two surgical methods on treatment of allergic rhiniti complicated with nasal septum deviation.@*METHOD@#Eighty-seven cases of allergic rhiniti complicated with nasal septum deviation were divided into 2 groups according to the degree of mucosal hypertrophy and hyperplasia of bone in inferior turbinate. They were treated by resection of nasal septum deviation combined with temperature-controlled radio-frequency, or combined with partial submucoperiosteous resection of inferior turbinate bone. The Lanzhou standard (2004) and nasal airway resistance were used to evaluate the efficacy.@*RESULT@#After one year follow-up time, the nasal resistance was significantly decreased and the effective rates were greater than 88% in each group.@*CONCLUSION@#Both of the two surgical methods can significantly depress the nasal resistance and improve the allergic symptoms, which shows good effect.

Prevalence of sensitization to allergens in 1 139 patients with allergic rhinitis in Zhengzhou area / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the main allergens in patients with allergic rhinitis in Zhengzhou district.</p><p><b>METHODS</b>Twenty standardization allergens were used to perform skin prick test in 1 139 patients with allergic rhinitis. The samples were divided into four groups according to the age of the patients. The distributions of different allergens in the four groups were analyzed.</p><p><b>RESULTS</b>The top five inhaled allergens were dermatophagoides farina (920 cases, 80.8%), dermatophagoides pteronyssinus (870 cases, 76.4%), cat hair (517 cases, 45.4%), herbs (397 cases, 34.9%) and poaceae (353 cases, 31.0%); the top five ingestive ones were shrimp (143 cases, 12.6%), peanut (66 cases, 5.8%), egg (56 cases, 4.9%), carp (51 cases, 4.5%) and meat (48 cases, 4.2%). The distribution of allergens was different among the different age groups.</p><p><b>CONCLUSION</b>Dust mites, cat hair, herbs and poaceae were the most common allergens in Zhengzhou district.</p>

Analysis on therapeutic efficacy of different approaches for treating fungal maxillary sinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To compare the response of simple endoscopic surgery and endoscopic surgery plus small windows through canine fossa surgery for fungal maxillary sinusitis.@*METHOD@#Twenty-five patients were applied the endoscopic surgery plus small windows through Canine fossa surgery as the treatment group, and the other 25 were applied the simple endoscopic surgery as control.@*RESULT@#During a follow up for 1-2 years, the effect of fungal maxillary sinusitis under endoscopic by dual approach is superior to simple endoscopic. There were obvious differences between the two groups(chi2 = 4.268, P < 0.05).@*CONCLUSION@#Endoscopic surgery plus small windows through canine fossa surgery for fungal maxillary sinusitis can fully expose maxillary sinus cavity,destroy the abnormal tissues completely, change the low oxygen environment, ensure the normal physiological function of maxillary sinus mucosa, and really achieve radical minimally invasive purpose.