BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglect...BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglected.AIM To investigate the Effect of nursing intervention on the rehabilitation of patients with chronic sinusitis and nasal polyps(CSNPS)after nasal endoscopy.METHODS A total of 129 patients with CSNPS hospitalized from February 2017 to February 2019 were studied.Using the digital parity method,we investigated nursing cooperation strategies for endoscopic surgery.The comparison group(64 cases):Surgical nursing was carried out with traditional nursing measures;experimental group(65 cases):Surgical nursing was carried out by traditional nursing countermeasures+comprehensive nursing measures.We compared postoperative recovery rates,nursing satisfaction rates,and nasal cavity ratings between the two groups.RESULTS Experimental group patients with CSNPS had a significantly higher recovery rate(98.46%)compared to the control group(79.69%).This difference was statistically significant(χ2=11.748,P<0.05).Additionally,the satisfaction rate with treatment was also significantly higher in the experimental group(98.46%)compared to the control group(79.69%),with a statistically significant difference(χ2=11.748,P<0.05).Before nursing,there was no significant difference in sinus nasal cavity scores between the experimental group(20.29±7.25 points)and the control group(20.30±7.27 points)(t=0.008,P>0.05).However,after nursing,the sinus nasal cavity score in the experimental group(8.85±3.22 points)was significantly lower than that in the control group(14.99±5.02 points)(t=8.282,P<0.05).CONCLUSION Comprehensive nursing intervention in patients with CSNPS can significantly improve the total recovery rate after endoscopic surgery.展开更多
Objective To identify factors affecting the efficacy of steroid-eluting sinus stents implanted after endoscopic sinus surgery(ESS)in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).Methods We performed ...Objective To identify factors affecting the efficacy of steroid-eluting sinus stents implanted after endoscopic sinus surgery(ESS)in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).Methods We performed a post-hoc analysis of a randomized self-controlled clinical trial on post-operative implantation of bioabsorbable steroid-eluting stents in patients with CRSwNP.Univariate logistic regression analysis was conducted to identify which of the following factors affect the response to post-operative stent implantation:sex,serum eosinophil levels,history of prior surgery,endoscopic scores,and comorbid conditions(asthma and allergic rhinitis).The primary outcome was the rate of post-operative intervention on day 30,and the secondary outcome was the rate of polypoid tissue formation(grades 2–3)on days 14,30,and 90.Results A total of 151 patients with CRSwNP were included in the post-hoc analysis.Asthma was identified as the only risk factor for a poor response to steroid-eluting sinus stents on post-operative day 30,with an odds ratio of 23.71(95%CI,2.81,200.16;P=0.004)for the need for post-operative intervention and 19(95%CI,2.20,164.16;P=0.003)for moderate-to-severe polypoid tissue formation.In addition,the asthmatic group showed higher rates of post-operative intervention and polypoid tissue formation than the non-asthmatic group on post-operative day 30.Blood eosinophil levels were not identified as a risk factor for poor outcomes after stent implantation.Conclusion Comorbid asthma,but not blood eosinophil level,impairs the efficacy of steroid-eluting sinus stents in the short term after ESS in patients with CRSwNP.展开更多
Nasal polyp(NP) is a common chronic inflammatory disease of the nasal cavity and sinuses. Although some authors have suggested that NP is related to inflammatory factors such as interleukin(IL)-1β, IL-5, IL-8, granul...Nasal polyp(NP) is a common chronic inflammatory disease of the nasal cavity and sinuses. Although some authors have suggested that NP is related to inflammatory factors such as interleukin(IL)-1β, IL-5, IL-8, granulocyte-macrophage colony-stimulating factor(GM-CSF), tumor necrosis factor(TNF)-α, and IL-17, the mechanisms underlying the pathogenesis and progression of NP remain obscure. This study investigated the expression and distribution of IL-17 and syndecan-1 in NP, and explored the roles of these two molecules in the pathogenesis of eosinophilic chronic rhinosinusitis with nasal polyps(Eos CRSwNP) and non-Eos CRSwNP. Real-time PCR and immunohistochemistry were used to detect the expression of IL-17 and syndecan-1 in samples [NP, unciform process(UP) from patients with CRS, and middle turbinate(MT) from healthy controls undergoing pituitary tumor surgery]. The results showed that the expression levels of IL-17 and syndecan-1 were upregulated in both NP and UP tissues, but both factors were higher in NP tissues than in UP tissues. There was no significant difference in IL-17 levels between the Eos CRSw NP and non-Eos CRSwNP samples, and syndecan-1 levels were increased in the non-Eos CRSwNP tissues as compared with those in Eos CRSwNP tissues. In all of the groups, there was a close correlation between the expression of IL-17 and syndecan-1 in nasal mucosa epithelial cells, glandular epithelial cells, and inflammatory cells, suggesting that IL-17 and syndecan-1 may play a role, and interact with each other, in the pathogenesis of non-Eos CRSwNP.展开更多
Recent studies indicated that interleukin（IL）-17, growth-related oncogene（GRO）-α and IL-8 play an important role in the pathogenesis of nasal polyps. However, the effects of the increased amount of IL-17 and the ...Recent studies indicated that interleukin（IL）-17, growth-related oncogene（GRO）-α and IL-8 play an important role in the pathogenesis of nasal polyps. However, the effects of the increased amount of IL-17 and the production of GRO-α and IL-8 in human nasal polyp fibroblasts are not completely understood. This study aimed to determine the effects of the increased IL-17 on the changes of GRO-α and IL-8 expression in human nasal polyp fibroblasts and further investigate the mechanism of neutrophil infiltration in nasal polyps. Nasal polyp fibroblasts were isolated from six cases of human nasal polyps, and the cells were stimulated with five different concentrations of IL-17. Real-time fluorescence quantitative polymerase chain reaction（RT-PCR） was used to detect the mRNA expression of GRO-α and IL-8. The mRNA of GRO-α and IL-8 was expressed in unstimulated controls and remarkably increased by stimulation with IL-17. Moreover, the levels of GRO-α and IL-8 produced by fibroblasts were increased gradually with the increases in IL-17 concentrations. The present study showed that nasal fibroblasts can produce GRO-α and IL-8, and their production is remarkably enhanced by IL-17 stimulation, thereby clarifying the mechanism of the IL-17 mediated neutrophil infiltration in nasal polyps. These findings might provide a rationale for using IL-17 inhibitors as a treatment for nasal inflammatory diseases such as nasal polyps.展开更多
To explore the role of tenascin (TN ) and fibronectin (FN ) in the pathophysiology of nasal polyps (NP) ,the expression of TN and FN in NP from 34patients and inferior turbinates from 2 0 patients with deviation of ...To explore the role of tenascin (TN ) and fibronectin (FN ) in the pathophysiology of nasal polyps (NP) ,the expression of TN and FN in NP from 34patients and inferior turbinates from 2 0 patients with deviation of nasal septum was imm unohistochem ically studied.In patients with NP,the relations between expression and histopathological features,eosinophils(EOS) infil- tration,clinical staging and the size of NP were analyzed.Our study showed that the gray score of TN and FN expression was16 3.10± 10 .5 4 and16 3.2 4± 11.5 2 in NP respectively,whereas itwas 175 .4 9± 9.2 9and173.93± 7.92 in inferior turbinates respectively.The difference between two groups was significant (P<0 .0 1) .The expression of TN and FN in edematous type was signifi- cantly stronger than that in cystic and glandular type and fibrous type (P<0 .0 5 ) .The association between FN expression and EOS infiltration was significant (r=- 0 .6 0 ,P <0 .0 1) .The expres- sion of TN and FN did not correlate with clinical staging and size(P>0 .0 5 ) .It was suggested that abnormal ECM m ight contribute to proliferation of epithelia,accum ulation of EOS and edem a formation,thereby causing development of NP.展开更多
E-cadherin is a key epithelial protein and adhesive molecule. This study detected the E-cadherin expression in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and controls, and analyzed its possible ro...E-cadherin is a key epithelial protein and adhesive molecule. This study detected the E-cadherin expression in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and controls, and analyzed its possible role in the pathogenesis of CRSwNP. The expression of E-cadherin was detected by using Western blotting and immunohistochemistry in controls and patients with CRSwNP. Computed tomography (CT) scan findings were scored. The results showed that the E-cadherin expression was up-regulated in patients with CRSwNP as compared with controls (P=0.039) and the positive staining was predominantly localized on the epithelial cell membrane. E-cadherin level was correlated negatively with Lund-Mackay scores in patients with CRSwNP (r=–0.604, P=0.005). It is suggested that E-cadherin may be involved in the pathogenesis of CRSwNP and correlated with disease severity.展开更多
Objectives:Prior research on olfactory dysfunction in chronic rhinosinusitis(CRS)has focused on patients with polyps and suggests that direct inflammation of the olfactory cleft mucosa plays a contributory role.The pu...Objectives:Prior research on olfactory dysfunction in chronic rhinosinusitis(CRS)has focused on patients with polyps and suggests that direct inflammation of the olfactory cleft mucosa plays a contributory role.The purpose of this study was to evaluate gene expression in superior turbinate mucosal specimens,comparing normosmic and dysosmic CRS patients without polyps(CRSsNP).Methods:Tissue samples were obtained from the superior turbinates of patients with CRSsNP at the time of endoscopic sinus surgery.Samples subsequently underwent RNA sequencing and functional analysis to investigate biological pathways associated with differentially expressed genes between dysosmic(n=7)and normosmic(n=4)patients.Results:Differential gene expression analysis comparing dysosmic and normosmic CRSsNP patients showed upregulation of 563 genes and downregulation of 327 genes.Using stringent criteria for multiple comparisons,one upregulated gene(Immediate Early Response 3[IER3])had an false discovery rate(FDR)correction adjustedP value considered statistically significant(P<0.001,fold change 2.69).Reactome functional analysis revealed eight biological pathways significantly different between dysosmic and normosmic patients(P<0.05,FDR correction)including IL-4 and IL-13 signaling,IL-10 signaling,and rhodopsin-like receptors.Conclusions:RNA sequencing of the superior turbinates in patients with CRSsNP can provide valuable information regarding biological pathways and genes involved in olfactory dysfunction.This study supports literature suggesting that Type 2 inflammation may play a role in olfactory dysfunction in at least some patients with CRSsNP.This study also prompts questions regarding the role of IL-10,rhodopsin-like receptors,andIER3 in the pathogenesis of olfactory dysfunction.展开更多
Objective:To analyze the oxidative stress status and its association with tissue neutrophilia and oral steroid response in chronic rhinosinusitis with nasal polyps(CRSwNP)patients.Methods:The levels of total oxidant s...Objective:To analyze the oxidative stress status and its association with tissue neutrophilia and oral steroid response in chronic rhinosinusitis with nasal polyps(CRSwNP)patients.Methods:The levels of total oxidant status(TOS)were detected in the sinonasal tissues by using specific assay kits.Tissue neutrophil was examined by immunohistochemical staining,and oxidant status index(OSI)was evaluated in polyps tissues,and the messenger RNA(mRNA)levels of superoxide dismutase 2(SOD2),aldehyde dehydrogenase 1(ALDH1A1),and microsomal glutathione S‐transferase 1(MGST1)were examined using quantitative real‐time polymerase chain reaction in the sinonasal tissues.The receiver operating characteristics(ROCs)curve of ALDH1A1,MGST1,and SOD2 mRNA levels were evaluated to determine the steroid response of CRSwNP patients.Results:The levels of TOS and OSI were significantly higher in CRSwNP and CRSsNP than in normal controls,and OSI in polyps tissues was positively associated with tissue neutrophilia and poor steroid response.The ALDH1A1,MGST1,and SOD2 mRNA levels showed comparable accuracy as predictors of poor steroid response indicated by the area under the curve.Conclusion:These findings provided evidence that the increased level of oxidative stress contributes to enhanced tissue neutrophilia and poor steroid response in CRSwNP patients.展开更多
Background Biofilms have given new insights to the understanding of pathogenesis of chronic rhinosinusitis （CRS）. However, the link between biofilms formation and local inflammatory response remains poorly defined i...Background Biofilms have given new insights to the understanding of pathogenesis of chronic rhinosinusitis （CRS）. However, the link between biofilms formation and local inflammatory response remains poorly defined in CRS with nasal polys. The aim of this study was to determine the potential association of the presence of biofilms in the nasal mucosal tissues with clinical features in Chinese patients, which had CRS with nasal polyps （CRSwNP）. Methods A total of 19 patients with CRSwNP and 12 patients with non-CRS were subjected to endoscopic surgery and their nasal mucosal tissue specimens were examined histologically and by scanning electron microscopy （SEM）. Their demographic and clinical features were recorded. Results Thirteen （68.4%） out of the 19 specimens from patients with CRSwNP, but none from control patients, were positive for biofilms that displayed typical characteristics of bacterial and fugal structures. The presence of biofilms in the nasal mucosal tissues was associated with significantly greater values of purulent nasal discharge and preoperative Lund-Kennedy scores, higher levels of serum total IgE and percentages of subjects with endoscopic surgery （ESS） history in patients with CRSwNP, and more severe inflammation in the nasal mucosal tissues of patients with CRSwNP. Conclusion Our study demonstrated the presence of biofilms in the nasal mucosal tissues of many patients, contributing to the understanding of the pathogenic process of CRSwNP in Chinese patients.展开更多
To explore the response of nasal mucosa epithelial cells to hypoxia in terms of formation of nasal polyps (NP) Methods Epithelial cells of NP and inferior turbinate (IT) were cultured serum fr ee under normal oxy...To explore the response of nasal mucosa epithelial cells to hypoxia in terms of formation of nasal polyps (NP) Methods Epithelial cells of NP and inferior turbinate (IT) were cultured serum fr ee under normal oxygen and hypoxic circumstances with stimulation of IL 1β and TNFα The vascular endothelial growth factor (VEGF)mRNA and VEGF protein leve ls of the cultured cells were detected using in situ hybridization and ELISA, re spectively Results The expression of VEGF mRNA was significantly higher in epithelial cells of NP t han in IT exposed to pro inflammatory cytokines or hypoxia ( P <0 01) VEGF levels were higher in NP epithelial cells than those of IT ( P <0 01) under hypoxia Conclusion VEGF induced by hypoxia is very important for the early stages of forming polyp s展开更多
Objective:To clarify whether the serum squamous cell carcinoma antigen(SCCA)levels of patients with inverted papilloma(IP)are different from patients with nasal polyps(NP)and rhinitis.Materials and methods:Serum SCCA ...Objective:To clarify whether the serum squamous cell carcinoma antigen(SCCA)levels of patients with inverted papilloma(IP)are different from patients with nasal polyps(NP)and rhinitis.Materials and methods:Serum SCCA levels were measured in 30 patients with IP and 30 patients with NP at one day before surgery and seven days after surgery and measured in 28 patients with rhinitis.Results:Elevated serum SCCA levels(>1.5 ng/ml)were found in 80.0%of patients in the IP group,6.7%of patients in the NP group and 14.3%of patients in the rhinitis group,which was a significant difference.The medians of serum SCCA levels in the IP,NP and rhinitis groups were 3.9,0.8 and 1.1 ng/ml,respectively,which was a significant difference.The SCCA level in IP group was not significantly correlated according to Krouse Staging.There was a significant difference in serum SCCA levels between the pre-and postoperative stages in the IP group,at 3.9 and 0.8 ng/ml,respectively,while in the NP group the levels were 0.8 and 1.0 ng/ml,not significantly different.With regard to the IP diagnosis in the IP and NP group based on the SCCA level(>1.5 ng/ml),sensitivity and specificity was 80.0%and 93.3%,respectively.Conclusions:The serum SCCA level in patients with IP was elevated and then it decreased after surgery.This was different from NP and rhinitis patients who mostly had normal levels,which did not change.展开更多
Objective To study the expression and significance of COX-2 and C/EBP-βin refractory sinusitis with nasal polyps,and to explore the relationship between them and the recurrence of sinusitis with nasal polyps.Methods ...Objective To study the expression and significance of COX-2 and C/EBP-βin refractory sinusitis with nasal polyps,and to explore the relationship between them and the recurrence of sinusitis with nasal polyps.Methods The protein expression of COX-2 and C/EBP-βin 20 cases of refractory sinusitis with nasal polyps,20 cases of sinusitis with nasal polyps and 20 cases of normal nasal mucosa were detected by western blot,and the relationship between the two was compared.Results The expression levels of COX-2 and C/EBP-βin refractory sinusitis with nasal polyps were significantly different from those in refractory sinusitis with nasal polyps(P<0.05);The expression levels of COX-2 and C/EBP-βin sinusitis tissues with nasal polyps were significantly different from those in normal nasal mucosa tissues(P<0.05);The expression levels of COX-2 and C/EBP-βin each group were significantly correlated(P<0.05).Conclusions The high expression of COX-2 and C/EBP-βmay be closely related to postoperative recurrence of sinusitis patients with nasal polyps.Both may be used as objective indicators to judge the postoperative follow-up and recurrence tendency of patients with sinusitis with nasal polyps..展开更多
OBJECTIVES: To study the concentration, distribution and expression of IL-5 in nasal polyp tissues and explore its significance in micro-environment differentiation of eosinophil accumulation. METHODS: The concentrati...OBJECTIVES: To study the concentration, distribution and expression of IL-5 in nasal polyp tissues and explore its significance in micro-environment differentiation of eosinophil accumulation. METHODS: The concentration and expression of IL-5 in nasal polyp tissues of 40 patients were determined by ELISA and immunohistochemistry and inferior turbinate mucosa from patients with nasal polyps and healthy volunteers were used as control. RESULTS: IL-5 concentration in polyp tissues was significantly higher than that in turbinate mucosa (P 0.05). IL-5 concentrations in polyp tissues were markedly higher in patients with allergic rhinitis compared with those without (P 0.05). 80.1% of the eosinophils were positive for IL-5 and 90.9% of IL-5 positive cells were eosinophils. Only 3.7% of lymphocytes and neutrophils were positive for IL-5; IL-5 was not detectable in epithelial cells. IL-5 expression in eosinophils of polyp tissues was remarkably stronger than that of the turbinate mucosa (P 0.05). IL-5 expression of eosinophils in polyp tissue was significantly stronger in patients with allergic rhinitis compared with those without (P 0.05). CONCLUSION: IL-5 is the key cytokine in eosinophilic pathologic mechanisms in nasal polyp tissues.展开更多
Objective To explore the significance of protein kinase C (PKC) in proliferation and infiltration of eosinophils in nasal polyps. Methods With in situ hybridization and immunohistochemistry staining methods,PKC,pro-ap...Objective To explore the significance of protein kinase C (PKC) in proliferation and infiltration of eosinophils in nasal polyps. Methods With in situ hybridization and immunohistochemistry staining methods,PKC,pro-apoptotic,and anti-apoptotic gene (Bax,bcl-2 ) expressions were measured in nasal polyp tissues from 26 patients and inferior turbinate mucosa tissues (ITMTs) from 20 healthy persons. The May-Grünwald-Giemsa (MGG) staining method was used to identify eosinophils. Results In eosinophils,the positive cell expressive rates of Bcl-2 mRNA and its protein were significantly higher in the group with nasal polyps than in the ITMT group ( P <0.01). Although the positive cell expressive rate of Bax mRNA and associated protein were a little higher in the group with nasal polyp tissues than in the ITMT group,the difference was not significant ( P >0.05). There was PKC expression in the eosinophils of 26 cases of nasal polyps,but occasional PKC expression in 7 of 20 ITMT cases. In the two groups,PKC positive cell expression was significantly different,and the expression of PKC and bcl-2 mRNA as well as associated protein in eosinophils of nasal polyps showed a remarkably positive relationship ( r 1=0.0875,r 2=0.0823,P <0.01). Conclusions Increased PKC expression in eosinophils of nasal polyp tissues is closely associated with apoptosis inhibition,and it is presumed that eosinophil apoptosis inhibition in nasal polyp tissues is obtained by activation of the PKC signal transduction pathway.展开更多
Objective:To review and evaluate outcomes of patients with aspirin-exacerbated respiratory disease(AERD)following endoscopic sinus surgery and subsequent aspirin desensitization.Methods:Electronic searches of OVID MED...Objective:To review and evaluate outcomes of patients with aspirin-exacerbated respiratory disease(AERD)following endoscopic sinus surgery and subsequent aspirin desensitization.Methods:Electronic searches of OVID MEDLINE(1948 to September 10,2019),EMBASE(1980 to September 10,2019),and PubMed were performed on September 10,2019.A systematic review of the literature was performed using the 2009 PRISMA guidelines.Studies with both preoperative and postoperative data for patients with AERD who underwent sinus surgery and aspirin desensitization were considered appropriate for inclusion.Publications were written in English and included patients aged 18 years or older.Results:Six studies met inclusion criteria for this systematic review.The primary outcome measure was change in symptom profile measured by patient-reported quality of life scores.The results demonstrate statistically significant improvement in symptoms following endoscopic sinus surgery,with sustained improvement following aspirin desensitization.Revision surgery rates were significantly lower in patients maintained on aspirin therapy.Conclusion:This review suggests that surgery followed by aspirin desensitization results in improvement in both subjective and objective outcome measures.The adjunctive use of aspirin desensitization allows for long-term stability in symptom scores.Recurrence of polyps and worsening symptoms requiring revision surgery occurs when aspirin maintenance therapy is inter-rupted.展开更多
文摘BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglected.AIM To investigate the Effect of nursing intervention on the rehabilitation of patients with chronic sinusitis and nasal polyps(CSNPS)after nasal endoscopy.METHODS A total of 129 patients with CSNPS hospitalized from February 2017 to February 2019 were studied.Using the digital parity method,we investigated nursing cooperation strategies for endoscopic surgery.The comparison group(64 cases):Surgical nursing was carried out with traditional nursing measures;experimental group(65 cases):Surgical nursing was carried out by traditional nursing countermeasures+comprehensive nursing measures.We compared postoperative recovery rates,nursing satisfaction rates,and nasal cavity ratings between the two groups.RESULTS Experimental group patients with CSNPS had a significantly higher recovery rate(98.46%)compared to the control group(79.69%).This difference was statistically significant(χ2=11.748,P<0.05).Additionally,the satisfaction rate with treatment was also significantly higher in the experimental group(98.46%)compared to the control group(79.69%),with a statistically significant difference(χ2=11.748,P<0.05).Before nursing,there was no significant difference in sinus nasal cavity scores between the experimental group(20.29±7.25 points)and the control group(20.30±7.27 points)(t=0.008,P>0.05).However,after nursing,the sinus nasal cavity score in the experimental group(8.85±3.22 points)was significantly lower than that in the control group(14.99±5.02 points)(t=8.282,P<0.05).CONCLUSION Comprehensive nursing intervention in patients with CSNPS can significantly improve the total recovery rate after endoscopic surgery.
基金supported by grants from the National Natural Science Foundation of China(No.81873694)the Key Research and Development Program of Hubei Province(No.2021BCA119 and No.2022BCA005)Knowledge Innovation Program of Wuhan-Basic Research(No.2022020801010446).
文摘Objective To identify factors affecting the efficacy of steroid-eluting sinus stents implanted after endoscopic sinus surgery(ESS)in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).Methods We performed a post-hoc analysis of a randomized self-controlled clinical trial on post-operative implantation of bioabsorbable steroid-eluting stents in patients with CRSwNP.Univariate logistic regression analysis was conducted to identify which of the following factors affect the response to post-operative stent implantation:sex,serum eosinophil levels,history of prior surgery,endoscopic scores,and comorbid conditions(asthma and allergic rhinitis).The primary outcome was the rate of post-operative intervention on day 30,and the secondary outcome was the rate of polypoid tissue formation(grades 2–3)on days 14,30,and 90.Results A total of 151 patients with CRSwNP were included in the post-hoc analysis.Asthma was identified as the only risk factor for a poor response to steroid-eluting sinus stents on post-operative day 30,with an odds ratio of 23.71(95%CI,2.81,200.16;P=0.004)for the need for post-operative intervention and 19(95%CI,2.20,164.16;P=0.003)for moderate-to-severe polypoid tissue formation.In addition,the asthmatic group showed higher rates of post-operative intervention and polypoid tissue formation than the non-asthmatic group on post-operative day 30.Blood eosinophil levels were not identified as a risk factor for poor outcomes after stent implantation.Conclusion Comorbid asthma,but not blood eosinophil level,impairs the efficacy of steroid-eluting sinus stents in the short term after ESS in patients with CRSwNP.
基金supported by grants from Research and National Promotion of Early Detection,Standardized Diagnosis and Treatment,and Preventive Strategy for Major Otology and Rhinologic Diseases(No.201202005)Wu Jieping Medical Foundation(No.LC1345)+1 种基金Foundation of Hubei Province Key Laboratory of Molecular Imaging(No.02.03.2013-64)the Natural Science Foundation of Hubei Province,China(No.2014CFB359)
文摘Nasal polyp(NP) is a common chronic inflammatory disease of the nasal cavity and sinuses. Although some authors have suggested that NP is related to inflammatory factors such as interleukin(IL)-1β, IL-5, IL-8, granulocyte-macrophage colony-stimulating factor(GM-CSF), tumor necrosis factor(TNF)-α, and IL-17, the mechanisms underlying the pathogenesis and progression of NP remain obscure. This study investigated the expression and distribution of IL-17 and syndecan-1 in NP, and explored the roles of these two molecules in the pathogenesis of eosinophilic chronic rhinosinusitis with nasal polyps(Eos CRSwNP) and non-Eos CRSwNP. Real-time PCR and immunohistochemistry were used to detect the expression of IL-17 and syndecan-1 in samples [NP, unciform process(UP) from patients with CRS, and middle turbinate(MT) from healthy controls undergoing pituitary tumor surgery]. The results showed that the expression levels of IL-17 and syndecan-1 were upregulated in both NP and UP tissues, but both factors were higher in NP tissues than in UP tissues. There was no significant difference in IL-17 levels between the Eos CRSw NP and non-Eos CRSwNP samples, and syndecan-1 levels were increased in the non-Eos CRSwNP tissues as compared with those in Eos CRSwNP tissues. In all of the groups, there was a close correlation between the expression of IL-17 and syndecan-1 in nasal mucosa epithelial cells, glandular epithelial cells, and inflammatory cells, suggesting that IL-17 and syndecan-1 may play a role, and interact with each other, in the pathogenesis of non-Eos CRSwNP.
基金supported by grants from Research and National Promotion of Early Detection,Standardized Diagnosisand Treatment,and Preventive Strategy for Major Otology and Rhinologic Diseases(No.201202005)Wu Jieping Medical Foundation(No.LC1345)Foundation of Hubei ProvinceKey Laboratory of Molecular Imaging(No.02.03.2013-64)
文摘Recent studies indicated that interleukin（IL）-17, growth-related oncogene（GRO）-α and IL-8 play an important role in the pathogenesis of nasal polyps. However, the effects of the increased amount of IL-17 and the production of GRO-α and IL-8 in human nasal polyp fibroblasts are not completely understood. This study aimed to determine the effects of the increased IL-17 on the changes of GRO-α and IL-8 expression in human nasal polyp fibroblasts and further investigate the mechanism of neutrophil infiltration in nasal polyps. Nasal polyp fibroblasts were isolated from six cases of human nasal polyps, and the cells were stimulated with five different concentrations of IL-17. Real-time fluorescence quantitative polymerase chain reaction（RT-PCR） was used to detect the mRNA expression of GRO-α and IL-8. The mRNA of GRO-α and IL-8 was expressed in unstimulated controls and remarkably increased by stimulation with IL-17. Moreover, the levels of GRO-α and IL-8 produced by fibroblasts were increased gradually with the increases in IL-17 concentrations. The present study showed that nasal fibroblasts can produce GRO-α and IL-8, and their production is remarkably enhanced by IL-17 stimulation, thereby clarifying the mechanism of the IL-17 mediated neutrophil infiltration in nasal polyps. These findings might provide a rationale for using IL-17 inhibitors as a treatment for nasal inflammatory diseases such as nasal polyps.
文摘To explore the role of tenascin (TN ) and fibronectin (FN ) in the pathophysiology of nasal polyps (NP) ,the expression of TN and FN in NP from 34patients and inferior turbinates from 2 0 patients with deviation of nasal septum was imm unohistochem ically studied.In patients with NP,the relations between expression and histopathological features,eosinophils(EOS) infil- tration,clinical staging and the size of NP were analyzed.Our study showed that the gray score of TN and FN expression was16 3.10± 10 .5 4 and16 3.2 4± 11.5 2 in NP respectively,whereas itwas 175 .4 9± 9.2 9and173.93± 7.92 in inferior turbinates respectively.The difference between two groups was significant (P<0 .0 1) .The expression of TN and FN in edematous type was signifi- cantly stronger than that in cystic and glandular type and fibrous type (P<0 .0 5 ) .The association between FN expression and EOS infiltration was significant (r=- 0 .6 0 ,P <0 .0 1) .The expres- sion of TN and FN did not correlate with clinical staging and size(P>0 .0 5 ) .It was suggested that abnormal ECM m ight contribute to proliferation of epithelia,accum ulation of EOS and edem a formation,thereby causing development of NP.
基金supported by a grant for the Doctoral Program of the Ministry of Education of China (No. 20020487062)
文摘E-cadherin is a key epithelial protein and adhesive molecule. This study detected the E-cadherin expression in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and controls, and analyzed its possible role in the pathogenesis of CRSwNP. The expression of E-cadherin was detected by using Western blotting and immunohistochemistry in controls and patients with CRSwNP. Computed tomography (CT) scan findings were scored. The results showed that the E-cadherin expression was up-regulated in patients with CRSwNP as compared with controls (P=0.039) and the positive staining was predominantly localized on the epithelial cell membrane. E-cadherin level was correlated negatively with Lund-Mackay scores in patients with CRSwNP (r=–0.604, P=0.005). It is suggested that E-cadherin may be involved in the pathogenesis of CRSwNP and correlated with disease severity.
基金National Institute of General Medical Sciences,Grant/Award Number:NIGMS GM103499MUSC's Office of the Vice President for Research。
文摘Objectives:Prior research on olfactory dysfunction in chronic rhinosinusitis(CRS)has focused on patients with polyps and suggests that direct inflammation of the olfactory cleft mucosa plays a contributory role.The purpose of this study was to evaluate gene expression in superior turbinate mucosal specimens,comparing normosmic and dysosmic CRS patients without polyps(CRSsNP).Methods:Tissue samples were obtained from the superior turbinates of patients with CRSsNP at the time of endoscopic sinus surgery.Samples subsequently underwent RNA sequencing and functional analysis to investigate biological pathways associated with differentially expressed genes between dysosmic(n=7)and normosmic(n=4)patients.Results:Differential gene expression analysis comparing dysosmic and normosmic CRSsNP patients showed upregulation of 563 genes and downregulation of 327 genes.Using stringent criteria for multiple comparisons,one upregulated gene(Immediate Early Response 3[IER3])had an false discovery rate(FDR)correction adjustedP value considered statistically significant(P<0.001,fold change 2.69).Reactome functional analysis revealed eight biological pathways significantly different between dysosmic and normosmic patients(P<0.05,FDR correction)including IL-4 and IL-13 signaling,IL-10 signaling,and rhodopsin-like receptors.Conclusions:RNA sequencing of the superior turbinates in patients with CRSsNP can provide valuable information regarding biological pathways and genes involved in olfactory dysfunction.This study supports literature suggesting that Type 2 inflammation may play a role in olfactory dysfunction in at least some patients with CRSsNP.This study also prompts questions regarding the role of IL-10,rhodopsin-like receptors,andIER3 in the pathogenesis of olfactory dysfunction.
基金National Natural Science Foundation of China(Grant/Award Numbers:81725004,81870703,82271138)Shanghai Science and Technology Committee Grants(Grant/Award Numbers:19XD4010000,20MC1920200)。
文摘Objective:To analyze the oxidative stress status and its association with tissue neutrophilia and oral steroid response in chronic rhinosinusitis with nasal polyps(CRSwNP)patients.Methods:The levels of total oxidant status(TOS)were detected in the sinonasal tissues by using specific assay kits.Tissue neutrophil was examined by immunohistochemical staining,and oxidant status index(OSI)was evaluated in polyps tissues,and the messenger RNA(mRNA)levels of superoxide dismutase 2(SOD2),aldehyde dehydrogenase 1(ALDH1A1),and microsomal glutathione S‐transferase 1(MGST1)were examined using quantitative real‐time polymerase chain reaction in the sinonasal tissues.The receiver operating characteristics(ROCs)curve of ALDH1A1,MGST1,and SOD2 mRNA levels were evaluated to determine the steroid response of CRSwNP patients.Results:The levels of TOS and OSI were significantly higher in CRSwNP and CRSsNP than in normal controls,and OSI in polyps tissues was positively associated with tissue neutrophilia and poor steroid response.The ALDH1A1,MGST1,and SOD2 mRNA levels showed comparable accuracy as predictors of poor steroid response indicated by the area under the curve.Conclusion:These findings provided evidence that the increased level of oxidative stress contributes to enhanced tissue neutrophilia and poor steroid response in CRSwNP patients.
基金This work was supported by grants from the National Natural Science Foundation of China （No.30973283） and the Support Funding for Training High-Level Health Technicians of Beijing Health System to Dr. ZHOU Bing, （No.2009-3-36）.
文摘Background Biofilms have given new insights to the understanding of pathogenesis of chronic rhinosinusitis （CRS）. However, the link between biofilms formation and local inflammatory response remains poorly defined in CRS with nasal polys. The aim of this study was to determine the potential association of the presence of biofilms in the nasal mucosal tissues with clinical features in Chinese patients, which had CRS with nasal polyps （CRSwNP）. Methods A total of 19 patients with CRSwNP and 12 patients with non-CRS were subjected to endoscopic surgery and their nasal mucosal tissue specimens were examined histologically and by scanning electron microscopy （SEM）. Their demographic and clinical features were recorded. Results Thirteen （68.4%） out of the 19 specimens from patients with CRSwNP, but none from control patients, were positive for biofilms that displayed typical characteristics of bacterial and fugal structures. The presence of biofilms in the nasal mucosal tissues was associated with significantly greater values of purulent nasal discharge and preoperative Lund-Kennedy scores, higher levels of serum total IgE and percentages of subjects with endoscopic surgery （ESS） history in patients with CRSwNP, and more severe inflammation in the nasal mucosal tissues of patients with CRSwNP. Conclusion Our study demonstrated the presence of biofilms in the nasal mucosal tissues of many patients, contributing to the understanding of the pathogenic process of CRSwNP in Chinese patients.
文摘To explore the response of nasal mucosa epithelial cells to hypoxia in terms of formation of nasal polyps (NP) Methods Epithelial cells of NP and inferior turbinate (IT) were cultured serum fr ee under normal oxygen and hypoxic circumstances with stimulation of IL 1β and TNFα The vascular endothelial growth factor (VEGF)mRNA and VEGF protein leve ls of the cultured cells were detected using in situ hybridization and ELISA, re spectively Results The expression of VEGF mRNA was significantly higher in epithelial cells of NP t han in IT exposed to pro inflammatory cytokines or hypoxia ( P <0 01) VEGF levels were higher in NP epithelial cells than those of IT ( P <0 01) under hypoxia Conclusion VEGF induced by hypoxia is very important for the early stages of forming polyp s
文摘Objective:To clarify whether the serum squamous cell carcinoma antigen(SCCA)levels of patients with inverted papilloma(IP)are different from patients with nasal polyps(NP)and rhinitis.Materials and methods:Serum SCCA levels were measured in 30 patients with IP and 30 patients with NP at one day before surgery and seven days after surgery and measured in 28 patients with rhinitis.Results:Elevated serum SCCA levels(>1.5 ng/ml)were found in 80.0%of patients in the IP group,6.7%of patients in the NP group and 14.3%of patients in the rhinitis group,which was a significant difference.The medians of serum SCCA levels in the IP,NP and rhinitis groups were 3.9,0.8 and 1.1 ng/ml,respectively,which was a significant difference.The SCCA level in IP group was not significantly correlated according to Krouse Staging.There was a significant difference in serum SCCA levels between the pre-and postoperative stages in the IP group,at 3.9 and 0.8 ng/ml,respectively,while in the NP group the levels were 0.8 and 1.0 ng/ml,not significantly different.With regard to the IP diagnosis in the IP and NP group based on the SCCA level(>1.5 ng/ml),sensitivity and specificity was 80.0%and 93.3%,respectively.Conclusions:The serum SCCA level in patients with IP was elevated and then it decreased after surgery.This was different from NP and rhinitis patients who mostly had normal levels,which did not change.
基金Health Science and Technology Program of Yunnan Province(No.2010NS034)Joint Special Project of Yunnan Provincial Science and Technology Department/Kunming Medical University Applied Basic Research(No.201901C07041)。
文摘Objective To study the expression and significance of COX-2 and C/EBP-βin refractory sinusitis with nasal polyps,and to explore the relationship between them and the recurrence of sinusitis with nasal polyps.Methods The protein expression of COX-2 and C/EBP-βin 20 cases of refractory sinusitis with nasal polyps,20 cases of sinusitis with nasal polyps and 20 cases of normal nasal mucosa were detected by western blot,and the relationship between the two was compared.Results The expression levels of COX-2 and C/EBP-βin refractory sinusitis with nasal polyps were significantly different from those in refractory sinusitis with nasal polyps(P<0.05);The expression levels of COX-2 and C/EBP-βin sinusitis tissues with nasal polyps were significantly different from those in normal nasal mucosa tissues(P<0.05);The expression levels of COX-2 and C/EBP-βin each group were significantly correlated(P<0.05).Conclusions The high expression of COX-2 and C/EBP-βmay be closely related to postoperative recurrence of sinusitis patients with nasal polyps.Both may be used as objective indicators to judge the postoperative follow-up and recurrence tendency of patients with sinusitis with nasal polyps..
基金ThisworkwassupportedbytheNationalOutstandingYouthFoundationofChina (No.39725025)andtheNaturalScienceFoundationofGuangdongProvince (No .K 160 )
文摘OBJECTIVES: To study the concentration, distribution and expression of IL-5 in nasal polyp tissues and explore its significance in micro-environment differentiation of eosinophil accumulation. METHODS: The concentration and expression of IL-5 in nasal polyp tissues of 40 patients were determined by ELISA and immunohistochemistry and inferior turbinate mucosa from patients with nasal polyps and healthy volunteers were used as control. RESULTS: IL-5 concentration in polyp tissues was significantly higher than that in turbinate mucosa (P 0.05). IL-5 concentrations in polyp tissues were markedly higher in patients with allergic rhinitis compared with those without (P 0.05). 80.1% of the eosinophils were positive for IL-5 and 90.9% of IL-5 positive cells were eosinophils. Only 3.7% of lymphocytes and neutrophils were positive for IL-5; IL-5 was not detectable in epithelial cells. IL-5 expression in eosinophils of polyp tissues was remarkably stronger than that of the turbinate mucosa (P 0.05). IL-5 expression of eosinophils in polyp tissue was significantly stronger in patients with allergic rhinitis compared with those without (P 0.05). CONCLUSION: IL-5 is the key cytokine in eosinophilic pathologic mechanisms in nasal polyp tissues.
文摘Objective To explore the significance of protein kinase C (PKC) in proliferation and infiltration of eosinophils in nasal polyps. Methods With in situ hybridization and immunohistochemistry staining methods,PKC,pro-apoptotic,and anti-apoptotic gene (Bax,bcl-2 ) expressions were measured in nasal polyp tissues from 26 patients and inferior turbinate mucosa tissues (ITMTs) from 20 healthy persons. The May-Grünwald-Giemsa (MGG) staining method was used to identify eosinophils. Results In eosinophils,the positive cell expressive rates of Bcl-2 mRNA and its protein were significantly higher in the group with nasal polyps than in the ITMT group ( P <0.01). Although the positive cell expressive rate of Bax mRNA and associated protein were a little higher in the group with nasal polyp tissues than in the ITMT group,the difference was not significant ( P >0.05). There was PKC expression in the eosinophils of 26 cases of nasal polyps,but occasional PKC expression in 7 of 20 ITMT cases. In the two groups,PKC positive cell expression was significantly different,and the expression of PKC and bcl-2 mRNA as well as associated protein in eosinophils of nasal polyps showed a remarkably positive relationship ( r 1=0.0875,r 2=0.0823,P <0.01). Conclusions Increased PKC expression in eosinophils of nasal polyp tissues is closely associated with apoptosis inhibition,and it is presumed that eosinophil apoptosis inhibition in nasal polyp tissues is obtained by activation of the PKC signal transduction pathway.
文摘Objective:To review and evaluate outcomes of patients with aspirin-exacerbated respiratory disease(AERD)following endoscopic sinus surgery and subsequent aspirin desensitization.Methods:Electronic searches of OVID MEDLINE(1948 to September 10,2019),EMBASE(1980 to September 10,2019),and PubMed were performed on September 10,2019.A systematic review of the literature was performed using the 2009 PRISMA guidelines.Studies with both preoperative and postoperative data for patients with AERD who underwent sinus surgery and aspirin desensitization were considered appropriate for inclusion.Publications were written in English and included patients aged 18 years or older.Results:Six studies met inclusion criteria for this systematic review.The primary outcome measure was change in symptom profile measured by patient-reported quality of life scores.The results demonstrate statistically significant improvement in symptoms following endoscopic sinus surgery,with sustained improvement following aspirin desensitization.Revision surgery rates were significantly lower in patients maintained on aspirin therapy.Conclusion:This review suggests that surgery followed by aspirin desensitization results in improvement in both subjective and objective outcome measures.The adjunctive use of aspirin desensitization allows for long-term stability in symptom scores.Recurrence of polyps and worsening symptoms requiring revision surgery occurs when aspirin maintenance therapy is inter-rupted.
