This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

Allergen-specific immunotherapy（AIT） remains the only therapeutic approach with the potential to modify the natural course of allergic rhinitis（AR）. Nevertheless, considerable inter-individual variability exists in patients'responses to AIT. To facilitate more reliable assessment of treatment efficacy, the China Rhinopathy Research Cooperation Group（CRRCG） convened young and middle-aged nasal experts in China to formulate the present consensus. The recommended subjective outcome measures for AIT comprise symptom scores, medication scores, combined symptom and medication scores, quality-of-life assessments, evaluation of disease control, and assessment of comorbidities. Objective indicators may supplement these measures. Currently available objective approaches include skin prick testing, nasal provocation testing, and allergen exposure chambers. However, these methods remain constrained by practical limitations and are not yet appropriate for routine implementation in clinical efficacy evaluation. In addition, several biomarkers, including sIgE and the sIgE/tIgE ratio, sIgG4, serum IgE-blocking activity, IgA, cytokines and chemokines, as well as immune cell surface molecules and their functional activity, have been shown to have associations with AIT outcomes. While these biomarkers may complement subjective assessments, they are subject to significant limitations. Consequently, large-scale multicenter trials and real-world evidence are required to strengthen the evidence base. The present consensus underscores the necessity of integrating patients'subjective experiences with objective testing throughout the treatment process, thereby providing a more comprehensive and accurate framework for efficacy evaluation. Looking forward, future investigations should prioritize the incorporation of multi-omics data and artificial intelligence methodologies, which hold promise for overcoming current limitations in assessment strategies and for advancing both the standardization and personalization of AIT.
Humans ; Allergens/immunology* ; China ; Consensus ; Desensitization, Immunologic ; Immunoglobulin E ; Quality of Life ; Rhinitis, Allergic/therapy* ; Treatment Outcome ; East Asian People

Objective:To investigate the clinical characteristics and independent risk factors of severe disease in patients with anti-nuclear matrix protein (NXP) 2 antibody-positive juvenile dermatomyositis (JDM).Methods:A retrospective cohort study was conducted, including 219 anti-NXP2 antibody-positive JDM patients admitted to 23 children′s hospitals across China from July 2011 to July 2023. Patients were classified into severe and non-severe groups based on classification criteria for severe dermatomyositis. Demographic characteristics, clinical manifestations, and laboratory parameters were compared between the 2 groups using independent sample t-test, Mann-Whitney U test, or χ2 test. Univariate and multivariate Logistic regression analyses were performed to identify risk factors for severe disease. The receiver operating characteristic curve was employed to calculate optimal cut-off values. Results:Among the 219 patients, 108 were male and 111 were female, with an age at onset of 6.3 (3.5, 9.4) years. The severe group comprised 69 patients, and the non-severe group 150 patients. The severe group had significantly higher rates of fever, heliotrope rash, subcutaneous edema, periorbital edema, anti-Ro52 antibody positivity, as well as elevated levels of ferritin-to-albumin ratio (FAR), creatine kinase (CK), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) (all P<0.05). Multivariate analysis identified anti-Ro52 antibody positivity ( OR=13.26, 95% CI 1.37-128.29) and elevated FAR ( OR=1.90, 95% CI 1.09-2.31) as independent risk factors for severe anti-NXP2 antibody-positive JDM (both P<0.05). Receiver operating characteristic curve analysis revealed that a FAR cutoff value of 6.82 predicted severe disease with an area under the curve of 0.87 (95% CI 0.81-0.94, P<0.001), sensitivity of 0.85, and specificity of 0.70. All patients received glucocorticoid therapy, and the severe group received higher proportions of steroid pulse therapy, cyclophosphamide, mycophenolate mofetil, intravenous immunoglobulin, biologics, and adjuvant treatments compared to the non-severe group (all P<0.05). In terms of outcomes, 2 patients (2.9%) in the severe group died (due to neurological involvement and intestinal perforation, respectively), while the remaining patients achieved complete clinical response or remission. All patients in the non-severe group achieved remission. Conclusions:The primary clinical features of anti-NXP2 antibody-positive JDM included fever, heliotrope rash, subcutaneous edema, periorbital edema, anti-Ro52 antibody positivity, and elevated levels of CK, AST, LDH, and FAR. Furthermore, anti-Ro52 antibody positivity and a FAR>6.82 were identified as independent risk factors.

Objective:To investigate the clinical characteristics and independent risk factors of severe disease in patients with anti-nuclear matrix protein (NXP) 2 antibody-positive juvenile dermatomyositis (JDM).Methods:A retrospective cohort study was conducted, including 219 anti-NXP2 antibody-positive JDM patients admitted to 23 children′s hospitals across China from July 2011 to July 2023. Patients were classified into severe and non-severe groups based on classification criteria for severe dermatomyositis. Demographic characteristics, clinical manifestations, and laboratory parameters were compared between the 2 groups using independent sample t-test, Mann-Whitney U test, or χ2 test. Univariate and multivariate Logistic regression analyses were performed to identify risk factors for severe disease. The receiver operating characteristic curve was employed to calculate optimal cut-off values. Results:Among the 219 patients, 108 were male and 111 were female, with an age at onset of 6.3 (3.5, 9.4) years. The severe group comprised 69 patients, and the non-severe group 150 patients. The severe group had significantly higher rates of fever, heliotrope rash, subcutaneous edema, periorbital edema, anti-Ro52 antibody positivity, as well as elevated levels of ferritin-to-albumin ratio (FAR), creatine kinase (CK), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) (all P<0.05). Multivariate analysis identified anti-Ro52 antibody positivity ( OR=13.26, 95% CI 1.37-128.29) and elevated FAR ( OR=1.90, 95% CI 1.09-2.31) as independent risk factors for severe anti-NXP2 antibody-positive JDM (both P<0.05). Receiver operating characteristic curve analysis revealed that a FAR cutoff value of 6.82 predicted severe disease with an area under the curve of 0.87 (95% CI 0.81-0.94, P<0.001), sensitivity of 0.85, and specificity of 0.70. All patients received glucocorticoid therapy, and the severe group received higher proportions of steroid pulse therapy, cyclophosphamide, mycophenolate mofetil, intravenous immunoglobulin, biologics, and adjuvant treatments compared to the non-severe group (all P<0.05). In terms of outcomes, 2 patients (2.9%) in the severe group died (due to neurological involvement and intestinal perforation, respectively), while the remaining patients achieved complete clinical response or remission. All patients in the non-severe group achieved remission. Conclusions:The primary clinical features of anti-NXP2 antibody-positive JDM included fever, heliotrope rash, subcutaneous edema, periorbital edema, anti-Ro52 antibody positivity, and elevated levels of CK, AST, LDH, and FAR. Furthermore, anti-Ro52 antibody positivity and a FAR>6.82 were identified as independent risk factors.

ObjectiveBased on the experience of traditional quality evaluation， the quality of Atractylodis Macrocephalae Rhizoma（AMR） with different production methods such as direct seeding， transplanting after seedling raising， topping and non-topping， and difference in growth years was compared. MethodVernier caliper was used to measure the trait data of AMR in different production methods. Paraffin sections of AMR with different production methods were made by saffron solid green staining， and the microstructure was observed. The contents of water-soluble and alcohol-soluble extracts in AMR with different production methods were determined according to the 2020 edition of Chinese Pharmacopoeia. The content of water-soluble total polysaccharides in AMR with different production methods was detected by sulfuric acid-anthrone method. Fiber analyzer was used to detect the content of fiber components in AMR with different production methods. The contents of monosaccharides， oligosaccharides and some secondary metabolites in AMR with different production methods were detected by ultra performance liquid chromatography（UPLC）， and the differences of chemical components were compared by multivariate statistical analysis methods such as principal component analysis（PCA） and partial least squares-discriminant analysis（PLS-DA）. ResultIn terms of traits， the 3-year-old AMR with direct seeding and without topping was close to the high-quality AMR with "phoenix-head and crane-neck， strong sweetness and clear aroma" recorded in ancient materia medica， followed by the 3-year-old AMR with topping after transplanting， while the 2-year-old AMR with topping after transplanting with high market circulation rate was generally fat and strong with mild odor. In the microscopic aspect， the arrangement of xylem vessels and fiber bundles in the 3-year-old samples formed two obvious rings. Compared with the 2-year-old samples cultivated in Bozhou and Zhejiang， the 3-year-old samples without topping after transplanting had more wood fibers. In terms of chemical composition， the contents of 70% ethanol extract， fructose， glucose， sucrose， 1-kestose， atractylenolide Ⅰ， chlorogenic acid， neochlorogenic acid， cryptochlorogenic acid and other components in 3-year-old AMR with direct seeding and without topping were significantly higher than those in the other three samples（P<0.05）. The contents of cellulose， 70% ethanol extract， sucrose， atractylenolide Ⅰ， atractylone and other components in 3-year-old AMR with topping after transplanting were significantly higher than those in the 2-year-old AMR with high market circulation rate（P<0.05）， while the contents of water-soluble extract and water-soluble total polysaccharides in 2-year-old samples with topping after transplanting were significantly higher than those in the 3-year-old AMR with topping after transplanting， direct seeding and without topping（P<0.05）. ConclusionUnder the current mainstream production mode， too much manual intervention makes AMR heavily enriched in polysaccharides and increased the yield， but the accumulation of sweet substances， fragrant substances and fiber substances is insufficient， which affects its quality. The current quality standard of AMR has some shortcomings in guiding the high quality production of it， it is suggested to revise the quality standard of AMR， supplement the quantitative analysis of secondary metabolites， and strengthen the production of imitation wild AMR.

Objective:Pediatric chronic sinusitis （CRS） is a common disease within the field of otolaryngology-head and neck surgery. Due to the immaturity of sinus development and immune competence in children, its etiology and pathophysiology are complex, and its clinical features and outcomes differ significantly from those in adult patients. Currently, there are issues in the diagnosis and treatment of pediatric CRS, particularly in areas such as antibiotic use and surgical interventions, owing to a lack of sufficient attention. In recognition of this, the Chinese Rhinopathy Research Cooperation Group developed this expert consensus based on a systematic review of the latest literatures from both domestic and international sources, with reference to the latest evidence-based medical evidence worldwide, and in combination with their own clinical experience. The consensus covers various aspects including epidemiology, predisposing factors, pathophysiology, diagnosis and differential diagnosis, as well as treatment strategies such as medical therapy and surgical intervention. It aims to standardize the clinical diagnosis and treatment of pediatric CRS, improve clinical efficacy and patient satisfaction, reduce clinical expenditures, and decrease the occurrence of adverse reactions.
Humans ; Sinusitis/therapy* ; Chronic Disease ; Child ; Consensus ; Anti-Bacterial Agents/therapeutic use*

Objective:To analyze the characteristics of inhibitory control and cognitive flexibility in hearing-impaired children.Methods:From March to April 2023, a convenience sampling method was used to select 33 hearing-impaired children from a special education school in Meizhou City, Guangdong Province, and 35 normal-hearing children from two ordinary schools as participants. Inhibitory control and cognitive flexibility of the participants were assessed by the Flanker task and the dimensional change card sorting (DCCS) task. Statistical analysis was conducted using SPSS 26.0 software, and independent sample t-test was used to compare the differences in reaction time and accuracy rate between two groups of participants. Results:There were no significant differences in the Flanker task reaction time ((558.39±123.65) ms vs (566.11±118.20) ms) and accuracy rate((0.93±0.10) vs (0.96±0.04))between hearing-impaired children and normal-hearing children ( t=-0.295, -1.645, both P>0.05). The hearing-impaired children had significantly longer reaction time ((1 019.60±131.08) ms)than the normal-hearing children ((857.85±129.19) ms) ( t=4.046, P=0.001) in the DCCS task, while there was no statistically significant difference in the accuracy rate between hearing-impaired children (0.62±0.16) and normal-hearing children (0.57±0.15) ( t=-1.602, P>0.05). Conclusion:There is no difference in inhibitory control ability between hearing-impaired children and normal-hearing children, but the hearing-impaired children have a lag in cognitive flexibility.

Objective:To investigate the mechanism of tumor necrosis factor alpha-induced protein 3 ( Tnfaip3) gene affecting the intestinal inflammation in mice with dextran sulfate sodium (DSS) -induced colitis by regulating mitochondria. Methods:Female Tnfaip3 heterozygous deficiency ( Tnfaip3 +/-) mice ( n = 14) and wild-type (WT) mice ( n = 14) were collected and divided into 4 groups including wild type (WT) group, colitis model (WT-DSS) group, Tnfaip3 heterozygous deficiency ( Tnfaip3 +/-) group, Tnfaip3 heterozygous deficiency colitis model ( Tnfaip3 +/--DSS) group, with 7 mice in each group. Mice colitis in WT-DSS and Tnfaip3 +/--DSS groups were induced by drinking 3% DSS water for 7 days, while mice in WT and Tnfaip3 +/- groups were treated with tap water. Body weight and disease activity index (DAI) were evaluated daily. The mice were sacrificed after 7 days of modeling, the colon length was measured, the colon tissue damage was observed under the microscope, and the colon histopathological score was evaluated. The mRNA expressions of inflammatory factors as tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and nuclear factor κB (NF-κB) in colon tissue were detected by quantitative real-time PCR. Oxidative stress indicators such as malonic dialdehyde (MDA), total antioxidant capacity (T-AOC), glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD) in colon tissue were detected. Transmission electron microscopy was used to observe the structures of mitochondria, lysosomes, and autophagic mitochondria, and calculate the numbers. Mitochondrial membrane potential JC-1 and adenosine-triphosphate (ATP) levels were detected, and Western blot was used to detect the expressions of mitophagy-related proteins PINK1, P62, and LC3B Ⅱ/LC3B Ⅰ in mitochondria and cytoplasm. Results:The survival rate of mice in all groups was 100%. Compared with WT group, the mice in Tnfaip3 +/- group had lower body weight, shorter colon and higher histopathological scores (all P < 0.05). Compared with WT-DSS group, the mice in Tnfaip3 +/--DSS group had lower body weight, higher DAI score, shorter colon, higher histopathological score, and higher mRNA expressions of inflammatory factors TNF-α, IL-1β and NF-κB in colon tissues (all P < 0.05). MDA level in colon tissues of Tnfaip3 +/- mice was higher than that of WT mice ( P < 0.05). Compared with WT-DSS group, the MDA level in Tnfaip3 +/--DSS group was higher, the levels of T-AOC, GSH-PX and SOD were lower (all P < 0.05). Compared with WT-DSS group, Tnfaip3 +/--DSS mice had more severe intestinal disordered mitochondrial structure, less mitochondrial number, higher mitochondrial membrane potential JC-1 level and lower mitochondrial ATP content, more number of lysosomes and autophagic mitochondria and higher expressions of proteins such as PINK1, P62 and ratio of LC3BⅡ/LC3BⅠ in mitochondria and cytoplasm (all P < 0.05) . Conclusion:Tnfaip3 gene may play a protective role in intestinal inflammation of colitis mice by regulating oxidative stress, mitochondria damage and mitophagy.

Objective:To investigate the mechanism of tumor necrosis factor alpha-induced protein 3 ( Tnfaip3) gene affecting the intestinal inflammation in mice with dextran sulfate sodium (DSS) -induced colitis by regulating mitochondria. Methods:Female Tnfaip3 heterozygous deficiency ( Tnfaip3 +/-) mice ( n = 14) and wild-type (WT) mice ( n = 14) were collected and divided into 4 groups including wild type (WT) group, colitis model (WT-DSS) group, Tnfaip3 heterozygous deficiency ( Tnfaip3 +/-) group, Tnfaip3 heterozygous deficiency colitis model ( Tnfaip3 +/--DSS) group, with 7 mice in each group. Mice colitis in WT-DSS and Tnfaip3 +/--DSS groups were induced by drinking 3% DSS water for 7 days, while mice in WT and Tnfaip3 +/- groups were treated with tap water. Body weight and disease activity index (DAI) were evaluated daily. The mice were sacrificed after 7 days of modeling, the colon length was measured, the colon tissue damage was observed under the microscope, and the colon histopathological score was evaluated. The mRNA expressions of inflammatory factors as tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and nuclear factor κB (NF-κB) in colon tissue were detected by quantitative real-time PCR. Oxidative stress indicators such as malonic dialdehyde (MDA), total antioxidant capacity (T-AOC), glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD) in colon tissue were detected. Transmission electron microscopy was used to observe the structures of mitochondria, lysosomes, and autophagic mitochondria, and calculate the numbers. Mitochondrial membrane potential JC-1 and adenosine-triphosphate (ATP) levels were detected, and Western blot was used to detect the expressions of mitophagy-related proteins PINK1, P62, and LC3B Ⅱ/LC3B Ⅰ in mitochondria and cytoplasm. Results:The survival rate of mice in all groups was 100%. Compared with WT group, the mice in Tnfaip3 +/- group had lower body weight, shorter colon and higher histopathological scores (all P < 0.05). Compared with WT-DSS group, the mice in Tnfaip3 +/--DSS group had lower body weight, higher DAI score, shorter colon, higher histopathological score, and higher mRNA expressions of inflammatory factors TNF-α, IL-1β and NF-κB in colon tissues (all P < 0.05). MDA level in colon tissues of Tnfaip3 +/- mice was higher than that of WT mice ( P < 0.05). Compared with WT-DSS group, the MDA level in Tnfaip3 +/--DSS group was higher, the levels of T-AOC, GSH-PX and SOD were lower (all P < 0.05). Compared with WT-DSS group, Tnfaip3 +/--DSS mice had more severe intestinal disordered mitochondrial structure, less mitochondrial number, higher mitochondrial membrane potential JC-1 level and lower mitochondrial ATP content, more number of lysosomes and autophagic mitochondria and higher expressions of proteins such as PINK1, P62 and ratio of LC3BⅡ/LC3BⅠ in mitochondria and cytoplasm (all P < 0.05) . Conclusion:Tnfaip3 gene may play a protective role in intestinal inflammation of colitis mice by regulating oxidative stress, mitochondria damage and mitophagy.

Objective     To summarize the surgical treatment experience in neonates with coarctation of the aorta (CoA) and aortic arch hypoplasia (AAH). Methods     The neonates with CoA and AAH who underwent surgical treatment in the Department of Pediatric Cardiac Surgery of Guangdong Provincial People's Hospital from 2013 to 2020 were retrospectively enrolled. The postoperative complications, long-term survival rate, and freedom from aortic reobstruction were analyzed. Patients undergoing extended end-to-end anastomosis were allocated into an extended end-to-end group, those undergoing extended end-to-side anastomosis into an extended end-to-side group, and those undergoing pulmonary autograft patch aortoplasty into a patch aortoplasty group. Results     Finally 44 patients were  enrolled, including 37 males and 7 females, aged 5.00-30.00 (19.34±7.61) days and weighted 2.00-4.50 (3.30±0.60) kg. There were 19 patients of extended end-to-end anastomosis, 19 patients of extended end-to-side anastomosis, and 6 patients of pulmonary autograft patch aortoplasty. The mean values of the Z scores of the proximal, distal, and isthmus of the aortic arch were –2.91±1.52, –3.40±1.30, and –4.04±1.98, respectively. The mean follow-up time was 45.6±3.7 months. There were 2 early deaths and no late deaths. Aortic reobstruction occurred in 8 patients, and 3 patients underwent reoperation intervention. The 5-year rate of freedom from reobstruction was 78.8%. The Cox multivariable regression analysis showed that the related factors for postoperative reobstruction were the Z score of the preoperative proximal aortic arch (HR=0.152, 95%CI 0.038-0.601, P=0.007) and the postoperative left main bronchus compression (HR=15.261, 95%CI 1.104-210.978, P=0.042). Conclusion     Three surgical procedures for neonates with CoA and AAH are safe and effective, but the aortic reobstruction rate in long term is not low. The smaller Z score of the preoperative proximal aortic arch and the postoperative left main bronchus compression are risk factors for long-term aortic reobstruction.