[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.

[Distribution characteristics and results of allergens in patients with allergic rhinitis in Ningxia area].

Objective:To investigate the distribution of allergens in patients with allergic rhinitis （AR） in Ningxia, and provide theoretical data for the prevention and treatment of AR in this region. Methods:A total of 1664 patients diagnosed with AR in the Otorhinolaryngology Head and Neck Surgery Department of Yinchuan First People's Hospital Outpatient Clinic from January 2018 to December 2021 were retrospectively collected. Use the allergen sIgE antibody detection kit （immunoblotting method） to detect inhalation and ingestion allergens in patients.Results: ①Among all AR patients, 1 158 cases were detected positive, resulting in the detection rate was 69.59%; ②The detection rate of inhalation allergen was 65.87%, and the detection rate of ingestion allergen was 19.83%; ③Mugwort was the most sensitive allergen, and 76.32% of the patients having a positive grade ≥3; ④Out of the patients, 294 cases （25.39%） were allergic to only one allergen, 244 cases （21.07%） were allergic to two allergens, and 620 cases （53.54%） were allergic to three or more allergens; ⑤During different seasons, the highest number of positive allergens detected was in the summer, with 968 cases （83.59%）. Mugwort was the main allergen during this season （69.01%）. After the COVID-19 epidemic, the total positive rate of sIgE tests in AR patients decreased compared to before, and the difference was statistically significant （P<0.001）; ⑥Mugwort, dog epithelium, mold combination, egg, peanut, soybean, Marine fish combination and fruit combination all showed statistically significant differences between different gender groups （P<0.05）; ⑦Common ragweed, mugwort, dust mite combination, cockroach, egg, milk, Marine fish combination, shrimp, fruit combination and nut combination all showed statistically significant differences among different age groups （P<0.05）; ⑧There were statistically significant differences in hay dust among different ethnic groups （P<0.05）. Conclusion:Artemisia argyi is the main allergen in Ningxia, and the distribution characteristics of different allergens are influenced by treatment season, the COVID-19 epidemic, gender, age, ethnicity, and other factors, showing certain distribution patterns and rules.

Zinc supplement reduces allergic responses through modulating the p38 MAPK pathway activation in an allergic rhinitis mouse model.

BACKGROUND: Allergic rhinitis (AR) is a chronic inflammatory disease of the nasal mucosa mediated by a variety of inflammatory mediators. Zinc (Zn) is one of the main essential trace elements in the human body and plays a variety of biological functions including the inhibition of inflammatory responses. This study aimed to investigate the effects and mechanism of Zn on the ovalbumin (OVA)-induced AR mouse model. METHOD: In this study, we established a model of AR by treating mice with OVA after feeding them with different doses of Zn. ELISA, real-time quantitative PCR, western blot and immunohistochemistry were used to detect the protein expression and mRNA transcription level of IgE, inflammatory cytokines and p38, respectively. RESULTS: The authors identified that immunoglobulin E concentrations were significantly higher in the Zn-deficient mice than in the Zn-normal group; Zn supplementation significantly reversed the increase in IgE concentrations caused by Zn deficiency. The increased concentrations of interleukin-6 and tumor necrosis factor-α in serum caused by Zn deficiency were reduced by Zn supplementation. The study further found that Zn deficiency could significantly increase the expression and activity of the p38 MAPK protein, while its levels were significantly decreased after Zn supplementation. The role of Zn supplement in the inflammatory response induced by Zn deficiency was verified by Zn-deficient mice with a p38 pathway inhibitor (SB203580), and it was observed that the elevated concentrations of IgE and inflammatory cytokines induced by Zn deficiency could be significantly reversed. CONCLUSION: Our data indicated that Zn exerted anti-allergic and anti-inflammatory effects by regulating the p38 MAPK activation in the AR mouse model. The findings provided evidence that Zn might be beneficial in regulating AR.

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.

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.

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.

[Survey on the prevalence of childhood allergic rhinitis in Yinchuan].

OBJECTIVE: To investigate the epidemic features of childhood allergic rhinitis (AR) and correlative risk factors in Yinchuan. METHOD: A questionnaire survey on AR was conducted among 800 children in eight communities, aged from 5 to 14 years old, by random cluster sampling, from March 2012 to March 2013 in Yinchuan. Suspects of AR, as identified by the survey, were recommended to specialist examinations for accurate diagnosis. The results were statistically analyzed. RESULT: Seven hundred and sixteen questionnaires were returned and 662 questionnaires were available. The prevalence rate of AR in children aged from 5 to 14 is 14.65% in Yinchuan. Seventy-nine point thirty-eight percent children suffered from intermittent AR, while 20.61% children suffered from persistent AR. The difference of prevalence between female (13.57%) and male (15.44%) was insignificant statistically (Χ2=0.454, P>0.05). The difference of prevalence between the Han (15.72%) and the Hui (11.35%) insignificant statistically (Χ2=2.055, P>0.05). The prevalence of AR children aged five to nine years was 13.80%, as aged ten to fourteen years was 19.72%. There was a significante differece between two groups (Χ2=4.056, P<0.05). The most explosive outbreak month in children with allergic rhinitis was July to September. The most common allergens found in patients were seasonal plants: mugwort, weed, dandelion, cereal, locust, ragweed, and willow. Fifteen point forty-six percent patients with AR also had rhinitic, 14.43% patients had asthma and 14.43% patients had allergic conjunctivitis. The history of drug allergy accounted for 12.37% in patients with AR, and food allergy accounted for 26.80%. In allergic rhinitis risk factors, family history accounted for 30.92%, non-breastfeeding representing accounted for 34.02%, animal feeding history accounted for 19.59%; exposure to passive smoking accounted for 42.26%; domestic decoration accounted for 12.37%. There were significante difference between AR children and normal in family history and non-breastfeeding (P<0.05). CONCLUSION: The prevalence rate of AR in children aged from 5 to 14 in Yinchuan is 14.45%. Strategy of prevention and treatment of AR should be worked out according to the epidemic feature of AR.