Correlation analysis of TGF-ß1, MMP-9, TIMP-1, IL-1, IL-4, IL-6, IL-17, and TNF-α in refractory chronic rhinosinusitis: A retrospective study.

OBJECTIVE: To investigate the potential correlation of transforming growth factor-ß (TGF-ß), matrix metalloprotein 9 (MMP-9), tissue inhibitor of metalloproteinases 1 (TIMP-1), Interleukin 1 (IL-1), IL-4, IL-6, IL-17, and tumor necrosis factor alpha (TNF-α) in refractory chronic rhinosinusitis. METHODS: A total of 150 participants were retrospectively included in this study from August 2018 to February 2020. The people enrolled were equally allocated into refractory group (patients with refractory chronic rhinosinusitis), chronic group (patients with chronic rhinosinusitis), and control group (normal people). The level of TGF-ß1, MMP-9, TIMP-1, IL-1, IL-4, IL-6, IL-17, and TNF-α were recorded. The unconditional multivariate binary logistic regression was used to analyze the factors affecting refractory chronic rhinosinusitis. RESULTS: The Davos score, T&T olfactometer threshold test, and Lund-Mackay CT scores in refractory group were significantly higher than the chronic group (P<0.05). The level of TGF-ß1, MMP-9, TIMP-1, IL-1, IL-4, IL-6, IL-17, and TNF-α in the refractory group were significantly higher than the chronic group and the control group (all P<0.05). Similarly, the level of the above mentioned indexes in the chronic group were significantly higher than the control group (P<0.05). The Davos score, T&T olfactometer threshold test score, Lund-Mackay CT score, and the level of TGF-ß1, MMP-9, TIMP-1, IL-1, IL-4, IL-6, IL-17, and TNF-α positively correlated with refractory chronic rhinosinusitis. Moreover, the unconditional multivariate binary logistic regression showed that the influencing factors of refractory chronic rhinosinusitis included TGF-ß1, MMP-9, TIMP-1, IL-1, IL-4, IL-6, IL-17, and TNF-α. CONCLUSION: The findings of the present study provide evidence for TGF-ß1, MMP-9, TIMP-1, IL-4, IL-6, IL-17, and TNF-α as the influencing factors of refractory chronic rhinosinusitis.

Role of Zinc Sulphate in Immune Regulation in Artemisia annua Pollen-challenged P815 Mastocytoma Cells.

Objective This study aimed to investigate the role of zinc sulphate in immune regulation in Artemisia annua pollen-challenged P815 mastocytoma cells. Methods P815 mastocytoma cells were treated with various concentrations of zinc sulphate and Artemisia annua pollen. Cell proliferation was measured using the Cell Counting Kit-8. The amount of ST2 and p38 in the cells were measured using Western blotting. The level of interleukins (IL)-33 in the supernatant was determined using the enzyme-linked immunosorbent assay. The levels of IL-2, IL-4, IL-5, interferon-γ, and tumor necrosis factor were measured using the cytometric bead array. Results Artemisia annua pollen at a concentration >0.001 µg/mL induced allergic response in the P815 mastocytoma cells. Expressions of IL-33, IL-4, ST2, and p38 increased along with higher concentrations of Artemisia annua pollen. Zinc sulphate of 50-200 µmol/L promoted the proliferation of P815 mastocytoma cells. Zinc sulphate attenuated the upregulation of IL-33, IL-4, ST2, and p38 caused by Artemisia annua pollen. Conclusion Zinc sulphate can promote the proliferation of P815 mastocytoma cells. It can also attenuate allergic response in the P815 mastocytoma cells induced by Artemisia annua pollen, which might provide a new treatment method for allergic diseases.

Diagnosis and treatment of McCune-Albright syndrome: A case report.

BACKGROUND: McCune-Albright syndrome (MAS) is extremely rare clinically. We here report a case of MAS with severe symptoms that have not been reported previously. CASE SUMMARY: A 10-year-old boy attended our outpatient clinic due to craniofacial malformations found two years ago. He underwent temporal bone computed tomography and digital radiography photography. Based on a literature review combined with the patient's medical history and imaging examination findings, he was diagnosed with multiple fibrous dysplasia of bone. As the clinical symptoms related to MAS in this patient were not obvious, he was only followed up and not given any special treatment. CONCLUSION: The unique clinical manifestations in this MAS patient may be related to mutations in the GNAS gene.

[Analysis of medium and long term efficacy of ossicle chain bypass technique in treatment of tympanosclerosis].

Objective:For tympanosclerosis patients with ossicular chain fixation, we use ossicular chain bypass technique and evaluate its long-term effects. Methods:From June 2017 to June 2019, 147 patients with tympanosclerosis who underwent middle ear surgery with otoscopy in Yinchuan First People's Hospital were reviewed. The subjects were divided into three groups according to the implemented operation plan, 51 cases in the ossicular chain mobilization group（OCM）, 56 cases in the ossicular chain bypass reconstruction group（OCB）, and 40 cases in the malleus-incus complex resection reconstruction group（MICR）. Through a three-year follow-up, the medium and long-term effects of different operation plans were compared and analyzed. Results:There was no significant difference among the three groups in the incidence of tympanic membrane perforation, delayed facial nerve palsy, and the dispatch and displacement of PORP. The incidence of tympanic membrane retraction pocket or cholesteatoma after operation in OCB group（0） was significantly lower than that in OCM group（11.76%） and MICR group（7.5%）（P<0.05）. At 12 months after operation, ΔABG of OCB group and MICR group were better than that in the OCM group（P<0.05）. At 36 months after operation, ΔABG of OCB group was better than that in the OCM group（P<0.05）, and there was no significant difference between OCB group and MICR group. The audiological performance of patients with epitympanic sclerosis（ETS） at 12, 24 and 36 months after operation was better than that of patients with posterior tympanosclerosis（PTS） and total tympanosclerosis（TTS）（P<0.05）. Conclusion:Compared with patients undergoing ossicular chain mobilization and malleus-incus complex resection for ossicular chain reconstruction, patients with tympanosclerosis undergoing bypass technique have better and stable hearing prognosis in medium and long term. This technique can effectively prevent the formation of retracted pocket and cholesteatoma in patients with tympanosclerosis after operation.

Regulatory Role of Zinc in Allergic Rhinitis through the IL-33/ST2 Pathway.

OBJECTIVE: We aimed to investigate the expression of serum zinc and cytokines interleukin- (IL-) 13 and IL-33 in patients with allergic rhinitis (AR) and observe the effects of zinc on cytokines and pathway proteins in P815 mast cells stimulated by Artemisia annua allergen (Art.) in the IL-33/suppression of the tumorigenicity 2 (ST2) pathway. We also aimed to explore the possible regulatory role of zinc in AR and provide new ideas to determine the etiology and treatment of AR. METHODS: AR patients treated from March to September in 2018 were selected as the research participants, and 50 healthy people in the same period were selected as the control group. Serum samples of all patients were collected, and those of AR patients were tested for the presence of allergens. The expression of IL-13 and IL-33 was detected by performing an enzyme-linked immunosorbent assay, while the serum zinc level was detected by conducting an inductively coupled plasma mass spectrometry. The cell counting kit (CCK-8) was used to detect the proliferation of P815 mast cells, and western blot was used to detect the expression of ST2, p38, and p65 proteins. RESULTS: A total of 92 AR patients were included in the study; of them, 52 had mild AR, while 40 had moderate AR. The primary allergen found in AR patients was Artemisia, and the positivity rate was 53.26%. The serum zinc ion level of AR patients decreased, and the expression of IL-13 and IL-33 increased. After Art. was used to treat P815 mast cells, the expression of IL-33 in the cell supernatant increased in a concentration-dependent manner, the expression of receptor ST2 increased, and the expression of downstream p38 and p65 proteins increased. However, after treatment with ZnSO4, the expression of IL-33 in the cell supernatant decreased, and the expression of ST2, p38, and p65 protein decreased. CONCLUSION: The serum zinc level of AR patients decreased. In the IL-33/ST2 pathway, ZnSO4 can reduce the hypersensitivity of mast cells induced by Art.

Association of Laryngopharyngeal Reflux Disease and Refractory Chronic Rhinosinusitis.

OBJECTIVE: The current study was conducted to explore the association between laryngopharyngeal reflux disease (LPRD) and refractory chronic rhinosinusitis (RCRS), and to reveal the potential role of LPRD in the development of RCRS. METHODS: A total of 104 patients diagnosed as chronic rhinosinusitis (CRS) and hospitalized, as well as 50 healthy participants were enrolled into this study. Among patients enrolled, 53 were RCRS and 51 were CRS. All participants were assessed with reflux symptom index (RSI) and reflux finding score (RFS). Patients with RSI >13 and/or RFS >7 were diagnosed as LPRD. In addition, pepsin in the nasal secretions from the middle meatus tract complex at fasting in the morning was analyzed using ELISA. Patients with pepsin concentration of >75 ng/ml was considered as positive, and confirmed as LPRD. RESULTS: There was no significant difference in age, sex, height, and weight among RCRS, CRS, and control groups. The positive rates of RSI and RFS scores were 39.6% in the RCRS and 52.9% in the CRS, respectively, which were significantly higher than that of the control group (14.0%, P < 0.05), respectively. Significantly higher positive rate of pepsin assay was also observed for RCRS(43.4%) and CRS(64.7%) when compared with the control group (18.0%, P < 0.05). The positive rate of pepsin assay was strongly associated with the positive rate of RSI or RFS (P < 0.001). CONCLUSION: The present findings have important implications that RSI and RFS score was highly associated with pepsin assay result in the patients with RCRS or CRS. We confirmed the importance of RSI and RFS scoring system as well as pepsin test, which may offer insight for clinical screening for LPRD among CRS patients.

Anterior skull base reconstruction with galeal-frontalis-pericranial flap based on temporalis myofascial flap.

Such a giant anterior skull base mucocele involving the orbito-ethmoido-maxillo-fronto sinuses is a rare case. This patient complained of a right orbital mass for 18 years, and he was recommended to our hospital for treatment. His history, physical examination, laboratory study results, diagnosis, and treatment are reported in detail. In conclusion, we show that modified transcranial pathway and ingenious assistant incision can get the utmost exposure and can obtain a satisfactory aesthetic result and that anterior skull base reconstruction with the galeal-frontalis-pericranial flap based on the temporalis myofascial flap for the first time can successfully prevent life-threatening complications from happening.

[The correlation of allergic rhinitis and trace elements in Ningxia region].

OBJECTIVE: To investigate the correlation of allergic rhinitis and trace elements and to provide a reference for clinical diagnosis, treatment and prevention of allergic rhinitis. METHODS: One hundred and six patients were diagnosed as allergic rhinitis in General Hospital of Ningxia Medical University between January and December in 2010, including 48 cases of perennial allergic rhinitis and 58 cases of seasonal allergic rhinitis. In the same time, one hundred and three healthy volunteers were selected as control. Intravenous blood 3-5 ml were obtained from all subjects both in experimental group and in control group. The content of Ca, Ni, Fe, Mg, Zn, Sr, Mn, Cu, Se in serum and hair was determined by inductively coupled plasma atomic emission spectrometry (ICP-AES). The t-test (SPSS 16.0) was used to compare the results of trace elements in serum between allergic rhinitis and control group. RESULTS: The testing results of trace elements in AR patients serum and normal controls serum were as follows: Cu, Ni (1 002.18 ± 104.62) µg/L, (21.58 ± 5.54) mg/L were super than control group, (832.78 ± 50.45) µg/L, (17.04 ± 4.93) mg/L (t value was 15.545, 5.154, both P < 0.05). But the content of Zn, Se (793.48 ± 46.88) µg/L, (84.25 ± 12.77) µg/L lower than control group (908.53 ± 31.26) µg/L, (98.35 ± 15.21) µg/L (t value was -24.175 and -7.797, both P < 0.05) . The testing results of trace elements in AR patients hair and normal controls hair were as follows: Cu, Ni (42.43 ± 5.03) µg/g, (31.72 ± 5.49) µg/g were super than control group, (23.00 ± 4.45) µg/g, (8.94 ± 7.53) µg/g (t value was -8.633 and 4.236, both P < 0.05). But the content of Zn, Se (92.16 ± 4.54) µg/g , (0.28 ± 0.04) µg/g lower than control group (189.09 ± 8.45) µg/g, (0.39 ± 0.06) µg/g (t value was -28.71 and -8.633, both P < 0.05). CONCLUSIONS: The content of Zn, Se in AR patients serum are lower than that in control group. But the content of Cu, Ni in AR patients serum are super than that in control group. There are no significant difference of trace elements in the serum between pennial allergic rhinitis and seasonal allergic rhinitis.

[Multi-center study on the treatment of sudden total deafness].

OBJECTIVE: To assess the results of drug therapy in patients with severe idiopathic sudden sensorineural hearing loss (ISSHL) with total frequency hearing loss. METHODS: A prospective randomized, single blind, multi-center clinical trial was designed. The untreated patients with ISSHL were included, who had severe hearing loss (pure tone audiometry showed patients had total frequency hearing loss, and their mean auditory threshold of 500, 1000, 2000, 4000 Hz was beyond 81 dB HL), age between 18 to 65 years old, and within 14 days of the onset . The patients were divided into one of the four drug groups [batroxobin, batroxobin + ginkgo biloba leaves extract (EGb), batroxobin + EGb + glucocorticoids, EGb + glucocorticoids] according to the random table, and receive treatment. RESULTS: Totally 276 patients with unilateral severe ISSHL were included from 33 hospitals, from August 2007 to October 2011. Among them, male patients accounted for 135 (48.91%), female 141 (51.09%); the average age was (41.7 ± 13.3)years. Forty cases were recovered (14.49%), 78 cases had marked effective (28.26%), 76 cases were effective (27.54%), 82 cases were in-effective (29.71%), and the total effective rate was 70.29%. Among four drug groups, the separate effective rate were 73.33%, 61.43%, 78.31% and 67.95% respectively, no significant difference was found between groups (χ(2) = 9.97,P = 0.62). Among the four groups, the separate cure rate for hearing loss were 11.11%, 12.86%, 16.87% and 15.38%, the glucocorticoid groups were significantly better than those not used. Among severe sudden deafness patients, 92.39% cases accompanied with tinnitus, 44.93% with dizziness (or vertigo), 50.36% with ear stuffy. There had no significant difference between the four groups with accompanied symptoms (all P > 0.05). CONCLUSIONS: It is value to give active treatment to sever sudden deafness patients because of an effective rate of 70%. However, the doctors and patients should be mind of a cure rate of only 14%. Steroids are recommended bacause it may play a role in the improvement rate.

[Clinical analysis of nasal inverted papilloma complicated with nasal polyp].

OBJECTIVE: To investigate the features and correlation of nasal inverted papilloma complicated with polyps. METHOD: Twelve patients diagnosed as nasal inverted papilloma complicated with polyps were studied. The pathological specimens were taken from the surface, core and base of papilloma and sinus in every patient. Through comparing pathological findings, the features and correlation of nasal inverted papilloma complicated with polyps were evaluated. RESULT: In most cases, nasal inverted papilloma was located in the core and base of the mass, while the polyps were located in the surface of the mass. CONCLUSION: Nasal inverted papilloma complicated with polyps may result from long-term inflammation that occurred in the surface of the epithelia of superficial papilloma. Therefore, the occurrence of neoplastic disease in core should be alerted in unilateral nasal polyp case.

[Discussion of cochlear implant indications in postlingually deaf adults].

OBJECTIVE: To explore the indications of cochlear implantation in postlingually deaf adults. METHOD: Five postlingually deaf adults participated in our investigation, surgery age 19-58 (median age 26 years). All patients received 24R (Cochlear,Australia). Four weeks after operation, all the patients have started the program. Through one year follow-up, we used the categories of auditory performance (CAP) and speech intelligibility rating criteria (SIR) to assess their hearing ability and speech intelligibility. RESULT: Through testing for five patients who used cochlear implant continuously more than one year by Pure-tone audiometry, CAP and SIR, we assessed and found that the five patients hearing threshold raise to 25-45 dB in 0.5 kHz, 1.0 kHz, 2.0 kHz, 4.0 kHz, CAP average of 3.4, SIR average of 2.4. Two patients' ability of speech recognition and emotional communication were not improved almost, while these ability in other three were improved in varying degrees. CONCLUSION: For postlingual deaf adults caused by different reasons, how to make patients benefit from cochlear implantation and increase their capacity for independent living and self-confidence due to select surgical indications correctly.