Objective:To explore the effect, postoperative mucosal pathological changes and molecular biological changes of reboot operation for type 2 inflammation chronic rhinosinusitis with nasal polyps（CRSwNP） patients, and to provide theoretical basis for the clinical application of this kind of operation. Methods:We collected 29 patients who were diagnosed with CRSwNP with type 2 inflammatino response and underwent Reboot surgery from June 2022 to August 2023, and 27 patients who were diagnosed with deviated septum and underwent simple submucosal resection of the septum as the control group. We conducted nasal symptom scoring, endoscopic sinusitis scoring, and CT scanning of the sinuses before and after surgery, as well as HE staining, immunohistochemical staining, and detection of inflammatory factors using Elisa kits at the time of surgery, 1, 3, and 6 months postoperatively. We also observed the ultrastructural changes using transmission electron microscopy and scanning electron microscopy, and performed proteomic analysis of the mucosa in the ethmoid sinus area of the sinusitis patients at the time of surgery and 6 months postoperatively. Results:After 6 months of postoperative follow-up, CT scores of the nasal cavity and sinuses had gradually decreased compared with the preoperative period. The VAS score of main symptoms, SNOT-22 score and Lund-Kennedy endoscopic score were decreased after 12 months follow-up. The histological morphology of the mucosa in the area of the screen was significantly improved compared with the preoperative period, with a reduction in the number of eosinophils. The levels of inflammatory factors such as IL-4 and IL-5 et al. in the mucosa of the area of the screen were gradually reduced compared with the preoperative period. The histological morphology, ultrastructure, and cilia structure of the mucosa in the area of the screen were gradually improved compared with the preoperative period, though not recovered completely. The number of CD4⁺T and CD8⁺T cells not changed significantly before and after the surgery yet. By conducting proteomic analysis of the ethmoidal sinus mucosa before and after surgery, differential proteins were selected, and bioinformatics analysis was conducted on the differentially expressed proteins. By using cytoHubba to identify hub genes and intersecting them with the genes related to chronic sinusitis, we found that MMP9 expression increased in non-type 2 CRS and type 2 CRS in sequence, while ACTC1 expression decreased in non-tpye 2 CRS and type 2 CRS in sequence. Conclusion:Reboot surgery can improve the postoperative symptoms and signs of patients, improve the pathological morphology of the mucosa, and influence the expression of protein after surgery. However, the surgery may not have a significant impact on the distribution of T cell subpopulations and inflammation signal pathway in the nasal mucosa.
Humans ; Sinusitis/metabolism* ; Nasal Polyps/metabolism* ; Nasal Mucosa/ultrastructure* ; Chronic Disease ; Rhinitis/complications* ; Inflammation ; Male ; Female ; Postoperative Period ; Adult ; Interleukin-5/metabolism* ; Interleukin-4/metabolism* ; Middle Aged ; Proteomics ; Rhinosinusitis

OBJECTIVE: To observe the morphological differences between normal uncinate process(UP) mucosa and inferior turbinate mucosa, and explore the physiology function of the UP with the electron microscope. METHOD: The experiment chose 12 patients who have taken nasal endoscopic surgeries(8 cases for normal UP, 4 cases for normal inferior turbinate mucosa). During the surgery, take the mucosa upwards on the filter paper and immediately use scanning electron microscopy and transmission electron microscopy specimens for standard sample preparation methods. Observe the cilia shape, structure and the distribution and the swing direction. RESULT: (1)The internal side and the external side of UP mucosa and inferior turbinate mucosa are all pseudostratified ciliated columnar epithelium, the shapes of cilia are classic "9+2" structures. The distribution of cilia on internal and external lateral of UP and inferior turbinate mucosa are in high density. (2)The direction of cilia on normal inferior turbinate mucosa are generally swing to up and backwards; the cilia on internal lateral of the UP generally swing towards inner side, down and backwards; the cilia on external lateral of the UP generally swing towards down and backwards. CONCLUSION The cilia on internal side and the external side of UP mucosa and inferior turbinate mucosa are in the same structure and shape, but the swing direction of cilia have their own characteristics. It can be concluded that the internal and external lateral of UP may have different functions in nasal sinuses mucus cilia clearance system.
Cilia ; ultrastructure ; Endoscopy ; Epithelium ; ultrastructure ; Humans ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Nasal Mucosa ; ultrastructure ; Nasal Surgical Procedures ; Paranasal Sinuses ; Turbinates ; ultrastructure

OBJECTIVE: To observe 18β-glycyrrhetinic acid (GA) impact on ultrastructure of tight junctions (TJs) of nasal mucosa epithelial cells in rats models of allergic rhinitis (AR). METHOD: Ninety-six Wistar rats were randomly divided into control group, model group, loratadine group, and 18β-glycyrrhetinic acid group, and each group had 24 rats. Ovalbumin was used to establish a rat AR model. The behavioral changes and the tight junctions of nasal epithelial were observed and compared in different groups after 2,4,6 and 10 weeks intervention. RESULT: The length of TJs in allergic rhinitis model became shorter, electron-high-density plasma membrane became thicker, number of the integration loci reduced and gap of TJs widened or even ruptured. With the consistent effect of allergens,the changes of TJs in the model group aggravated gradually,and the changes of ultrastructure of TJs in 18β-glycyrrhetinic acid group was relieved apparently compared to model group and even were close to the control model with time. CONCLUSION 18β-glycyrrhetinic acid can recover the ultrastructure of the tight junctions of AR rat nasal epithelial cells.
Animals ; Cell Count ; Epithelial Cells ; ultrastructure ; Glycyrrhetinic Acid ; analogs & derivatives ; pharmacology ; Nasal Mucosa ; cytology ; Ovalbumin ; Rats ; Rats, Wistar ; Rhinitis, Allergic ; drug therapy ; Tight Junctions ; drug effects

OBJECTIVE: To investigate the effects of intranasal steroid on nasal mucosa in rat model of allergic rhinitis (AR). METHOD: Thirty-six SD rats were randomly divided into three groups (each included 12 rats): the intranasal steroid group(group A),the allergic rhinitis group(group B) and the normal control group(group C). AR model was reproduced by ovalbumin in group A and B. The control group was allergized by NS instead of ovalbumin. Group A was used steroid spray in nasal and Group B and C was used normal saline. Then ,after the last provocation,the allergic symptoms were evaluated,the number of eosinophil (EOS) of the rats' nasal mucosa was counted under hematoxylineosin staining and the goblet cells was counted under alcian blue-periodic acid-Schiff staining. The morphological changes of the rats' nasal mucosa were observed by scanning electron microscope. RESULT: Compared with group B,the inhibition of nasal symptoms was found after used of steroid spray in group A. The EOS and the goblet cells in group A was significantly different with that in Group B (P < 0.05), but no significant differences compared with group C (P > 0.05). Observed by scanning electron microscope, the cilia of the epithelium in group B were significantly lodging, disoriented, winding and secreting,while the cilia of the epithelium in Group A and C had similar appearance. CONCLUSION Intranasal steroid spray can relieve symptoms and inflammatory conditions of nasal mucosa in allergic rhinitis, and can repair injured nasal mucosa cilia.
Androstadienes ; pharmacology ; Animals ; Anti-Inflammatory Agents ; pharmacology ; Cilia ; ultrastructure ; Disease Models, Animal ; Inflammation ; Nasal Mucosa ; drug effects ; pathology ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic, Perennial ; drug therapy ; pathology

OBJECTIVE: The serum levels of interleukin-4, interleukin-12 will be detected to elucidate and compare the involvement of Th1 and Th2 cells and the surface structures of nasal mucosa will also be observed in patients with allergic rhinitis (AR), chronic rhinosinusitis with nasal polyps (CRSwNP), chronic rhinosinusitis without nasal polyps (CRSsNP) and nasal septal deviation (NSD) to obtain the characteristics and regularity of pathological changes. METHOD: The serum levels of interleukin-4, interleukin-12 were detected by enzyme linked immunosorbent assay method. Four pieces of nasal mucosa on lateral side of middle turbinate were sampled from four patients and observed by scanning electron microscope. RESULT: The levels of interleukin-4 in AR and NSD groups were significantly higher than the healthy controls (P < 0.01). The levels of interleukin-4 and interleukin-12 in CRSwNP and CRSsNP groups were both higher than the healthy controls (P < 0.01 or P < 0.05), but no differences of the interleukin-4 and interleukin-12 levels were found between them (P > 0.05). There were two points of regularity with different degrees in our observations: (1) disoriented and absence of cilium; (2) the cellular separations at cell junctions were obvious, even with cells lost. CONCLUSION There was an immunologic deviation towards Th2 pattern in patients with NSD the same as AR. Both Th1 and Th2 with hyperactivity participated in chronic inflammatory process of CRSwNP and CRSsNP. The pathological changes of ciliated columnar epithelium in patients with the four types of rhinitis, suggest that a comprehensive treatment including antral irrigations, multiple antibiotics, topical steroid sprays, or antihistamines, as well as nasal surgery to correct nasal deformities should be adopted, which can effectively prevent the development and expanding of the nasal mucosa inflammation.
Adult ; Female ; Humans ; Interleukin-12 ; blood ; Interleukin-4 ; blood ; Male ; Microscopy, Electron, Scanning ; Middle Aged ; Nasal Mucosa ; metabolism ; pathology ; ultrastructure ; Nasal Polyps ; blood ; pathology ; Rhinitis ; blood ; pathology ; Sinusitis ; blood ; pathology

OBJECTIVE: To characterize explore the feature of nasal mucosa ultrastructure changes after prolonged allergen challenge and to examine the relationships between nasal airway hyperresponsivity and ultrastructure ciliates changing. METHOD: We prepared rat allergic rhinitis for ovalbumin. Rats were subsequently challenged two times a week with ovalbumin from day 16 to day 42, 56, 112 and 140. We examined allergen-induced nasal symptoms and objective nasal symptoms using evaluation of symptoms and EOS. Moreover, the pathologic changes were investigated after allergen challenge. RESULT: The extended allergen challenge protocol caused significant nasal ultrastructure changing. Specifically, ultrastructure changing were characterized by disordered Ciliated cells and some sticky integrated, dumping of epithelium ciliates, even some loss. Allergen-induced nasal symptoms were first increased but gradually decreased in nasal symptoms after prolonged allergen challenge. CONCLUSION We have demonstrated that ultrastructure changes of nasal mucosa ciliates in a rat allergic rhinitis model prolonged allergen exposure. Moreover, prolonged allergen exposure induced a reduction of nasal symptoms together with a progression of nasal mucosa ciliates damaging.
Animals ; Cilia ; ultrastructure ; Female ; Male ; Nasal Mucosa ; pathology ; ultrastructure ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic, Perennial ; pathology

OBJECTIVE: This paper aims to demonstrate the maxillary mucosa restoration after operation to the nasal fungal sinusitis. METHOD: Observation by microscopic, transmission electron microscopic and scanning electron microscopic was done to the same parts in the maxillary mucosa 3-4 months before and after the endoscopic sinus surgery in the 24 cases of the nasal fungal sinusitis during 2003-2005. RESULT: Before the operation, all the cases demonstrated epithelia shedding, proliferation, squamous metaplasia, glandular and fibrous tissue proliferation and lymphocytes infiltration. The microtubule was abnormal and mitochondria diminished, 3-4 months after operation, the cavity was clear and smooth and the epithelia complete. The cilia average increased and the cilia lined in the same direction. The structure of microtubules was clear. The mitochondria was elongated and dense. CONCLUSION There was no significant difference in the damage on ultramicrostructure of the maxillary mucosa between the chronic nasal sinusitis and chronic nasal fungal sinusitis. It is crucial in the successful recovery that the operation gives a thorough clean to the fungal clot and sinus aeration, and that good cleaning and sinus aeration are maintained after the operation. The ultramicrostructure restoration and the function recovery of mucosa will be achieved after careful cleaning for 3-4 months after operation.
Adolescent ; Adult ; Aged ; Chronic Disease ; Female ; Fungi ; Humans ; Male ; Microscopy, Electron, Scanning ; Microscopy, Electron, Transmission ; Middle Aged ; Mycoses ; pathology ; surgery ; Nasal Mucosa ; pathology ; surgery ; ultrastructure ; Sinusitis ; microbiology ; pathology ; surgery ; Young Adult

OBJECTIVE: To observe the ultrastructural feature and ECP expression in nasal polyps, and aim to explore its role in the pathogenesis of CRSwNP. METHOD: 5 CRSwNP, 5 CRS and 5 control patients underwent sinus surgery were gathered to detect its ultrastructure and expression of ECP by in situ hybridization and electron microscopy technique. RESULT: Under electron microscopy, the eosinophilic cells in CRSwNP group increased, its membrane was intact but fold, the feature of pseudopodium, degranulation and cavitation were all found. The expression level of ECP mRNA was up-regulated. CONCLUSION The findings suggest that eosinophilic infiltrate and ECP cytologic inflammation reactions may involve in the pathogenesis of CRSwNP.
Adolescent ; Adult ; Case-Control Studies ; Eosinophil Cationic Protein ; metabolism ; Eosinophils ; metabolism ; Female ; Humans ; Male ; Microscopy, Electron ; Middle Aged ; Nasal Mucosa ; metabolism ; pathology ; ultrastructure ; Nasal Polyps ; metabolism ; ultrastructure ; Young Adult

OBJECTIVE: To study the mechanism of the nasal mucous membrane inflammation induced by the inhalable particle matter (PM10). METHOD: Three dosage PM10 were instilled in rat nasal cavity of different groups for one week. The morphology of nasal mucosa and the numbers of inflammatory cell were observed in each samples. RESULT: The total numbers of inflammatory cells in PM10-treated groups were increased in a dose-respondent manner and significantly different from that in control group. The results of histopathological and scanning electron microscope (SEM) analysis indicated that PM10 caused nasal mucosa injury and pathological changes, such as the damage of cilia and nasal mucosa epithelium in a dose dependent way. The infiltration of inflammatory cells in nasal mucosa epithelium matrix, especially eosinophilia were observed. CONCLUSION PM10 can cause rat's nasal mucosa inflammation and epithelial injury.
Air Pollutants ; adverse effects ; Animals ; Inhalation ; Male ; Microscopy, Electron, Scanning ; Nasal Mucosa ; pathology ; ultrastructure ; Particulate Matter ; adverse effects ; Rats ; Rats, Sprague-Dawley

OBJECTIVEThe aim of this study was to investigate the mechanisms of C. minima in the treatment of allergic rhinitis.

METHODAn allergic rhinitis animal model induced by ragweed pollen was established. After treatment with an active extract of C. minima, histopathological changes in the nasal mucosa of guinea pig were observed by transmission electron microscope.

RESULTIn the allergeic rhinitis model group, there appear a large number of lysosomes in the nasal epithelium with organelles vacuolated and nucleus deformed. Cells in the proper lamina of connective tissue were disarranged with organelles damaged, and there was also infiltration of eosinophils and mast cells in the connective tissue. However, in the treatment group receiving C. minima extract, the pathological changes mentioned above were significantly decreased.

CONCLUSIONC. minima is effective in treating allergic rhinitis.

Animals ; Asteraceae ; chemistry ; Epithelium ; ultrastructure ; Female ; Guinea Pigs ; Lysosomes ; drug effects ; Male ; Mitochondrial Swelling ; drug effects ; Nasal Mucosa ; pathology ; ultrastructure ; Oils, Volatile ; isolation & purification ; pharmacology ; Phytotherapy ; Plants, Medicinal ; chemistry ; Rhinitis, Allergic, Seasonal ; drug therapy ; pathology