Chinese Society of Allergy and Chinese Society of Otorhinolaryngology-Head and Neck Surgery Guideline for Chronic Rhinosinusitis

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.

LncRNA MALAT1/MiR-145 Adjusts IL-1β-Induced Chondrocytes Viability and Cartilage Matrix Degradation by Regulating ADAMTS5 in Human Osteoarthritis

PURPOSE: Accumulating evidence suggests that microRNA-145 (miR-145) plays an important role in osteoarthritis (OA), which is a chronic progressive joint disease. Long noncoding RNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) promotes metastasis in cancers and functions as a sponge for miR-145. However, the role of MALAT1/miR-145 in OA pathogenesis has not yet been elucidated. MATERIALS AND METHODS: The expression of MALAT1 and miR-145 was examined by quantitative real-time PCR; the interaction between miR-145, MALAT1 and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) 5 was verified by luciferase reporter assay. Correlations among MALAT1, miR-145, and ADAMTS5 were analyzed by Spearman rank analysis. Chondrocytes viability and cartilage extracellular matrix (ECM) degradation were investigated with cell viability assay and Western blotting analyzing expression of ADAMTS5, collagen type 2 alpha 1 (COL2A1), aggrecan (ACAN), and cartilage oligomeric matrix protein (COMP). RESULTS: MALAT1 was upregulated, and miR-145 was downregulated in OA samples and IL-1β-induced chondrocytes. Mechanically, miR-145 could directly bind to MALAT1 and ADAMTS5. Moreover, miR-145 expression was negatively correlated with MALAT1 and ADAMTS5 expression in OA patients, whereas MALAT1 and ADAMTS5 expression was positively correlated. Functionally, overexpression of MALAT1 inhibited chondrocyte viability and promoted cartilage ECM degradation in IL-1β-induced chondrocytes. In support thereof, MALAT1 silencing and miR-145 upregulation exerted the opposite effect in IL-1β-induced chondrocytes. Moreover, the effect of MALAT1 was counteracted by miR-145 upregulation, and ADAMTS5 restoration could abate miR-145 effects. CONCLUSION: An MALAT1/miR-145 axis contributes to ECM degradation in IL-1β-induced chondrocytes through targeting ADAMTS5, suggesting that MALAT1/miR-145/ADAMTS5 signaling may underlie human OA pathogenesis.

Study of fractional exhaled nitric oxide concentrations in healthy school children of Beijing, Tianjin, Hebei province / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the normal range of fraction exhaled nitric oxide(FeNO) in healthy schoolchildren in Beijing, Tianjin and Hebei Province. METHODS A total of 337 schoolchildren(161 males and 176 females) in Beijing, Tianjin and Hebei Province were selected randomly in our outpatient clinic and met the health standards. FeNO values were measured using NIOX. Age, height, weight and body mass index(BMI) were investigated. At the same time, skin prick tests were performed on children with suspected atopy. RESULTS Geometric mean of FeNO value in healthy schoolchildren in Beijing, Tianjin and Hebei Province was 13 ppb(part per billion, ppb), and the 95％ Confidence Interval(CI, bias distribution) was 5-23 ppb, which was related to the gender of schoolchildren(P ＜0.001). There was no signif icant cor relation between age, height, weight, body mass index(BMI) and regional differences(P all＞0.05). FeNO values were no significant difference among the three regions(P ＞0.05); the geometric mean of FeNO values were 13 ppb in Beijing, 13 ppb in Tianjin, and 14 ppb in Hebei; 95％CI was 5 to 21 ppb, 5 to 21 ppb, 5 to 23 ppb, respectively. CONCLUSION FeNO values of healthy schoolchildren in Beijing, Tianjin and Hebei provinces are only significantly correlated with gender. However, FeNO values are highest among schoolaged girls in Hebei, and 23 ppb is the 95％ normal range of FeNO in healthy schoolchildren in Beijing, Tianjin and Hebei province. Gender and regional factors must be considered when FeNO values are evaluated.

Bilateral effects of the pre- and postoperative septoplasty evaluated objectively with acoustic rhinometry and rhinomanometry / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate effects of septoplasty on bilateral nasal cavities with acoustic rhinometry and rhinomanometry objectively.@*METHOD@#Twenty-two patients who underwent septoplasty were examined with rhinomanometry and acoustic rhinometry before and 6 to 12 months after surgery. Of the 22 patients, 1 patient whose rhinomanometry and acoustic rhinometry datum were not available for the bilateral nasal obstruction, 3 patients with bilateral turbinectomy and 2 patients with unilateral turbinectomy wide nasal cavities were excluded. Finally, 18 narrow side nasal cavities and 16 wide side nasal cavities were analyzed.@*RESULT@#Rhinomanometry: nasal resistance on the deviation side decreased significantly (P 0.05). Acoustic Rhinometry: the predecongestion nasal minimal cross-sectional area (NMCA) and 0-5 cm NCV on the deviation side increased significantly due to the operation (P 0.05). Only slight median increases were noted in the bilateral assessment postoperatively in NCV (P > 0.05) before and (P < 0.05) after decongestion.@*CONCLUSION@#The nasal patency on the deviation side is undoubtedly increased after septoplasty, and the airway on the wide side is not worsened after the operation.

Comparison of two specific immunoglobulin E test systems in the diagnosis of allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the diagnostic performance of the AllergyScreen system from Mediwiss An alytic GmbH and the Pharmacia CAP system from Pharmacia Diagnostics for the detection of four inhalant allergens in the diagnosis of allergic rhinitis.@*METHOD@#All 35 serum samples were collected from patients who were referred to the allergist for a suspected allergic rhinitis between January to March in 2007. Patients were classified as study diagnosis-positive for inhalant allergy if they both had a positive clinical examination/history and a related positive skin test for the suspected inhalant allergen.@*RESULT@#Comparing with the reference standard, the diagnostic indexes (sensitivity, specificity, accuracy, predictive value of positive, and predictive value of negative) of the CAP system and the AllergyScreen system were 0.96 vs 0.89, 0.84 vs 0.75, 0.89 vs 0.80, 0.78 vs 0.65 and 0.93 vs 0.93 respectively. The CAP system method had higher sensitivity, specificity and accuracy than AllergyScreen system method, but there have no statistical difference between two systems (P>0.05).@*CONCLUSION@#This data support the use of ImmunoCAP system and AllergyScreen system to identify potentially significant individual allergens in the diagnosis of allergic rhinitis. The diagnostic indexes between the two systems have no statistical difference. As a simple, rapid turnaround time and low-cost system, AllergyScreen system can test multi-allergens in one time, so it can be used as a complementary with the ImmunoCAP system.