The purpose of this review is to explain the relationship between chronic rhinosinusitis (CRS) and lower respiratory tract inflammation, especially asthma and introduce the new advances in the treatment of CRS patient with asthma. We also introduce our treatment strategy for these patients, including surgery technique and perioperative management.
Asthma ; pathology ; Chronic Disease ; Humans ; Inflammation ; pathology ; Otolaryngology ; methods ; Respiratory System ; physiopathology ; Sinusitis ; physiopathology

A novel method was developed for the direct analysis of testosterone, androstenedione, methyltestosterone and methenolone in serum samples by fully automated online turbulent flow solid phase extraction coupled with high performance liquid chromatography-tandem mass spectrometry. An aliquot of 50 μL serum sample was preconcentrated directly on a Turboflow SPE column after centrifugation. Turboflow SPE C18-P could be used to remove serum matrix effectively. The optimum loading flow rate and elution time were 4. 0 mL/min and 1. 0 min, respectively. The linearity ranges were from 1. 0 μg/L to 100. 0 μg/L for four target compounds. The method limits of detection ( LODs) were in the range of 0. 2-0. 3 μg/L. The relative standard deviations (RSDs) ranged from 2. 9% to 14. 1% (n=5). The time for one sample analysis including extraction, separation and determination was 32 min. The proposed method has been successfully applied for the analysis of serum samples.

Objective:To investigate the clinical effect of surgical procedures on patients with chronic sinusi-tis. Method: 104 patients with chronic sinusitis were treated by endoscopic and Caldwell-Luc's approaches. Thelesions were cleared away completely. Result:The clinical cure rate was 96.1％ after 6～12 months (average 9months ) follow up. Conclusion:It suggests that patients with severe maxillary sinus diseases might be cured byendoscopic and Caldwell-Luc's procedure.

Objective:To analyze the long-term curative effect of endoscopic sinus surgery (ESS), and to study the factors related to the defeat of endoscopic sinus surgery.Method:201 cases（353 sides）of chronic sinusitis and nasal polyps were treated with ESS，and were treated by taking the nasal cavity as a whole unit.Result:Following up survey from 12 months to 24 months postoperatively，it was found that 108 cases were cured （53.7%），82 cases achieved symptomatic relief（40.8%），11 cases remained failure （5.5%）.Conclusion:It is very important to improve the ESS technique in order to reduce the recurrence of nasal polyps and sinusitis and to improve the curative effect of ESS，in addition，the treatment after operation is also indispensable to successful surgery.

Objective To explore the characteristics of chest multi-slice spiral CT and dynamic changes in adult patients with se-vere adenovirus pneumonia.Methods Clinical and CT data of 6 patients with severe pneumonia in an epidemic of the respiratory ade-novirus infection were retrospectively analyzed.The impact of hormone therapy was also studied.Results The first chest CT exami-nations in 6 patients were performed 2.22 ± 0.75 days after fever.CT showed segmental consolidation with ground-glass opacity (GGO)in one case,patchy consolidation with GGO in 3 cases,patchy interstitial changes in one case and small nodules in one case. The duration reaching the standards of severe pneumonia was 6.1 7 ± 0.37 days from the onset.During severe phase chest CT showed a range of lobar consolidation in one case,lobar in 2 cases,segmental in 2 cases or patchy in one case,consolidation with GGO in 5 cases.In all cases the lesions were commonly seen in the lower lobes of bilateral lungs.Multiple lobes were involved in 2 cases.After methylprednisolone treatment,no new lesion was showed but the early lesion was enlarged.During the first 2 to 4 days GGO absorbed completely in 6 cases,consolidation absorbed completely in one case and mostly in 5 cases.Conclusion Chest CT findings of severe adenovirus pneumonia in adult are single or multiple lobar or segmental consolidations with or without GGO which distribute mainly at lower lobes.

Cerebrospinal Fluid Rhinorrhea ; surgery ; Endoscopy ; Humans

Endoscopy ; Humans ; Learning ; Nasal Surgical Procedures ; Paranasal Sinuses ; surgery

BACKGROUND: Based on the characteristics of cartilage tissue, such as consisting of single type of cells, the cartilage cells or chondrocyte, absence of blood vessel, rather low consumption level of oxygen and nutrition, low level of allo-immunocompetence and simple function in vivo, it seems to be easy for cartilage cell lines to be established for tissue and cell transplantation. We want to set up a cell line with the purpose of current use in tissue engineering in vitro. It will provide the basis for artificial tissue and organ that will become to be standardized and yielded in batch.OBJECTIVE: To explore the potential stimulatory effects of basic fibroblast growth factor(bFGF) and insulin on the proliferation and differentiation in primary culture mice chondrocytes in vitro. The effect and application of the cell factors will be evaluated for tissue engineering.DESIGN: A grouping controlled and repeated trial was conducted with the cells as the subjects.SETTING: Key laboratory of tissue transplantation and immunology of a college.MATERIAIS: The experiment was completed in the Key Laboratory of Tissue Transplantation and Immunology of the Ministry of Education, Jinan University from November 2002 to May 2003. Cultured cartilage cells at random were obtained as the study objects.METHODS: Mice cartilage cells were cultured in medium at the minimum concentrations of serum. The effects of different concentration of bFGF and insulin on the proliferation and differentiation in mice cartilage cells were observed with WST1 and immunofluorescence staining.MAIN OUTCOME MEASURES: Primary results: ① Effect of bFGF on proliferation of primary cultured mice cartilage cells. ② Effect of insulin on proliferation of primary cultured mice cartilage cells. Secondary results:morphological observation of cartilage cells RESULTS: Primary cultured mice cartilage cells were cultured in medium at the minimum concentration of serum(4 g/L fatal bovine serum). It was found that bFGF and insulin might play an important role on the proliferation and growth of mice cartilage cells in a dose-dependent manner. In addition, morphological observation of cartilage cells showed that both bFGF and insulin not only promoted the proliferation of the cells but also enhanced the matrix secretion of cartilage cells.CONCLUSION: Both bFGF and insulin can stimulate the proliferation of cartilage cells in vitro.

Objective To investigate the effects of hyperbaric oxygen preconditioning (HBOP) on brain edema, inflammatory reaction and neuronal cell apoptosis induced by experimental hemorrhage in rats. Method Eighteen male Spraque-Dawley rats, weighing 300 - 350 g,received five successive sessions of HBOP with 3 atmosphere absolute pressure and 100% O2 one hour daily for five successive days, and other eighteen rats received five successive sessions of pretreatment with one atmosphere absolute pressure, air, one hour daily for five successive days. Twenty-four hours after the final pre-conditioning, rats received an infusion of 100 μL autologous blood into the basal ganglion. Seventy-two hours later, rats were sacrificed for brain edema measurements in 12 rats of each group. The histopathological changes around the hematoma were observed microscopically, and the neuronal cell apoptosis was detected by using the terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) in six rats of each group. Data of brain water content were analyzed by using Stata 7.0 software and statistical analysis was carried out by two-tailed Student t -test. Results Compared with the control group, HBOP significantly attenuated brain edema 72 hours after intra-cerebral hemorrhage in experimental rats (81. 6± 0. 7% vs. 82. 8± 0.9%, P < 0.01). Inflammatory cell infiltration and neuronal cell apoptosis were also significantly decreased in the HBOP group. Conclusions HBOP protects the rats against brain edema formation, and quells inflammatory reaction and neuronal cell apoptosis following intra-cerebral hemorrhage in experimental rats.

Objective To investigate the value of advanced virtual monoenergetic technique(mono-plus) of dual-energy CT (DECT) in improving imaging quality of the lliofemoral arteries.Methods Forty consecutive patients underwent DECT scan.Mono-plus images (40 keV),optimal monoenergy images and mixed energy images were obtained by using Siemens Syngo.via VB10A workstation.CT values,signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and subjective image quality were calculated in the abdominal aorta,iliac artery,external iliac artery,femoral artery,profound femoral artery, lateral circumflex femoral artery,transversal branch of lateral circumflex femoral artery,medial circumflex femoral artery and profound branch of medial circumflex femoral artery and compared among the three groups.Results Compared with the optimal monoenergy and mixed energy groups,CT value and CNR of the 9 arteries were significantly higher in the mono-plus group (P<0.003).SNR of the transversal branch of lateral circumflex femoral artery and the profound branch of medial circumflex femoral artery showed no significant difference (P>0.05) among the threegroups,whereas SNR of the arties bigger than the 6th grade branch were significantly lower in the mono-plus group (P<0.05).The subjective image quality in the mono-plus group was significant better than the other two groups(P<0.001).Conclusion 40 keV mono-plus technique in DECT can improve the display of lliofemoral arteries especially the small and distal branches.