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Objective: To explore the expression of interleukin-25 (IL-25) in chronic rhinosinusitis with nasal polyps (CRSwNP) and its potential significance in pathogenesis., Method: IL-25 expression in blood was detected by enzyme-linked immunosorbent assay (ELISA). IL-25 expression in tissue was detected by immunohistochemistry (LSAB method) from polyps (68 CRSwNP patients) and 55 inferior turbinate mucosa from patients with deviation of nasal septum served as control. Complete blood count and HE staining of blood and tissue eosinophil infiltration degree., Result: IL-25 expression in CRSwNP group were significantly higher than the control group, the difference was statistically significant (P < 0.01). IL-25 expression in local organizations was positively correlated with the number of eosinophil infiltration in CRSwNP group (r = 0.679, P < 0.01)., Conclusion: The expression of IL-25 in CRSwNP patients mutually reinforcing and might increase eosinophil infiltration and play an important role in the development of CRSwNP.

Objective: To discuss the relation between total IgE, special IgE and Eosinophils of serum in blood and the occurrence of nasal polyps (NP) of chronic rhinosinusitis (CRS) patients, and then to get the best clinic index., Method: One hundred and fifty two cases of CRS patients were divided into two groups (CRSsNP, CRSwNP). Allergen in vitro were screened, and then. the acidophilic granulocyte percentage and the total IgE of serum in blood were determined., Result: (1) The IgE concentration of CRSsNP was mainly at one level while the IgE concentration of (CRSwNP was mainly at two or three levels (Z = 0.906, P > 0.05). There was no significant difference of sIgE serum between the two groups. (2) The EOS percentage of CRSwNP was distinctly higher than that of CRSsNP(F = 4.337, P = 0.039 t = 3.315, P < 0.01). The 95% confidential interval (CI) of EOS of CRSwNP was 3.90%-5.260, 5% TM value was 4.3, which were higher than the concentration of CRSsNP and normal val ue. There was no significant difference between different groups (classes) if the CRSwNP group were classified by sIgE concentration (P > 0.05). (3) CRSwNP patients were mainly mixed-type allergen allergy and the proportion of patients with this mixed-type allergen would increase in accordance with the increasing of allergen concentration gradient (chi2 = 8.595, P < 0.05)., Conclusion: The occurrence of CRSwNP is related to the increase of EOS and mixed allergens. When the concentration of EOS range from 3.90% to 5.26%, CRSwNP is more likely to occur. The concentration of total IgE and sIgE are not the risk factors singly. Allergen screening result combined with the clinical symptoms can help to get knowledge of and keep away from allergen, and also is beneficial to make treatment plan of perioperative period of CRS.

Objective: To investigate the clinical significance of 1,3-beta-D glucanase detection in plasma to the diagnosis of fungal rhinosinusitis., Method: MB-80 rapid microorganism detection system was used to detect preoperative and postoperative 1,3-beta-D glucanase in plasma of 37 patients of fungal rhinosinusitis which were treated by endoscopic sinus surgery and confirmed by postoperative pathology. Blood samples of 47 patients who underwent endoscopic surgery(fungal rhinosinusitis excluded) were taken as control group., Result: 1,3-beta-D glucanase content is more than 10 pg/ml in 34 cases of the fungal rhinosinusitis group,and every 1,3-beta-D glucanase content of 47 control cases is less than 10 pg/ml. Significant difference is found between case and control groups(chi2 = 72.6, P < 0.01)., Conclusion: 1,3-beta-D glucanase detection in plasma is a simple,rapid diagnostic method of fungal rhinosinusitis.

Objective: To evaluate the changes of epidermal growth factor (EGF) in serum before and after endoscopic surgery in patients with chronic sinusitis, and then to explore its clinical significance., Method: Serum was collected before and after operation and EGF concentrations were measured by the radioimmunoassay at different times., Result: EGF levels in patients with chronic sinusitis (1.24 +/- 0.41) microg/L were higher than that in control group (0.92 +/- 0.23) microg/L, but there were no significantly difference between them (P > 0.05). The concentrations of EGF were reduced after surgery, and the lowest were evaluated after 4 weeks. Significant difference of EGF concentrations were found between before and 4 weeks after operation (P < 0.01). The concentration of EGF were raised 6 weeks after surgery, and returned to normal after 8 weeks., Conclusion: The changes of EGF in serum before and after endoscopic surgery may relate with the epithelization process of sinus mucosa after endoscopic surgery.

Objective: The serum levels of interleukin-4, interleukin-12 will be detected to elucidate and compare the involvement of Th1 and Th2 cells and the surface structures of nasal mucosa will also be observed in patients with allergic rhinitis (AR), chronic rhinosinusitis with nasal polyps (CRSwNP), chronic rhinosinusitis without nasal polyps (CRSsNP) and nasal septal deviation (NSD) to obtain the characteristics and regularity of pathological changes., Method: The serum levels of interleukin-4, interleukin-12 were detected by enzyme linked immunosorbent assay method. Four pieces of nasal mucosa on lateral side of middle turbinate were sampled from four patients and observed by scanning electron microscope., Result: The levels of interleukin-4 in AR and NSD groups were significantly higher than the healthy controls (P < 0.01). The levels of interleukin-4 and interleukin-12 in CRSwNP and CRSsNP groups were both higher than the healthy controls (P < 0.01 or P < 0.05), but no differences of the interleukin-4 and interleukin-12 levels were found between them (P > 0.05). There were two points of regularity with different degrees in our observations: (1) disoriented and absence of cilium; (2) the cellular separations at cell junctions were obvious, even with cells lost., Conclusion: There was an immunologic deviation towards Th2 pattern in patients with NSD the same as AR. Both Th1 and Th2 with hyperactivity participated in chronic inflammatory process of CRSwNP and CRSsNP. The pathological changes of ciliated columnar epithelium in patients with the four types of rhinitis, suggest that a comprehensive treatment including antral irrigations, multiple antibiotics, topical steroid sprays, or antihistamines, as well as nasal surgery to correct nasal deformities should be adopted, which can effectively prevent the development and expanding of the nasal mucosa inflammation.

Objective: To explore correlation of allergy and outcomes after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis., Method: Before ESS, 115 cases were arranged to detect allergic serum relative index: the concentration of serum TIgE, specific IgE semi-quantitative test and the concentration of serum ECP; to survey QOL status: VAS, SNOT-20 and SF-36; as well as inquire medical record, Lund-Mackay CT system scoring, clinical classification of chronic rhinosinusitis. After ESS (>1 year), 74 cases were followed up. The subjective and objective assessment were achieved by means of VAS, SNOT-20, SF-36 and Lund-Kennedy endoscopic scores., Result: The improvements of VAS scores of the cases with increased serum TIgE were significantly lower than those without increased serum TIgE (P<0.05). In cases of II, III types, the objective outcomes of the cases with increased serum TIgE were significantly worse than those without increased serum TIgE (P<0.05). The objective outcomes of the cases with positive allergen (> or = 3) were significantly worse than those with positive allergen (<3) (P<0.05). The objective outcomes of the cases with strong positive allergen were significantly worse than those without strong positive allergen (P<0.05). VAS scores and SNOT-20 scores after endoscopic sinus surgery of the cases with strong positive allergen were significantly worse than those without strong positive allergen (P<0.05). The concentration of serum ECP of the invalid cases was significantly higher than effective cases (P<0.05). The concentration of serum ECP was positive correlated with Lund-Kennedy endoscopic scores (r=0.49, P<0.05). In cases of II, III types, the objective outcomes of the cases with increased serum ECP were significantly worse than those without increased serum ECP (P<0.05), VAS scores and SNOT-20 scores after endoscopic sinus surgery of the cases with increased serum ECP were significantly worse than those without incre- ased serum ECP (P<0.05), the improvements of VAS scores of the cases with increased serum ECP were significantly lower than those without increased serum ECP (P<0.05)., Conclusion: Those allergic serum relative indexes make some negative effect on subjective and objective outcomes. Especially, in cases with polyps, the increase of serum TIgE and serum ECP has more negative effect. Our results might help to choose immunotherapy to combine with endoscopic sinus surgery for those selected patients to improve the outcomes of chronic rhinosinusitis.

Objective: To explore the correlation between allergic factors and chronic rhinosinusitis, and discuss its effects on the development of illness., Method: One hundred and one cases were selected to detect allergic serum relative index: the concentration of serum TIgE, specific IgE semi-quantitative test, the concentration of serum ECP as well as inquiring medical record, Lund-Mackay CT system scoring., Result: The concentration of serum TIgE and serum ECP in CRS was higher than those in control (P < 0.01). The increased proportion of serum TIgE and serum ECP was significantly different among clinical stages (P < 0.05) and between the cases with and without prior sinus surgery (P < 0.05). CT scores of the cases with serum TIgE and serum ECP increased were significantly higher than those without serum TIgE and serum ECP increased. The strong positive rate in CRS was significantly different among clinical stages (P < 0.05). The strong positive rate increased significantly in the cases with prior sinus surgery (P < 0.05). CT scores in the cases with strong positive allergen were significantly higher than that in the cases without positive allergen (P < 0.05)., Conclusion: These results suggest that allergic factors make some negative effect on the severity of CRS and are the index for the severity and worse prognosis of illness.

Objective: To evaluate the method of the perioperative blood glucose control in chronic rhinosinusitis coexisting diabetes., Method: Twenty-two cases of chronic rhinosinusitis coexisting diabetes were investigated retrospectively, including one case of type 1 diabetes and 21 cases of type 2 diabetes. The study cohort was divided into two groups, the one was complication group and the other was non-complication group. The patients in complication group were injected insulin to control blood glucose level, and the patients in non-complication group were prescribed oral medicine., Result: Blood glucose levels below 9.0 mmol/L in complication group and below 7.0 mmol/L in non-complication group were both the surgical indication for the patients in this research cohort. Twenty-one cases were completely recovered and one case made progress significantly., Conclusion: The detection of blood and urine glucose levels must be the routine item before the nasal endoscopic surgery. To control blood glucose levels in type 2 diabetes with non-complication, oral medicine is the first choice, in type 1 diabetes and type 2 diabetes with complication, insulin should be first considered.