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Abstract Background Charcot‐Leyden crystals (CLCs) are recognized to be classic hallmarks of eosinophilic inflammation. Both protein and mRNA levels of CLC in nasal secretions and nasal brushing samples have been associated with nasal polyp recurrence. However, whether the crystalline CLC structures in nasal tissue could serve as an effective biomarker to predict polyp recurrence remains unclear. Methods A total of 110 patients with chronic rhinosinusitis with nasal polyps (CRSwNP) completing the postoperative follow‐up over a period of 24 months were recruited. Hematoxylin and eosin staining was employed for CLCs identification. The predictive factors for polyp recurrence were determined by binary logistic regression analysis. Results Thirty three (30.00%) patients developed recurrence during a 24‐month postoperative follow‐up, in which 84.85% (28/33) patients had crystalline CLC structures. Logistic regression analysis showed that crystalline CLC structure in nasal tissues is predictive of polyp recurrence. Youden index demonstrated crystalline CLC structure higher than 1 per high power field can predict postoperative polyp recurrence with 84.80% sensitivity and 98.70% specificity. Conclusions The crystalline CLC structures in nasal tissues may serve as an easy‐counting and promising biomarker to predict CRSwNP recurrence.

Objectives To assess the efficacy and safety of omalizumab for chronic rhinosinusitis with nasal polyps (CRSwNP) and to identify evidence gaps that will guide future research on omalizumab for CRSwNP.Design Systematic review and meta-analysis.Data sources A comprehensive search was performed in PubMed, Embase, Web of Science and the Cochrane Library on 13 October 2020.Eligibility criteria Randomised controlled trials (RCTs) comparing omalizumab with placebo, given for at least 16 weeks in adult patients with CRSwNP.Data extraction and synthesis Two independent authors screened search results, extracted data and assessed studies using the Cochrane risk of bias tool. Data were pooled using the inverse-variance method and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed by the χ2 test and the I2 statistic.Results A total of four RCTs involving 303 participants were identified. When comparing omalizumab to placebo, there was a significant difference in Nasal Polyps Score (MD=−1.20; 95% CI −1.48 to −0.92), Nasal Congestion Score (MD=−0.67; 95% CI −0.86 to −0.48), Sino-Nasal Outcome Test-22 (MD=−15.62; 95% CI −19.79 to −11.45), Total Nasal Symptom Score (MD=−1.84; 95% CI −2.43 to −1.25) and reduced need for surgery (risk ratio (RR)=5.61; 95% CI 1.99 to 15.81). Furthermore, there was no difference in the risk of serious adverse events ((RR=1.40; 95% CI 0.29 to 6.80), adverse events (RR=0.83; 95% CI 0.60 to 1.15) and rescue systemic corticosteroid (RR=0.52; 95% CI 0.17 to 1.61).Conclusions This was the first meta-analysis that identified omalizumab significantly improved endoscopic, clinical and patient-reported outcomes in adults with moderate to severe CRSwNP and it was safe and well tolerated.PROSPERO registration number CRD42020207639.

Background: artificial intelligence (AI) for cellular phenotyping diagnosis of nasal polyps by whole-slide imaging (WSI) is lacking. We aim to establish an AI chronic rhinosinusitis evaluation platform 2.0 (AICEP 2.0) to obtain the proportion of inflammatory cells for cellular phenotyping diagnosis of nasal polyps and to explore the clinical significance of different phenotypes of nasal polyps on the WSI. Methods: a total of 453 patients were enrolled in our study. For the development of AICEP 2.0, 179 patients (WSIs) were obtained from the Third Affiliated Hospital of Sun Yat-Sen University (3HSYSU) from January 2008 to December 2018. A total of 24,625 patches were automatically extracted from the regions of interest under a 400× HPF by Openslide and the number of inflammatory cells in these patches was counted by two pathologists. For the application of AICEP 2.0 in a prospective cohort, 158 patients aged 14–70 years old with chronic rhinosinusitis with nasal polyps (CRSwNP) who had undergone endoscopic sinus surgery at 3HSYSU from June 2020 to December 2020 were included for preoperative demographic characteristics. For the application of AICEP 2.0 in a retrospective cohort, 116 patients with CRSwNP who had undergone endoscopic sinus surgery from May 2016 to June 2017 were enrolled for the recurrence rate. The proportion of inflammatory cells of these patients on WSI was calculated by our AICEP 2.0. Findings: for AICEP 2.0, the mean absolute errors of the ratios of eosinophils, lymphocytes, neutrophils, and plasma cells were 1.64%, 2.13%, 1.06%, and 1.22%, respectively. The four phenotypes of nasal polyps were significantly different in clinical characteristics (including asthma, itching, sneezing, total IgE, peripheral eosinophils%, tissue eosinophils%, tissue neutrophils%, tissue lymphocytes%, tissue plasma cells%, and recurrence rate; P

Objective To identify the top 100 most impactful articles in nasopharyngeal carcinoma (NPC). Methods Articles on NPC from 1970 to 2018 were retrieved from the Web of Science (WoS). These articles were ranked in descending order based on the number of times they were cited, and all titles and abstracts were screened to identify the top 100 most-cited articles. Results The earliest and most recent articles were published in 1971 and 2016, respectively. The most prolific decade was the 2000s, with 51 articles published. The highest citation count reached 1223 and the lowest was 155. Thirty-four journals contributed to the 100 articles, with the International Journal of Radiation Oncology Biology Physics contributing the most articles (n=16). Notable contribution origins were Hong Kong (n=34), the United States (n=26), and China (mainland, n=12). The top three contributors were Chan ATC, Lee AWM, and Lo KW who were from Hong Kong. The types of articles included basic research (n=50), clinical research (n=36), and reviews (n=14). Conclusions This study identified the top 100 most impactful articles in NPC and stressed the multidisciplinary and multimodal nature of NPC management. Understanding historical articles may guide future NPC study.

Objective This study aimed to identify the top 100 most influential articles in the field of allergic rhinitis (AR). Methods Web of Science was queried for 1970 to 2018. Articles were sorted in descending order of the citation count. All titles and abstracts were screened to identify the top 100 articles. Results The top 100 most influential articles in AR were identified. The earliest article was published in 1975, and the most recent in 2015. The most prolific decade was the 2000s, with 59 articles published. Twenty-nine journals contributed to the top 100 articles, with the Journal of Allergy and Clinical Immunology contributing most of the articles (n = 34). The top three countries of article origin were the United States (n = 34), followed by the United Kingdom and France (n = 14 each). The type of article covered clinical research (n = 68), reviews (n = 22), and basic research (n = 10). For the clinical research articles, there were 6 studies with level 1 evidence, 25 with level 2 evidence, 11 with level 3 evidence, and 26 with level 4 evidence. Conclusions This study identified the top 100 most influential articles in the area of AR. Recognition of important historical contributions to this field may guide future investigations into AR.

The aim of the present study was to compare the accuracy of 64-multi-slice spiral computed tomography (64-MSCT) and 320-MSCT in the display of coronary artery stents and diagnosis of in-stent restenosis. The data collected from the 64- and 320-MSCT coronary angiography of 93 patients following coronary artery stent implantation were retrospectively analyzed. The 64-MSCT group comprised 30 cases with 57 stents and the 320-MSCT group comprised 63 cases with 93 stents. The image quality, heart rate of the patients and the radiation effective dose (ED) they were subjected to, were compared. Furthermore, the diagnostic abilities of 64-and 320-MSCT coronary angiography for in-stent restenosis were evaluated using invasive coronary angiography results as the gold standards. Statistically significant differences were observed in the heart rate and ED of the patients from the two groups (P<0.05), but no significant difference was identified in the accuracy index (P>0.05). The sensitivity, specificity, positive and negative predictive value and accuracy of the 64-MSCT group were found to be 100% (7/7), 93.94% (31/33), 77.78% (7/9), 100% (31/31) and 95% (38/40), respectively, and those in the 320-MSCT group were found to be 100% (16/16), 95.89% (70/73), 84.21% (16/19), 100% (70/70) and 96.63% (86/89), respectively. The present findings suggest that both 64-MSCT and 320-MSCT can be used for follow-up and curative effect evaluation following coronary stent implantation; however, 320-MSCT has fewer requirements of the patients' heart rate and uses a lower radiation dose. [ABSTRACT FROM AUTHOR]

In this study, the effect of 18 weeks of dietary supplementation of porcine submaxillary gland mucin (PSM) as an abundant source of N-hydroxyacetylneuraminic acid (Neu5Gc) on the expression of proteins involved in the nuclear factor kappa-B (NF-κB) signaling pathway in the liver, serum interleukin (IL)-6, IL-1β, tumor necrosis factor-alpha (TNF-α), serum amyloid A protein (SAA) and the gut microbiota in cytidine-5’-monophosphate-N-acetylneuraminic acid knockout (Cmah-/-) mice was investigated. Meanwhile, the effect of gender on Neu5Gc-induced inflammation in Cmah-/- mice was analyzed. The results showed that Neu5Gc activated the NF-κB signaling pathway and significantly increased the serum concentration of IL-6, IL-1β, TNF-α and SAA in both male and female mice when compared with normal controls. In the PSM-treated male mice, the ratio of Bacteroidetes to Firmicutes (B/F) significantly increased, the relative abundance of Muribaculaceae and Prevotellaceae significantly decreased, and the relative abundance of Clostridia UCG-014 and Prevotellaceae_NK3B31_group, which are positively associated with intestinal inflammation, significantly increased. In the PSM-treated female mice, the richness of gut microbiota significantly decreased, and so did the relative abundance of Lachnospiraceae and Oscillospiraceae. In conclusion, Neu5Gc in PSM could promote inflammatory responses in Cmah-/- mice through significantly down-regulating the abundance of relevant bacterial communities, facilitating the growth of bacterial communities positively associated with intestinal inflammation, leading to structural disorders of gut microbiota, activating the NF-κB signaling pathway and increasing the secretion of serum inflammatory cytokines, and inflammatory response induced in mice by Neu5Gc was affected by gender. Our study provides a reference for a healthy diet.