[Bioinformatics analysis of nasal epithelial cell gene expression in seasonal and perennial allergic rhinitis].

Objective: Transcriptome sequencing and bioinformatics analysis were performed on the gene expression of nasal epithelial cells in patients with seasonal allergic rhinitis (AR) and perennial AR, so as to obtain the differences in the gene expression of nasal epithelial cells between seasonal AR and perennial AR. Methods: The human nasal epithelial cell line(HNEpC) was cultured in vitro, treated with 100 µg/ml mugwort or house dust mite (HDM) extracts for 24 hours. Total cell RNA was extracted, and quantitative real-time polymerase chain reaction (qPCR) was used to detect the expression of cytokines, including IL-6, IL-8, IL-33 and thymic stromal lymphopoietin (TSLP). From November 2019 to November 2020, 3 seasonal AR patients, 3 perennial AR patients, and 3 healthy controls who attended the Department of Otolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University were analyzed. The patients' primary nasal epithelial cells were cultured in vitro, treated with corresponding allergens for 24 hours. Total RNA was extracted for transcriptome sequencing, and the sequencing results were analyzed by bioinformatics. Results: The qPCR results showed that the cytokines IL-6, IL-8, IL-33 and TSLP of HNEpC treated with mugworts extracts and HDM extracts had the same trend of change. After the nasal epithelial cells from patients with seasonal AR and perennial AR were treated with corresponding allergens, there were differences in biological processes and signal pathways between those and control. Gene ontology (GO) enrichment analysis showed that the differentially expressed genes (DEG) in AR patients allergic to mugwort were mainly enriched in the oxidation-reduction process, the negative regulation of apoptosis process, and the cell adhesion; the DEG in AR patients allergic to HDM were mainly enriched in cell adhesion, the negative regulation of cell proliferation and the response to drug. Enrichment analysis of Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway showed that the DEG of AR patients allergic to mugwort were significantly enriched in arachidonic acid metabolism, p53 signaling pathway and transforming growth factor ß (TGF-ß) signaling pathway, while the DEG of AR patients allergic to HDM were mainly enriched in cells cycle, Fanconi anemia pathway and DNA replication. Gene Set Enrichment Analysis (GSEA) showed that the inflammatory response, TNF-α/NF-κB signaling pathway and IL-2/STAT5 signaling pathway were significantly up-regulated in AR patients allergic to mugwort, indicating the promotion of inflammatory response; and AR patients allergic to HDM had significant down-regulation of G2M, E2F, and MYC, indicating the inhibition of cell proliferation. The protein-protein interaction network showed that TNF and CDK1 were the most interacting proteins in mugwort and HDM allergic AR patients, respectively. Conclusion: Seasonal AR and perennial AR may affect the different biological processes and signal pathways of nasal epithelial cells, leading to differences in the occurrence and development of AR.

[Interpretation of the guidelines for multidisciplinary treatment of epistaxis of the British Academy of Rhinology].

SummaryEpistaxis is a common condition that can be associated with significant morbidity, and it places a considerable burden on our healthcare system. In China, a draft guidelines for diagnosis and treatment of epistaxis was released in 2015. In UK, a national audit of management for epistaxis was promulgated in 2016, followed by multidisciplinary consensus recommendations on the hospital management of epistaxis in 2017. Here, we compared the management of diagnosis and treatment for epistaxis between China and UK in five clinical aspects, including initial assessment, cautery, intranasal agents, antithrombotic therapy and hematological factors, as well as surgery and radiological intervention. The results demonstrate that the management recommendations in UK combined a wide-ranging review of the relevant literature with established and rigorous methods of guideline generation, while the guidelines in China is more specific on the procedures of diagnosis and treatment for epistaxis. The current discussion provides perspectives to improve the guidelines for epistaxis in China.

[Complementary and alternative medicine for rhinitis and sinusitis].

Complementary and alternative medicine (CAM) describes a broad category of practices and treatments for the prevention or treatment of disease outside the realm of conventional medicine. CAM is widely used in the treatment of allergic rhinitis, acute and chronic rhinosinusitis. This article summarizes a variety of CAM and the efficacy in the treatment of rhinitis and sinusitis, with the purpose of increasing people's awareness of CAM and enriching the treatment of rhinitis and sinusitis, so that patients can benefit from it.

[Application of three-dimensional digital subtraction angiography on hepatic artery chemoembolization].

Objective: To explore the clinical value of 3D-DSA technology in the diagnosis and treatment guidance of hepatic artery chemoembolization. Methods: Liver cancer patients in the treatment groups were collected to receive 3D-DSA imaging guidance at the Affiliated Hospital of Xuzhou Medical University between March and May 2017. In addition, routine 2D-DSA imaging was selected for treatment-received group. Intra-operative blood vessels and tumor-like lesions were observed. The total exposure dose (CAK, unit mGy), cumulative irradiation intensity per unit area (DAP, unit mGy.cm2) and dosage of contrast agent (ml) were calculated separately for two groups of patients. The same senior physicians and technicians operated both groups of patients. Comparisons of measurement were analyzed by t-test and chi-square test was used for count data. Results: Data of twenty patients were collected from the two groups. Tumor location, target vessels structure and shape of development were clear in all patients in the treatment group. The control group had 17 cases of tumor development and the target vascular structure was clear in 16 cases. CAK mean treatment group was lower than control group (554.11 + 38.87) mGy and (644.53 + 26.70) mGy, and DAP mean treatment group was lower than the control group (125.25 + 7.54) mGy·cm(2) and (143.49 + 6.18) mGy·cm(2). The two groups were compared (P value < 0.05), and the differences were statistically significant. The mean dose of contrast agent in the two groups were lower than control group (64.42 + 3.92) ml, (70.79 + 4.47) ml, and the differences between the two groups were statistically significant (P < 0.05). Conclusion: 3D-DSA imaging technology can provide effective diagnosis and guidance in the treatment of hepatic artery chemoembolization. It can effectively reduce the radiation exposure dose and radiation intensity, and it is of high clinical value for interventional embolization of liver cancer.

[Taste dysfunction analysis in patients with allergic rhinitis].

Objective:To investigate the taste dysfuction and its features in patients with allergic rhinitis,and to study its influence on quality of life.Method:Three hundred and five consecutive cases were enrolled. Rhino conjunctivitis Quality of Life Questionnaire, visual analogue scale and Lund-Kennedy nasal endoscopy scores were used to assess the taste dysfunction. In addition, taste test with paper strips was used to evaluate the four basic tastes of the twenty patients with severity dysfuction VAS.Result:Taste dysfuction accounted for 18.03% (55/305) in all allergic rhintis, while hypogeusia and hypergeusia were 98.18% (54/55), 1.82% (1/55) respectively. There were significant differences of RQLQ scores in taste dysfuction group compared to no taste dysfunction group, there were positive correlated relationship, but no difference between taste function and nasal VAS scores nor Lund and Kennedy nasal endoscopy scores. Saline taste, bitter taste, sweet taste and sour taste were impaired in AR, thus, saline taste was more diminishes than another three (P< 0.05). Conclusion:Taste dysfunction is common symptom in allergic rhinitis, mainly including hypogeusia, especially saline taste.Taste dysfunction can impact patients'quality of life.

[Investigation on the expression of microvessel pericyte coverage index and lymph vessel density in nasal polyps].

Objective: To investigate the role of lymph vessel density (LVD) and microvessel pericyte coverage index (MPI) in the pathogenesis of nasal polyps. Methods: Using immunohistochemistry and immunofluorescence double staining method, the expressions of albumin, D2-40 and CD34-α-SMA in 11 specimens of normal nasal mucosa, 26 specimens of nasal polyp and 26 specimens of inferior turbinate tissue from patients with nasal polyps were investigated. The counts of microvessel density (MVD), lymph vessel density (LVD) and microvessel pericyte coverage index (MPI) were compared. SPSS 17.0 software was used to analyze the data. Results: The nasal polyp group(0.269±0.096) had more albumin than inferior turbinate tissue group(0.159±0.078) and normal nasal mucosa group(0.138±0.045), the differences were significant (q value was 4.873, 4.446, both P<0.05). The counts of MVD in nasal polyp group (30.52±4.42) were not significantly higher than those in inferior turbinate tissue group (30.33±6.03) and normal nasal mucosa group(28.21±6.84), the differences were not significant (q value was 0.130, 1.147, both P>0.05). The MPI in nasal polyp group (0.291±0.096) was significantly lower than those in inferior turbinate tissue group(0.432±0.101) and normal nasal mucosa group(0.416±0.071), the difference was significant (q value was 5.399, 3.680, both P<0.05). The counts of LVD in the nasal polyp group(0.245±0.073) were significantly lower than those in inferior turbinate tissue group (0.431±0.054) and normal nasal mucosa group(0.470±0.078), the difference was significant (q value was 10.004, 9.328, both P<0.05). MPI expression in the nasal polyp group was negetively correlated to albumin expression(r=-0.889, P<0.05). The LVD expression in the nasal polyp group was negetively correlated to albumin expression(r=-0.901, P<0.05). Conclusion: Different LVD and MIP in nasal polyp tissues and normal nasal mucosa tissues imply that microcirculatory dysfunction plays a crucial role in the pathogenesis of nasal polyps.

[New therapeutic strategies in allergic rhinitis].

Allergic rhinitis (AR) is a nasal inflammatory, IgE-mediated disease that occurs when some individuals inhales something he or she is allergic to, such as pollen or animal dander. It is also a refractory disease with high prevalence in the field of rhinology. The treatment of AR is really a difficult and challenging task because of the high prevalence, economic burden and the interference to the quality of life. At present, nasal corticosteroid and antihistamines were the mainly therapies, however, there is up to 40% patients not satisfactory to these therapies. So exploring new therapy or target is necessary. This article will review the results of previous studies focused on the new therapies of AR.

[Drug treatment of allergic rhinitis based on immunological mechanisms of progress].

The current treatment of allergic rhinitis remains a challeng for clinician while developing non-specific immunotherapy can make up the disadvantages of routine medications.It has solved the problems like long treatment course of specific immunotherapy or adverse reactions;It has improved the theoretical basis and treatment methods of airway allergic disease.This article reviwed the recent clinical studies about mechanisms of allergic rhinitis.