Nasal airflow of patient with septal deviation and allergy rhinitis

A numerical simulation of a patient’s nasal airflow was developed via computational fluid dynamics.Accordingly,computerized tomography scans of a patient with septal deviation and allergic rhinitis were obtained.The three-dimensional(3D)nasal model was designed using InVesalius 3.0,which was then imported to(computer aided 3D interactive application)CATIA V5 for modification,and finally to analysis system(ANSYS)flow oriented logistics upgrade for enterprise networks(FLUENT)to obtain the numerical solution.The velocity contours of the cross-sectional area were analyzed on four main surfaces:the vestibule,nasal valve,middle turbinate,and nasopharynx.The pressure and velocity characteristics were assessed at both laminar and turbulent mass flow rates for both the standardized and the patient’s model nasal cavity.The developed model of the patient is approximately half the size of the standardized model;hence,its velocity was approximately two times more than that of the standardized model.

OBSERVATION OF REMOTE AND RECENT THERAPEUTIC EFFECTS OF ACUPOINT-THREAD EMBEDDING, WESTERN MEDICINE OR ALLIED THERAPY ON PERENNIAL ALLERGIC RHINITIS

Objective: The comparison of the remote and recent therapeutic effects on perennial allergic rhinitis was carried on among single application of acupoint-thread embedding, western medicine (certirizine+flixonase) and allied therapy. Method: Ninety cases were randomized into thread-embedding group, western medicine group and embedding+western medicine group (allied-therapy group), 30 cases in each one. In thread embedding group, Yingxiang (迎香 LI 20) and Feishu (肺俞 BL 13) were selected for thread embedding, once a week, totally 4 treatments were required. In western medicine group, certirizine tablet 10 mg in combination with flixonase sprayer was applied once per day, continuously for 30 days in treatment. In allied-therapy group, both of the above methods were adopted continuously for 30 days in treatment. The therapeutic effects were in statistics at the end of treatment and 1 year later. Results: At the end of treatment, in thread-embedding group, 21 cases were remarkably effective, 3 cases effective and 6 cases no effect. In western medicine group, 20 cases were remarkably effective, 3 cases effective and 7 cases no effect. In allied-therapy group, 23 cases were remarkably effective, 2 cases effective and 5 cases no effect. It was shown in statistics that there was no significant difference in therapeutic effects among three groups ( P>0.05 ). But one year after the end of treatment, it was indicated that in thread-embedding group, 3 cases were remarkably effective, 10 cases effective and 17 cases no effect; in western medicine group, 2 cases were remarkably effective, 9 cases effective and 19 cases no effect; in allied-therapy group, 7 cases were remarkably effective, 11 cases effective and 12 cases no effect. The significant difference in the therapeutic effects had not been presented in the comparison between thread-embedding group and western medicine group (P>0.05), but that had been presented between allied-therapy group with either of the groups with single therapy applied (P<0.05). Conclusion: Quite good recent therapeutic effect of either acupoint-thread embedding or western medicine (certirizine+flixonase) was achieved on perennial allergic rhinitis. The remote therapeutic effect of allied therapy was more advantageous than that of single application of either thread embedding or western medicine.

Observation of Ultrastructure in Nasal Mucosa on Allergic Perennial Rhinitis Cases before and after the Operations

Objective: The partial inferior turbinectomy and septoplasty was applied to treat the allergic perennial rhinitis (APR), and to observe the ultrastructure changes of the nasal mucosa before and after the operations. Methods: For 36 cases of research objects diagnosed with APR, the partial inferior turbinectomy and septoplasty was administered. For 6 APR cases among them, the pre- and postoperative observation of anterior nasal mucosa of the inferior turbinate on the same side under the electron microscope was conducted for one year respectively. In addition, their pathological alterations of tissues were also conducted. Results: In the pre-operative observation under the electron microscope, it was found that the nasal mucosae epithelium cells were nude without cilia. The lamina propria had edema, and mesenchyme presented the infiltration of substantial eosinophilic granulocytes, basophilic granulocytes, plasmacytes and mast cells. Additionally, abundant degranulation and vacuolation of cytoplasts were observed. The plentiful glands, duct ectasia, edema and structural changes were also found. Some gland cells had degenerated. After the operation, it was found that the epithelium nudity still existed and the deficiency of cilia was not improved. Only a very small amount of microvilli existed. The edema of lamina propria was improved and eosinophilic granulocytes were rarely observed in mesenchyme. However, the infiltration of basophilic granulocytes, plasmocytes and mast cells was still observed. The particle structure was generally stable and the central crystal was clear without degranulation. Meanwhile, the amount of glands was reduced and the tissue structure tended to be recovered. Overall, the nasal mucosa showed changes as chronic inflammation. Conclusions: For the treatment of APR with the methods presented by our research institution, in one year before and after the operation, ultrastructural changes of inferior turbinate mucosa tissues were observed from the preoperatively pathological changes of typical APR to the chronic inflammation with the primary infiltration of neutrophilic granulocyte and mast cells.

Sublingual immunotherapy for pediatric allergic rhinitis: The clinical evidence

Allergic rhinitis affect 10%-20% of pediatric population and it is caused by the Ig E-sensitization to environmental allergens, most importantly grass pollens and house dust mites. Allergic rhinitis can influence patient's daily activity severely and may precede the development of asthma, especially if it is not diagnosed and treated correctly. In addition to subcutaneous immunotherapy, sublingual immunotherapy(SLIT) represents the only treatment being potentially able to cure allergic respiratory diseases, by modulating the immune system activity. This review clearly summarizes and analyzes the available randomized, double-blinded, placebo-controlled trials, which aimed at evaluating the effectiveness and the safety of grass pollen and house dust mite SLIT for the specific treatment of pediatric allergic rhinitis. Our analysis demonstrates the good evidence supporting the efficacy of SLIT for allergic rhinitis to grass pollens in children, whereas trials regarding pediatric allergic rhinitis to house dust mites present lower quality, although several studies supported its usefulness.

Study on Cytokines IL-2,IL-6,IL-10 in Patients of Chronic Allergic Rhinitis Treated with Acupuncture

OBJECTIVES: To observe the plasmatic concentration of IL-6, IL-10 and IL-2 in the patient of chronic allergic rhinitis before and after acupuncture therapy. METHODS: Cytokine levels were determined before and after treatment in 30 healthy volunteers (Group A) and 90 patients of chronic allergic rhinitis (Group B) with an increased plasma IL-10 level. Group B was then divided into 3 subgroups: 30 patients treated with real acupuncture (Group B1); 30 patients treated with sham acupuncture (Group B2); 30 non-treated patients (Group B3). RESULTS: The allergic subjects of group B1, compared with controls, showed a significant reduction of IL-10 after a specific treatment with acupuncture (P

Pediatric allergic conjunctivitis and allergic rhinitis

Objective： To assess the relationship between allergic conjunctivitis（AC） and allergic rhinitis（AR） in pediatric ophthalmology and E.N.T outpatient clinic. Methods：Eight hundred and ninety two patients were enrolled in survey during Mar. 2005-Jan. 2007, 407 allergic conjunctivitis cases were placed in the ophthalmology clinic group and 485 allergic rhinitis cases were from the E.N.T clinic. The comorbid disorders, histories, symptoms, signs of patients were recorded. Type 1 allergy was tested in 479 cases by a specific IgE antibody blood test. Eosinophils were detected in superficial conjunctival scrapings of the superior tarsal conjunctiva and mucosa surface scrapings of middle nasal meatus in 88 cases with both diseases. Results：302（74%）, 374（92%）, 116（29%） in 407 cases with allergic conjunctivitis had concomitant eczema, rhinitis and asthma, respectively; 334（69%）, 430（89%）, 145（30%） in 485 cases with allergic rhinitis had concomitant eczema, allergic conjunctivitis and asthma, respectively. The prevalence of allergic conjunctivitis concomitant allergic rhinitis and allergic rhinitis concomitant allergic conjunctivitis had no significant difference（x2=2,6, P 〉 0.05）. The prevalence of allergic conjunctivitis and allergic rhinitis concomitant eczema and asthma also had no significant difference （x2=3.08; x2=0.21, P 〉 0.05）. The degree of severity of two kinds of disease symptoms is not parallel, in the patients with seasonal allergic conjuctivitis（SAC） and perennial allergic conjunctivitis（PAC）, the clinical signs of AR were always severer（x2=258.2, P 〈 0.05） than those of AC. However, the results coincided with the cases with vernal keratoconjuctivitis（VKC）（x2=66.5, P 〈 0.05）; Eosinophils were revealed in 50（57%） conjunctival scrapings and nasal mucosa scrapings（x2=1.5, P〉 0.05）, 47（53%） cases had positive results in both scrapings. The main aeroallergens were house dust mites, house dust and fungi, and the main food-allergens were fish, crab and shrimp. Conclusion：The two disorders were shown to share more similarities than differences, as suggested that allergic conjunctivitis should be considered in future guidelines on preventing the development of rhinitis and asthma in children.

Clinical Research into Ke Min Yin for Treatment of Persistent Allergic Rhinitis in Patients with Qi Deficiency and Blood Stasis

Persistent allergic rhinitis (PAR) is one of the common diseases at ear-nose-throat department. From August 1998 to May 2001, we randomly selected 60 cases of PAR with qi deficiency and blood stasis for a clinical observation. 30 patients in the treatment group were treated with Ke Min Yin (克敏饮), a herbal medicine, to supplement qi, expel wind, nourish blood and promote blood circulation; and the other 30 cases in the control group were treated with cetrine. Through systematic observation and statistical processing, the clinical research is summarized and reported in the following.

A CLINICAL OBSERVATION ON THERAPEUTIC EFFECTS OF ACUPUNCTURE FOR ALLERGIC RHINITIS

The author applied acupuncture to treat52 cases of allergic rhinitis with certaintherapeutic effectiveness confirmed by afollowing-up for one year and more.The resultis reported as follows.

Study on the mechanism of Fuzi in the treatment of allergic rhinitis based on network pharmacology and experimental validation

Objective:To study the key target genes and signaling pathways in the treatment of Allergic Rhinitis(AR)with Radix Aconiti Lateralis Preparata(aka Fuzi).Methods:The TCMPS and PubChem databases were used to screen the active ingredients and target genes of Fuzi using oral bioavailability and drug similarity as screening conditions,and the GeneCards database was used to screen the target genes of AR.The online tool Venny2.1 was used to screen the target genes of Fuzi for the treatment of Allergic Rhinitis;the STRING database was used to obtain the protein-protein interaction(PPI)network of drug-disease targets,and the key target genes were identified by the MCC algorithm.The potential biological processes and signaling pathways were identified by GO enrichment and KEGG enrichment analysis.Finally,animal experiments were conducted to demonstrate the therapeutic effect ofFuzi on Allergic Rhinitis.Results:The TCMSP,PubChem and GeneCards databases were used to screen the 21 active compound components of Fuzi and 68 potential therapeutic target genes of Fuzi for Allergic Rhinitis.PPI network analysis identified the top ten key target genes,namely:PTGS2,TNF,IL6,AKT1,ALB,STAT3,CCL2,CXCL8,VEGFA and JUN,GO functional and KEGG pathway enrichment analysis showed that the significantly enriched functions and pathways of Fuzi on Allergic Rhinitis were closely related to Allergic Rhinitis.Finally,animal experiments were conducted to verify that Fuzi is effective in the treatment of Allergic rhinitis.Conclusion:Increased expression of IL-6 and TNF-αin nasal mucosal tissues of patients with Allergic Rhinitis was positively correlated with indicators related to the disease activity of AllergicRhinitis.Fuzi ameliorated the inflammatory changes in mice with Allergic Rhinitis by inhibiting the activation of Toll-like signaling pathway in the nasal mucosa and decreasing the expression activity of IL-6 and TNF-α.

Treatment of 48 Cases of Perennial Allergic Rhinitis with Thunder-fire Moxibustion

Perennial allergic rhinitis is an allergic reaction of the nasal mucosa. It is characterized by paroxysmal and repeated runny nose, sneeze, stuffy nose, rhinocnesmus and nasal mucosa edema. The author used ＂Doctor ZHAO＇s thunder-fire moxibustion＂ in treating 48 cases of this disease. Now it is reported as follows.

Effects of Acupuncture-moxibustion on Monocyte Th1/Th2 Cytokine in Peripheral Blood of Patients with Perennial Allergic Rhinitis

Objective： To observe the effects of acupuncture-moxibustion on symptoms, signs, and Th1/Th2 cytokine, and regulation on Th1/Th2 in patients with perennial allergic rhinitis（PAR） to provide experimental basis for acupuncture treating allergic rhinitis and investigate the mechanism. Methods： Thirty patients with allergic rhinitis were treated with acupuncture-moxibustion, and 30 healthy cases were the control. Clinical symptoms, signs, and nasal mucosa were observed, and contents of IL-4, IFN-γ, and granulocyte-macrophage colony stimulating factor （GM-CSF） in the supernatant of peripheral blood monocyte cultured with PHA by ELISA, before treatment, after one course of treatment, and after two courses of treatment. Results： Before the treatment, the contents of IL-4, and GM-CSF were higher （P〈0.01） and IFN-γ was lower （P〈0.01） in the PAR cases than in the control cases. In the PAR cases, the content of GM-CSF was positive correlation with that of IL-4 （P〈0.01）, and negative correlation with IFN-7 （P〈0.01）. After the treatment, contents of IL-4 and GM-CSF were lowed （P〈0.01）, content of IFN-γ was increased （P〈0.05）, and all IL-4, GM-CSF and IFN-γ had no difference compared with those in the control cases. Conclusion： Acupuncture- moxibustion could improve the symptoms and signs in PAR patients, enhance the immune function. It may be achieved by regulating the expression of Th1 and Th2, correcting the imbalance of Th1/Th2.

Vesiculation Therapy of Cantharides Extract forPerennial Allergic Rhinitisand Its Effect on Serum Tolal IgE

The therapy of 10% Cantharides extract in treating 50 cases of perennial allergic rhinitis(PAR) was studied. The extract was plastered and blistered on Dazhui and Neiguan points. It was observedby nasal mucosa provocative test, cells in nasal secretion test and serum total IgE test. The results showedthat ite effective rate was 88% . After treatment the allergic nasal mucosa provocative test of the treatedgroup was alleviated obviously ( P < 0 . 01 ) and the number ot eosinopnil affd basophil in nasal secretion de-creased significantly ( P < 0 . 01 , P < 0 . 05 ) . The serum total lgE also reduced significantly I P < 0 . 01 ) .

A fifteen-year review of skin allergy testing in Irish patients with symptomatic rhinitis

Objective:Our objective was to review skin prick allergy testing(SPAT)results in patients with symptomatic rhinitis in an Irish population.Methods:A fifteen-year retrospective review of our database of symptomatic patients with rhinitis was performed.All patients who had SPAT performed during this interval were included.Data was analysed in terms of demographics and dominant allergens.Results:1158 patients were included.617 Females vs 541 Males.Age range five to eighty-five years old.Mean age thirty-four years.49%of our patients tested positive to at least one aeroallergen.The most common allergens were dust mites(23%)and timothy grass(22%).Patients born during the Irish pollen season(April-July)were between 5 and 7 times more likely to be sensitive to timothy and ryegrass pollens compared to others tested.241 patients had both SPAT and serum allergen specific IgE testing(SASIgET)performed;positive results were consistent between both groups.Conclusion:Results demonstrated that half of our patients with symptomatic rhinitis had allergen sensitisation.Dust mites and grass were the main allergens in our area.Our nurse led clinic has allowed efficient patient education and the development of a unique Irish SPAT database.Retesting a patient with a known allergy test result it is not indicated.

Treatment of 60 Cases of Allergic Rhinitis with Acupuncture and Moxibustion

Sixty patients with allergic rhinitis were treated by Acupuncture-Moxibustion, Of the 60 cases, 43 cases were clinical cured, 15 cases were effective and 2 cases were ineffective, with an effective rate of 96.7%.

Examination of Homologies between COVID-19 Vaccines and Common Allergens:The Potential for T Cell-mediated Responses for Allergic Rhinitis and Asthma

As the SARS-CoV-2 virus shares relatively large protein sequences homologous to grass pollens,dust mites,and molds,our objective was to assess the potential overlap between the COVID-19mRNA vaccines fromPfizer-BioNtech andModerna and known allergens.We found 7 common allergens with potential for cross-reactivity with the Pfizer vaccine and 19 with theModerna vaccine,including common grasses,molds,and dust mites.T-cell mediated antigen cross-reactivity between viruses and allergens is a relatively new area of study in clinical immunology;a discipline that may be particularly useful regarding the SARS-CoV-2 virus and the allergic response in humans.These results suggest that vaccination with the Pfizer-BioNtech andModerna COVID-19 vaccinesmay contribute to T-cell cross-reactivity with allergens that impact allergic asthma and allergic rhinitis.Further research should assess the clinical implications of COVID-19 vaccination on the severity and symptomatology of the allergic disease,in addition to natural viral infection.

变应性鼻炎1903例变应原检测结果特征分析

目的探讨山西省太原市及其周边地区变应性鼻炎(AR)变应原分布情况及相关因素。方法以2021年1月—2022年12月在山西医科大学第一医院耳鼻咽喉头颈外科变态反应科门诊就诊并诊断为AR的1903例患者作为调查对象,其中男性983例(51.7%)、女性920例(48.3%)。采用AllergyScreen敏筛■过敏原检测试剂盒检测变应原。描述不同种类变应原的分布特征,并结合性别、年龄、就诊时间等临床资料分析AR的影响因素。结果1903例患者中,艾蒿(60.0%)、矮豚草(27.0%)、室内尘螨组合(23.4%)的阳性率位列前三位。男、女性AR患者最常见的变应原均为艾蒿、矮豚草,艾蒿、室内尘螨组合、猫毛皮屑、虾/蟹、混合真菌、狗毛皮屑、牛奶、牛肉/羊肉在女性患者的阳性率高于男性,树木组合、悬铃木/白蜡、刺柏/桦在男性患者的阳性率高于女性。<18岁年龄组艾蒿、矮豚草、猫毛皮屑、树木组合、葎草、鸡蛋白、牛奶的阳性率高于其余年龄组(P<0.05)。艾蒿、矮豚草、混合真菌、狗毛皮屑、花生/黄豆、蟑螂、牛奶、悬铃木/白蜡、刺柏/桦在不同季节阳性率的差异具有统计学意义(P<0.05)。结论太原市及周边地区近2年AR的主要变应原为艾蒿、矮豚草及室内尘螨组合,不同变应原在不同性别、年龄、季节的阳性率不同。

“重灸消敏”枕下三角区治疗过敏性鼻炎经验

过敏性鼻炎是常见的过敏性疾病之一,可严重影响患者的工作及生活。现代临床已证实艾灸可以通过激活一系列信号通路和神经内分泌免疫活动来产生治疗效果。门诊观察艾灸治疗过敏性鼻炎1例,根据其特点属于中医学中肺气虚寒型鼻鼽,通过重灸枕下三角区治疗后,患者鼻炎迅速缓解。本文试从过敏性鼻炎的中医认识、枕下三角区与过敏性鼻炎的关系、枕下三角区易受邪的原理以及艾灸消“敏”的治疗机理等各方面,分析本病案中重灸取效的影响因素,为临床治疗提供新的诊疗思路。

基于倾向评分回归调整探讨艾灸治疗常年变应性鼻炎灸感与灸效的前瞻性队列研究

目的:采用倾向评分回归调整(PSRA)均衡基线资料,比较艾灸同一穴位(上印堂)不同灸感(热敏灸态vs静息态)治疗常年变应性鼻炎(PAR)灸效差异。方法:采用前瞻性队列研究设计,纳入106例合格受试者,用艾条悬灸上印堂激发灸感,根据热敏灸感的有无,自然分组为热敏灸组(n=69)和传统灸组(n=37)。两组均在上印堂施灸,每次时间为30min,每天1次,连续四周,共计24次。结局指标为变异性鼻炎症状量表(TNSS)、伴随症状量表(TNNSS)以及生存质量调查问卷(RQLQ)。结果:使用PSM进行1:1配对,匹配容差0.02,成功匹配25对,共50例患者。两组患者基线资料均无统计学差异(P>0.05)。匹配后,治疗后热敏态组TNSS评分为4.01±1.52,低于静态组的5.42±1.10,有统计学意义(P<0.01);热敏态组TNNSS评分为1.26±0.43,低于静态组的1.52±0.50,有统计学意义(P<0.01);热敏态组RQLQ评分为37.62±6.01,低于静态组的47.22±7.76,有统计学意义(P<0.01);说明热敏灸组在改善PAR患者症状、体征和生活质量方面均有疗效优势。将倾向性评分匹配前单因素分析具有差异的结果纳入进行多因素logistic回归分析,结果显示,是否用药、病程为艾灸疗效的独立危险因素(P<0.05)。结论:艾灸热敏态穴位治疗PAR的临床疗效优于静息态组。

《变应性鼻炎及其对哮喘的影响》指南2010年修订版解读

《变应性鼻炎及其对哮喘的影响》(Allergic rhinitis and its impact on asthma,ARIA)指南最新修订版(简称ARIA2010版)最近由《Journal of Allergy and Clinical Immunology》杂志全文发表。与旧版ARIA指南使用循证医学的方法不同,ARIA2010版采用推荐、评估、发展和评价分级(Grading of Recommendations,Assessment,Development and Evaluation,GRADE)工作组提出的透明的、系统化的方法修订了临床建议,以提高其实用价值。

腺样体切除术后圆枕增生与变应性鼻炎的关系

人们已经注意到,变应性鼻炎（allergic rhinitis,AR）患儿腺样体肥大发病率较非AR患儿高,近几年AR患儿发病率逐渐增高,我们考虑,腺样体切除术后圆枕增生可能和AR有密切关系,本文用回顾性分析的方法对此问题进行了探讨。