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Background: Few data are available concerning the prevalence and risk factors for allergic rhinitis (AR) in school children in Hubei Province which is located in the central part of China. This study investigated the epidemiological features of AR among school children in Hubei Province. Methods: A cross-sectional questionnaire survey on AR in school children was carried out in 5 cities in Hubei Province by cluster sampling from June to September 2018. Questionnaires were filled out by children and their parents jointly. The diagnostic criteria of AR were according to the SFAR. Questions from the questionnaire were used to examine the pattern of AR. Logistic regression analysis was used to assess the risk factors for childhood allergies. Results: The total prevalence rate of AR was 16.16%, with 24.31% (Wuhan), 4.34% (Xiangyang), 4.31% (Tianmen), 10.92% (Jingmen), and 11.42% (Huangshi), respectively. The prevalence of AR was positively correlated with gross domestic product per capita (p < 0.05). Multivariate analysis revealed that male, city of Wuhan, family history of allergy, food allergy, drug allergy, air purifier, exposure to dust, living in towns or urban area before 2 years old, maternal age for 26–35 years old, and frequent application of antibiotics increased the risk of AR, while daily outdoor time for 1–2 h, daily sleeping time >8 h, siblings, and breastfeeding for >6 months reduced the risk significantly. Conclusion: We found the apparent geographic variation of children allergies in Hubei Province. Both genetic and environment factors had impacts on the prevalence of AR in school children. Public policies should specifically target at the local risk factors for different areas.

Laryngeal squamous cell carcinoma (LSCC) is a laryngeal malignancy with a high mortality rates, and its treatment remains difficult. Sevoflurane is a surgical anesthesia which has anti-tumor effect. This investigation assessed the effects of LSCC cells treatment with Sevoflurane in vitro and in vivo. Hep-2 and Tu177 cells, human LSCC samples and BALB/C nude mice were used for result assessments. Cell viability, proliferation, migration and invasion were assessed via Cell Count Kit-8, wound healing assay and transwell invasion assay respectively. MiR-26a and FOXO1 expressions was examined by qRT-PCR. FOXO1, E-cadherin, N-cadherin and vimentin activities were examined by Western blotting. Moreover, animal experiments were performed to verify our findings in vitro. Lastly, miR-26a and FOXO1 expression levels in clinical samples were analyzed. According to the results, Sevoflurane decreased LSCC cells’ viability and even stimulated their apoptosis in vitro and in vivo. Moreover, it could reduce the migration, invasion and EMT. Mechanistically, sevoflurane could downregulate miR-26a expression and that miR-26a could negatively modulate FOXO1 activity. Thus, sevoflurane could increase FOXO1 activity. In the clinical samples, miR-26a expression was significantly upregulated, but FOXO1 was remarkably down-regulated and miR-26a expression in LSCC was linked with better prognosis. In conclusion, MiR-26a is increased and FOXO1 is reduced in human LSCC, Sevoflurane inhibits proliferation and mediates apoptosis of LSCC cells. Further, MiR-26a binds FOXO1 directly, and FOXO1 expression is down-regulated by Sevoflurane. Finally, Sevoflurane triggers LSCC cells apoptosis in vivo. Sevoflurane use to target miR-26a/FOXO1 may be a novel alternative for LSCC therapy.

Background Over the past decade, the prevalence of allergic rhinitis (AR) in China increased and showed a trend of younger age. The clinical features of AR in primary schoolchildren are still not clear enough. Objective To investigate the prevalence and epidemiological characteristics of AR among 6- to 12-year-old children in the central region of China. Methods Children from 6 primary schools were randomly selected from urban area of Wuhan, which lies in the central region of China. The questionnaires were distributed by mobile APP and filled out by the children and their parents online together. AR was diagnosed by Score for Allergic Rhinitis. Logistic regression analysis was performed to assess the risk factors for AR. Results A total of 5550 valid questionnaires were returned for evaluation. The prevalence of AR among 6- to 12-year-old children in urban area of Wuhan was 28.6%. Multivariate analysis revealed that male (odds ratio [OR] = 1.521, 95% confidence interval [CI] = [1.335, 1.732]), family history of atopy (OR = 3.220, 95% CI = [2.818, 3.681]), previous food allergy (OR = 1.590, 95% CI = [1.302, 1.942]), air purifier (OR = 1.420, 95% CI = [1.240, 1.625]), exposure to dust (OR = 1.764, 95% CI = [1.410, 2.207]), maternal exposure to smoke during pregnancy (OR = 1.242, 95% CI = [1.047, 1.473]), living in towns (OR = 1.468, 95% CI = [1.043, 2.006]) or metropolis (OR = 1.629, 95% CI = [1.205, 2.201]) before 2 years old, frequent application of antibiotics are risk factors for AR, while daily outdoor time for more than 1 hour (OR = 0.770, 95% CI = [0.673, 0.881]) and breastfeeding for more than 6 months (OR = 0.799, 95% CI = [0.701, 0.910]) reduced the risk significantly. Conclusions We found an unexpectedly high prevalence of AR among primary schoolchildren aged 6 to 12 years in the central region of China. Both genetic and environmental factors were associated with the development of AR.

Introduction: Chronic rhinosinusitis (CRS) is a local inflammation of the nasal mucosa and sinus that persists for >12 weeks. As CC chemokine ligand (CCL) 19 expression is known to be elevated in CRS, and CCL 19, CCL21, and CCL25 share the same atypical chemokine receptor 4, so we focused on CCL21 and CCL25. Objectives: To investigate the expression of CCL21 and CCL25 in different types of CRS and their significance in CRS development. Methods: A total of 116 patients participated in the study, and uncinate process mucosa or nasal polyp (NP) specimens were collected during surgery. Western blotting and immunohistochemistry were performed to detect the expression of CCL21 and CCL25, respectively, in the nasal mucosa. Immunofluorescence was used to determine their cellular localization in NPs, whereas macrophage culture was used to determine their relationships with macrophages. Results: Immunohistochemistry revealed that the expressions of CCL21 and CCL25 were increased in NPs only. Western blotting revealed that these expressions were gradually increased in control, CRS without NP and CRS with NP groups and were positively correlated with disease severity. Furthermore, increased expressions of CCL21 and CCL25 in NPs were not related to eosinophil infiltration. Immunofluorescence results demonstrated colocalization of CCL25+ cells and CD68+ macrophages. CCL25 expression was increased in macrophage culture, especially in M1 macrophages, while CCL21 expression was not significantly associated with macrophages. Conclusions: CCL21 and CCL25 were significantly upregulated in NPs and positively correlated with disease severity. CCL25 upregulation was related to M1 macrophages.

Long non-coding RNAs (LncRNAs) have gained widespread interest and attention as vital regulators in cancer occurrence and development. Nonetheless, the functions and mechanisms of lncRNAs involved in nasopharyngeal carcinoma (NPC) are largely unknown. By analysing the data from GSE61218, we identified a novel lncRNA LINC01515 which is altered in NPC. A series of experiments were performed to examine the exact roles of LINC01515 as well as the molecular mechanisms by which LINC01515 acted in NPC. LINC01515 expression was increased in NPC and that high LINC01515 expression was associated with a worse prognosis. Functionally, depletion of LINC01515 resulted in an inhibition of cell proliferation, migration and invasion, while apoptosis was promoted. Mechanistically, LINC01515 facilitated cell division cycle associated 5 (CDCA5) expression via serving as a sponge for miR-325. And more notably, miR-325 suppressed NPC progression in vitro by targeting CDCA5. Furthermore, the anti-tumor property induced by LINC01515 knockdown was partially reversed due to the overexpression of CDCA5. Taken together, LINC01515 exerted the carcinogenic effect in NPC through regulating miR-325/CDCA5 pathway. Our findings shed light on the possibility of exploiting LINC01515 as a prognostic biomarker or therapeutic target in NPC.

Background: A hallmark of eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) is mucosal eosinophil-predominant inflammation. Nasal nitric oxide (nNO) is a known biomarker of eosinophilic inflammation in the upper airway. However, the utility of nNO measurement in the upper airway remains controversial. The present study aimed to compare the use of other clinical parameters with nNO to prediagnose patients with eCRSwNP from Central China. Methods: From June 2019 to December 2019, 70 patients with CRSwNP undergoing endoscopic sinus surgery and 30 healthy subjects were enrolled. nNO measurements were performed in all of these subjects. Computed tomography scans, full blood count with differential analysis, and determination of total immunoglobulin E (total IgE) and plasma cytokines were performed before surgery. Receiver operating characteristic curves and logistic regression analysis were used to assess the predictive potential of the clinical parameters. Results: We recruited 24 patients with eCRSwNP and 46 with noneosinophilic CRSwNP (non-eCRSwNP). In patients with eCRSwNP, nNO levels were significantly higher than those in patients with non-eCRSwNP (p < 0.0001). Blood eosinophil percentages and counts, total IgE, and CT-derived ethmoid sinus and maxillary sinus ratio (E/M ratio) were all significantly higher compared with those in patients with non-eCRSwNP (p < 0.05). To diagnose eCRSwNP, the highest area under the curve (0.803) was determined for nNO. At a cutoff of >329 parts per billion (ppb), the sensitivity was 83.30% and the specificity was 71.70%. However, the levels of plasma cytokines Th1/Th2 were not significantly different between the histological types of CRSwNP (p > 0.05). Conclusion: Measurement of nNO is useful for the early diagnosis of eCRSwNP.

To explore the relationship between autophagy and cell function, we investigated how PLAC8‐mediated autophagy influences proliferation, apoptosis and epithelial‐mesenchymal transition (EMT) in NPC. Colony formation analyses and CCK8 assays were used to assess the proliferative capacity of NPC cells. Transmission electron microscopy (TEM) was used to identify autophagosomes. Autophagic flux was monitored using the tandem monomeric RFP‐GFP‐tagged LC3 (tfLC3) assay. The rate of apoptosis in NPC cells was analysed by flow cytometry. Western blot analysis was used to evaluate the activation of autophagy and the signalling status of the AKT/mTOR pathway. Our study reveals that knocking out PLAC8 (koPLAC8) induces autophagy and apoptosis, while suppressing NPC cell proliferation and EMT. However, inhibition of autophagy with 3‐methyladenine or by knocking down Beclin‐1 reverses the cell proliferation, apoptosis and EMT influenced by koPLAC8. We find that koPLAC8 inhibits the phosphorylation of AKT and its downstream target, mTOR. Moreover, immunofluorescence and co‐immunoprecipitation reveal complete PLAC8/AKT colocalization and PLAC8/AKT interaction, respectively. Furthermore, knockout of PLAC8 induced autophagy and inactivated AKT/mTOR signalling pathway of NPC xenografts. Overall, our findings demonstrate that koPLAC8 induces autophagy via the AKT/mTOR pathway, thereby inhibiting cell proliferation and EMT, and promoting apoptosis in NPC cells.

Background Allergic rhinitis (AR) has been reported to be associated with chronic rhinosinusitis (CRS). The objective of this study was to investigate the effect of AR on nasal mucosa remodeling in CRS. Methods Patients were enrolled and divided into the following groups: CRS with nasal polyps (NP) with allergic rhinitis (AR)(CRSwNPwAR; n = 20), CRS with NP without AR (CRSwNPsAR; n = 20), CRS without NP with AR (CRSsNPwAR; n = 20), CRS without NP without AR (CRSsNPsAR; n = 20), AR without CRS (AR; n = 20) and controls (n = 14). Eosinophil infiltration, mucus production, and collagen deposition were examined by hematoxylin and eosin, periodic acid schiff and masson’s trichrome staining, respectively. VEGF-A and microvessel density were detected by immunohistochemistry. The expression of remodeling markers, including TGF-β1, MMP-7, MMP-9 and TIMP-1 were measured by Western blot. Results The expression of remodeling factors, including VEGF-A, CD31, CD34 and TIMP-1 were significantly increased in CRSwAR compared to CRSsAR. Goblet cell hyperplasia, as well as VEGF-A, CD31, CD34, and MMP-9 expression were significantly higher in CRSwNPwAR compared to CRSwNPsAR. However, the expression of collagen fibers, MMP-7 and TGF-β1 were significantly higher in CRSsNPwAR compared to CRSsNPsAR. Conclusions AR could enhance the remodeling process in CRS. Moreover, AR had different effects on CRSwNP and CRSsNP.

BackgroundClinically, distant metastasis after primary treatment remains a key problem in nasopharyngeal carcinoma (NPC). Thus, identification of the underlying mechanisms and development of novel therapeutic strategies are urgently needed. NOTCH has been shown to function as a tumor promotor that enhances angiogenesis, cancer invasion and metastasis in NPC. However, the precise roles of the four individual NOTCH receptors and their mechanisms of action are unclear.MethodsWe used Western blot analysis, immunofluorescence, immunohistochemical analysis, phalloidin staining, mouse tumor metastatic dissemination models, gene set enrichment analysis, immunoprecipitation assays and a series of functional assays to determine the potential role of NOTCH2 in regulating NPC metastasis.ResultsNOTCH2 expression in the NPC tissues of patients with cervical lymph node metastasis was lower than that of patients without cervical lymph node metastasis. Correspondingly, NOTCH2 expression was low in metastatic and poorly differentiated NPC cells. NOTCH2 expression correlated negatively with survival time in patients with NPC. Suppression of NOTCH2 expression promoted NPC cell metastasis, whereas NOTCH2 overexpression inhibited this process. Furthermore, NOTCH2 attenuated the TRAF6–AKT signaling axis via an interaction between the NOTCH2 intracellular domain (N2ICD) and TRAF6, which inhibited epithelial–mesenchymal transition (EMT) and eventually suppressed NPC metastasis.ConclusionsThese findings reveal that loss of NOTCH2 activates the TRAF6/AKT axis and promotes metastasis in NPC, suggesting that NOTCH2 may represent a therapeutic target for the treatment of NPC.

Background It has been reported that semaphorin 3A (sema3A) could improve allergic symptoms in allergic rhinitis (AR) mice. However, the immunomodulatory roles of sema3A in AR remain unclear. This study was performed to determine the immunoregulatory effects of sema3A on airway inflammation in an AR mice model. Methods First, sema3A expression was measured in the serum of AR patients and also in a mice model. Then, nasal symptoms, ovalbumin (OVA)-specific immunoglobulin E (IgE) production, cytokine levels, and histologic structure were analyzed in OVA-sensitized mice, sema3A mice, mice given saline, and controls. The percentages of CD4+ IL-4+ IFN-γ- Th2 cells, CD4+ IFN-γ+ IL-4- Th1 cells, CD4+ IL-17+ Th17 cells, and CD4+ CD25+ Foxp3+ Treg cells in the spleen were also analyzed. Results Serum sema3A levels in both AR patients and OVA-sensitized mice decreased significantly compared with controls. The intranasal administration of sema3A reduced allergic symptom scores, eosinophil infiltration, and OVA-specific IgE production in OVA-sensitized mice. In addition, levels of IL-4 and IL-17 as well as percentages of CD4+ IL-17+ Th17 cells were suppressed by sema3A administration. Levels of IFN-γ and IL-10 and ratios of CD4+ IFN-γ+ IL-4- Th1/CD4+ IL-4+ IFN-γ- Th2 cells, as well as percentages of CD4+ CD25+ Foxp3+ Treg cells, were increased by administration of sema3A. Conclusion Our results demonstrate that sema3A suppressed allergic inflammation in AR via inhibition of Th2/Th17 responses and enhancement of Th1/Treg responses.

Background: The Notch signaling pathway plays an important role in regulating human immune function, but the relationship between allergic rhinitis (AR) and Notch signaling remains unclear. Objective: To investigate the role of Notch signaling in the pathogenesis of AR and its regulation on Foxp3-Treg cells. Method: The sera of 100 patients with AR and 50 controls were collected to assess the differences in Notch1, Jagged1, and DLL1 (Delta-like 1) expression. Experimental mice were divided into normal control, AR, Notch inhibitor, and dexamethasone groups. Allergic symptoms, total IgE levels, and the proportion of Treg cells in the peripheral blood were detected. Notch1, Jagged1, NICD (Notch intracellular domain, also known as ICN), and Foxp3 expression and Th1/Th2/Th17-related cytokines in the spleen were detected and compared between each group of mice. Results: Compared with the control group, the expression of Notch1 and Jagged1 in patients with AR was significantly elevated (p < 0.05). The expression of Notch1 and Jagged1 in patients with severe AR was higher than that observed in the mild to moderate AR patients and positively correlated with the levels of allergen sIgE (p < 0.05). The animal experiments revealed that compared with the normal control group, the expression of Notch1, Jagged1, and NICD in the AR group was increased, Foxp3 expression was decreased, and the proportion of Treg cells was decreased (p < 0.05). Compared with the AR group, allergic symptoms and total serum IgE levels and the expression of Notch1, Jagged1, and NICD were significantly decreased in the Notch inhibited group, whereas the expression of Foxp3 and the proportion of Treg cells were increased significantly (p < 0.05). The Th2-type immune responses were also enhanced and Th1-type immune responses decreased in the AR group, but the Th1/Th2 imbalance was reversed in the Notch inhibited group. Conclusion: Notch signaling downregulates Foxp3 expression and inhibits the differentiation of Treg cells to promote the development of AR. Blocking Notch signaling may be a potential treatment for AR.

The development of allergic rhinitis is considered to be determined by the interaction between genetic and environmental factors. Surfactant protein D (SP-D) has been proposed to offer protection against allergenic challenge at various levels in allergic responses. The present study aimed to investigate whether polymorphisms within the SFTPD gene (Met11Thr, Ala160Thr, and Ser270Thr) are associated with allergic rhinitis. Genotyping of SFTPD polymorphisms was performed using the pyrosequencing method. The study population comprised 216 patients with allergic rhinitis and 84 normal controls. The frequency of 11Thr/Thr genotype and Thr allele in the patient group was significantly higher than that in the control group after applying Bonferroni corrections (P = 0.007 and P = 0.006, respectively). Our subjects with the 11Thr/Thr genotype are more susceptible to allergic rhinitis. There were no significant differences between the patient group and the control group for frequencies of genotypes and alleles in either Ala160Thr or Ser270Thr single nucleotide polymorphisms (P > 0.05). No significant associations could be detected between any of these three SFTPD gene polymorphisms and the skin prick test response (P > 0.05). Meanwhile, there was a lack of association between the three loci and the levels of serum total immunoglobulin E (P > 0.05). In summary, our results suggest that the Met11Thr polymorphism in SP-D plays a major role in the genetic predisposition to allergic rhinitis in Chinese adult population, whereas the other two SP-D polymorphisms displayed no significant association with allergic rhinitis.

To summarize the clinical features of epistaxis in the posterior fornix of inferior meatus and its comprehensive treatment measures.We collected and retrospectively analyzed the clinical data of 212 cases of epistaxis hospitalized in our department, among which 23 cases were diagnosed as epistaxis in the posterior fornix of inferior meatus. They underwent nasal endoscopic exploration and coagulation surgery with one case under general anesthesia and the other 22 under local anesthesia. The bleeding from olfactory cleft, spheno-ethmoidal recess and the middle nasal meatus were excluded for all the patients during the surgery. After shifting the inferior turbinate inward by fracture, the active bleeding was found in the posterior fornix of inferior meatus, which was stopped immediately by bipolar coagulation. The areas of coagulation and nasal mucosa erosion were packed with nasopore after operation.For all the patients, bleeding spots were definitely located during the operation and successfully coagulated. None of them suffered from recurrent-bleeding within 1 week postoperatively. Followed up for 6 to 12 months, there was no epstaxis recurrence or nasal cavity adhesion at the bled side in all patients.For intractable epistaxis patient, after excluding the bleeding in olfactory cleft, sphenoethmoidal recess and the middle nasal meatus, it should be considered that the bleeding might come from posterior fornix of inferior meatus. It is the key point to thoroughly expose the posterior fornix of inferior meatus by shifting the inferior turbinate inward by fracture and explore for the bleeding spot carefully.

To investigate the positive rates of some allergens in different age groups of allergic rhinitis patients, and to analyze the relationship between serum specific immunoglobulin E(sIgE) and total immunoglobulin E(IgE).Six hundred and fifty-three patients with allergic rhinitis, tested by AllergyScreen system, were enrolled in our research.The positive rate of sIgE in all patients was 85.5%. The positive rate of dust mite was the highest with the result of 76.3%, and the positive rate of feline or dogs hair was the lowest of 20.3%. The statistical significance of different positive rate of some allergens were found in the different age groups. All the patients were divided into two groups, one was younger than 18 years old group, which including 18 years old and another was older than 18 years old group. Except Mx, the positive rate of other allergens existed statistical difference. The level of serum total IgE could not reflect the positive rate of sIgE completely.It is an effective and reliable method of the diagnosis of allergic rhinitis to combine the analysis of total serum IgE and sIgE levels with patients clinical manifestations. Different strategies should be employed for the prevention and treatment of allergic rhinitis according to their ages.

To discuss the clinical experience of diagnosing and managing of cerebrospinal fluid (CSF) rhinorrhea.Twenty-four cases of cerebrospinal rhinorrhea were analysed retrospectively from Jan 2003 to Sept 2008, among which 18 cases from department of Otolaryngology Head and Neck Surgery and 6 cases from Neurosurgery.Postoperative follow-up lasted from 4 months to 72 months. All the cases were successfully cured, among which 6 cases with conservative treatment and 18 cases under surgery, and no relapse case was found. The 18 cases under surgery included endoscopic approach (12 cases), extra-nasal approach (4 cases), transnasal approach under microscope (2 cases).It is not only minimally invasive, safety and efficiency of transnasal endoscopic technique for CSF leaks, but also without facial scarring after operation. Transnasal endoscopic approach can be preferred for the closure of uncomplicated CSF leak, located at the cribriform plate or the sphenoid sinus. The extra-nasal or intracranial approach may be an attractive option for more complicated and large CSF leak, or the leak site is not easily found with endoscopic.

Surfactant protein A (SP-A) is protein that appears to play an important role in mammalian first-line host defense. The objective of this study was to immunolocalize SP-A in human sinonasal tissue.Eleven cases of allergic rhinitis, fifteen cases of polyp and seven cases of normal middle turbinate were studied with immunohistochemistry and immunofluorescence method to detect the expression of SP-A.The expression of SP-A in allergic rhinitis and polyp were dramatically higher than that in controls (P0.05), and there was no remarkable difference in the expression of SP-A between allergic rhinitis and polyp (P0.05). The result demonstrated that SP-A was positively correlated with eosinophils within the basement membrane of epithelium (R = 0.81, 0.55). In the result of immunofluorescence, there was significantly higher expression SP-A in nasal mucosa of allergic rhinitis and nasal polyp than that in control group (P0.05).SP-A is likely to play key roles in the inflammatory reaction process of allergic rhinitis and polyp. Its secretion in the upper airway indicates that future studies may allow manipulation of this protein and development of novel treatments for sinonasal pathology.

To analyze the characteristic of chronic paranasal sinusitis CT scans and discuss the relationship between the anatomic variations in ostiomeatal complex (OMC) and the incidence of chronic sinusitis.One hundred and ninety-seven cases diagnosis as sinusitis were selected and analyzed,whose age ranged between 4 and 74 years old. Several common anatomical abnormalities in ostiomeatal complex were evaluated through the observation of the coronal and axial plane CT scans of the paranasal sinusitis.The incidence of anatomic variations in OMC concentrated in the age between 11-20. The incidence of chronic sinusitis also concentrated in the age between 11-20. Deviation of nasal septum, uncinate variations, inferior-turbinate hypertrophy were observed between the chronic sinusitis group and the none chronic sinusitis group,the correlation between deviation of nasal septum, uncinate variations, inferior-turbinate hypertrophy and chronic sinusitis were significant (P0.05).The occurrence of OMC variation is common. The anatomic variations may be one of the causes of chronic paranasal sinusitis, especially deviation of nasal septum, uncinate variations and inferior-turbinate hypertrophy. If these abnormalities were altered,it will have a great significance for the preservation and treatment of chronic paranasal sinusitis.

To analyze the results of serum in allergic rhinitis and investigate the specific clinic allergen and serum immunoglobulin E (IgE) levels.Allergy Screen method was used to detect the specific allergen and total serum IgE level of 134 cases of Allergic rhinitis.The dust mite was the most common allergen in inhalation group in 134 cases of allergic rhinitis, the positive rates was 90%; then were donly, feline and scurfy fungus, the positive rates were 16%, 9%. The positive rates of total IgE was 54%. The serum IgE levels between 100 to 200 kU/L, there was 21 cases together, but there existed 7 negative cases. There were 51 cases' IgE levels more than 200 kU/L, the rates was 70.8%, but there still existed 4 negative cases.Allergy screen method can find relevant allergen and provide basis for the prevention and treatment of allergic disease.

To explore the effect of a comprehensive surgical approach of hyoid suspension with Repose system plus uvulopalatopharyngoplasty (UPPP) on the treatment of severe obstructive sleep apnea hypopnea syndrome (OSAHS).Twelve patients with severe OSAHS (AHI40) diagnosed by polysomnography, were determined for the obstruction in both the velo-pharyngeal and the hypopharynx by preoperative physical examination, fiberoptic pharyngo-laryngoscopy. Two cases were given continuous airway pressure via nose, seven days before operation and then were performed hyoid suspension plus UPPP. The follow up was 3 months postoperatively. The pair T test was used to compare the preoperative and postoperative results by SPSS11.0 for windows.At postoperative 3 month, there were statistically significance between preoperative and postoperative measurement in all. Mean AHI decreased from preoperative 69.28 +/- 6.50 to postoperative 19.77 +/- 9.23, lowest mean oxygen saturation increased from 65.25 -/+ 3.14 to 90.17 +/- 2.86. Snoring and sleep apnea disappeared or lessened, with the disappearance or decrease of lethargy at daytime. No severe complication occurred.Comprehensive surgical approach of hyoid suspension with Repose system plus UPPP is effective surgical approach for patients with severe OSAHS who suffered from oropharyngeal and hypopharyngeal obstruction in short- term result.

To explore the etiology of paranasal sinus fungus ball and evaluate the curative effect of endoscopic sinus surgery on paranasal sinus fungus ball.The clinical and follow-up data of 55 patients with paranasal sinus fungus ball were retrospectively analyzed.All patients were cured by endoscopic sinus surgery, no complications were observed. Following up for 6-48 months, two cases were recurred.Anatomic abnormalities of the paranasal sinuses and wound in the mucosa are the main pathogenesis of paranasal sinus fungus ball. Endoscopic sinus surgery is an effective treatment of paranasal sinus fungus ball. Relapse rate is related with regular irrigation after operation.

To study the expression of Eotaxin and Eotaxin-2 in nasal polyposis and nasal polyp and explore the different mechanism between polyposis and polyp.Fifteen cases of nasal polyposis, thirteen cases of polyp and eight cases of normal middle turbinate were studied with immunohistochemical SP method to detect the expression of Eotaxin and Eotaxin-2.There were significant differences between either two groups about the expression of Eotaxin-2 (P0.05). The expression of Eotaxin in nasal polyposis and polyp were dramatically higher than in controls (P0.05), the expression of Eotaxin between nasal polyposis and polyp was no remarkable difference (P0.05).Both of Eotaxin and Eotaxin-2 likely play key roles in the inflammatory reaction process of nasal polyposis and polyp. The different expression of Eotaxin-2 between nasal polyposis and polyp demonstrates it may be one of the main causes in the different mechanism of the two diseases.

To observe the long term effect of composite therapy on patients with nasal polyposis.All 36 cases with nasal polyposis accepted antibiotic for a week and systemic corticosteroids for 3 days before operation, then underwent ESS. Systemic corticosteroids were used for 5 days and topic corticosteroids for 6 months after operation, then they were followed up by endoscopy for more than 3 years.The symptoms were significantly improved after composite therapy. The effective rates of ventilation and headache were respectively 100% and 95%, the improvement of dysosmia is relatively poor. Catch cold and no use of topic corticosteroids can lead recurrence of nasal polyposis.Composite therapy is effective in the treatment of nasal polyposis. Using antibiotic for a week and systemic corticosteroids for 3 days before operation, making use of systemic corticosteroids for 5 days and topic corticosteroids for 6 months after operation , and a reasonable regular following-up by endoscopy , a suitable and prompt postoperative treatment are indispensable to improve the effect of treatment.

To observe the incidence rate of chronic sinusitis in the patients with perennial allergic rhinitis, and explore the possible etiology of sinusitis.Fifty-seven patients were examined with endoscope and CT scan.Of the 57 patients, 18 (32%) patients had chronic sinusitis, among which 17 patients had different kinds and different extents of anatomy abnormalities of nose cavity including deviation of nasal septum, concha bullosa, hypertrophy of uncinate process, paradoxical curvature of middle turbinate, etc. Thirty-nine patients didn't complicated with chronic sinusitis, among which only 7 patients had anatomy abnormalities of nose cavity.Anatomy abnormalities of nose cavity may be the basic etiology of sinusitis in patients with perennial allergic rhinitis; The edema of nasal mucous and the change of nasal discharge caused by perennial allergic rhinitis may be the triggering factor of chronic sinusitis. Both of these two factors are involved in the pathogenesis of sinusitis.

To study the effect of radiofrequency ablation on perennial allergic rhinitis.Thirty-five cases of perennial allergic rhinitis undergone the treatment in radiofrequency ablation were study.All patients were followed more than 6 months, total effective rate is 94.3% (33/35). Among the total, excellence is 85.7% (30/35).The radiofrequency ablation is a simple and safe instrument to treat perennial allergic rhinitis.

To observe the effects of systemic steroids on the infiltration of eosinophils and the expression of TGF beta 1 in nasal polyps.The SP immunohistochemical methods were applied to explore the expression of TGF beta 1 in nasal polyps before and after corticosteroids use; the optical density of positive cells in mucosal epithelia, eosinophils, glandular epithelium, vascular endothelial, matrix and mucous membrane was measured by using HPIAS-1,000 image-conduct system.The expression of TGF beta 1 was positive in nasal polyps. The number of eosinophils and the expression of TGF beta 1 was significantly reduced in nasal polyps after treated with corticosteroids compared with pre-treated.The effects of systemical steroid use on the nasal polyps may depend on decreasing the infiltration of eosinophils and the expression of TGF beta 1.

To investigate common reasons for revision endoscopic sinus surgery (RESS) and evaluate the effect of RESS.Before the revision surgery 114 patients were examined by CT scans and nasal endoscopy, after surgery all the patients were followed up for more than 2 years.There were 16 cases of recurrence of polyps, 98 cases of recurrence of sinusitis. Among 114 cases there were 18 cases of anterior ethmoid sinus disease, 2 frontal recess stenosis, 31 anterior ethmoid sinuse disease with maxillary ostium obstruction, 6 middle turbinate adhesion, 18 posterior ethmoid sinus disease, 36 posterior ethmoid sinus disease with sphenoid sinus disease, 3 isolated sphenoid sinusitis. There were 15 cases with septal deviation. 99 cases were successful and 15 unsatisfied.Sinus disease that was not completely resected during the original surgical procedure due to the surgeon's less experience was the most common reason for the RESS, another reason was recurrent polyposis. The results were very rewarding except nasal polyposis.