Risk factors for asthma in patients with allergic rhinitis in eastern China.

BACKGROUND: Asthma is one of the most common chronic diseases among children and adults and can lead to a high health and socioeconomic burden. Allergic rhinitis (AR) often precedes the development of asthma. This study aims to clarify the risk factors for cocurrent asthma in patients with AR in eastern China. METHODS: A cross-sectional study of 3739 patients with AR was performed in eastern China. Patients meeting the criteria for AR were evaluated using a skin-prick test (SPT) of 16 common aeroallergens. A logistic regression analysis was used to assess the risk factors of asthma in patients with AR. RESULTS: The prevalence of asthma in patients with AR was 14.23%. The patients sensitive to dust mites (D. farinae and D. pteronyssinus) had the highest prevalence (76.84% and 73.68%). A significant difference was found in sensitization to four types of allergens (D. farinae, D. pteronyssinus, dog dander, Alternaria alternata) in patients with AR with and without asthma. The strongest risk factor for asthma in patients with AR was an allergy to Aspergillus fumigatus (adjusted OR, 2.42; 95% CI, 1.50-3.90), followed by allergy to D. pteronyssinus (adjusted OR, 2.06; 1.30-3.27), and allergy to dog dander (adjusted OR, 1.92; 1.24-2.97). Various risk factors that are independently associated with asthma in patients with AR were found in different age groups. CONCLUSIONS: We observed a difference in risk factors in patients with AR with and without asthma. Clarifying the risk factors for asthma in patients with AR is important and may be beneficial to the optimal interventions of asthma.

Significantly reducing post-tonsillectomy hemorrhage requiring surgery by double-layer suture: A retrospective analysis.

BACKGROUND: Although tonsillectomies carry a low-risk for adverse events, postoperative hemorrhage has been reported as the most common complication. AIM: To compare the rates of postoperative secondary hemorrhage for tonsillectomy with or without double-layer suture. MATERIAL AND METHODS: This is a retrospective study of 5087 patients who underwent coblation tonsillectomy with or without suture from 2006 to 2016. All cases had been followed up 3 weeks and severe secondary hemorrhage cases requiring operation were analyzed. RESULTS: The severe secondary hemorrhage rate was statistically higher in group without suture (1.96%) as compared with the group with suture (1.08%). The surgery time (36.55 ± 7.45) was longer in patients with suture as compared to patients without suture (31.50 ± 6.23). In the age between 18 and 49 years group, the higher secondary hemorrhage rate (2.44%) was found in patients without suture. The rate of postoperative hemorrhage (0.96%) was significantly higher in patients without suture as compared with patients with suture (0.36%) on postoperative 5th day. CONCLUSIONS: The risk of severe secondary hemorrhage is reduced in coblation tonsillectomy with suture. The rate of secondary hemorrhage is lower in patients with suture in 18 to 49 years old group and on the 5th day after surgery.

[Effect of Kangxianling Recipe on p38MAPK/NF-KBp65 Mediated Inflammatory Factors in 5/6 Nephrectomized Mice].

Objective To observe effects of Kangxianling Recipe ( KXLR) on p38MAPK/NF- κBp65 mediated inflammatory factors in chronic renal failure ( CRF) model mice. Methods Totally 56 C57BL/6J male mice (18 -22 g) were recruited in this experiment. Ten were randomly selected as a sham-operation group. The rest 46 mice were used for preparing CRF model by 5/6 nephrectomization. To- tally 33 successfully modeled mice were divided into the model group, the rapamycin (RAP) group, and the KXLR group according to serum creatinine (SCr) level, 11 in each group. Mice in the RAP group were administered with rapamycin (0.13 mg/100 g per day, 0. 5 mL each time) by gastrogavage. Mice in the KXLR group were administered with KXLR (2 g/100 g per day, 0. 5 mL each time) by gastrogavage. Equal volume of distilled water was administered to mice in the model group and the sham-operation group. Mice were sacrificed after 8 weeks of consecutive medication. The expression of neutrophils was ob- served using immunohistochemical assay. Expression levels of p38MAPK/NF-κB p65 protein and TNF-α/ IL-6 mRNA were detected by Western blot and Real-time PCR. Results Compared with the sham-opera- tion group, the number of positive neutrophils increased, expression levels of p38MAPK/NF-κB p65 protein and TNF-α/IL-6 mRNA were enhanced significantly in the model group (P <0. 05, P <0. 01). Com- pared with the model group, the number of neutrophils was reduced, expression levels of p38MAPK/NF- κB p65 protein and TNF-α/IL-6 mRNA were decreased significantly in the KXLR group and the RAP group (P <0. 05, P <0. 01). RAP showed better effect in decreasing p38MAPK protein expression than KXLR (P <0. 05). There was no statistical difference in the rest indices between the KXLR group and the RAP group (P >0. 05). Conclusions KXLR participated the regulation of p38MAPK/NF-κB p65 mediated in- flammation factors. It had certain improvement in renal fibrosis induced renal failure.

A Clinical Multicenter Randomized Controlled Study on JianpiQinghua Decoction in Treating Stage 3 Chronic Kidney Disease with A Syndrome Type of Dampness-heat due to Spleen Deficiency.

Objective To evaluate the clinical effectiveness of JianpiQinghua decoction in treating stage 3 chronic kidney disease (CKD3) with syndrome type of dampness-heat due to spleen deficiency. Methods A multicenter, randomized, controlled, prospective, double-blind, and double-simulation study was undertaken. A total of 270 CKD3 patients with syndrome type of dampness-heat due to spleen deficiency from the outpatient departments of six general hospitals were randomly divided into telmisartan+analog traditional Chinese medicine (TA) group, traditional Chinese medicine+analog telmisartan (TCMA) group, and telmisartan+traditional Chinese medicine (TTCM) group, in which the corresponding treatment was applied in addition to basic treatment. Six months later, changes in the traditional Chinese medicine (TCM) clinical symptom scores and renal functions before and after treatment were compared among these three groups. Results Of these 270 CKD3 patients who had been enrolled in this study, 30 cases lost to follow-up. The baseline data were comparable among these three groups. After treatment, the TCM clinical symptom scores of both syndrome of spleen-qi deficiency and dampness-heat in TA group were significantly higher than those in TCMA group and TTCM group (P<0.001). With the treatment time prolonged, the TCM clinical symptom scores showed similar descending trends in TCMA group and TTCM group but were different from that in TA group. After treatment, abnormal creatinine rate decreased (P=0.003), and these three treatments and their interactions with each visit had no effect on serum urea nitrogen value (P=0.270, P=0.520); with prolonged treatment, the estimated glomerular filtration rates in three groups tended to be relatively stable after the first rise. The liver function and abnormal serum potassium rate were not statistically significant before and after treatment (P>0.05). Conclusions JianpiQinghua decoction can improve clinical symptoms of TCM in CKD3 patients with syndrome type of dampness-heat due to spleen deficiency and thus improve the quality of life and prognosis. The clinical efficacy of JianpiQinghua decoction alone or combined with telmisartan is superior to telmisartan monotherapy.

Severity of Rhinosinusitis: Comparison Between Visual Analog Scale Given by Patients and Otorhinolaryngologists.

BACKGROUND: Visual Analog Scale (VAS) as determined by the patient is recommended by the European Position Paper on Rhinosinusitis and Nasal Polyps 2012 in evaluation of the total severity of the chronic rhinosinusitis (CRS) patients' symptoms. OBJECTIVE: To evaluate the correlation between evaluations performed by otorhinolaryngologists and CRS patients with commonly used systems. METHODS: Scores of VAS and Sino-Nasal Outcome Test-20 (SNOT-20) Chinese version were obtained from 110 CRS patients with nasal polyps (CRSwNPs, n = 61) and without nasal polyps (CRSsNPs, n = 49) before surgery, which were compared with scores of Lund-Kennedy endoscopic staging system, the Lund-Mackay computed tomography (CT) staging system, and VAS from 3 attending otorhinolaryngologists. RESULTS: The median VAS scores given by CRS patients (6.0; 4.25-7.5) do not correlate significantly with the VAS scores by the 3 otorhinolaryngologists (5.5; 4.83-6.5) with a correlation coefficient of .218 (-0.146 to 0.466). For CRS patients, there was only a moderate correlation between scores of VAS and the SNOT-20 (r = .37), and no significant difference of VAS scores between CRSwNP and CRSsNP, and between unilateral and bilateral nasal polys. For otorhinolaryngologists, a higher median VAS score was found in CRSwNP (6.0; 5.17-7.0), especially in bilateral (6.0; 5.0-7.08) and revision surgery (6.08; 5.33-7.63). The VAS scores of otorhinolaryngologists correlated significantly with the Lund-Mackay CT score (r = .7536) and Lund-Kennedy endoscopic staging (r = .5947). CONCLUSIONS: VAS scores between patients and physicians are not correlated significantly in this study, but they fall within the same therapeutic range and do not change the clinical management of the patients.