Glucocorticoids (GC) are increasingly being used to treat chronic rhinosinusitis, its efficacy and safety are the focus of attention. This article will be divided into chronic rhinosinusitis with nasal polyps and without nasal polyps two subtypes discussed nasal and oral glucocorticoids in the clinical therapeutic efficacy and medication safety.
Chronic Disease ; Glucocorticoids ; therapeutic use ; Humans ; Rhinitis ; drug therapy ; Sinusitis ; drug therapy

Objective To investigate the correlation between the single nucleotide polymorphisms (SNPs) of IL-4 gene -590C/T as well as IL-13 gene -1112C/T and the incidence of asthma in children.To address whether the SNPs of two loci have any impact on total serum IgE( TIgE) levels.Methods Polymerase chain reaction-restriction fragment length polymorphism technique( PCR-RFLP) was used to determine the two locus polymorphisms of 250 patients with asthma and 200 healthy subjects in control group.The level of TIgE was tested by enzyme-linked immunosorbent assay(ELISA) in two groups.Results (1)The genotype distribu-tion in each locus was different in two groups(P<0.01).(2)In patient and control groups, the C allele fre-quency at IL-4-590 locus was 23.00%and 35.25%,the T allele frequency at the same locus was 77.00%and 64.75%, respectively.Besides, the C allele frequency at IL-13 -1112 locus was 59.20%and 70.50%,the T allele frequency at the same locus was 40.80%and 29.50%, respectively.The allele frequencies at each locus had the significant difference in asthma and control group(P<0.01).(3)The subjects with variant allele have higher risks for asthma than those without variant allele ( OR=1.82, 95%CI=1.36-2.44, and OR=1.647, 95%CI=1.246-2.178).(4)The TIgE level of asthma group was higher than that of control group in those with the same genotype (P<0.05).(5)No significant difference with the TIgE levels was observed in those with or without variant T allele at IL-13 -1112 locus(P>0.05), which was in contrast with that at IL-4 -590 locus in asthma group(P<0.05).Conclusion The SNPs of two loci were associated with childhood asthma.Variant al-lele T at 590C/T locus in IL-4 gene correlated with higher serum IgE levels.There was no significant correlation between the serum IgE levels and variant T allele at IL-13 -1112C/T locus.

Objective To evaluate of left atrial(LA) function in patients with rheumatic mitral stenosis(MS) by real time three‐dimensional echocardiography (RT‐3DE) .Methods Thirty patients with MS and 50 healthy volunteers underwent RT‐3DE . The left atrial end‐diastolic volume (LAVmax ) ,end‐systolic volume (LAVmin ) and pre‐systolic volume (LAVpre ) were measured to calculate the total ,passive and active atrial stroke volume (TASV ,PASV ,AASV) ,left atrial expansion index (LAEI) ,left atrial to‐tal ,passive ,active ejection fraction (LAEF ,LAEFpassive ,LAEFactive ) .The volume data were corrected by body surface area (BSA) to gettheleftatrialend‐diastolicvolumeindex (LAVmaxI),end‐systolicvolumeindex(LAVminI),pre‐systolicvolumeindex(LAVpreI) and the total ,passive and active atrial stroke volume index (TASVI ,PASVI ,AASVI) .The correlations between the LA volume , stroke volume ,function indices and the mitral valve area (MVA) were analyzed .Results (1)LAVmaxI ,LAVminI and LAVpreI were significantly greater in patients with MS than the controls(all P<0 .05) .(2)There was no significant difference in TASVI ,PASVI and AASVI between the two groups(all P>0 .05) .(3) LAEI ,LAEF ,LAEFpassive and LAEFactive were significantly lower in patients with MS than the controls(all P<0 .05) .(4)There was a significant correlation between the LAVmax I ,LAVmin I ,LAVpre I ,LAEF , LAEFpassive and MVA (r= -0 .432 ,-0 .421 ,-0 .440 ,0 .352 ,0 .401 ,all P<0 .05) ,there was no correlation between the TAVSI , PASVI ,AASVI ,LAEI ,LAEFactive and MVA(all P>0 .05) .Conclusion LA function in patients with mitral stenosis decreased .RT‐3DE can be used to evaluate LA function in patients with MS and sinus rhythm .

Objective To investigate whether the genetic variant rs10830963 of melatonin receptor 1B(MTNR1B)gene is associated with increased risk for gestational diabetes mellitus (GDM).Methods Eighty-seven GDM subjects(GDM group)and 91 normal pregnant women (control group)were randomly recruited form Women and Children's Hospital of Quzhou,Zhejiang Province,China.The allele and genotype frequencies of the rsi0830963 in MTNR1B gene were determined in all participants with PCR amplification and DNA sequencing.The allele and genotype frequencies of rs10830963 were compared to determine their differences between GDM subjects and normal controls.In addition,multiple linear regression was conducted to investigate the association patterns of the risk allele with fasting glucose and HbAlc levels.Results Both GG genotype and G allele frequencies of the rs10830963 loci in the GDM group were significantly higher than those in the controls,and women with G allele and GG genotype were associated with increased GDM risk(OR=1.53,95％ CI:1.005-2.324,P=0.047 and OR=2.16,95％ CI:1.052-4.434,P=0.034 respectively).After adjusting for age,body mass index before pregnancy,and family history of diabetes mellitus,women carrying GG genotype still had a higher GDM risk(OR =2.07,95％ CI:1.048-4.372,P =0.022).Multiple linear regression showed that the rs10830963 G allele was positively correlated with higher levels of fasting glucose(0.068 mmol/L,P=0.015)and HbAlc(0.073％,P=0.028).Conclusions Genetic variant rs10830963 in MTNR1B gene may contribute to the susceptibility to GDM in Chinese population and the rs10830963 G allele is a risk factor for the GDM susceptibility.

OBJECTIVE: To explore the efficacy of individualized subcutaneous immunotherapy (SCIT) in allergic rhinitis(AR) maintain phase. METHOD: Compare nasal symptom scores (VAS) and special disease scale--nasal conjunctivitis quality of life questionnaire(RQLQ) score after 3 years treatment to evaluate the therapeutic effect of each group and the level of improving patients quality of life. Take patients' blood to detect the serum level of IL-10 by enzyme linked immunosorbent test (enzyme linked immunosorbent assay). RESULT: After 3 years treatment, there was no difference of VAS between the conventional SCIT group and the individualized SCIT group. ELISA results showed that the level of IL-10 was significantly higher in the drug symptomatic treatment group than that in the healthy group, the levels of IL-10 were significantly lower in the conventional SCIT group and the individualized SCIT group than that in the healthy group, but there was no difference between the conventional SCIT and the individualized SCIT group. CONCLUSION After 3 years treatment, there was no difference between conventional and individualized SCIT groups. But the efficacy of the conventional and individualized SCIT groups were significantly better than that in the drug symptomatic treatment group.
Desensitization, Immunologic ; Enzyme-Linked Immunosorbent Assay ; Humans ; Injections, Subcutaneous ; Interleukin-10 ; blood ; Precision Medicine ; Quality of Life ; Rhinitis, Allergic ; drug therapy ; Surveys and Questionnaires

【Objective】 To determine the best collection time period of plasma which can be used for human COVID-19 immunoglobulin for intravenous injection through SARS-CoV-2-IgG change and neutralizing antibody distribution against different virus strain in representative mixed plasma before and after Omicron strain infection by ELISA and pseudovirus neutralization test. 【Methods】 An ELISA method for quantitative detection of SARS-CoV-2-IgG was established and its linear range,accuracy and precision was verified. SARS-CoV-2-IgG potency was detected in 25 convalescent plasma which were collected 20-40 days after confirmed Omicron infection, two groups of mixed plasma samples WP1 and WP2 were prepared according to the SARS-CoV-2-IgG results, and pseudovirus neutralization experiments with different virus strain (prototype strain, BA. 1,BA.2, BA.4/5, BF.7, BQ.1.1) were carried out to determine the distribution of neutralizing antibodies against different virus strain. SARS-CoV-2-IgG potency of representative mixed plasma collected from 14 plasma stations subordinate to the company before and after Omicron strain infection was detected, including Omicron convalescent plasma (OP) collected from different plasma stations from December 2022 to May 2023 and normal pool plasma (VN) feed in March 2023 which collected from March 2022 to December 2022. According to the results, the difference and the change rule with time of SARS-CoV-2-IgG before and after Omicron strain infection were analyzed. 【Results】 The linearity of SARS-CoV-2-IgG ranged from 6.25 to 200 EIU/mL, the accuracy in-batch ranged from 81.793% to 106.985%, the precision in-batch ranged from 1. 100% to 13.000%, and the total error in-batch ranged from 2.988% to 22.679%. The accuracy between batches ranged from 90.788%to 96.893%, the precision between batches ranged from 4.870% to 6.272%, and the total error between batches ranged from 9.192% to 15.399%. The results of pseudovirus neutralizing antibody showed that the potency of different virus strain neutralizing antibodies were in the order of prototype strain>BA.2>BA.4/5>BF.7≈ BQ.1.1>BA.1 and the correlation between WP1 and WP2 was high (Pearson r=0. 931 1, P=0.002 3) which indicated that the potency distribution of neutralizing antibodies of different virus strain in Omicron convalescent plasma was basically stable. Compared with the mixed convalescent plasma sample G128 collected in June 2022, the potency of Omicron neutralizing antibodies of WP series were significantly higher, the ratio of BA.2 antibody to prototype antibody increased from 26.9% (before infection) to 82.6%-87.5% (after infection). The results of VN series before Omicron infection were < 100 EIU/mL, and the results of OP series after Omicron infection showed that the plasma collected from the beginning of December 2022 was the peak of antibody in the same month,and then dropped sharply, entering a short plateau in February-March 2023 (potency was about 40% of the peak value),and then dropped sharply again in April (potency was about 20% of the peak value). 【Conclusion】 The potency and proportion of neutralizing antibody against Omicron subtype in convalescent plasma after COVID-19 Omicron strain infection increased significantly. IgG antibody of plasma donors in different regions reached its peak in the month of infection, then continued to dropped sharply. The best collection period of plasma that can be used for human COVID-19 immunoglobulin for intravenous injection was 1 to 2 months after infection.