[Classification of chronic rhinosinusitis with nasal polyps based on eosinophilic inflammation]

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disorder characterized by chronic sinonasal mucosal inflammation. CRSwNP can be subdivided into two types based on eosinophilic inflammation: eosinophilic CRSwNP (Eos CRSwNP) and non-eosinophilic CRSwNP (Non-Eos CRSwNP). Eos CRSwNP and Non-Eos CRSwNP demonstrate distinct clinical manifestations, treatment outcomes, and cellular and immunopathologic characteristics. However, currently, there is no unified and generally accepted standard to define the Eos CRSwNP. The aim of this review is to compare the advantages and disadvantages of current methods used to classify Eos CRSwNP, in order to lay foundation for further study.

[Diagnostic value of endobronchial ultrasonography with guide-sheath combined with virtual bronchoscopy navigation in peripheral lung cancer]

Objective: To explore the diagnostic value and safety of endobronchial ultrasonography with guide-sheath (EBUS-GS) combined with virtual bronchoscopy navigation (VBN) in peripheral lung cancer. Methods: Between Dec. 2015 to Dec. 2016, patients with pulmonary solitary nodule suspected of early lung cancer on computed tomography (CT) in Department of Respiratory, Tangdu Hospital, Fourth Military Medical University were enrolled for this study. The patients underwent EBUS-GS transbronchoscopic lung biopsy (TBLB) with or without VBN. The visibility rate, diagnostic yield, influencing factors, the operation time and complications were evaluated in the 2 groups. The data were compared using independent sample t test or chi-squared test. Results: A total of 134 patients were enrolled and completed this study. Among them 74 were males and 60 were females. There were 64 cases in the group of EBUS-GS with VBN (VBNA), and 70 in the group without VBN (NVBNA). The visibility rate and diagnosis rate of VBNA group were 87.5% (56/64) and 78.1% (50/64), respectively. The mean time of operation and confirming the target lesions were (25±5), (5.8±1.3) min, respectively. The visibility rate and diagnosis rate of NVBNA group were 81.4%(57/70) and 75.7%(53/70), respectively. The mean time of operation and confirming the target lesions were (27±6), (9.8±1.5)min .There was no significant difference in the visibility rate and diagnosis rate between the 2 groups (χ(2)=0.933, P=0.334; χ(2)=0.109, P=0.838). There was no significant difference in the mean operation time between the 2 groups(t=0.633, P=0.524). But the time of confirming the target lesions between the 2 groups was statistically different (t=17.41, P<0.01). EBUS-GS-TBLB was well tolerated. No severe complications such as pneumothorax or chest pain were observed. There were 3 patients in the VBNA group and 7 patients in the NVBNA group experiencing a small amount of biopsy site bleeding. The incidence of complications did not differ between the 2 groups(χ(2)=1.366, P=0.330). Conclusions: VBN could not improve the diagnostic yield of EBUS-GS. However, it could shorten the time needed to confirm the target lesions and did not increase the incidence of EBUS-GS complications, indicating that EBUS-GS with VBN was a safe and effective method.

[Short-term effects of household indoor- and outdoor-originating fine particulate matters on heart rate and heart rate variability in chronic obstructive pulmonary diseases patients, Beijing]

Objective: To assess the associations of indoor fine particulate matter (PM(2.5)) from outdoor and indoor sources with heart rate (HR) and heart rate variability (HRV) in patients with chronic obstructive pulmonary disease (COPD) of Beijing. Methods: A total of 40 male patients in a stable stage of COPD were recruited from a hospital in a panel study in Beijing with 5 consecutive days of measurement for each subject. General information and disease history of the participants from questionnaires were obtained prior to the study. HR and HRV were repeatedly examined using dynamic electrocardiograph. HRV included standard deviation of all NN intervals (SDNN), root mean square of successive differences between adjacent NN intervals (rMSSD), total power (TP) power in the low-frequency band (LF) and the high-frequency band (HF). Iron was used as tracer element to separate indoor-originated PM(2.5) and outdoor-originated PM(2.5). Mixed-effect models were applied to assess the associations of outdoor-originated PM(2.5) or indoor-originated PM(2.5) and health effects. Results: The P(50) (P(25), P(75)) values of daily indoor PM(2.5), indoor-originated PM(2.5) and outdoor-originated PM(2.5) were 50.9 (26.8, 122.7), 16.0 (1.9, 43.7) and 27.3 (13.5, 61.8) μg/m(3), respectively. The mean±SD of concentrations of real-time indoor PM(2.5), indoor-originated PM(2.5) and outdoor-originated PM(2).5 were (61.5±58.8), (25.3±39.1) and (36.2±42.7) μg/m(3), respectively. Compared with outdoor-originated PM(2.5), indoor-originated PM(2.5) had significant associations with HRV and HR. Each 10 μg/m(3) increase at 4 h indoor-originated PM(2.5) and outdoor-originated PM(2.5) moving average was associated with 3.4% (95%CI: -4.7%, -2.1%) and 0.6% (95%CI: -2.0%, -0.8%) reduction in TP (P<0.001). Each 10 μg/m(3) increase at 12 h indoor-originated PM(2.5) moving average was associated with 7.6% (95%CI: -10.1%, -5.1%), 4.7% (95%CI: -6.7%, -2.7%), 3.3% (95%CI: -4.2%,-2.4%) and 3.0% (95%CI: -4.5%, -1.5%) reduction in HF, LF, SDNN and rMSSD, respectively. Each 10 μg/m(3) increase at 12 h outdoor-originated PM(2.5) moving average was associated with 0.7% (95%CI: -2.7%, -1.4%), 0.2% (95%CI: -1.9%, 1.4%), 0.7% (95%CI: -1.4%, -0.1%) and 0.2% (95%CI: -1.3%, 0.9%) reduction in HF, LF, SDNN and rMSSD, respectively (P<0.001). Each 10 μg/m(3) increase at 8 h indoor-originated PM(2.5) and outdoor-originated PM(2.5) moving average was associated with 0.7% (95%CI: 0.4%, 1.0%) and 0.4% (95%CI: 0.2%, 0.6%) increase in HR. Conclusion: Exposure to indoor-originated PM(2.5) was more strongly associations with HRV indices and HR compared with outdoor-originated PM(2.5) in male COPD patients.

[Validity of Padua risk assessment scale for assessing the risk of deep venous thrombosis in hospitalized patients]

To analyze the clinical features of deep venous thrombosis(DVT) in hospitalized patients and evaluate the effectiveness of Padua risk assessment model.The clinical data of DVT patients were retrospectively analyzed in Beijing Shijitan Hospital from April 1 2017 to June 30, 2017.Padua risk assessment scale was used to evaluate the risk score of DVT in the departments of internal medicine and surgery. Effectiveness of predicting DVT was analyzed by receiver operating characteristic curve (ROC).Logistic regression analysis was used to evaluate the related factors of DVT.In DVT group, age (OR=0.96),acute infection(OR=8.23),prothrombin time(OR=0.76),D dimer(OR=1.00),erythrocyte sedimentation rate(OR=1.02) and platelet count(OR=1.01) were significantly associated with thrombosis(all P<0.05).The specificity of Padua model to predict DVT in internal medical patients was better than the sensitivity(80.7% vs. 50%,P<0.05).Surgical patients reported similar findings with specificity to sensitivity of 87.5% vs. 67.5%(P<0.05).The area under curve of ROC in internal medical patients was more than that in surgical patients[0.62 (95%CI 0.59-0.67) vs.0.61(95%CI 0.56-0.66), P<0.05].Padua model is more specific than sensitive to predict DVT in hospitalized patients.It has better predictive value of DVT in internal medical patients than surgical patients.

Forsythia suspensa extract protects broilers against breast muscle oxidative injury induced by corticosterone mimicked pre-slaughter acute stress

Broilers were used to determine the protective effects of Forsythia suspensa extract (FSE) against breast muscle oxidative injury induced by corticosterone (CS) mimicking pre-slaughter acute stress. A total of 144 male Arbor Acre broilers was randomly allotted to one of 4 treatments in a 2 × 2 factorial arrangement that included FSE supplementation (0 or 100 mg/kg) and subcutaneous injection of CS (0 or 4 mg/kg) at 3 h before slaughter. Corticosterone increased live BW loss, and the adverse effect was attenuated by FSE in broilers subjected to CS (P < 0.05). Serum levels of CS, uric acid, and glucose were increased, and postmortem breast muscle pH values at 45 min and 24 h were decreased for CS-challenged broilers (P < 0.05). Corticosterone increased lightness and yellowness values and decreased redness of breast muscle (P < 0.05), and FSE decreased yellowness and increased redness of breast muscle (P < 0.05). Drip loss was increased by CS for birds supplemented without FSE (P < 0.05) and decreased by FSE for birds under CS challenge (P < 0.05). Corticosterone increased monounsaturated fatty acid (FA) and decreased polyunsaturated FA in breast muscle (P < 0.05), and saturated FA was decreased and polyunsaturated FA was increased by FSE (P < 0.05). Malondialdehyde and carbonyl contents in breast muscle were increased by CS and decreased by FSE (P < 0.05). Inhibition of 1,1-diphenyl-2-picryl-hydrazyl was decreased by CS and increased by FSE (P < 0.05). The activities of total-antioxidant capacity, glutathione peroxidase, and superoxide dismutase in breast muscle were lower in birds subjected to CS (P < 0.05) and were greater in birds supplemented with FSE (P < 0.05). Collectively, live BW loss and breast muscle oxidative injury were increased by CS in broilers, and these stress-related adverse effects could be attenuated by FSE supplementation via enhanced scavenging ability of free radicals and antioxidant capacity. Therefore, FSE could protect broilers against breast muscle oxidative injury when acute stress happens.

Simultaneous Blood-Brain Barrier Crossing and Protection for Stroke Treatment Based on Edaravone-Loaded Ceria Nanoparticles

Cerebral vasculature and neuronal networks will be largely destroyed due to the oxidative damage by overproduced reactive oxygen species (ROS) during a stroke, accompanied by the symptoms of ischemic injury and blood-brain barrier (BBB) disruption. Ceria nanoparticles, acting as an effective and recyclable ROS scavenger, have been shown to be highly effective in neuroprotection. However, the brain access of nanoparticles can only be achieved by targeting the damaged area of BBB, leading to the disrupted BBB being unprotected and to turbulence of the microenvironment in the brain. Nevertheless, the integrity of the BBB will cause very limited accumulation of therapeutic nanoparticles in brain lesions. This dilemma is a great challenge in the development of efficient stroke nanotherapeutics. Herein, we have developed an effective stroke treatment agent based on monodisperse ceria nanoparticles, which are loaded with edaravone and modified with Angiopep-2 and poly(ethylene glycol) on their surface (E-A/P-CeO₂). The as-designed E-A/P-CeO₂ features highly effective BBB crossing via receptor-mediated transcytosis to access brain tissues and synergistic elimination of ROS by both the loaded edaravone and ceria nanoparticles. As a result, the E-A/P-CeO₂ with low toxicity and excellent hemo/histocompatibility can be used to effectively treat strokes due to great intracephalic uptake enhancement and, in the meantime, effectively protect the BBB, holding great potentials in stroke therapy with much mitigated harmful side effects and sequelae.

Correlation between the methylation of LIVIN gene and the pathogenesis of bone tumor

OBJECTIVE

We investigated the correlation between the methylation of LIVIN gene and the pathogenesis of bone tumor at the molecular level, in order to improve the treatment method and enhance the cure rate of bone tumor.

PATIENTS AND METHODS

The expression level of Livin protein was detected using Western blot analysis, and its expressions in control group and patients were detected by immunohistochemistry. The methylation frequency of LIVIN gene was calculated by direct sequencing. Finally, the prognosis of treatment was investigated by follow-up.

RESULTS

The experiment found that Livin protein was not expressed in normal cells, while its expression rate was about 71.4% in 112 patients. The methylation frequency of LIVIN gene was gradually decreased with the increase of clinical stage, and had no significant relationship with age and sex. The prognosis experiment indicated that the lower the methylation frequency of LIVIN gene was, the shorter the survival time would be.

CONCLUSIONS

The methylation of LIVIN gene was closely related to the pathogenesis of bone tumor, which may be one of the important factors to induce the formation of a bone tumor. In addition, the methylation frequency of LIVIN gene could be used as a biomarker for the prognosis of bone tumor treatment.

[Effects of high-efficiency particulate air purifiers on indoor fine particulate matter and its constituents in a district of Beijing during winter]

OBJECTIVE

To analyze the effect of domestic high-efficiency particulate air (HEPA) purifiers on the concentrations of indoor fine particulate matter (PM_2.5) and its elementary constituents in 20 residences in a district of Beijing during winter.

METHODS

From November 2015 to January 2016, 20 residences in a district of Beijing were selected, where indoor and outdoor PM_2.5 data were collected simultaneously in three time periods according to the operating of air purifiers (Group 0 h: 24 hours before operating; Group 24 h: 24 hours after operating; Group 48 h: 24 to 48 hours after operating). The content of 21 elements in PM_2.5 samples were determined by inductively coupled plasma mass spectrometry (ICP-MS) and inductively coupled plasma optical emission spectrometry (ICP-OES). Indoor/outdoor particle concentration ratio (I/O ratios) and ΔI/O ratios were used to describe the pollution levels and the variation range of PM_2.5 and its 21 elementary constituents. One-way analysis of variance (ANOVA) for repeated measurement data was applied to compare the I/O ratios of PM_2.5 and its elementary constituents among the different groups, and Bonferroni method was used for comparison in pairs. Wilcoxon signed rank test for paired-samples was used to compare ΔI/O ratios of 21 elementary constituents with that of PM_2.5.

RESULTS

The median I/O ratios of PM_2.5 in the three groups were 1.27 (P25-P75: 0.50-2.68), 0.45 (P25-P75: 0.27-1.03) and 0.36 (P25-P75: 0.28-2.48), respectively. Compared with Group 0 h, the I/O ratios of PM_2.5 in Group 24 h (P=0.042) and Group 48 h (P=0.006) decreased significantly. However, there was no significant difference between Group 24 h and Group 48 h. Significant differences were found comparing ΔI/O ratios of aluminium, ferrum and titanium to that of PM_2.5, in both Group 24 h and Group 48 h (P<0.05). No significant change was found in the I/O ratios of these three elements among the three groups before and after air purifier operating (P>0.05). Distances from residences to traffic arteries could affect I/O ratios of some elements from traffic-related source (P<0.05).

CONCLUSION

Domestic HEPA air purifiers could effectively reduce indoor PM_2.5 concentration, and the pollution level of PM_2.5 tend to be stable after the purifier operating for a time. The purifiers had different effects on different elements, among which most showed statistical significances.

Cardiovascular benefits of reducing personal exposure to traffic-related noise and particulate air pollution: A randomized crossover study in the Beijing subway system

To assess the cardiovascular benefits of protecting against particulate air pollution and noise, we conducted a randomized crossover study with 40 young healthy college students from March to May 2017 in the underground subway, Beijing. Participants each received 4 treatments (no intervention phase [NIP], respirator intervention phase [RIP], headphone intervention phase [HIP], respirator plus headphone intervention phase [RHIP]) in a randomized order during 4 different study periods with 2-week washout intervals. We measured personal exposure to particulate matter (PM), noise and electrocardiogram (ECG) parameters (heart rate variability (HRV), heart rate (HR) and ST segment changes), ambulatory blood pressure (BP) continuously for 4 hours to investigate the cardiovascular effects. Compared with NIP, most of the HRV parameters increased, especially high frequency (HF) [21.1% (95% CI: 15.7%, 26.9%), 18.2% (95% CI: 12.8%, 23.9%), and 35.5% (95% CI: 29.3%, 42.0%) in RIP, HIP, and RHIP, respectively], whereas ST segment elevation and HR decreased for all 3 modes of interventions. However, no significant differences were observed in BP among the 4 treatments. In summary, short-term wearing of a respirator and/or headphone may be an effective way to minimize cardiovascular risk induced by air pollution in the subway by improving autonomic nervous function.

Association of size-fractionated indoor particulate matter and black carbon with heart rate variability in healthy elderly women in Beijing

Associations between size-fractionated indoor particulate matter (PM) and black carbon (BC) and heart rate variability (HRV) and heart rate (HR) in elderly women remain unclear. Twenty-nine healthy elderly women were measured for 24-hour HRV/HR indices. Real-time size-fractionated indoor PM and BC were monitored on the same day and on the preceding day. Mixed-effects models were applied to investigate the associations between pollutants and HRV/HR indices. Increases in size-fractionated indoor PM were significantly associated with declines in power in the high-frequency band (HF), power in the low-frequency band (LF), and standard deviation of all NN intervals (SDNN). The largest decline in HF was 19% at 5-minute moving average for an interquartile range (IQR) increase (24 μg/m³ ) in PM_0.5 . The results showed that smaller particles could lead to greater reductions in HRV indices. The reported associations were modified by body mass index (BMI): Declines in HF at 5-minute average for an IQR increase in PM_0.5 were 34.5% and 1.0% for overweight (BMI ≥25 kg/m² ) and normal-weight (BMI <25 kg/m² ) participants, respectively. Moreover, negative associations between BC and HRV indices were found to be significant in overweight participants. Increases in size-fractionated indoor PM and BC were associated with compromised cardiac autonomic function in healthy elderly women, especially overweight ones.