Loading...

Table of Content

    20 May 2022 Volume 36 Issue 3
      
    Clinical use and significance of allergy testing and diagnostics
    CHENG Lei, XU Qiuyan, CHEN Hao
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  1-6.  doi:10.6040/j.issn.1673-3770.0.2022.184
    Abstract ( 855 )   PDF (694KB) ( 235 )   Save
    References | Related Articles | Metrics
    Allergic diseases are among the most prevalent diseases worldwide and their burden on healthcare systems continues to increase. Confirmation of allergen sensitization and the identification of causal allergens are essential for developing management strategies for these maladies. This paper provides an updated introduction of the most commonly used detection methods, both in vivo and in vitro, in the diagnosis of type I IgE-mediated allergy and its clinical significance.
    An endotype study of chronic rhinosinusitis with nasal polyps and precise control and treatment under the guidance
    AO Tian,CHENG Lei
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  7-14.  doi:10.6040/j.issn.1673-3770.1.2022.005
    Abstract ( 898 )   PDF (538KB) ( 246 )   Save
    References | Related Articles | Metrics
    Chronic rhinosinusitis with nasal polyps(CRSwNP)refers to chronic inflammation of the nasal cavity and paranasal sinuses with polyp formation over a course of more than 12 weeks. CRSwNP covers a group of complex diseases with similar phenotypes, but significantly different underlying mechanisms. Based on the inflammatory factors involved and the pathological mechanisms, CRSwNP can be divided into type 1, 2, and 3 inflammation, among which type 2 inflammation corresponds to CRSwNP dominated by eosinophil infiltration. There are many differences in the clinical manifestations, demographic characteristics, treatment responses, and prognosis of the different endotypes. Therefore, to optimize diagnosis, it is necessary to establish indirect predictive models that are based on the clinical characteristics and an in-depth of the different pathological mechanisms. Furthermore, the accurate control and treatment of symptoms can also be achieved to improve prognosis, under the guidance of endotypes. This article reviews the current progresses in the field of CRSwNP endotypes and their precise control and treatment under clinical guidance.
    Advancements in the diagnosis and treatment of chronic sinusitis based on phenotypes and endotypes
    XIONG Panhui, SHEN Yang,YANG Yucheng
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  15-19.  doi:10.6040/j.issn.1673-3770.0.2022.034
    Abstract ( 839 )   PDF (595KB) ( 145 )   Save
    References | Related Articles | Metrics
    Chronic rhinosinusitis(CRS)is a heterogeneous disease with complex phenotypes and endotypes. Depending on the presence or absence of nasal polyps, CRS phenotypes can be classified as with or without polyps. Other phenotypic classifications of CRS include allergies, asthma, and aspirin intolerance. In recent years, breakthroughs have been made in research on the pathogenesis of CRS endotypes, such as type 2 inflammation and non-type 2 inflammation, and effective biological agents have been introduced for the treatment of CRS. This article describes the latest phenotype and endotype classification of chronic rhinosinusitis and the latest treatment progress based on phenotypes and endotypes. The identification of specific endotype and phenotype combinations will allow more accurate diagnoses of chronic rhinosinusitis and personalized treatments in the future.
    Advances in endotypes and precision medicine in chronic rhinosinusitis
    YAO Shuang,LOU Hongfei
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  20-29.  doi:10.6040/j.issn.1673-3770.0.2021.561
    Abstract ( 844 )   PDF (925KB) ( 412 )   Save
    References | Related Articles | Metrics
    Chronic rhinosinusitis(CRS)has complex pathogenesis and a high degree of heterogeneity, with some types responding poorly to conventional therapy. Therefore, clinicians should have an in-depth understanding of endotypes and promote precision medicine with biologics as core management for CRS. In this study, we aimed to review endotypes and corresponding biologic treatment of CRS to clarify the importance of both in precision medicine. We provide a reference framework for establishing and improving individualized treatment strategies for CRS.
    Research progress in biologic targeted drug therapy for chronic sinusitis
    LIANG Xu,SHI Li
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  30-35.  doi:10.6040/j.issn.1673-3770.1.2022.572
    Abstract ( 766 )   PDF (1364KB) ( 147 )   Save
    References | Related Articles | Metrics
    Chronic sinusitis(CRS)is a chronic inflammatory disease of the nasal cavity and sinuses. Based on its pathogenesis, CRS can be divided into type 1, type 2, and type 3 inflammatory intrinsic type. At present, the drug therapy and surgical treatment of CRS have the risk of various adverse reactions and complications; among these cases of refractory sinusitis, some cannot achieve satisfactory results and are prone to recurrence despite appropriate drug and surgical treatment, thus seriously affecting the quality of life of patients. The application and development of biologic targeted drugs provide an effective and safe alternative to the treatment of CRS. This review focuses on the research progress of biologic targeted drug therapy targeting the cytokines associated with the three intrinsic types of CRS inflammation, including TNF-α, IL-4, IL-5, IL-13, IgE, and IL-17.
    Research advances of dupilumab in the treatment of chronic rhinosinusitis with nasal polyps
    SHI Shuai, ZHENG Quan,CHENG Lei
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  36-42.  doi:10.6040/j.issn.1673-3770.0.2021.565
    Abstract ( 1084 )   PDF (475KB) ( 268 )   Save
    References | Related Articles | Metrics
    Chronic rhinosinusitis(CRS)is a common inflammatory disease of the paranasal sinus mucosa. Complex mechanisms lead to a strongly heterogeneous CRS, and some patients do not find relief using the current standard drug treatment and surgery. CRS has different inflammatory endotypes and clinical phenotypes; CRS with nasal polyps(CRSwNP)has always been difficult to treat, as its symptoms are relatively severe and often complicated by asthma. It is often unresponsive to conventional drugs and surgery and has a high risk of reoccurring. In recent years, dupilumab has been found to be effective in adult intractable CRSwNP by blocking the signal transduction of interleukin(IL)-4 and IL-13, which are the key driving factors in type II inflammation. Currently, the study of dupilumab in the treatment of CRSwNP in China has not been reported. This article reviews the progress achieved in the research of dupilumab in the treatment of CRSwNP, to provide a reference for its further application and research in treating CRSwNP.
    Research progress of olfactory dysfunction in chronic rhinosinusitis
    WANG Huan, HU Li,YU Hongmeng
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  43-49.  doi:10.6040/j.issn.1673-3770.0.2022.041
    Abstract ( 808 )   PDF (697KB) ( 307 )   Save
    References | Related Articles | Metrics
    Olfactory dysfunction, one of the main clinical symptoms in patients with chronic rhinosinusitis, seriously affects patients' quality of life. With improved socio-economic circumstances and social progress, demands for the improvement of olfactory function in patients with chronic rhinosinusitis have increased. Rhinologists, therefore, should be able to assess the severity of anosmia in chronic rhinosinusitis and choose appropriate and effective treatment methods. Accordingly, this article focuses on discussing the evaluation tools and treatment progress that has emerged in recent years to assist rhinologists with improving their diagnosis and treatment of this condition.
    Eosinophils and Olfactory Dysfunction
    YI Ruonan,CHEN Fuquan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  50-55.  doi:10.6040/j.issn.1673-3770.0.2021.533
    Abstract ( 737 )   PDF (756KB) ( 172 )   Save
    References | Related Articles | Metrics
    Chronic rhinosinusitis(CRS)is a refractory disease with a very complex pathogenesis. Olfactory dysfunction is an important clinical symptoms of CRS.Despite drug and surgical intervention, the recurrence rate of CRS is high, and the olfactory dysfunction of patients sometimes cannot be improved, which may seriously affects a patient's quality of life.Eosinophils(EOS)are an important cell type.The degradation and accumulation of eosinophils, the release of cytokines and mucus secretion play important roles in the pathogenesis of different types of chronic rhinosinusitis. While many scholars consider that tissue EOS to be closely related to olfactory dysfunction caused by peripheral blood EOS and CRS, but some scholars hold different views.
    The interaction between neutrophils and eosinophils in chronic rhinosinusitis and the implications on treatment options
    GU Yu, WAN Xin,XIAO Zi'an
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  56-63.  doi:10.6040/j.issn.1673-3770.0.2021.513
    Abstract ( 1092 )   PDF (1471KB) ( 198 )   Save
    References | Related Articles | Metrics
    Chronic rhinosinusitis(CRS)has traditionally been classified as T-helper(Th)2 type inflammation(type 2 inflammation)with recruitment of predominantly eosinophils or as a Th1/Th17 type inflammation with predominantly neutrophils. These two inflammatory processes have long been thought of as being mutually exclusive in CRS. However, recent studies have found that neutrophilic(NEU)and eosinophilic(EOS)infiltrates increased significantly and influenced each other in the nasal mucosa or nasal polyp tissue in severe CRS. In this review, we examined the recent investigations into this mixed NEU/EOS inflammation in CRS in terms of cellular interactions and the implications on possible clinical treatment strategies.
    The roles of ion channels in the pathogenesis of chronic rhinosinusitis
    LIN Hai, ZHU Ying,ZHANG Weitian
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  64-70.  doi:10.6040/j.issn.1673-3770.0.2021.577
    Abstract ( 568 )   PDF (645KB) ( 115 )   Save
    References | Related Articles | Metrics
    Chronic rhinosinusitis(CRS)is a common chronic inflammatory disease in rhinology; its etiology and pathogenesis are not fully understood. Ion channels are proposed to participate in a variety of physiological activities, such as stabilizing membrane potential, maintaining cellular volume homeostasis, regulating intercellular signal transduction, and other functions. Calcium channels, potassium channels, sodium channels, chloride channels and hydrogen ion-related ion channels are closely related to the pathogenesis of CRS. Numerous studies have shown that ion channels are abnormally expressed in nasal mucosa tissues from CRS patients, indicating that disturbance of ion channel regulation may be involved in the inflammatory immune response of CRS and lead to its further aggravation. This review summarizes research progress on the roles of ion channels in the pathogenesis of CRS. The aim is to provide new insights into further explorations of CRS pathogenesis and treatment strategies.
    Research progress on the signal transduction pathway and other factors related to epithelial-mesenchymal transformation in chronic rhinosinusitis
    QIAO Xinjie,
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  71-77.  doi:10.6040/j.issn.1673-3770.0.2021.581
    Abstract ( 655 )   PDF (670KB) ( 202 )   Save
    References | Related Articles | Metrics
    Chronic rhinosinusitis is a chronic inflammatory disease of the nasal cavity and sinus mucosa. Although it can be caused by many factors, its pathogenesis and pathophysiological process remain unknown. Epithelial-mesenchymal transformation has been found to be an important factor in mucosal tissue remodeling of the nasal sinus and development of chronic rhinosinusitis. Furthermore, studies have shown that different types of chronic rhinosinusitis have different characteristics of epithelial-mesenchymal transformation. This article reviews recent research progress on the study of signal transduction pathways and other factors related to epithelial-mesenchymal transformation in chronic rhinosinusitis.
    Progress of research regarding the role of the epithelial barrier in chronic rhinosinusitis with nasal polyps
    HUANG Danyi, ZHANG Ting,CHEN Jing, ZHANG Wei
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  78-83.  doi:10.6040/j.issn.1673-3770.0.2021.583
    Abstract ( 823 )   PDF (527KB) ( 352 )   Save
    References | Related Articles | Metrics
    Chronic rhinosinusitis with nasal polyps(CRSwNP)is a common disease in otorhinolaryngology characterized by the highly heterogeneous chronic inflammation of the nasal and sinonasal mucosa. Recently, CRSwNP has been reported to have substantially affected the quality of life of patients and increased social and economic burdens due to the increase in its worldwide incidence, frequent recurrence, and poor therapeutic outcomes. As a gatekeeper, the epithelial barrier, which is composed of epithelial cells, is the first line of defense against the invasion of pathogens and allergens in the nasal cavity. It maintains the homeostasis within hosts by initiating defense mechanisms, activating various physicochemical factors, and regulating immune responses. Studies have shown that epithelial barrier dysfunction is closely related to the occurrence of CRSwNP; this is currently one of the major focuses of CRSwNP-associated research. Therefore, it is crucial to elucidate the molecular biological mechanisms underlying CRSwNP-associated epithelial barrier dysfunction. This review summarizes the progress of current research regarding the functions and the mechanisms underlying the action of, and the factors damaging, the epithelial barrier during CRSwNP. Our review will provide insights into the pathological mechanism of CRSwNP and shed light on new directions for research regarding its diagnosis and treatment.
    The role of epigenetics in the pathogenesis of chronic rhinosinusitis with nasal polyps
    LI Jiani, ZHU Dongdong,MENG Cuida
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  84-91.  doi:10.6040/j.issn.1673-3770.0.2021.562
    Abstract ( 559 )   PDF (707KB) ( 198 )   Save
    References | Related Articles | Metrics
    The pathogenesis of chronic rhinosinusitis(CRS)with nasal polyps has not been fully elucidated. Epigenetics mainly refers to changes in gene expression levels based on non-gene sequence changes, such as DNA methylation, histone modification, and microRNA regulation. In this review, the role of epigenetic modification of CRS-related genes and changes in the expression levels of corresponding cytokines and other related proteins in the pathogenesis of CRS are discussed. The aim of this review is to provide new directions for research on the pathogenesis of CRS and the development of therapeutic methods.
    Research progress on the correlation between nasal bacterial microbiome and chronic rhinosinusitis with nasal polyps
    YU Longgang,JIANG Yan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  92-97.  doi:10.6040/j.issn.1673-3770.1.2021.576
    Abstract ( 745 )   PDF (774KB) ( 212 )   Save
    References | Related Articles | Metrics
    Chronic sinusitis with nasal polyp(CRSwNP)is a refractory subtype of chronic sinusitis. The pathophysiological mechanism of CRSwNP is still unclear; however, bacteria are hypothesized to play an important role in its pathogenesis. The microbiome is one of the new perspectives in human health research, including respiratory diseases. With the development of next-generation sequencing technology, the nasal bacterial microbiome of CRSwNP has been further elucidated. Changes in bacterial abundance and diversity in the nasal cavity may be related to the type of inflammation, concomitant diseases and prognosis of CRSwNP. Nasal bacteria are also promising in the diagnosis and treatment of CRSwNP. This review summarizes the current findings and understanding of the correlation between the bacterial microbiome of the nasal cavity and CRSwNP.
    Application status of oral corticosteroids during the perioperative period of chronic rhinosinusitis with nasal polyps
    ZI Haokun,XIAO Xuping, LI Yunqiu
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  98-103.  doi:10.6040/j.issn.1673-3770.0.2020.428
    Abstract ( 664 )   PDF (444KB) ( 228 )   Save
    References | Related Articles | Metrics
    Endoscopic sinus surgery (ESS) has become the “gold standard” for the surgical treatment of chronic rhinosinusitis with nasal polyps (CRSwNP). The perioperative management of ESS has an important influence on the results of surgery. At present, oral glucocorticoids have been used as ESS perioperative adjuvant drugs to enhance the surgical effect due to their antiinflammatory and immunosuppressive effects. However, there are still controversies related to their dosage form and efficacy. This article reviews the recent studies on oral glucocorticoids and CRSwNPrelated literature on perioperative efficacy. The effects and treatment strategies of oral glucocorticoids during the perioperative period have been reviewed to provide more treatment options and research directions.
    Advances in the application of hyaluronic acid in chronic sinusitis
    CAO Xuan,XIAO Xuping, LI Yunqiu
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  104-109.  doi:10.6040/j.issn.1673-3770.0.2021.226
    Abstract ( 901 )   PDF (452KB) ( 377 )   Save
    References | Related Articles | Metrics
    In otolaryngology-head and neck surgery, chronic sinusitis is a common disease that affects 5%-12% of the population with a complex etiology and pathophysiological mechanism. Drug and surgical treatment for this disease are constantly being improved. Hyaluronic acid(HA), through various pathways, is widely used in clinical practice in patients with chronic rhinosinusitis(CRS). This paper aims to explain the possible mechanism of action of hyaluronic acid in CRS and its current application in achieving the treatment mode, as well as explore the possible future treatment mode of HA to improve the clinical treatment of CRS.
    Research progress on health-related quality of life in allergic rhinitis
    NI Jingzi, WAN Wenjin,CHENG Lei
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  110-115.  doi:10.6040/j.issn.1673-3770.1.2021.165
    Abstract ( 754 )   PDF (461KB) ( 205 )   Save
    References | Related Articles | Metrics
    As a common chronic inflammatory disease, allergic rhinitis has a significant negative impact on the sufferers' quality of life. In addition to nasal symptoms, patients may also suffer from ocular and even systemic symptoms, including fatigue, sleep disturbance, depression, anxiety, and other emotional disorders, including decreased work ethic and learning efficiency. In recent years, health-related quality of life(HRQoL)has gradually received attention as an important parameter. This paper reviews the clinical symptoms of allergic rhinitis and its specific effects on daily activities, emotion, sleep, and education of patients. We raise the point that clinicians should pay more attention to the patients' subjective disease burden, and we further show that it is necessary to strengthen the citizens' awareness of the quality of life burden caused by allergic rhinitis to facilitate an early diagnosis and treatment.
    Research progress on gut microbiome in children with allergic rhinitis
    LIN Yihang,LI Youjin
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  116-122.  doi:10.6040/j.issn.1673-3770.0.2021.496
    Abstract ( 659 )   PDF (684KB) ( 150 )   Save
    References | Related Articles | Metrics
    With increasing awareness of the specialization of the structure and function of microbiota, the relationship between gut microbiota and the occurrence, development, and outcome of allergic diseases has been explored. The development of gut microbiota during childhood is a highly dynamic process and the characteristics of gut microbiota in children of different ages closely correlate with allergic rhinitis(AR). Although AR is the most common chronic respiratory disease in children, it currently has poor clinical outcomes with drug treatment and low acceptability of long-term immunotherapy treatment. Numerous clinical studies have been conducted to explore the benefits of adjusting the gut microbiota in children with AR. This review summarizes the progress in the clinical research of gut microbiota and potential interventions and evaluates the feasibility of fecal microbiota transplantation in treating allergic diseases.
    Mechanisms and research progress of pyroptosis in allergic rhinitis
    LIU Zhen,SONG Xicheng
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  123-129.  doi:10.6040/j.issn.1673-3770.0.2021.463
    Abstract ( 640 )   PDF (707KB) ( 154 )   Save
    References | Related Articles | Metrics
    Allergic rhinitis is an allergic inflammatory disease of the nasal mucosa caused by environmental and hereditary factors. The incidence rate of allergic rhinitis is increasing every year, and this has a serious impact on people's physical and mental health. The main therapeutic methods include drug therapy and immunotherapy, but the treatment effect is not ideal in some cases. The reason is mainly due to its complicated pathogenesis is complicated. Pyroptosis is a type of programmed cell death. In the recent years, studies have shown that pyroptosis is involved in the occurrence and development of allergic rhinitis. Some drugs can treat allergic rhinitis by inhibiting pyroptosis. Therefore, further exploration of the regulatory mechanisms of pyroptosis may provide new insights for the treatment of allergic rhinitis. This article reviews the mechanisms and research progress of pyroptosis in allergic rhinitis.
    Research progress on prostate-derived ETS factor in asthma and inflammatory diseases of the nasal mucosa
    WANG Na,CHAI Xiangbin
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  136-141.  doi:10.6040/j.issn.1673-3770.0.2020.498
    Abstract ( 722 )   PDF (418KB) ( 182 )   Save
    References | Related Articles | Metrics
    The SAM pointed domain-containing ETS transcription factor(SPDEF), a new member of the E26 transformation-specific(ETS)transcription factor family, SPDEF is also known as prostate-derived ETS factor(PDEF),has been found, for the first time, to be highly expressed in prostate tumor cells and involved in cell proliferation, differentiation, migration, apoptosis, and angiogenesis. Recently, some scholars found that SPDEF is related to the proliferation and differentiation of goblet cells, and it is the core factor that regulates the hypersecretion of the respiratory tract mucus. This article mainly reviews the mechanism underlying the regulation of mucus hypersecretion by SPDEF and the research progress on its involvement in chronic airway inflammatory diseases to provide new insights into the pathogenesis, diagnosis, and treatment of respiratory mucus hypersecretion diseases.
    Research progress on NLRP3 inflammasome in chronic rhinosinusitis and allergic rhinitis
    LIU Yitong, ZHOU Suizi,QIU Qianhui
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  142-146.  doi:10.6040/j.issn.1673-3770.0.2021.584
    Abstract ( 726 )   PDF (619KB) ( 313 )   Save
    References | Related Articles | Metrics
    Chronic rhinosinusitis(CRS)and allergic rhinitis(AR)are common upper airway inflammatory diseases. CRS and AR pathogenesis may be related to the overactivation of inflammasomes containing nucleotide-binding oligomerization domain-like receptor family(NLRs). NLR protein 3(NLRP3)is the most clinically important inflammasome in the NLR family. The reported frequency of NLRP3 has increased in recent years. This review summarizes the influence of NLPR3 on CRS and AR from three aspects: pathogenesis, disease progression, and disease treatment. Our goal is to provide a deeper understanding of the occurrence and development of these diseases and provide references for exploring various therapeutic targets.
    Efficacy of alkaline isotonic saline in laryngopharyngeal reflux symptom-positive or finding score-positive patients with chronic rhinosinusitis following endoscopic sinus surgery
    QIN Ming, SUN Zhanwei, WANG Weiwei, LI Shichao, WU Tianyi, WANG Guangke
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  147-153.  doi:10.6040/j.issn.1673-3770.0.2021.529
    Abstract ( 638 )   PDF (664KB) ( 144 )   Save
    References | Related Articles | Metrics
    Objective To study the efficacy of alkaline isotonic saline in laryngopharyngeal reflux symptom-positive or finding-positive patients with chronic rhinosinusitis(CRS)following endoscopic sinus surgery(ESS). Methods Eighty CRS patients who were reflux symptom- or finding score-positive and who had undergone ESS were randomized to receive alkaline isotonic saline(study group; n=40)or normal saline(control group; n=40). All patients were classified by phenotype(high-%EOS or low-%EOS)according to whether the eosinophil proportion in peripheral blood(%EOS)exceeded 4.27%. Follow-up evaluations were conducted at 2 and 6 weeks after surgery. Evaluations included reflux symptom index(RSI), reflux finding score(RFS), sino-nasal outcome test-20(SNOT-20), visual analogue scale(VAS), nasal obstruction symptom evaluation(NOSE), Lund-Kennedy endoscopic score, and adverse events. Results The study group showed better improvement in the VAS score [3.0(2.0,4.0)] than the control group [1.5(0.0,3.0)] at 2 weeks postoperatively(P=0.016<0.05); the variation in SNOT-20 and VAS scores [(13.4±10.3)and 3.0(2.0,4.0), respectively] was significantly reduced in the study group at 6 weeks(P=0.001<0.05). After stratification, patients in the low-%EOS + study subgroup showed a significant improvement in the variation of SNOT-20 and VAS scores at 2 weeks [13.0(8.0,19.0)and(3.2±1.9), respectively](P=0.024<0.05,P=0.030<0.05, respectively)and 6 weeks [(15.7±9.5)and 2.0(2.0,4.0), respectively] postoperatively(P=0.002<0.05,P=0.005<0.05, respectively). There were no severe side effects among the groups. Conclusions Alkaline isotonic saline has a better clinical efficacy in patients with CRS who are RSI-positive or RFS-positive during the early postoperative care period of CRS, particularly those with a low %EOS.
    Based on network pharmacology and molecular docking to explore the mechanism of “Chuanxiong-Baizhi” medicine in the treatment of sinusitis
    WANG Lu, XIE Hui, LU Meidi, DENG Xinxing, LI Qingyun
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  154-164.  doi:10.6040/j.issn.1673-3770.0.2021.270
    Abstract ( 773 )   PDF (11784KB) ( 97 )   Save
    References | Related Articles | Metrics
    Objective Using network pharmacology and molecular docking technology, we explored the target(s)and molecular mechanism(s)of combination therapy with Ligusticum and Chuanxiong-Baizhi medicine to treat sinusitis. Methods The chemical components and potential drug targets of Ligusticum Chuanxiong-Baizhi were extracted from the TCMSP database. Drug targets relevant to sinusitis were screened for using Genecards, Drugbank, DisGeNET, and OMIM databases. Cytoscape 3.8.0 software and the STRING platform were used to construct drug-component-target and PPI network diagrams of intersecting targets, To further identify key targets, we conducted GO and KEGG pathway enrichment analyses, constructed a component-target-pathway network diagram, screened for core targets, and finally, used Autodock software to verify molecular docking. Results This study identified 10 chemical constituents of Ligusticum Chuanxiong-Baizhi, and 35 targets at the intersection of constituents and diseases. The core active ingredients of Ligusticum Chuanxiong-Baizhi are β-sitosterol, myricanone, stigmasterol, mandenol, and prangenidin. Its core targets are CASP3, JUN, PTGS2, HSP90AA1, MAPK14, and PIK3CG. KEGG enrichment analysis showed that Ligusticum Chuanxiong-Baizhi may display efficacy in treating sinusitis through signal pathways including TNF, neurotrophic factors, VEGF, neuroactive ligand-receptor interactions, and calcium. Conclusion Network pharmacology research indicates that the Ligusticum Chuanxiong-Baizhi drug combination supplies multiple active components to treat sinusitis via multiple targets and multiple pathways. Molecular docking results show that its core active ingredients form effective molecular complexes with core targets, providing a theoretical basis for further research into mechanism, and experimental verification.
    Relationships between RANTES gene polymorphisms and chronic sinusitis with bilateral nasal polyps
    LIU Houjun, ZHANG Qian, CHENG You, XUE Fei, XU Li, WU Minghai
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  165-170.  doi:10.6040/j.issn.1673-3770.0.2021.469
    Abstract ( 655 )   PDF (1167KB) ( 100 )   Save
    References | Related Articles | Metrics
    Objective The aim of this study was to examine the relationship between single nucleotide polymorphisms of the RANTES gene(rs2107538 and rs2280788)and chronic sinusitis with bilateral nasal polyps(CRSwBNP)in the Han population of Jiangsu and Anhui regions. Methods One hundred and forty-one CRSwBNP patients(case group)and 108 healthy persons(control group)were enrolled, for a total of 249 participants. Clinical data were collected from all participants. Peripheral blood samples were collected and DNA was extracted. The RANTES gene locus(rs2107538 and rs2280788)was genotyped and the results were compared between case and control groups using logistic regression analysis. Results No significant differences in gender or age distribution were found between the case and control groups(P>0.05). CC, CT, and TT genotypes were detected at the rs2107538 locus and GG, CC, and CG genotypes were detected at the rs2280788 locus. The rs2107538 T allele was associated with a significantly increased risk of CRSwBNP(P=0.037, odds ratio[OR]=0.68, 95% confidence interval[CI]=0.47-0.98). The genotype at the rs2280788 locus was not associated with an increased risk of CRSwBNP. Linkage disequilibrium analysis showed that the RANTES rs2107538/rs2280788 C/G haplotype was protective against CRSwBNP(P=0.037, OR=0.68, 95%CI=0.47-0.98). Conclusion Thers2280788 polymorphism of the RANTES gene was not associated with CRSwBNP, but the rs2107538 polymorphism of the RANTES gene was associated with susceptibility to CRSwBNP.
    Bioinformatics analysis of gene expression profile in pediatric patients with chronic rhinosinusitis
    LI Lin, GAO Zhengwen, CUI Nan, SUN Jianping, HUANG Xianming, CUI Jing
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  171-180.  doi:10.6040/j.issn.1673-3770.0.2021.556
    Abstract ( 669 )   PDF (13395KB) ( 57 )   Save
    References | Related Articles | Metrics
    Objective We performed a preliminary bioinformatics analysis of genes from pediatric patients with chronic rhinosinusitis(CRS)to provide a scientific basis for preventing and treating CRS. Methods Data of pediatric patients with CRS were downloaded from Gene Expression Omnibus(GEO)database. Differentially expressed genes(DEGs)were screened in sinus mucosa tissue from pediatric patients with CRS and normal children. DEGs associated with the Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway were analyzed using the DAVID tool and Gene Set Enrichment Analysis(GESA). Protein-protein interaction(PPI)network associated with DEGs were analyzed using STRING and Cytoscape. Results Ninety-two DEGs were screened using adjusted P<0.05 and∣log2 FC∣>2. Of these DEGs, 57 were up-regulated, and 35 were down-regulated. GO analysis showed that up-regulated DEGs were enriched in phagocytosis, β cell receptor signaling pathway, bacterial defense response, immune response, and the external side of the plasma membrane. KEGG pathway analysis showed that up-regulated DEGs were enriched in salivary secretion, and down-regulated DEGs were enriched in retinol metabolism, chemical carcinogenesis, and tyrosine metabolism. All 49 DEGs were involved in the PPI network, with 61 edges, an average protein node degree of 1.51, and a local clustering coefficient of 0.387. The PPI enrichment had a significant difference(P<0.001). The top 10 hub genes were ASPM, NCAPG, TPX2, MCM10, TOP2A, STATH, ADH1C, ADH6, CYP26A1, and UGT2A2. Except for STATH, the hub genes were all in Modules 1 and 2. Conclusion The CRS pathogenesis in pediatric patients is mediated by interleukins, inflammation, immune response, β cell receptor signaling pathway, salivary secretion, and bacterial defense response by hub genes. Further studies are required to explore the putative mechanisms in pediatric patients with CRS.
    Role of nasal nitric oxide in diagnosis of chronic sinusitis
    LIANG Xu, JIN Peng, ZHAO Li, YU Kena, ZI Xiaoxue, YUAN Guangmei, ZANG Yirang, ZHANG Qinqin, ZHANG Hailing, SHI Li, ZHANG Hongping
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  181-188.  doi:10.6040/j.issn.1673-3770.0.2021.535
    Abstract ( 757 )   PDF (3965KB) ( 177 )   Save
    References | Related Articles | Metrics
    Objective To investigate the clinical value of nasal nitric oxide(nNO)in the diagnosis of chronic sinusitis(CRS). Methods The clinical characteristics of 135 CRS patients with or without nasal polyps(wNP and sNP, respectively), and 40 non-CRS patients were analyzed. The retrospective analyses included the differences of nNO levels, correlation between nNO and age, body mass index(BMI), peripheral blood eosinophils count and percentage, computed tomography Lund–Mackay score, and the ethmoid sinus/maxillary sinus(E/M)CT ratio. The diagnostic value of nNO in CRS was determined by receiving operating curve(ROC)curve and logistic regression model analyses. Results The level of nNO in CRSsNP and CRSwNP patients was significantly lower than in non-CRS patients(P<0.001). The level of nNO in CRSwNP patients was significantly lower than in CRSsNP patients(P<0.001). The level of nNO in patients with eosinophilic CRSwNP was lower than that in the non-eosinophilic CRSwNP patients(P<0.001). The nNO levels in the CRS and CRSwNP groups were significantly negatively correlated with E/M ratio and Lund-Mackay score(r=-0.423, P<0.001; r=-0.650, P<0.001; r=-0.434, P<0.001; and r=-0.608, P<0.001, respectively). Logistic regression analysis revealed the significant correlation between nNO level and CRS typing(P<0.01). nNO had moderate predictive value in distinguishing non-CRS from CRSsNP and CRSwNP(area under the ROC curve(AUC=0.849,P<0.001; AUC=0.771,P<0.001; AUC=0.894,P<0.001, respectively). nNO also had moderate predictive value in distinguishing CRSsNP from CRSwNP,(AUC=0.776, P<0.01). nNO had moderate predictive value in distinguishing non-CRS from non-eCRSwNP,(AUC=0.861, P<0.001)and high predictive value in distinguishing non-CRS from eCRSwNP(AUC=0.910,P<0.001). Conclusion nNO has clinical value in the preliminary diagnosis of CRS, distinguishing CRSsNP from CRSwNP, predicting eCRSwNP and non-eCRSwNP, and predicting lesions of nasal polyps.
    Postoperative efficacy of proton pump inhibitor in the treatment of difficult-to-treat rhinosinusitis with laryngopharyngeal reflux
    ZENG Xianting, WANG Guangke, SUN Zhanwei, WU Tianyi, LI Shichao, WANG Weiwei
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  189-194.  doi:10.6040/j.issn.1673-3770.0.2021.512
    Abstract ( 612 )   PDF (498KB) ( 67 )   Save
    References | Related Articles | Metrics
    Objective To explore the clinical effect of proton pump inhibitor(PPI)after the operation for difficult-to-treat rhinosinusitis(DTRS)with laryngopharyngeal reflux(LPR). Methods A total of 42 patients with DTRS with LPR were collected, of which 21 patients were given standard PPI treatment for 8 weeks plus routine perioperative treatment(experimental group), and 21 patients were given routine perioperative treatment(control group). The general information, peripheral blood eosinophil count, VAS score, peripheral blood IgE, Lund-Kennedy nasal endoscopy score, Lund-Mackay CT score, reflux symptom index scale(RSI)and reflux sign score(RFS)were compared between the two groups. The nasal endoscopic score, sinus CT score, VAS score, RSI and RFS scores of both groups were collected at the 1st, 3rd, 6th and 12th month after operation. Differences between the throat symptom score and objective examination results of both groups were analyzed, and the postoperative clinical effect of PPI therapy on DTRS with LPR was evaluated. Results After 1 year continuous follow-up, RFS, RSI, endoscopic score, sinus CT score and VAS scores were significantly lower compared with the control group [(2.57±1.54)points vs.(3.57±1.60)points,P=0.045<0.05;(2.86±1.59)points vs.(4.62±1.77)points,P=0.002<0.05;(3.43±1.93)points vs.(5.43±3.11)points, P=0.017;(1.00±0.78)points vs(2.10±1.09)points, P=0.018<0.05;(0.67±0.66)points vs.(1.24±0.83)points,P=0.001<0.05] Conclusion PPI after operation for DTRS with LPR can obviously improve nasal symptoms, improve quality of life and reduce the symptoms and signs related to throat reflux, which can be used as an individualized treatment for these patients.
    Effects of three different nasal uses of glucocorticoid on mucosal outcome after endoscopic sinus surgery
    CHEN Shiqin, WEI Pingcun, HU Yunlong, HU Jinwang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  195-201.  doi:10.6040/j.issn.1673-3770.0. 2020.477
    Abstract ( 864 )   PDF (1363KB) ( 125 )   Save
    References | Related Articles | Metrics
    Objective To study the effects of three different glucocorticoid administration methods on nasal mucosal outcome after endoscopic sinus surgery for chronic rhinosinusitis patients. Methods 60 patients who with chronic rhinosinusitis after endoscopic surgery were randomly divided into three groups, 20 patients cavities in each group. Respectively nasopore filled in surgical cavity and conventional hormone nasal spray(Group A), nasopore with budesonide suspension liquid filled and conventional hormone nasal spray(Group B), nasopore filled and hormone nasal spray at the head back position(Group C). Comparing nasal symptoms improvement and mucous membrane outcome between groups of patients. Results Visual analogue scale(VAS)and Lund-Kennedy scores of nasal endoscopy in group B and group C were lower than those in group A at the 2, 4 and 12 weeks after surgery(P<0.05). The rates of nasal vesicles, edema, secretion and scab in group B and group C were lower than those in group A at 2, 4 and 12 weeks after operation(P<0.05). The nasal scar adhesion rate of group B and group C were lower than those in group A at 4 and 12 weeks after surgery(P<0.05). At 4 and 12 weeks after surgery, VAS and Lund-Kennedy scores in group C were lower than those in group B(P<0.05). The incidence of nasal edema and secretions in group C were lower than those in group B at 12 weeks after operation(P<0.05). Conclusion The two methods of nasopore with budesonide suspension liquid filled in the nasal cavity joint with conventional hormone nasal spray,and nasopore filled joint with the hormone spray at the head back position after the operation play an active role after endoscopic surgery for chronic rhinosinusitis. They can relieving patients'symptoms, repairing and remodeling the mucous membrane in the operative cavity. And the effect of the hormone spray at the head back position is better.
    Exploring the medication pattern of professor Ruan Yan in the treatment of chronic sinusitis based on data mining
    LIU Zheng, FANG Caishan, MAO Shuxian, LAN Wanning, JIN Yan, LIAO Bolin, HUANG Danlin, ZHONG Fangjian, RUAN Yan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  202-208.  doi:10.6040/j.issn.1673-3770.0.2021.420
    Abstract ( 736 )   PDF (3613KB) ( 97 )   Save
    References | Related Articles | Metrics
    Objective To analyze the medication patterns of Professor Ruan Yan of the First Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, for the treatment of chronic sinusitis, based on the Traditional Chinese Medicine(TCM)inheritance aid platform system. Methods Valid medical records of patients with chronic rhinosinusitis from Professor Ruan Yan's outpatient clinic were collected and collated. The medical cases that met the criteria were selected strictly according to the inclusion and exclusion criteria, and a medical case database was established. Subsequently, frequency statistics, association rule analysis, and cluster analysis were used to statistically analyze the distribution of evidence types, frequency of drugs, and combinations of Chinese medicines in the medical case repertoire. This was done to explore the characteristics of Professor Ruan Yan's treatment of chronic rhinosinusitis and the rules of prescription grouping. Results We collected 159 medical records of patients treated for chronic sinusitis by Professor Ruan Yan, containing 245 prescriptions with 109 Chinese herbs(except Stevia rebaudiana). The statistical analysis showed that the largest proportion of all cases was the spleen and stomach damp-heat evidence type; 24 herbs were used ≥20 times. The association rule analysis of high-frequency herbs yielded 13 associated pairs, 15 groups of three associated herbs, and four groups of four associated herbs. Additionally, seven potential core basic prescriptions and seven core new prescriptions for the treatment of chronic sinusitis were derived using cluster and factor analyses. Conclusion Most patients with chronic rhinosinusitis in Lingnan have evidence patterns consistent with climatic characteristics, with the majority of patients having the damp-heat evidence pattern of the spleen and stomach. Professor Ruan Yan considers deficiency and reality as the main pathogenesis based on his unique treatment method for chronic sinusitus. Additionally, Professor Ruan Yan is good at using the main treatment methods such as benefiting qi and strengthening the spleen, promoting nasal circulation, and clearing heat and dampness to achieve both the symptoms and the root cause of the disease according to local conditions. What'more, Xanthium Powder is the basic prescription of Professor Ruan Yan for treating chronic sinusitis.
    Meta-analysis of the efficacy and safety of traditional Chinese medicine for nasal irrigation in the treatment of chronic rhinosinusitis
    LIN Manqing, ZHOU Min, CHEN Tengyu, LI-Dan, FANG Caishan, WANG Ruizhi, ZHU Jinxiang, RUAN-Yan, XU Huixian, WANG Peiyuan
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  209-225.  doi:10.6040/j.issn.1673-3770.0.2021.524
    Abstract ( 897 )   PDF (4992KB) ( 117 )   Save
    References | Related Articles | Metrics
    Objective To systematically evaluate the efficacy of nasal irrigation using traditional Chinese medicine(TCM)in treating chronic rhinosinusitis(CRS)after Functional Endoscopic Sinus Surgery(FESS)in the recent decade. Methods Using Chinese herbal irrigation, chronic rhinosinusitis, and randomized controlled trials as the key search terms,we searched the Pubmed、Web of science、the Cochrane Library、Embase、CNKI、VIP、CBM and Wanfang for related studies that were published for the recent ten years. We included randomized controlled trial articles about Chinese herbal irrigation as an intervention for chronic rhinosinusitis. The studies were screened strictly according to inclusion and exclusion criteria,and the quality was assessed; R software were used for data analysis. Results A total of 47 randomized controlled trials were included in the meta-analysis.These articles were divided into three groups. The meta-analysis showed that the total effective and cure rates of the TCM nasal irrigation group were higher than those of the saline irrigation and non-treatment control group. TheVAS score of the TCM nasal irrigation group was better than that for the other groups. Compared with the Western medicine irrigation and the non-treatment control group, the TCM nasal irrigation group reduced symptoms more effectively as evident by the symptom scores relating to nasal obstruction and hyposmia. The TCM nasal irrigation group also reduced the runny nose symptom score more effectively than the saline irrigation and non-treatment control groups. Comparing the saline irrigation,Western medicine irrigation, and blank control groups, there were no statistical differences in symptom scores relating to headache. The TCM irrigation group was superior to the control group in promoting postoperative nasal epithelialization,the Lund-Kennedy endoscopic score, and nasal mucosal ciliary transport rate. Safety was reported in 11 studies and no adverse reactions occurred. Conclusion TCM nasal irrigation is effective for the treatment of chronic sinusitis after surgery. Moreover, it is superior to isotonic saline irrigation, antibiotics, and hormone irrigation.TCM nasal irrigation should be considered in the clinical practice.
    Evaluation of the efficacy and potential mechanism of biyuan tongqiao granules in chronic sinusitis treatment based on Meta-analysis bridging network pharmacology
    JIANG Xuelian, ZHANG Jingyue, WEI Xudong
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  226-236.  doi:10.6040/j.issn.1673-3770.0.2021.505
    Abstract ( 788 )   PDF (19655KB) ( 63 )   Save
    References | Related Articles | Metrics
    Objective The efficacy of biyuan tongqiao granules and clarithromycin in the treatment of chronic rhinosinusitis was evaluated in this study. Based on Meta-analysis and network pharmacology, the potential mechanism of biyuan tongqiao granules and clarithromycin in chronic rhinosinusitis treatment was investigated. Methods Web of Science, PubMed, EMBASE, China journal full text database(CNKI), Vipers full text database(VIP), and Wanfang database literature(established since November 2021)were used to retrieve and screen the literature on chronic rhinosinusitis treatment using biyuan tongqiao granules. Randomized controlled trials(RCTs)were selected, and the quality of the literature that met the inclusion criteria was evaluated. Meta-analysis was performed for studies that met the quality criteria using RevMan 5.3 software. Target nasal abnormalities were screened using the TCMSP and BATMAN-TCM databases. Chronic sinusitis targets were screened using the GeneCards database, OMIM database, drug bank database, and PharmGKB database. Both targets, nasal abnormalities and chronic sinusitis, were screened using the FunRich software. The DAVID platform was used to conduct gene ontology biological processes, Kyoto gene, and genome encyclopedia pathway analysis on the shared targets of chronic rhinosinusitis. Key target screening was performed using the Cytoscape software. Results Eight original studies with a total of 1018 patients were included, among these 530 patients were in the treatment group and 488 patients in the control group. The clinical efficiency of biyuan tongqiao granules alone in the treatment group [RR=1.15, 95%CI(1.05, 1.27], Z=2.91, P=0.004)and the clinical efficiency of biyuan tongqiao granules combined with clindamycin in the treatment group [RR=1.31. 95%CI(1.18, 1.45), Z=5.14, P<0.000 01] were significantly different. The VAS scores(MD=-7.15, 95%CI(-8.22, -6.08), Z=13, P<0.000 01)in the treatment group for biyuan tongqiao granules combined with clindamycin and in the control group for clindamycin were also significantly different. The Lund-Kennedy score [MD=-2.68, 95%CI(-4.64, -0.72), Z=2.68, P=0.007] was significantly different. Network pharmacology identified a total of 48 targets and the KEGG-enriched pathways included the HIF-1 signaling pathway, Toll-like receptor signaling pathway, NOD-like receptor signaling pathway, and NF-kappa B signaling pathway. The key targets in the treatment of chronic sinusitis were TNF, IL6, AKT1, VEGFA, and PTGS2. Conclusion The combination of biyuan tongqiao granules with clarithromycin or biyuan tongqiao granules alone indicated that their therapeutic effects were better than those of clarithromycin alone. Due to the limitation of the quality of included studies, more high-quality studies are required to validate the above findings. Key targets for the effects of biyuan tongqiao granules in the treatment of chronic rhinosinusitis are TNF, IL6, AKT1, VEGFA, and PTGS2.
    Effects of ozone on nuclear protein expression of NF-κB p65 in nasal mucosa and inflammatory factors in a rat model of allergic rhinitis
    SUN Na, HUANG Yu, ZHANG Ruxin, ZHANG Xueyan, NIU Yue, DUAN Yusen, KAN Haidong
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  237-244.  doi:10.6040/j.issn.1673-3770.0.2021.564
    Abstract ( 560 )   PDF (4863KB) ( 104 )   Save
    References | Related Articles | Metrics
    Objective This study aimed to investigate the effect of ozone on the pathogenesis and inflammatory factors in a rat model of allergic rhinitis. Methods Forty-eight healthy female Sprague Dawley rats were randomly divided into six groups: normal control group(NC group), allergic rhinitis(AR)model group, normal rat ozone inhalation exposure group(NE group, 1 ppm), AR model exposed to low concentration ozone group(AREL group and 0.5 ppm), AR model exposed to moderate concentration ozone group(AREM group, 1 ppm), and AR model exposed to high ozone concentrations(AREH group, 2 ppm). AR rat models were sensitized to ovalbumin(OVA). The rats were exposed to different concentrations of ozone using the prepared ozone inhalation exposure system for 2 h per day for 6 weeks consecutively. Within 15 min of the last OVA nasal challenge, the numbers of sneezes and scratches were recorded, and the amounts of nasal secretions were measured. Nasal lavage fluid and nasal mucosa were collected 24 h after the last exposure. Western blotting was performed to detect the protein expression of nuclear factor-kappa B(NF-κB)p65. Quantitative real-time PCR was used to detect the mRNA expression of the NF-κB target genes for tumor necrosis factor-alpha(TNF-α), interleukin(IL)-6, and IL-8 in the nasal mucosa. OVA-specific IgE levels and protein levels of the pro-inflammatory factors IL-6, IL-8, and TNF-α in nasal lavage fluid were determined by ELISA. Pathological changes in the nasal mucosa were assessed by hematoxylin and eosin staining. Statistical analyses and graphical representations were performed using SPSS 20.0. Results The frequency of sneezing, nasal scratching, and nasal secretion in rats with AR was higher in the ozone exposure group than in the AR and NC groups(P<0.05). The serum OVA slgE levels in the ARE group were higher than those in the AR and NC groups(P<0.05); the increase was most obvious in the AREH group. Nuclear protein expression of NF-κB p65 in the AREM and AREH groups was higher than that in the AR and NC groups(P<0.05). The mRNA expressions of IL-6, IL-8, and TNF-α in nasal mucosa and the protein content of IL-6, IL-8, and TNF-α in nasal lavage fluid were increased in the AR ozone exposure group. The nasal lavage fluid levels of IL-6, IL-8, and TNF-α were higher in the AREL group than in the NC group, and those in the medium- and high-concentration exposure groups were higher than those in the AR and NC groups(P<0.05). Conclusion Ozone inhalation can increase the serum OVA slgE of AR; promote the release of inflammatory factors TNF-α, IL-6, and IL-8; and lead to the aggravation of AR symptoms. This pathological process may be related to the transfer of NF-κB into the nucleus and expression of its target genes in nasal mucosa activated by ozone in AR rats.
    Analysis of proportion of outpatients with allergic rhinitis during the coronavirus infectious disease 2019 pandemic
    GONG Xiaoyang, CHENG Lei
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  245-255.  doi:10.6040/j.issn.1673-3770.0.2021.422
    Abstract ( 833 )   PDF (2786KB) ( 146 )   Save
    References | Related Articles | Metrics
    Objective This study aimed to explore the proportion of outpatients with allergic rhinitis(AR)during the coronavirus infectious disease 2019(COVID-19)pandemic, analyze the relevant factors affecting the incidence of AR during the COVID-19 pandemic, and discuss the impact of staying indoors and wearing masks on the incidence of AR. Methods We collected data from the outpatients in the clinic of the Otolaryngology Department of Jiangsu Province Hospital in March, April, and May of 2017, 2018, 2019, and 2020 and total number of patients who were diagnosed with “AR,” and “chronic rhinitis.” We analyzed the proportion of patients with AR among the total number of patients, and further analyzed the differences in the incidence of AR by sex and age. Results The proportion of outpatients with AR in the total number of outpatients in March, April, and May before the COVID-19 pandemic in 2020 was statistically significant compared to that in April 2018(P=0.028)and May 2019(P=0.001)due to the low number of patients in March, while the differences in other months were not statistically significant. However, the peak of the total number of patients was delayed due to the impact of the COVID-19 pandemic. The proportion of male patients with AR was slightly higher than that of the female patients with AR, with no statistical significance compared to previous years. Regarding age, the proportion of patients with AR in the aged 0-18 years group was higher than that in previous years, and the difference was statistically significant(P<0.05). The aged 19-40years and 41-60 years groups showed no statistical significance compared to previous years, while the sample size of the aged >60 years group was limited and the proportion changed greatly. After the COVID-19 pandemic stabilized in June 2020, the visits of patients with AR gradually approached and partially exceeded the level of the same period from 2017 to 2019. Conclusions During the COVID-19 pandemic in 2020, the proportion of outpatients with AR in the total number of outpatients did not decrease due to factors, such as mask sealing problems, epidemic pressure, indoor allergens, and indoor air conditions, but slightly increased in some months after the COVID-19 pandemic stabilized compared to the past 3 years. Wearing masks and home quarantine did not significantly reduce the onset of the number of patients with AR, but it is still recommended in patients with AR to wear a face mask when going out, especially since pollen allergies during the sensitization pollen spread out, recommends wearing particulate respirators, keep the room ventilated, and purify indoor air, to alleviate AR-related symptoms.
    Expression and significance of the MAPK,PI3K-AKT,NF-κB pathways of allergic rhinitis in mice
    ZHANG Yaqi, LIU Huimin, CAO Linman, WANG Ziyu, LIN Xu, LI Yanping, XUE Gang, WU Jingfang
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  254-259.  doi:10.6040/j.issn.1673-3770.0.2021.174
    Abstract ( 994 )   PDF (8722KB) ( 135 )   Save
    References | Related Articles | Metrics
    Objective To explore the mechanism of multi-signaling pathways proteins in the development of allergic rhinitis(AR)in mice. Methods Forty Kunming mice were randomly divided into allergic rhinitis group(AR group)and control group(Con group)each 20 mice. The nasal of 8 mice in each group was fixed with 4% paraformaldehyde, embedded in paraffin, sectioned and stained by HE method to observe the pathological changes of nasal mucosa. And the expression of MAPK, NF-κB and PI3K-AKT pathways proteins were detected by immunohistochemistry(IHC). The other 24 mice of each group were prepared for Western blot(WB)analysis. Results The behavioral results showed that scratching, sneezing and runny nose of the AR group were far more than Con group(P<0.05). In the HE staining, the mucosa showed pseudostratified ciliated columnar epithelial necrosis, epithelial structural remodeling and eosinophil infiltration etc. typical pathological changes of rhinitis. IHC showed that the positive proteins of three key pathways in the AR group was higher than that of the Con group. The proteins expression of MAPK, PI3K-AKT and NF-κB in the AR group were increased compared with the Con group and had a significant differences by western blot(P<0.05). Conclusion The increased proteins of MAPK, NF-κB and PI3K-AKT signaling pathways may have a synergistic effect on the pathogenesis of AR in mice.
    Analysis of sIgE in polysensitized children with allergic rhinitis
    LU Weili, JIANG Tao, LI Xianhua
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  260-265.  doi:10.6040/j.issn.1673-3770.0.2021.438
    Abstract ( 650 )   PDF (1233KB) ( 83 )   Save
    References | Related Articles | Metrics
    Objective To investigate the distribution of serum specific IgE(sIgE)in polysensitized children with allergic rhinitis(AR)in Dalian. Methods Retrospectively analyzed the sIgE results of 272 polysensitized pediatric AR patients, grouped by sex, age, allergen type and intensity, number and intensity of inhaled and ingested allergens, to compare the distribution of allergens between groups. Results Pearson correlation analysis(r=0.587, P=0.035)showed that polysensitization was positively correlated with age in all AR children, and the intensity was higher. Spearman's correlation analysis(r=-0.913, P<0.001)showed a negative correlation between the number of allergen species and the corresponding number of patients, and the intensity was higher. Based on age, the patients were divided into 3 groups, 2-5 years, 5-9 years, and 10-14 years. There was a negative correlation between the allergen-positive cases and number of allergen species in each group, and the intensity was higher. The top 5 allergen-positive cases were house dust mite/powder mite, Artemisia, cat, egg white and common ragweed. Based on age, there was a significant difference in the frequency of inhalational and ingestion allergens between the 6-9 years old group(t=2.275, P=0.048). There was significant difference in average strength between inhalation and ingestion allergens(t=2.361, P=0.035). There was a significant difference in average strength between inhalatant and ingestant allergens in the 10-14 years old group(t=3.658, P=0.002). The differences in spring, autumn and year-round among inhalatant allergens were not statistically significant in the number, total intensity and mean intensity. Conclusion As children get older and Increased types of contact allergens, the number of children with polysensitization will also increase. Allergen testing needs to be rechecked regularly. Dermatophagoides farinae / Dermatophagoides farinae, Artemisia argyi, cat, egg white and common ragweed are the main allergens of AR children with polysensitization in Dalian, and attention should be paid to prevention and control. The sensitization of ingestant allergens should be paid attention to at the age of 6-9.
    Meta-analysis of acupoint catgut embedding in the treatment of allergic rhinitis based on the theory of “lung and spleen”
    HUANG Kaiyue, LI Xueqing, HAN Gouxin, ZHANG Qinxiu
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  266-274.  doi:10.6040/j.issn.1673-3770.0.2021.153
    Abstract ( 718 )   PDF (4652KB) ( 77 )   Save
    References | Related Articles | Metrics
    Objective To evaluate the effectiveness of acupoint catgut embedding in the treatment of allergic rhinitis based on the “lung and spleen” theory. Methods An internet search was conducted for randomized controlled trials related to acupoint catgut embedding in the treatment of allergic rhinitis published in the CNKI(2000.1-2021.2), VIP(2000.1-2021.2), WANGFANG(2000.1-2021.2), and Pubmed(2000.1-2020.2)databases. Two researchers separately carried out screening on the selected documents and focused on: quality evaluation and extraction of relevant data. RevMan 5.4 was used for meta-analysis. Results A total of 12 articles comprising 931 cases met the inclusion criteria. The results of the meta-analysis showed that the effective rate of the acupoint catgut embedding group was better than that of the control group(RR=1.29, 95%CI: 1.22, 1.38, P<0.000 1). The recurrence rate of the acupoint catgut embedding group was compared with that of the control group and the difference was statistically significant(RR=0.3, 95%CI: 0.16, 0.55, P<0.000 1). Furthermore, when the total score of signs and symptoms in the acupoint catgut embedding group was compared before and after treatment with the control group, and the difference was statistically significant [SMD=-0.97,95%CI(-1.51,-0.43),P=0.000 4]. Conclusion The Meta-analysis of the included articles showed that the acupoint embedding method is more effective in the treatment of allergic rhinitis and has a lower recurrence rate. However, the limited quality and quantity of the included articles must have created a publication bias. Therefore, the above analysis and conclusions require further research and investigation.
    Comparison of sinus computed tomography characteristics in patients with eosinophil and non-eosinophil chronic nasosinusitis
    WAN Xia, KONG Yonggang, CHEN Shiming, HUA Hongli, WEI Yuanyuan, ZENG Manli
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  275-280.  doi:10.6040/j.issn.1673-3770.0.2022.050
    Abstract ( 792 )   PDF (905KB) ( 92 )   Save
    References | Related Articles | Metrics
    Objective To investigate the characteristics of sinus computed tomography in patients with eosinophil chronic nasosinusitis(ECRS)and non-eosinophil chronic nasosinusitis(NECRS). Methods A total of 1010 patients with chronic rhinosinusitis(CRS)were enrolled and divided into the ECRS(n=458)and NECRS(n=552)groups according to the eosinophil to inflammatory cell count ratio(Eos%)in tissue, with a cut off limit of Eos%≥10%. The Lund Mackay score, sinus lesion rate, and sinus lesion type were analyzed between the two groups. The Lund Mackay score and sinus lesion type were analyzed between the ECRS and NECRS groups at different ages, and the value of ethmoid sinus to maxillary sinus score(E/M)in predicting ECRS was also investigated. Results In the ECRS group, the ethmoid sinus, frontal sinus, sphenoid sinus, ostiomeatal complex(OMC)and total scores were higher(P<0.01), while the maxillary sinus scores were lower than those in the NECRS group(P<0.01). The lesion rates of anterior ethmoid sinus, posterior ethmoid sinus, sphenoid sinus, and frontal sinus in the ECRS group were also higher than those in the NECRS group. There was no significant difference in Lund Mackay scores between the ECRS(P=0.786)and NECRS(P=0.634)groups at different ages. The proportions of full set of sinusitis, ethmoid sinus lesion dominant, and non-ethmoid sinus lesion dominant CRS types in ECRS and NECRS groups were 39.08%, 37.24%, 23.58% and 26.45%, 8.88%, 64.67%, respectively. In addition, with the increase of age, the proportion of full set of sinusitis in ECRS in adult patients increased gradually(P=0.04). When E/M>2 was used as the cut-off value, the AUC for predicting ECRS in all patients was 0.67, while that in patients without a full set of sinusitis was 0.75. Conclusions The ethmoid sinus, frontal sinus, and sphenoid sinus lesions in ECRS are more severe than those in NECRS, while the maxillary sinus lesions are less severe. Furthermore, the ethmoid sinus, sphenoid sinus, and frontal sinus are more easily involved in ECRS than in NECRS. ECRS comprises mainly ethmoid sinus lesions with full set of sinusitis, while NECRS comprises mainly non-ethmoid sinus lesions with full set of sinusitis. The incidence of full set of sinusitis in adult ECRS patients increases with age. E/M > 2 has limited predictive value for ECRS in patients with full set of sinusitis.
    Meta-analysis of the curative effect of traditional Chinese medicine decoction combined with conventional western medicine on allergic rhinitis
    ZHU Zhengru, ZHANG Xiaobing
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  281-289.  doi:10.6040/j.issn.1673-3770.0.2020.519
    Abstract ( 731 )   PDF (5868KB) ( 163 )   Save
    References | Related Articles | Metrics
    Objective Meta-analysis was conducted to explore the influence of combined Chines decoctione and conventional western medicine on the short-term and long-term efficacy of allergic rhinitis. Methods Computer retrieval Chinese National Knowledge Infrastructure(CNKI), Wan Fang Data, VIP, CBM, Pubmed, Embase, The Cochrane Library databases of combining traditional Chinese and western medicine treatment of allergic rhinitis in clinical research of randomized controlled trials, from building Library retrieval timeuntil October 2020. After quality evaluation and relevant data extraction by two professional researchers, RevMan5.3 software and Stata 15.0 software were used for Meta analysis. Results In the end into the 20 research, a total of 2056 patients, using fixed effect model to the total effect value to merge, Meta analysis results show that the recent effective rate of combining traditional Chinese decoctione and conventional western medicine treatment of allergic rhinitis was superior to that of control group [RR=1.18, 95%CI(1.13,1.22), P<0.001], long-term effectiveness significantly better than control group [RR=1.79, 95%CI(1.50,2.13), P<0.001], After classification, the short-term effective rates of tonifying fei-qi method, fortifying the Spleen and boosting qi method and Qingxuan-fei-qi method combined with conventional western medicine were all better than those of the control group. Meta-analysis results were [RR=1.17, 95%CI(1.11,1.23), P<0.001],[RR=1.18, 95%CI(1.09,1.29), P<0.001],[RR=1.18, 95%CI(1.10,1.26), P<0.001], respectively. the difference is statistically significant. In this study, funnel plot showed the basic symmetry between the left and the right, and the begg bias test was used to obtain P=0.069>0.05 means that the publication bias of the 19 literatures selected in this study is small. Conclusion This study shows that the combined treatment of Chinese medicine decoction and conventional western medicine for AR is superior to the treatment of western medicine alone in both short-term and long-term efficacy.
    Primary extraskeletal Ewing sarcoma/peripheral primitive neuroectodermal tumor in the nasal cavity and paranasal sinus: a case report and literature review
    CHEN Jiahong, WANG Lin, JIANG Yan, YU Longgang, ZHANG Jisheng, ZHANG Zhiyong, KONG Jingwen
    Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):  290-296.  doi:10.6040/j.issn.1673-3770.0.2022.009
    Abstract ( 621 )   PDF (10708KB) ( 84 )   Save
    References | Related Articles | Metrics
    Objective This study aimed to analyze the characteristics of primary extraskeletal Ewing sarcoma(EES)/peripheral primitive neuroectodermal tumor(pPNET)in the nasal cavity and paranasal sinus to provide reference for the diagnosis and treatment of the disease. Methods We conducted a retrospective study on the data of two patients with EES/pPNET in the nasal cavity and paranasal sinuses admitted to our hospital from March 2014 to July 2019. We also performed a literature review in Chinese and English from 2006 to 2021, including the two cases in this study. A total of 48 patients were included, and their clinical manifestations, diagnosis, treatment methods, and prognosis were summarized. Results The median age of the patients was 26 years, age range was 7-83 years, and ratio of men to women was 1.5. The main symptoms of the disease were nasal symptoms, including nasal congestion 16/28(57.1%), epistaxis/nasal discharge stained with blood 12/28(42.9%), headache 3/28(10.7%), and hyposmia 3/28(10.7%). The lesion invasion sites were the nasal cavity 32/48(66.7%), maxillary sinus 24/48(50.0%), ethmoid sinus 27/48(56.3%), sphenoid sinus 8/48(16.7%), frontal sinus 3/48(6.3%), orbital invasion 17/48(35.4%), and skull base 6/48(12.5%). Univariate analysis, such as comprehensive treatment(P=0.009)and radiotherapy(P=0.014), could significantly improve the prognosis of patients. Invasion in the sphenoid sinus(P=0.027)and skull base(P=0.002)showed poor prognosis. Multivariate Cox regression analysis showed that skull-base invasion was an independent risk factor for prognosis(P=0.008). Patients with skull-base invasion had a higher risk of death compared to those without skull-base invasion, HR=8.940(95%CI: 1.756-45.506). Conclusions EES in the nasal cavity and paranasal sinus is mostly common in young women. Nasal congestion and epistaxis are common symptoms. It mainly involves the nasal cavity, maxillary sinus, and ethmoid sinus, which also could invade the orbit and skull base. Skull base invasion was an independent risk factor for prognosis. Chemotherapy combined with radiotherapy is the main treatment.