Significance of Exhaled Nitric Oxide and Carbon Monoxide in Auxiliary Diagnosis and Evaluation of Allergic Rhinitis.

Objective: The concentration of exhaled NO and CO is considered as a candidate marker of respiratory inflammatory disease. This report discusses the exhaled NO and CO in the auxiliary diagnosis and evaluation of allergic rhinitis (AR). Methods: 60 AR patients from October 2017 to March 2019, compared with 30 healthy controls. The severity of AR disease was distinguished by symptom score. Both groups were tested for exhaled nitric oxide through the nose or mouth and exhale carbon monoxide through the mouth. AR patients received glucocorticoid nasal spray for 1 month and were tested again for nNO, eNO, eCO, and symptom score. Results: Before treatment, all the nNO, eNO, and eCO of the AR group were higher than the control group. There were differences in the severe and moderate subgroup: severe > moderate > mild. eCO was not significantly different between the mild and control groups. The nNO, eNO, and eCO levels were positively correlated with symptom score. After treatment, nNO decreased significantly in the three subgroups; eNO and eCO in the severe AR group decreased significantly. Drawing the ROC curve, the area under curve (AUC) of nNO is 0.978. The AUC of eNO and eCO was 0.786 and 0.577, respectively. Conclusion: The nNO, eNO, and eCO in the AR group are higher than healthy people, which positively correlated with the severity of AR symptoms. The detection of nNO, eNO, and eCO can monitor the changes of AR. The detection of nNO level as an indicator of AR auxiliary diagnosis has high accuracy.

[Correlation between exhaled nitric oxide and carbon monoxide and allergic rhinitis].

Objective:In this study, the level of nasal nitric oxide（nNO）, exhaled nitric oxide（eNO）, and exhaled carbon monoxide（eCO） in patients with allergic rhinitis（AR） were tested, to explore the correlation between nNO, eNO, eCO and AR. Method:A total of 60 AR patientswere enrolled as the allergy group and then divided into mild, medium and severe subgroups according to symptom scores. 30 healthy volunteers were recruited as control group. The levels of nNO, eNO and eCO were detected in AR group, AR subgroups and control group. Result:The levels of nNO, eNO and eCO in AR group were higher than those in control group（P<0.05）. nNO, eNO and eCO levels were positively correlated with symptom scores（P<0.05）.Pairwise comparison was used between mild, moderate and severe subgroups. The difference of both nNO and eNO levels between mild, moderate and severe AR subgroups was statistically significant, severe>and moderate>were mild（P<0.05）, but there was no significant difference in eNO levels between the mild AR subgroup and the control group（P>0.05）. Level of eCO in severe AR subgroup was higher than those in moderate and mild AR subgroups（P<0.05）, but there was no significant difference between mild, moderate AR subgroups and control group（P>0.05）. nNO, eNO and eCO levels were used as indicators to evaluate the severity of AR, and the receiver operating characteristic（ROC） curves were plotted. The area under curve（AUC） was 0.978, 0.786 and 0.577, respectively. Taking eCO level as the indicator for disease assessment of severe AR, the AUC was 0.728. It showed that nNO had a high accuracy in evaluating the severity of AR, eNO had a certain accuracy in evaluating the severity of AR, and eCO had a certain accuracy in the assessment of severe AR. Conclusion:The detection of nNO, eNO and eCO levels can be used as an objective assessment method of the severity of AR.

Mesh-preservation approach to treatment of mesh infection after large incisional ventral hernia repair-how I do it.

Mesh infection after large incisional ventral hernia repair is a clinical dilemma in abdominal wall hernia surgery. It is believed foreign material should be removed but it causes secondary trauma to the abdominal wall tissue and might be associated with a higher risk of complications. Currently, there is no consensus on mesh-preservation treatment in cases of mesh infection after hernia repair in general. Herein we present the case of a 27-year-old male who recovered well from mesh infection after large incisional ventral hernia repair by mesh-preservation approach. The path to success is choice of material of prosthetic mesh; surgical approach of hernia repair, sufficient wound irrigation and drainage, and acquiring sterility of the mesh surface by wound care techniques such as local iodophor packing and vacuum sealing drainage. Clinical cohorts are needed to verify the feasibility of mesh-preservation treatment of mesh infection after large incisional hernia repair.

Impact of genetic variants of GLCCI1 on operational therapy in Chinese chronic rhinosinusitis patients.

BACKGROUND: Endoscopic surgery and postoperative glucocorticoids may effectively control inflammation in patients with chronic rhinosinusitis (CRS). However, some patients who are insensitive to glucocorticoids have a poor prognosis. Studies have shown that the GLCCI1 polymorphism is related to sensitivity to glucocorticoids, but no study has been conducted in China to investigate the relationship between GLCCI1 polymorphisms and postoperative prognosis of CRS. METHODS: A total of 208 CRS patients received routine functional endonasal sinus surgery and then were treated with glucocorticoids. Polymerase chain reaction-restriction fragment length polymorphism was employed to detect the rs37973G/A polymorphism of GLCCI1. The visual analogue scale (VAS) score, Lund-Kennedy score, and computed tomography (CT) Lund-Mackay score were determined 6 months after surgery among patients with different genotypes. Moreover, the polymorphism frequency was compared among different subgroups. RESULTS: There were no marked differences in VAS score, Lund-Kennedy score, or CT Lund-Mackay score among patients with different genotypes before surgery. In patients with the AA genotype, the changes in VAS score, Lund-Kennedy score, and CT Lund-Mackay scores were significantly higher than in patients with the GA/GG genotype (p < 0.05). However, there were no marked differences between patients with the GA genotype and those with the GG genotype (p > 0.05). Compared with patients with non-eosinophilic sinusitis, the difference between the AA genotype and the GA/GG genotype was more evident in patients with eosinophilic sinusitis (p < 0.01). CONCLUSION: The rs37973 polymorphism is related to postoperative recovery from CRS for individual sensitivity to glucocorticoids. Furthermore, AA genotype was associated with better treatment response in CRS.

Hydrogen-Rich Saline Ameliorates Allergic Rhinitis by Reversing the Imbalance of Th1/Th2 and Up-Regulation of CD4+CD25+Foxp3+Regulatory T Cells, Interleukin-10, and Membrane-Bound Transforming Growth Factor-ß in Guinea Pigs.

It is well known that CD4+CD25+Foxp3+Treg cells play an important role in the development of allergic rhinitis (AR); the defect of cell numbers and functions contribute to AR. Hydrogen has been proven effective in alleviating symptoms of AR. We herein aim to verify the protective effects of hydrogen on CD4+CD25+Foxp3+Treg cells in guinea pigs with AR and to explore the effect of hydrogen-rich saline (HRS) on CD4+CD25+Foxp3+Treg cells in animals with AR and investigate the underlying anti-inflammatory mechanism. Eighteen guinea pigs were randomly divided into three groups (control group/AR group/AR-HRS group). The guinea pigs were injected with hydrogen-rich saline (AR-HRS group) for 10 days after sensitization. The control group was injected with an equal volume of normal saline. The number of sneezes, degree of runny nose, and nasal-rubbing movements were scored. Peripheral blood eosinophil count was recorded. The proportions of Th1/Th2 of the peripheral blood and the CD4+CD25+Foxp3+T cells in the CD4+T cells of the spleen and peripheral blood were determined by flow cytometry. The content of interleukin (IL)-10 and transforming growth factor (TGF)-ß in the serum was detected by enzyme-linked immunosorbent assay (ELISA). The protein and mRNA expression of Foxp3, IL-10, and TGF-ß were determined by Western blot, immunofluorescence, and real-time PCR analysis, respectively. Scores of symptoms, number of eosinophils,and nasal mucosa damage were dramatically reduced after HRS treatment. HRS increased the expression of Foxp3, IL-10, TGF-ß, and number of CD4+CD25+Foxp3+Treg cells, which were reduced in AR. HRS also revised the dysregulation of Th1/Th2 balance. Both the number and biological activity of CD4+CD25+Foxp3+Treg cells increased with up-regulation of Th1/Th2 after HRS administration. HRS could play a protective role in attenuating AR through improving the proportion and functions of CD4+CD25+Foxp3+Treg cells.

Protective effect of cyanidin 3-O-glucoside on beta-amyloid peptide-induced cognitive impairment in rats.

Alzheimer's disease (AD) is a neurodegenerative disorder that results in cognitive impairment. It has been proposed that deposits of beta-amyloid (Aß) form the cores of the plaque and, subsequently, induce the activation of GSK-3ß and the hyperphosphorylation of tau, resulting in cognitive impairment. Oxidative stress has been proposed to be an important factor in the pathogenesis of AD. Cyanidin 3-O-glucoside (Cy3G) is a neuroprotective antioxidant. However, the effects of Cy3G on cognition are unclear. In this paper, we show that Cy3G is protective against the Aß-induced impairment of learning and memory, but has no effect on normal learning and memory. Moreover, we found that Gy3G attenuated the Aß-induced tau hyperphosphorylation and GSK-3ß hyperactivation observed in AD. Taken together, these results demonstrated that Cy3G can rescue the cognitive impairments that are induced by Aß via the modulation of GSK-3ß/tau, suggesting a potential therapeutic role of Cy3G in AD.