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Diseases involving the clivus are highly variable, and the incidence of each disease is rare. Primary central nervous system vasculitis (PACNS) is a rare disease with very heterogeneous clinical manifestations, its diagnosis is often challenging, and histopathology is the gold standard. We report a patient with PACNS of the clivus, with a 1‐month history of headache and diplopia, who was misdiagnosed as having a tumor of the clivus during prior treatment, due to computed tomography findings of clivus occupation and bone destruction. Endoscopic resection of the nasal clivus lesions was performed. Pathological examination revealed a small abscess with hemorrhage, necrosis, extensive infiltration of lymphocytes and plasma cells, and granulation tissue scar formation. After histopathological examination, the diagnosis was confirmed, and oral glucocorticoid and cyclophosphamide were commenced. This study is the first to report a tumor‐like PACNS, that occurs in the clivus, thereby enriching our understanding of PACNS. [ABSTRACT FROM AUTHOR]

B cell activation and excessive immunoglobulin (Ig) production were suggested as the key molecular events of chronic rhinosinusitis with nasal polyp (CRSwNP). However, whether T follicular cells (Tfh cells) were involved in this process has not been documented. In this study, 22 CRSwNP patients and 12 normal controls were enrolled, Bcl-6 (the key transcription factor for Tfh cell differentiation) immunoreactivity was examined by immunohistochemical staining, and the mRNA and protein expression of Bcl-6 and IL-21 was examined using qPCR, ELISA and Western blot, respectively. Moreover, the frequencies of Bcl-6CD4 cells (Tfh cells) in polyp tissues and normal controls were measured by flow cytometry. We found that Bcl-6 mRNA and protein levels, as well as the frequencies of Bcl-6CD4 cells were significantly increased in polyp tissues compared with normal controls. The frequencies of Bcl-6CD4 cells were found to be significantly associated with B cell cluster formation, tissue eosinophilia, asthma comorbidity and polyp recurrence. These findings thus added a new insight into the molecular mechanisms underlying CRSwNP and raise the possibility that Tfh cells could be a novel therapeutic target for difficult-to-treat CRSwNP. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesignStudy sampleResultsConclusionsThe aim of this study was to evaluate the efficacy of the Chinese version of Speech, Spatial and Qualities of Hearing Scale (C-SSQ12) in the Chinese Mandarin-speaking population and to determine its screening cut-off value by comparing measured pure-tone average (PTA), the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) scores and C-SSQ12 scores.All participants completed the C-SSQ12 questionnaire and underwent the pure-tone audiometry. Older subjects aged ≧ 60 years completed the HHIE-S questionnaire. The optimal cut-off value for the C-SSQ12 as a hearing screening tool was calculated by comparing different cut-offs and hearing thresholds.A total of 300 subjects were recruited.There was a negative correlation between C-SSQ12 scores and HHIE-S scores (r = −0.749). C-SSQ12 scores were negatively correlated with PTA (r = −0.507; r = −0.542). The best cut-off value for the C-SSQ12 was 6.0, with a sensitivity of 78.2%, specificity of 80.3%, positive predictive value of 63.7% and negative predictive value of 97.0% (PTA > 40dBHL for bilateral ears).Compared to mild hearing loss, the C-SSQ12 is a reliable and validated hearing screening tool with increased sensitivity for detecting moderate-to-severe hearing loss. [ABSTRACT FROM AUTHOR]

Background: Several biological processes are regulated by miR‐200a‐3p, including cell proliferation, migration, and epithelial–mesenchymal transition (EMT). In this study we aimed to uncover the diagnostic value and molecular mechanisms of miR‐200a‐3p in chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: The expressions of miR‐200a‐3p were detected by quantitative real‐time polymerase chain reaction (qRT‐PCR), Zinc finger E‐box binding homeobox 1 (ZEB1) levels were examined by qRT‐PCR and immunofluorescence staining. The interaction between miR‐200a‐3p and ZEB1 was predicted by TargetScan Human 8.0 and confirmed by dual‐luciferase reporter assays. In addition, the effect of miR‐200a‐3p and ZEB1 on EMT‐related makers and inflammation cytokines was assessed by qRT‐PCR and Western blotting in human nasal epithelial cells (hNEpCs) and primary human nasal mucosal epithelial cells (hNECs). Results: We found that miR‐200a‐3p was downregulated in non‐eosinophilic and eosinophilic CRSwNP patients when compared with controls. The diagnostic value of miR‐200a‐3p in serum is reflected by the receiver operating characteristic curve and the 22‐item Sino‐Nasal Outcome Test. Bioinformatic analysis and luciferase reporter assay identified ZEB1 as a target of miR‐200a‐3p. ZEB1 was more highly expressed in CRSwNP than in controls. Furthermore, miR‐200a‐3p inhibitor or ZEB1 overexpression significantly suppressed the epithelial marker E‐cadherin; promoted the activation of vimentin, α‐spinal muscle atrophy, and N‐cadherin; and aggravated inflammation in hNEpCs. Knockdown of ZEB1 significantly alleviated the cellular remodeling caused by miR‐200a‐3p inhibitor via the extracellular signal‐regulated kinase (ERK)/p38 pathway in hNECs. Conclusions: miR‐200a‐3p suppresses EMT and inflammation by regulating the expression of ZEB1 via the ERK/p38 pathway. Our study presents new ideas for protecting nasal epithelial cells from tissue remodeling and finding a possible target for disease. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to investigate the bleeding sites and their relationship with clinical characteristics in hospitalized epistaxis patients.We retrospectively reviewed the data of 646 hospitalized epistaxis patients.The bleeding sites were identified in 395 (61.1%) patients and unidentified in 251 (38.9%). We found that age > 50 years (P = 0.030) and the history of cardiovascular diseases (P = 0.027) were more frequent in patients with unidentified bleeding sites. Among patients with identified sites, inferior meatus (n = 130, 32.9%) was the most common site, followed by the septal surface of the olfactory region (n = 102, 25.8%), nasal septum (n = 80, 20.3%), middle meatus (n = 60, 15.2%), and others (n = 23, 5.8%). After dividing patients into five groups by the area of the bleeding sites, we found significant differences in age (P = 0.026), history of hypertension (P = 0.001), cardiovascular diseases (P = 0.032), and nasal packing (P = 0.011). The logistic regression also revealed that these four factors were predictors for different bleeding sites.The bleeding sites can be identified in most epistaxis patients. Age > 50 years and the history of cardiovascular diseases are more frequent in patients with unidentified bleeding sites. In our patients, the most common bleeding site is inferior meatus, followed by the septal surface of the olfactory region, nasal septum, and middle meatus. Age, histories of hypertension, cardiovascular diseases, and nasal packing are factors associated with the bleeding risks of different bleeding sites. According to the different clinical characteristics of patients, the order of the nasal endoscopic examination should be adjusted to develop their treatment plans.Methods: This study aims to investigate the bleeding sites and their relationship with clinical characteristics in hospitalized epistaxis patients.We retrospectively reviewed the data of 646 hospitalized epistaxis patients.The bleeding sites were identified in 395 (61.1%) patients and unidentified in 251 (38.9%). We found that age > 50 years (P = 0.030) and the history of cardiovascular diseases (P = 0.027) were more frequent in patients with unidentified bleeding sites. Among patients with identified sites, inferior meatus (n = 130, 32.9%) was the most common site, followed by the septal surface of the olfactory region (n = 102, 25.8%), nasal septum (n = 80, 20.3%), middle meatus (n = 60, 15.2%), and others (n = 23, 5.8%). After dividing patients into five groups by the area of the bleeding sites, we found significant differences in age (P = 0.026), history of hypertension (P = 0.001), cardiovascular diseases (P = 0.032), and nasal packing (P = 0.011). The logistic regression also revealed that these four factors were predictors for different bleeding sites.The bleeding sites can be identified in most epistaxis patients. Age > 50 years and the history of cardiovascular diseases are more frequent in patients with unidentified bleeding sites. In our patients, the most common bleeding site is inferior meatus, followed by the septal surface of the olfactory region, nasal septum, and middle meatus. Age, histories of hypertension, cardiovascular diseases, and nasal packing are factors associated with the bleeding risks of different bleeding sites. According to the different clinical characteristics of patients, the order of the nasal endoscopic examination should be adjusted to develop their treatment plans.Results: This study aims to investigate the bleeding sites and their relationship with clinical characteristics in hospitalized epistaxis patients.We retrospectively reviewed the data of 646 hospitalized epistaxis patients.The bleeding sites were identified in 395 (61.1%) patients and unidentified in 251 (38.9%). We found that age > 50 years (P = 0.030) and the history of cardiovascular diseases (P = 0.027) were more frequent in patients with unidentified bleeding sites. Among patients with identified sites, inferior meatus (n = 130, 32.9%) was the most common site, followed by the septal surface of the olfactory region (n = 102, 25.8%), nasal septum (n = 80, 20.3%), middle meatus (n = 60, 15.2%), and others (n = 23, 5.8%). After dividing patients into five groups by the area of the bleeding sites, we found significant differences in age (P = 0.026), history of hypertension (P = 0.001), cardiovascular diseases (P = 0.032), and nasal packing (P = 0.011). The logistic regression also revealed that these four factors were predictors for different bleeding sites.The bleeding sites can be identified in most epistaxis patients. Age > 50 years and the history of cardiovascular diseases are more frequent in patients with unidentified bleeding sites. In our patients, the most common bleeding site is inferior meatus, followed by the septal surface of the olfactory region, nasal septum, and middle meatus. Age, histories of hypertension, cardiovascular diseases, and nasal packing are factors associated with the bleeding risks of different bleeding sites. According to the different clinical characteristics of patients, the order of the nasal endoscopic examination should be adjusted to develop their treatment plans.Conclusion: This study aims to investigate the bleeding sites and their relationship with clinical characteristics in hospitalized epistaxis patients.We retrospectively reviewed the data of 646 hospitalized epistaxis patients.The bleeding sites were identified in 395 (61.1%) patients and unidentified in 251 (38.9%). We found that age > 50 years (P = 0.030) and the history of cardiovascular diseases (P = 0.027) were more frequent in patients with unidentified bleeding sites. Among patients with identified sites, inferior meatus (n = 130, 32.9%) was the most common site, followed by the septal surface of the olfactory region (n = 102, 25.8%), nasal septum (n = 80, 20.3%), middle meatus (n = 60, 15.2%), and others (n = 23, 5.8%). After dividing patients into five groups by the area of the bleeding sites, we found significant differences in age (P = 0.026), history of hypertension (P = 0.001), cardiovascular diseases (P = 0.032), and nasal packing (P = 0.011). The logistic regression also revealed that these four factors were predictors for different bleeding sites.The bleeding sites can be identified in most epistaxis patients. Age > 50 years and the history of cardiovascular diseases are more frequent in patients with unidentified bleeding sites. In our patients, the most common bleeding site is inferior meatus, followed by the septal surface of the olfactory region, nasal septum, and middle meatus. Age, histories of hypertension, cardiovascular diseases, and nasal packing are factors associated with the bleeding risks of different bleeding sites. According to the different clinical characteristics of patients, the order of the nasal endoscopic examination should be adjusted to develop their treatment plans. [ABSTRACT FROM AUTHOR]

The electrical coagulation of sphenopalatine artery(SPA) under nasal endoscopy has gradually become an important surgical intervention for epistaxis To investigate the effectiveness and complications of SPA electrocoagulation for epistaxis. The clinical data of 47 patients undergoing SPA electrocoagulation were analyzed, retrospectively. Forty-seven patients were enrolled, with a male to female ratio of approximately 3:1. 11of 36 were under 45 years old, 25 of 36were 45 years old and above. Among female patients, one was under 45 years old, and the others were 45 years old and above, but there was no significant difference in gender composition between different age groups (χ2 = 1.069, p =.301). All patients were unilateral epistaxis. The effective control rates of epistaxis within 24 h after surgery, early postoperative, and late postoperative were 100%, 100%, and 97.9%, respectively. There were 6 patients with complications, including 3 patients with nasal dryness and ecdysis on the affected side, 2 patients with numbness on upper lip, 1 patient with nasal adhesion and pus on affected side. Refractory epistaxis has no relationship with age and sex, SPA electrcoagulation can effectively control refractory epistaxis and is an effective surgical method [ABSTRACT FROM AUTHOR]