Prevalence and influencing factors of post-traumatic stress disorder among Chinese healthcare workers during the COVID-19 epidemic: a systematic review and meta-analysis.

Background: Post-traumatic stress disorder is an important psychological problem affecting the physical mental health of Chinese healthcare workers during the COVID-19 pandemic. Aims: To estimate the prevalence and influencing factors of post-traumatic stress disorder (PTSD) among Chinese healthcare workers during COVID-19. Methods: Search of Chinese and English literature in PubMed, EMbase, Web of Science, Medline, Elsevier, SpringerLink, China Biomedical Literature Database, CNKI, Wan-fang, and CQVIP for the period from December 2019 to August 2023. Stata 14.0 software was used for data analysis. The methodological quality of each study was scored, and data were extracted from the published reports. Pooled prevalence was estimated using the Random-effects model. Publication bias was evaluated using Egger's test and Begg's test. Results: Twenty-one studies included 11841 Chinese healthcare workers in this review. First, the overall prevalence of Post-traumatic stress disorder among Chinese healthcare workers during the COVID-19 epidemic was 29.2% (95% CI: 20.7% to 33.7%). Twelve factors included in the meta-analysis were found to be protective against PTSD among Chinese healthcare workers: female, nurse, married, front-line work, less work experience, family or friend diagnosed with COVID-19, history of chronic disease and fear of COVID-19. Conversely, outside Hubei, higher education, social support and psychological resilience are protective factors. Conclusion: These recent findings increase our understanding of the psychological status of Chinese healthcare workers and encourage that long-term monitoring and long-term interventions should be implemented to improve the mental health of Chinese healthcare workers in the aftermath of the COVID-19.

The Role of IL-6 in Inner Ear Impairment: Evidence from 146 Recovered Patients with Omicron Infected in Tianjin, China.

PURPOSE: To explore the effect of inflammatory factors on inner ear impairment in a sample of Omicron-infected patients with a high rate of vaccination in China. METHODS: One hundred and forty-six recovered Omicron-infected patients performed the distortion product otoacoustic emission (DPOAE) test and serum test for inflammatory factors; demographic data and vaccination statuses were collected from the questionnaire. RESULTS: Out of 146 patients, the DPOAE pass rate was 81.5% (119/146). Inner ear impairment was significantly correlated with IL-6 titer. The odds ratio (aOR) was 1.24 (95% CI: 1.04-1.49) after adjusting for age, sex, and vaccine characteristics. Notably, this relationship only existed in the 18-60 years group. There were no significant protective effects of vaccination on inner ear function. CONCLUSIONS: Inner ear impairment still exists in Omicron-infected patients, which was significantly correlated with IL-6 titer. This relationship was mainly observed in young and middle-aged people, possibly due to a stronger immune response in this age group. The protective effect of vaccination on the inner ear could not be proved.

Interleukin-6 affects the severity of olfactory disorder: a cross-sectional survey of 148 patients who recovered from Omicron infection using the Sniffin' Sticks test in Tianjin, China.

OBJECTIVES: The mechanism of olfactory disorder (OD) in patients with COVID-19 is unclear. Our study aimed to elucidate the relationships between inflammatory factors and OD in a sample of patients infected with the Omicron variant, with a high vaccination rate in China. METHODS: The Sniffin' Sticks 12-item test was performed in a cross-sectional study of 148 recovered patients who were infected with the Omicron variant to evaluate OD severity. We compared demographic, laboratory, and clinical data. RESULTS: A total of 148 patients infected with the Omicron variant were enrolled. A total of 129 cases of OD were detected. Increased inflammation contributed to OD severity, especially in the adult group. OD was shown to be aggravated by an increase in interleukin-6 levels. The adjusted odds ratio (OR) was 2.22 (95% confidence interval 0.98-5.05, P = 0.056) after adjustment for age, sex, and vaccine characteristics. CONCLUSION: These findings indicated that the prevalence of OD remains high in vaccinated patients infected with the Omicron variant and that the Sniffin' Sticks 12-item test might be a feasible method to screen for OD. Interleukin-6 may play a role in the biochemical and pathological processes underlying OD.

Diversity of TH cytokine profiles in patients with chronic rhinosinusitis: A multicenter study in Europe, Asia, and Oceania.

BACKGROUND: To date, no study has evaluated the diversity of TH cell cytokine patterns of patients with chronic rhinosinusitis (CRS) among centers in different continents using identical methods. OBJECTIVE: We sought to assess TH cytokine profiles in patients with CRS from Europe, Asia, and Australia. METHODS: Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and without nasal polyps (CRSsNP; n = 435) and control subjects (n = 138) were recruited from centers in Adelaide, Benelux, Berlin, Beijing, Chengdu, and Tochigi. Nasal mucosal concentrations of TH2, TH17, and TH1 cytokines; eosinophilic cationic protein (ECP); myeloperoxidase (MPO); IL-8; and tissue total and Staphylococcus aureus enterotoxin (SE)-specific IgE were measured by using identical tools. RESULTS: Combinations of TH1/TH2/TH17 cytokine profiles in patients with CRSwNP varied considerably between regions. CRSwNP tissues from patients from Benelux, Berlin, Adelaide, and Tochigi were TH2 biased, whereas those from Beijing mainly demonstrated TH2/TH1/TH17 mixed patterns, and patients from Chengdu showed an even lower TH2 expression. Concentrations of IL-8 and tissue total IgE in patients with CRSwNP were significantly higher than those in control subjects in all regions. More than 50% of patients with CRSwNP in Benelux, Berlin, Adelaide, and Tochigi showed a predominantly eosinophilic endotype compared with less than 30% of patients in Beijing and Chengdu. SE-specific IgE was found in significantly greater numbers in patients with CRSwNP from Benelux, Adelaide, and Tochigi and significantly lower numbers in patients from Beijing and Chengdu. Moreover, the TH1/TH2/TH17 cytokine profiles in patients with CRSsNP showed diversity among the 6 regions. CONCLUSION: TH cytokine levels, eosinophilic/neutrophilic patterns, and SE-specific IgE expressions show extreme diversity among patients with CRS from Europe, Asia, and Oceania.

Prevalence of allergic rhinitis among adults in urban and rural areas of china: a population-based cross-sectional survey.

PURPOSE: The aim of the present study was to compare the prevalence of self-reported and confirmable allergic rhinitis (AR) with positive skin prick test (SPT) results among adults living in urban and rural areas of China. METHODS: Adults from a community in Beijing and a village in Baoding were selected as representative urban and rural dwellers, respectively. All eligible residents were enrolled from the population register and received a face-to-face interview using modified validated questionnaires. Equal sets of randomly selected self-reporting AR-positive and AR-negative participants who responded to the questionnaires were also investigated using skin prick tests. RESULTS: A total of 803 participants in the rural area and a total of 1,499 participants in the urban area completed the questionnaires, with response rates being 75.9% and 81.5% respectively. The prevalence of self-reported AR of the rural area (19.1%) was significantly higher than that of the urban area (13.5%). The elementary school of educational level increased the risk of having AR (adjusted OR=2.198, 95% CI=1.072-2.236) .The positive SPT rates among subjects with self-reported AR in the rural and urban areas were 32.5% and 53.3%, respectively; the confirmable AR prevalence of 6.2% and 7.2% among the rural and urban adults, respectively. CONCLUSIONS: The prevalence of confirmable AR is similar between rural and urban areas in China, although there is a higher prevalence of self-reported AR in the former.

The microbiology of chronic rhinosinusitis with and without nasal polyps.

CONCLUSION: Staphylococcus aureus, Streptococcus, Haemophilus, Enterobacter, and Corynebacterium appear to be more frequently associated with patients with chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) than with patients with CRS without nasal polyps (CRSsNP) or control subjects. Furthermore, the isolation rate of Staphylococcus aureus appears to be much lower in Chinese CRSwNP patients compared with their caucasian counterparts. OBJECTIVES: To compare the predominant bacteriologic profiles in middle meatus of patients with CRSwNP, those with CRSsNP, and control subjects. METHODS: A total of 165 CRSwNP patients, 76 CRSsNP patients, and 44 control subjects were recruited into the study. Swab samples were obtained from the middle meatus during endoscopic sinus surgery and processed for the presence of aerobic and non-aerobic bacteria and fungi. RESULTS: Mostly aerobic and facultative anaerobic bacteria were detected in the samples from all three study groups, of which the most common aerobic bacteria were coagulase-negative staphylococci, Corynebacterium species, Staphylococcus aureus, and Haemophilus influenzae. In contrast, comparatively few anaerobic bacteria and fungi were isolated from the three study groups. In CRSwNP patients, significantly more Gram-negative aerobic and facultative anaerobic bacteria were isolated from the subgroup with normal eosinophil numbers than from the subgroup with increased blood eosinophils (p = 0.005). Correspondence analysis showed coagulase-negative staphylococci to be closely associated with all three patient groups, whereas Staphylococcus aureus, Streptococcus, Haemophilus, Enterobacter, and Corynebacterium species were associated with CRSwNP patients.

The expression of epithelial intercellular junctional proteins in the sinonasal tissue of subjects with chronic rhinosinusitis: a histopathologic study.

OBJECTIVE: To evaluate the expression of five epithelial intercellular junctional proteins in the sinonasal tissue of subjects with chronic rhinosinusitis (CRS). METHODS: Forty-one samples of nasal polyp tissue of CRS patients with nasal polyps (wNP), 20 ethmoid sinus mucosa of CRS patients without nasal polyps (sNP) and 19 nasal mucosa of controls were collected and assessed for the expression of zonulae occludens (ZO-1), claudin-1, E-cadherin and desmoglein-1 and -2 (DSG1, DSG2) using immunohistochemical staining. Interleukin (IL)-5, IL-6 and IL-8 concentrations in the tissues were also measured using ELISA. RESULTS: The expression of ZO-1, claudin-1, DSG1 and DSG2 in the CRSwNP patient group and the expression of claudin-1, DSG1 and DSG2 of the CRSsNP patient group was significantly lower compared to that of the control group. Furthermore, the expression of DSG1 in the CRSwNP patient group was also significantly lower than in the CRSsNP patient group. In contrast, the expression of E-cadherin in the CRSwNP and the CRSsNP patient groups was significantly greater compared to the controls. The assessment of associations between the expression of the intercellular junctional proteins and cytokines demonstrated negative correlations between IL-5 and claudin-1, IL-6 and claudin-1, IL-6 and DSG2, IL-8 and DSG1, and IL-8 and DSG2. In contrast, a positive correlation was found between IL-8 and E-cadherin. CONCLUSIONS: Differences in the expression of epithelial intercellular junctional proteins may play an important role in the pathogenesis of CRS.