A comparative study of endoscopic silicone tube intubation and conventional blind silicone tube intubation in the treatment of chronic dacryocystitis / 中国耳鼻咽喉头颈外科

OBJECTIVE To compare the costeffectiveness of two surgical approaches:endoscopic silicone tube intubation(ESTI) and conventional blind silicone tube intubation(CBSTI),in the management of chronic dacryocystitis(CDC).METHODS There were 46 cases of CDC from the Third Affiliated Hospital of Sun Yat-sen University from 2014 to 2015.Randomly,22 CDC patients were included in ESTI,24 patients were performed CBSTI.We analyzed both the final success rate,operating time,intraoperative visual analogue scale(VAS) and the rate of post-operative complications,as well as the final therapeutic effect.RESULTS In ESTI group,17 cases were cured,5 cases were improved and 3 cases were invalid.The success rate was 88.00％.Correspondingly for CBSTI group,14 cases were cured,6 eases were improved and 5 cases were invalid,and the success rate was 80.00％.ESTI was better,but there was no significant in success rate between the two groups (x2=0.881,P=0.644).Besides,the operating time and intraoperative VAS score in ESTI group was (10.32±2.30)min and 2.02±0.86,and they were(25.32 ± 4.87)min and 4.11 ± 1.44 in CBSTI group.So ESTI was better than CBSTI(t=-13.918,P=0.000;t=-6.012,P=0.000).ESTI had fewer complications(x2=4.878,P=0.027).CONCLUSION Compared to CBSTI,ESTI is a minimally invasive and highly effective technique for the treatment of CDC.The visualization of nasal endoscopy is the optimization of CBSTI,and this method need to be popularization and application.

Incidence of Otitis Media with Effusion in Adenoid Hypertrophy with Allergic Rhinitis in Children / 中山大学学报(医学科学版)

Objective]In order to study the impact of adenoid hypertrophy(AH)with allergic rhinitis(AR)in the otitis media with effusion(OME)in children,as well as to discuss the risk factors on the inducement of OME in patients with AH.[Methods]The clinical materials were collected and analyzed from 205 children with AH who admitted for surgical treatment between 2013 and 2015, including medical history and signs,acoustic immittance measurement,allergy screen as well as blood routine,and to evaluate the situation of OME and AR in patients with AH. All the data were analyzed by SPSS 20.0.[Results]Among the 205 AH children,66 cases(32.20%)were accompanying with OME. The AH patients aged 3-5 years had the highest incidence of OME,which decreased with age(P=0.018). It is significant on the prevalence of the OME in patients with AH between the two groups with and without AR (P = 0.010). In the logistic model investigating the risk factors of inducing OME among patients with AH,the third-degree AH, Type-three and the accompanying with AR were significant. The third-degree and third-type AH children were 2.729 and 6.390-folds higher than others respectively (P = 0.047,P = 0.001). The incidence of OME appeared to be 1.212-folds higher among patients with AR(P = 0.010).[Conclusion]Mechanical obstruction and AR played a superimposed role in the inducement of OME among patients with AH,which was effected by multiple factors. We should pay attention to the“lateral respiratory”allergic diseases on eustachian tube and middle ear.

Distribution and treatment onintractable epistaxis in concealed sites / 中国耳鼻咽喉头颈外科

OBJECTIVE To drew the map of distribution of concealed sites in epistaxis and optimize the mode of diagnosis and treatment. METHODS We have searched 117 references on intractable/refractory/latent epistaxis treated under nasal endoscopy in the last decade, including 11 708 cases with epistaxis. There were total 11 860 cases in this study plus 152 cases in our hospital. We summed up the experiences of the optimized treatment mode performed on concealed epistaxis, which was searching the accurate bleeding areas by nasal endoscopy and performing minimally invasive radiofrequency treatment without nasal packing. RESULTS We had found that the offending arteries about epistaxis are mainly sphenopalatine artery and anterior or posterior ethmoid artery. The frequency of bleeding areas came as follows: the vault of inferior nasal meatus in 3783 cases(31.90%), the olfactory sulcus of middle turbinate in 3522 cases(29.70%), the posterior regions of middle meatus in 1349 cases(11.37%), the regions of deviation of nasal septum in 1065 cases(8.98%), the foremost regions of nasal cavity in 738 cases(6.22%), and the others or uncertain in 1403 cases(11.83%). Finally, we drew a concise map of distribution about epistaxis on the basis of the concealed bleeding areas and offending vessels. 151 of 152 patients(99.34%) could find out the bleeding sites accurately and stop the bleeding through minimally invasive radiofrequency ablation. CONCLUSION We drew a map of distribution about epistaxis in concealed areas so that it is convenient for us to seek out the bleeding sites. Rational use of nasal endoscopy to explore the sites of intractable epistaxis and minimally invasive radiofrequency are optimized mode of treatment.

Clinical characteristics in patients with allergic rhinitis and nonallergic rhinitis in Guangzhou / 中国耳鼻咽喉头颈外科

OBJECTIVE To obtain and compare the clinical characteristics in patients with allergic rhinitis(AR) and nonallergic rhinitis(NAR) and investigate the trends in the proportion of AR and NAR in recent 10 years in Guangzhou. METHODS 5486 patients with nasal hyper-reactivity symptoms were divided into the AR group and NAR group. Clinical data including gender, age distribution and seasonality were analyzed. RESULTS The trends in the proportion of AR and NAR during the past decade did not change significantly. Male made up the majority of AR patients and NAR patients and AR patients were significantly younger than NAR patients. Male AR patients were significantly younger than females, while there were no significant difference in the age distribution among the male NAR patients and female ones. As the age increasing, the proportion of AR and NAR patients in overall study population present opposite tendency. The main onset season in AR was summer and in NAR was winter in Guangzhou city. CONCLUSION There were significant differences between AR and NAR in age, gender and seasonality. However, the trends in the proportion of AR and NAR in recent 10 years did not change significantly in Guangzhou.

Compliance to sublingual immunotherapy in patients with allergic rhinitis in Guangzhou city / 中国耳鼻咽喉头颈外科

ABSTRACT]OBJECTIVETo study the compliance to sublingual immunotherapy(SLIT) in patients with allergic rhinitis(AR) in Guangzhou city.METHODSFrom January 2014 to May 2014, 202 patients with AR received SLIT were followed up by telephone. According to age, the patients were divided into group A(age0.05). Main reasons for poor compliance included poor efficacy (48.48%), insufficient education about SLIT (16.67%), inconvenience (15.15%), and adverse reactions(10.61%).CONCLUSION In Guangzhou city, lost follow-up rate in AR patients receiving SLIT is high. Compliance to SLIT is relatively low and improvements shall be made.

The application of PureceptionTM gradient centrifugation technique for sperm separation in artificial insemination by husband / 国际检验医学杂志

Objective To probe into the application of PureceptionTM gradient centrifugation technique for sperm separation in artificial insemination by husband (AIH) .Methods Prepare the semen by PureceptionTM gradient centrifugation technique ,and used for 1360 AIH cycles in 672 infertile couples .Results After preparing the semen by PureceptionTM gradient centrifugation technique ,the sperm concentration was increased from (54 .86 ± 26 .03) × 106/mL to (63 .89 ± 34 .40) × 106/mL ,the rate of PR sperm was increased from (32 .47 ± 9 .31)% to (69 .78 ± 5 .10) ,the differences were both statistically significant (P<0 .05) .the recovery rate of PR sperm was (34 .08 ± 3 .95)% .672 infertile couples received 1360 AIH cycles ,and the clinical pregnance rate was 16 .62% (226/1360) .According to the sperm concentration before preparing the semen ,the cycles were divided into 3 groups :≥15 × 106/mL (GroupⅠ) ,(≥10 ,<15)× 106/mL (GroupⅡ ) and <10 × 106/mL (Group Ⅲ ) ,the clinical pregnancy rates were 17 .13% ,16 .05% and 4 .26% ,respectively ,Group Ⅲ was significantly lower than the other two groups (P<0 .05);According to the rate of PR sperm ,the cycles were divided into 3 groups:≥32% (Group A) ,(≥10 ,<32)% (Group B) and <10% (Group C) , the clinical pregnancy rates were 17 .53% ,16 .55% and 4 .65% ,respectively ,Group C was significantly lower than the other two groups (P<0 .05) .According to the number of PR sperm after preparing the semen ,the cycles were divided into 2 groups:≥10 × 106 and <10 × 106 ,the clinical pregnancy rates were 17 .33% and 10 .22% ,the difference was statistically significant (P<0 .05) . Conclusion PureceptionTM gradient centrifugation technique is a better way for sperm separation ,and the clinical pregnance rate is satisfactory when it is used in AIH .When the sperm concentration is ≥10 × 106/mL and the rate of PR sperm is ≥10% before pre‐paring the semen ,and the number of PR sperm is ≥10 × 106 after preparing the semen ,patients will get a more ideal pregnancy rate .

Correlation of gammadelta-T-cells, Th17 cells and IL-17 in peripheral blood of patients with allergic rhinitis.

BACKGROUD: Gammadelta-T-cells play an important role in the mucosal immune system of the respiratory tract. Th17 cells plays an important role in promoting inflammation and autoimmune diseases. Th17 cells mainly secrete IL-17. However, little information is available on the relation between gammadelta-T-cells and Th17 cells in allergic rhinitis (AR). OBJECTIVE: To explore the correlation between the prevalence of gammadelta-T-cells, the prevalence of Th17 cells and the expression of IL-17 in the peripheral blood of patients with AR. METHODS: Peripheral blood from the AR group (32 cases) and the control group (20 cases) was collected from March 2012 to July 2012. The percentages of gammadelta-T-cells and Th17 cells were measured by flow cytometry, and the levels of IL-17 were measured by ELISA. RESULTS: The percentage of gammadeta-T-cells and Th17 cells in the AR group were significantly higher than those in the control group (P < 0.01). The levels of IL-17 in the AR group were also significantly higher than those in the control group (P < 0.01). There were positive correlations between the gammadelta-T-cell percentage and the Th17 cell percentage in the peripheral blood of AR patients (r = 0.597, P < 0.01); and between the gammadelta-T-cells percentage and the levels of IL-17 (r = 0.469,P < 0.01). However, no correlation was found between the Th17 cell percentage and the levels of IL-17 (r = 0.100, P > 0.05). CONCLUSION: Gammadelta-T-cells and Th17 cells may be involved in the pathogenesis of AR; gammadelta-T-cells may primarily be associated with the secretion of IL-17.

Interleukin-1beta induces MUC2/MUC5B gene expression in human nasal epithelial cells / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To demonstrate the effects of IL-1beta on MUC2/MUC5B gene expression in cultured human nasal epithelial cells.@*METHOD@#In passage-2 cultured human nasal epithelial cells, the mRNA levels of MUC2/MUC5B gene expression induced by IL-1 beta were determined by fluorescent quantitative RT-PCR.@*RESULT@#MUC2/MUC5B mRNAs were detected after 24 h of exposure to IL-1beta. MUC2 mRNA levels in IL-1 beta treatment [(39.26 +/- 6.10) x 10(4) copy/microg] were significantly higher than control [(5.70 +/- 4.16) x 10(4) copy/microg] (P < 0.01). MUC5BmRNA levels in IL-1beta treatment [(5.7 +/- 2.06) x 10(5) copy/microg] were significantly higher than control [(1.11 +/- 0.72) 10(5) copy/microg] (P < 0.05).@*CONCLUSION@#IL-1 beta increased MUC2/MUC5B mRNA levels in human nasal epithelial cells. These results suggest that IL-1beta may enhance mucin gene expression in cultured human nasal epithelial cells.

The expression of MUC5AC in sinus mucosa of chronic rhinosinusitis / 中国医师杂志

Objective To investigate the expression of MUC5AC in human sinus mucosa and compare the expression of MUC5AC mRNAs in normal and chronic sinus mucosa. Methods Thirty two chronic ethmoid sinusitis mucosa samples and 7 normal ethmoid sinus mucosa samples were used. The protein expression of MUC5AC was examined by using immunohistochemical method. RNAs were extracted from sinus mucosa, and fluorescent quantitative nested RT-PCR was performed for MUC5AC. Results The mean gray scale of MUC5AC protein expression was 159. 72 ± 14. 14 in chronic ethmoid sinusitis mucosa and 115.80 ±31.58 in normal ethmoid sinus mucosa. There was significantly different between two groups (t =3.57, P ＜0.01). The levels of MUC5AC mRNAs in chronic rhinosinusitis [(35.80 ± 19. 74) × 105copies/μg] were higher than those in normal sinus mucosa [(4. 66 ± 2. 47) × 105 copies/μg] . M UC5 AC mRN A expression had significant difference between chronic ethmoid sinusitis mucosa and normal sinus mucosa(t =4. 12, P ＜0.01). Conlusion This result suggested that up-regulation of MUCSAC in chronic rhinosinusitis might play an important role in the pathogenesis of sinus hyperesecretion in chronic rhinosinusitis.

Aeroallergen Specific IgE in Serum of Patients with Allergic Rhinitis / 中山大学学报(医学科学版)

[Objective] To study the aeroallergens in the patients with allergic rhinitis in Guangzhou.[Methods] Using the German screen allergens quantitative detection system to determinate serum aeroallergen specific IgE and total IgE levels of 625 cases with allergic rhinitis diagnosed in The Third Hospital of SUN Yat-sen University.The samples were stratified on two age groups:the juvenile and the adult.Difference of serum aeroallergen specific IgE of the two groups was investigated.[Results]Aeroallergen specific IgE antibody in the serum of 625 patients with allergic rhinitis were positive.Total IgE in serum was positive in 413 cases,accounting for 66.1%.The positive rate of total IgE was less than that of aeroallergen specific IgE.The positive rate of aeroallergen specific IgE in order were mite mixture (84.32%),cockroach (19.04%),cypress (15.20%),cat-dog epithelia (13.12%),tree mixture (7.20%),ragweed (5.12%),humulus lupulus (1.76%),mugwort (1.76%),mould mixture (1.44%).In the two groups,the positive rate of aeroallergen specific IgE in order were similar.There were significantly higher sensitivity and positive rate of mite mixture in the juvenile group than the adult group (P ＜ 0.01).[Conclusion] The most important aeroallergens are mite mixture,cockroach,cypress,cat-dog epithelia,which could be referenced as Guangzhou patients .The juvenile is more sensitive to mite than the adult.

Prevalence and prognostic factors for postoperative complications of uvulopalatopharyngoplasty in patients with obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the complication incidence and risk factors within immediate 24 hours after uvulopalatopharyngoplasty in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and provide theoretical foundation for preventing postoperative complication incidence.@*METHOD@#162 patients undergoing UPPP procedure between Mar, 2002, and Oct 2006, were analysed retrospectively. All patients were divided into two groups according to the development of postoperative complications or not. The retrospective chart review focused on the demographic data and pertinent history, preoperative sleep evaluation, surgical and anesthetic management, and need for postoperative interventions. Potential risk factors were first evaluated with univariate analysis followed by multivariate logistic regression with the occurrence of complications within immediate 24 hours after operation as the dependent variable.@*RESULT@#A total of 162 consecutive cases for UPPP were enrolled into current study. 31 cases (19.1%) had postoperative complications necessitating a medical intervention, including respiratory complications (n =21, 13.0%), cardiovascular complications (n =6, 3.7%) and hemorrhage (n =9, 5.6%). The differences in body mass index (BMI), apnea-hypopnea index (AHI), lowest oxygen saturation (LSAT) and difficult intubation were significant between two groups. Risk factors for postoperative complications were BMI (OR =1.136, 95% CI: 1.007-2.558, P =0.049), preoperative AHI (OR =4.828, 95% CI: 1.827-13.924, P =0.012) and difficult intubation (OR = 1.971, 95% CI: 1.251- 4.839, P =0.034).@*CONCLUSION@#Baseline BMI and AHI, difficult intubation in anaesthetic procedure were the most important predictors of postsurgical morbidity. Keeping in mind the aforementioned cautionary notes, aggressively preoperative preparation should be applied for such populations to avoid the occurrence of postoperative complications.

Up-regulation of MUC2 mucin gene in chronic rhinosinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the expression of MUC2 in human sinus mucosa and compare the expression of MUC2 mRNAs in normal and in chronic sinus mucosa.@*METHOD@#Thirty-two chronic ethmoid sinusitis mucosa samples and 8 normal ethmoid sinus mucosa samples were obtained; RNAs were extracted from sinus mucosa, and fluorescent quantitative PCR was performed for MUC2.@*RESULT@#The levels of MUC2 mRNAs in chronic rhinosinusitis were significantly increased compared with those in normal sinus mucosa.@*CONCLUSION@#This result suggest that up-regulation of MUC2 in chronic rhinosinusitis may play an important role in the pathogenesis of sinus hypersecretion in chronic rhinosinusitis.