Objective To explore the correlation between food allergies and duodenal mast cells in pathogenesis with functional dyspepsia (FD).Methods The symptoms of FD were scored in 48 patients with FD,which included 23 patients with postprandial distress syndrome (PDS) and 25 patients with epigastric pain syndrome (EPS).The specimens of duodenal and descending part of duodenum mucosa were obtained under gastroscopy in 48 FD patients and 21 healthy volunteers,and 3 mL venous blood was taken at same time.The percentages of mast cells and degranulated mast cells were calculated after the specimens were stained by toluidine blue.The serum specific IgG antibodies of 14 food allergies were detected by enzyme-linked immunosorbent assay.Two-sample comparison was performed by t test,LSD-t-test for groups' comparison,chi-square or Fisher’s exact test for rates comparison and Pearson linear correlation for correlation analysis.Results The number of mast cells in duodenal and descending part of duodenum of FD group,PDS group and EPS group was significantly higher than that of control group and the differences were statistically significant (duodenal:t =3.387,3.536 and 3.510; descending part of duodenum:t=5.810,4.400 and 3.813; all P＜0.01).In duodenal and descending part of duodenum,the percentages of degranulated mast cells in all mast cells of FD [(60.23± 5.10)％ and (66.97±5.30)％],PDS [(59.84±4.50)％ and (66.63±5.37) ％] and EPS [(60.58±5.66) ％ and (67.28±5.32) ％] were all higher than those of control group [(25.38 ± 2.32％) and (30.66 ±2.89)％],and the differences were statistically significant (duodenal:t=33.639,25.496 and 26.563; descending part of duodenum:t=32.513,30.521 and 31.612; all P＜0.05).There was no correlation between the number of mast cells,percentage of degranulated mast cells in duodenal or descending part of duodenum and the scores of symptoms (all P＞0.05).In PDS group,the rates of positive specific IgG antibodies of beef,crab,shrimp,wheat and chicken were significantly higher than those of control group,and the differences were statistically significant (beef x2=12.108,crab x2=17.771,shrimp x2=6.832 and wheat x2=4.375,chicken (Fisher’s exact test); all P＜0.05).In EPS group,the rates of positive specific IgG antibodies of beef,soy and chicken were significantly higher than those of control group,and the differences were statistically significant (beef x2 =8.915,soy x2 =18.600,chicken (Fisher' s exact test) ; all P ＜0.01).The scores of positive specific IgG antibodies of food allergies and types of FD,PDS and EPS were significantly higher than those of control group,and the differences were statistically significant (the score of positive IgG:t=14.988,4.062 and 3.693; the positive type of IgG:t=8.805,4.177 and 3.388; all P＜0.01).The scores of positive specific IgG antibodies of food allergies and types were positively correlated with the number of mast cells and the percentage of degranulated mast cells in duodenal part of duodenum (the score of positive IgG:r=0.247 and 0.307,the positive type of IgG:r=0.243 and 0.326; all P＜0.05).Conclusion The specific IgG antibody of food allergies might play a role in the pathogenesis of FD through inducing an increase in the number of mast cells and the percentage of degranulated mast cells in duodenal mucosa.

Objective To evaluate the predictive value of fracture risk assessment tool (FRAX) for determining fracture probabilities in middle-aged and elderly patients with type 2 diabetes.Methods Retrospective analysis was carried out on 153 type 2 diabetic patients aged over 50 years undergoing dual energy X-ray absorptiometry measurements.Fracture risk factors including age,gender,height,weight,body mass index,history of previous fragility fractures,parental history of hip fracture,history of smoking,excessive drinking,long-term use of steroid hormone,history of rheumatoid arthritis,the history of secondary osteoporosis diseases,and femoral neck T-score of bone mineral density (BMD) were recorded.FRAX scores with BMD (FRAX/BMD) and without BMD (FRAX/-) were calculated.Therapeutic interventions were recommended if the 10-year risk of fractures was more than 3％ for hip osteoporotic fractures and more than 20％ for other major fractures.Subjects were separated into the identical treatment recommendation group and the different treatment recommendation.Fracture risk factors were compared between groups.Results 133 (6.9 ％) patients had identical fracture risk predictions in the FRAX calculation,regardless of whether BMD join in or not.Age,gender and femoral neck T scores had significant differences between the two groups (all P＜0.001),while other risk factors had no statistical differences between the two groups (all P＞0.05).Conclusions In most middle-aged and elderly patients with type 2 diabetes,the FRAX/-provides the same prediction as FRAX/BMD value for predicting fracture risk,which shows that fracture risks can be predicted without bone density examination.The FRAX/-has higher predictive values on fracture for people who are younger,male,and has higher BMD.

OBJECTIVE: To evaluate the short-term efficacy and investigate the factors of specific immunotherapy (SIT) efficacy of allergic rhinitis. METHOD: Fifty-seven patients with allergic rhinitis to dermatophagoides pteronysinus were included to receive SIT. Pair t-test was used to compare the symptom scores, visual analogue scores (VAS) and medication scores in patients before SIT and into maintain treatment statement to evaluate the clinical efficacy. T-test and Spearman correlation analysis were used to analyze the correlation between gender, age,reaction condition of skin prick test (SPT) and serum sIgE and the efficacy of SIT. RESULT: SIT was able to significantly reduce the symptom scores, VAS and medication scores. But the correlation between gender, age, SPT, and sIgE and theefficacy of SIT were not significant. CONCLUSION SIT is effective in the short-term treatment of AR. Further research is needed to investigate the factors that impact the efficacy of SIT.
Animals ; Humans ; Immunoglobulin E ; blood ; Immunotherapy ; Pyroglyphidae ; Rhinitis, Allergic ; therapy ; Skin Tests

OBJECTIVE: To discuss endoscopic surgical treatment and its effect on structural rhinitis. METHOD: Eighty-four patients with structural rhinitis were treated by endoscopic rhinoplasty of nasal cavity, include: (1) inferior turbinoplasty with three segment method, (2) middle turbinoplasty, (3) functional resection of ostiomeatal complex, (4) endoscopic submucous septoplasty. To achieve organic combination of the above surgery methods according to the patient's symptom and the different results of the CT scan, the surgical procedure were designed individually. RESULT All patients were followed-up for 8 to 12 months, average 10 months. The rate of fully recovered without serious complication was 95.24%. CONCLUSTION: Structural rhinitis is a sort of functional disease as a result of multi-abnormality of nasal cavity structure. Endoscopic rhinoplasty is an effective treatment by means of reconstructing the balance of bilateral nasal cavity and improving its function.
Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; surgery ; Rhinitis ; surgery ; Rhinoplasty ; methods ; Young Adult

OBJECTIVE: Patients undergone septoplasty, which is one of the most common procedures, always feel very painful after surgery because of routine nasal packing. The objective of this study was to evaluate the effect of septal suture technique without nasal packing after septoplasty. METHOD: Eighty patients who had undergone septoplasty were included in this study. The patients were allocated into tow groups: packing group, mercel was used for nasal packing after septoplasty and inferior turbinate coblation; suturing group, septal suture and inferior turbinate coblation were performed after septoplasty without nasal packing. Postoperative signs and symptoms(visual analogue scale,VAS) were compared between the two groups. RESULT: The patients of packing group experienced significantly more postoperative nasal pain, headache, dysphagia, sleep disturbance and bleeding after surgery (P < 0.01). No difference of epiphora was found between the two groups. More pain and bleeding were experienced during the pack removal(packing group), compared to that during the clearance of nasal cavity (suturing group ). One patient with postoperative septal hematoma was found in the packing group. CONCLUSION Nasal septum suture combined with inferior turbinate coblation might be a significantly more comfortable, reliable alternative to nasal packing. Nasal packing is not the necessary application for septoplasty.
Adult ; Bandages ; Female ; Humans ; Male ; Nasal Cavity ; surgery ; Nasal Septum ; abnormalities ; surgery ; Rhinoplasty ; methods ; Suture Techniques

Objective To explore distribution characteristics and risk factors of cerebral microbleeds (CMBs),and the correlation between CMBs and white matter lesions (WML) in patients with ischemic cerebrovascular disease(ICVD).Methods 180 patients with ICVD in neurology department of Hebei General Hospital from February 2015 to January 2017 were recruited.Those patients were underwent brain magnetic resonance imaging (MRI),and magnetic susceptibility weighted imaging (SWI).Recorded the baseline data and risk factors of high blood pressure,diabetes,hyperlipidemia,and high homocysteine were recorded.Patients with CMBs were counted and graded to understand the characteristics of CMBs distribution.Logisitic regression analysis was used to analyze the influencing factors.ICVD patients were divided into CMBs group and non CMBs group.CMBs group was further divided into 4 groups according to the severity,which was divided into level 1-3.The correlation between CMBs influencing factors and classification was further studied.Then patients with ICVD were divided into WML group and non WML group.WML group scored each region with age-related white matter changes rating scale (ARWMCrs).The correlation between WML and CMBs classification was further studied.Results (1) The overall prevalence of CMBs in patients with ICVD was 61.7％ (111/180).The most common location of CMBs in patients with ICVD was the cortical and subcortical regions (80/111,72.1％),followed by the basal ganglia and thalamus regions (61/111,55.0％),and the infratentorial regions(38/111,34.2％).The difference between them were significant (x2 =32.061,P=0.000).In cortical and subcortical regions of CMBs,temporal lobe was the most common (61.3％).(2) Age(B=0.046,Or=1.047,95％CI =1.017～ 1.077,P=0.002) and the high homocysteine (B =1.458,Or=4.299,95％ CI =2.114 ～ 8.744,P＜0.001) were the risk factors for CMBs.(3) Four classification of CMBs was positively correlated with and WML total score (r=0.393,P=0.393).Conclusion The temporal lobe was the most common region for CMBs in patients with ICVD.Age and high homocysteine were risk factors for CMBs.With the increase of WML total score,severity of CMBs was also increased.

Objective: To investigate the effect of blood eosinophils on clinical effect of endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: From March 2011 to March 2016, 72 cases with CRSwNP were treated by endoscopic sinus surgery in Department of Otorhinolaryngology Head and Neck Surgery, Peking University People′s Hospital. The clinical records were retrospectively reviewed, and the cases were divided into eosinophilia elevated and non-elevated group according to blood eosinophils, and nasal polyps were evaluated for histopathology eosinophil count. Statistical analysis was performed to compare two groups′ pre- and post-operative symptoms of VAS score, sinus computed tomography (CT) scans scores according to the Lund-Mackay system and the outcome of surgery. Both groups′ factors that might have affected their outcome were analyzed by t-test, Chi square, Pearson Correlation Coefficient and Willcoxon rank sum test. Results: Seventy two cases were followed up from 24 to 78 months.The average follow-up time was 56 months. The VAS score in the eosinophilia elevated group (n=16) was higher than that in the non-elevated group(n=56), and the difference was statistically significant (11.44±7.13 vs 4.98±5.64, t=3.726, P<0.05). The control of symptoms in the peripheral blood eosinophilia elevated group was less than that in the non-elevated group, and the difference was statistically significant (Z=-1.979, P<0.05). There was a positive correlation between eosinophil counts in peripheral blood and tissues of 72 cases (r=0.429, P<0.05). Conclusion There is a significant correlation between tissue and blood eosinophil counts, and eosinophilia group has poorer outcomes.

Objective: To investigate the type 2 innate lymphoid cells (ILC2s) in eosinophilic nasal polyps, non-eosinophilic nasal polyps and controls, and to compare the characteristics of ILC2s indifferent types of nasal polyp. Methods: Flow cytometric analysis was used to quantify the ILC2s and Th2 cells in tissues from 19 patients with chronic rhinosinusitis with nasal polyp (CRSwNP) and 6 controls. The patients were classified into two groups as eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) and non-eosinophilic chronic rhinosinusitis with nasal polyps (non-ECRSwNP) based on eosinophil counts under hematoxylin-eosin staining. ILC2 and Th2 cell frenquencies, measured as a percentage of CD45⁺ cells, were compared among ECRSwNP group (n=9), non-ECRSwNP group (n=10) and control group (n=6) using Mann-Whitney U test .The correlation between ILC2, Th2 cell frequencies and eosinophil count in tissues was analyzed using Pearson correlation coefficient. Results: ILC2 frequencies in ECRSwNP group were significantly higher than non-ECRSwNP group and controls ((0.051±0.025) vs (0.011±0.017), (0.051±0.025) vs (0.004±0.004), Z value was -3.185, -3.186, respectively, both P<0.05). There was no significant difference between ILC2 frequencies in non-ECRSwNP and controls ((0.011±0.017) vs (0.004±0.004), Z=-0.712, P=0.492). Th2 cell frequencies in ECRSwNP and non-ECRSwNP group were significantly higher than controls ((0.500±0.437) vs (0.106±0.102), (0.275±0.170) vs (0.106±0.102), Z value was -2.946, -2.278, respectively, both P<0.05). There was no significant difference between Th2 frequencies in non-ECRSwNP group and ECRSwNP group ((0.275±0.170) vs (0.500±0.437), Z=-1.306, P=0.211). ILC2 frequencies significantly correlated with Th2 cell frequencies (r=0.571, P=0.011) and tissue eosinophilia (r=0.579, P=0.009). Th2 cell frequencies significantly correlated with tissue eosinophilia (r=0.844, P=0.001). There was no significant association between ILC2 and allergic status. Conclusion ILC2s are elevated in ECRSwNP, and not influenced by allergic status, suggesting that ILC2s play an important role in ECRSwNP without allergic diseases.