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Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a prevalent inflammatory disorder affecting the upper respiratory tract. Recent studies have indicated an association between CRSwNP and mitochondrial metabolic disorder characterized by impaired metabolic pathways; however, the precise mechanisms remain unclear. This study aims to investigate the mitochondrial-related signature in individuals diagnosed with CRSwNP. Methods: Through the integration of differentially expressed genes (DEGs) with the mitochondrial gene set, differentially expressed mitochondrial-related genes (DEMRGs) were identified. Subsequently, the hub DEMRGs were selected using 4 integrated machine learning algorithms. Immune and mitochondrial characteristics were estimated based on CIBERSORT and ssGSEA algorithms. Bioinformatic findings were confirmed through RT-qPCR, immunohistochemistry, and ELISA for nasal tissues, as well as Western blotting analysis for human nasal epithelial cells (hNECs). The relationship between hub DEMRGs and disease severity was assessed using Spearman correlation analysis. Results: A total of 24 DEMRGs were screened, most of which exhibited lower expression levels in CRSwNP samples. Five hub DEMRGs (ALDH1L1, BCKDHB, CBR3, HMGCS2, and OXR1) were consistently downregulated in both the discovery and validation cohorts. The hub genes showed a high diagnostic performance and were positively correlated with the infiltration of M2 macrophages and resting mast cells. Experimental results confirmed that the 5 genes were downregulated at both the mRNA and protein levels within nasal polyp tissues. Finally, a significant and inverse relationship was identified between the expression levels of these genes and both the Lund-Mackay and Lund-Kennedy scores. Conclusion: Our findings systematically unraveled 5 hub markers correlated with mitochondrial metabolism and immune cell infiltration in CRSwNP, suggesting their potential to be based to design diagnostic and therapeutic strategies for the disease.

The growing recognition of mulberries as a potent source of bioactive and nutritional compounds, coupled with their increasing global consumption, underscores the need for efficient off-season cultivation. This study explores the influence of both in-season and off-season cultivation on the yield, bioactive components, and antioxidant activity of ‘Taiwan Changguosang’ (Morus laevigata Wall.) in a greenhouse setting. Despite the lower fruit yield during the off-season, the off-season fruit exhibits higher levels of bioactive compounds, including total anthocyanins, polyphenols, and flavonoids compared to its in-season counterpart. Additionally, the off-season fruit demonstrates enhanced DPPH (1,1-diphenyl-2-picrylhydrazyl) radical scavenging and FRAP (ferric-reducing antioxidant power), attributed to climatic conditions during fruit development, particularly air temperature and solar radiation. Moreover, the off-season fruit proves to be more palatable, showcasing a favorable balance between sugar and acid. Principal Component Analysis (PCA) and correlation analysis revealed a close association between antioxidant activity and the chemical contents of total polyphenols and flavonoids. This study underscores the feasibility and benefits of off-season cultivation for enhancing the nutritional profile and antioxidant potential of mulberries, providing valuable insights for optimizing cultivation practices.

Abstract Background To evaluate the possibilty of preventing recurrent vitreous hemorrhage (RVH) after vitrectomy in proliferative diabetic retinopathy (PDR) patients with unabsorbed vitreous hemorrhage (VH) by intravitreal injection of viscoelastic agent (VA) at the end of the surgery and compared its effect with triamcinolone acetonide (TA). Methods This was a pilot prospective, observational study. PDR patients with VH who underwent vitrectomy were assigned to 3 groups according to the tamponade applicated at the end of the surgery, including VA group (intravitreally injected 1 ml VA if the retina was prone to bleed during the operation), TA group (intravitreally injected 2 mg TA when there was much exudates), or balanced salt solution (BSS) group (no tamponade). Then postoperative follow-up was performed routinely until 6 months after surgery. The primary outcome was the incidence of RVH, secondary outcome were the best-corrected visual acuity (BCVA) and introcular pressure (IOP). Cataract formation and other complication were also assessed. Results A total of 68 eyes, from 68 patients, were included. 18,18,32 eyes were enrolled in the VA group, TA group and BSS group, respectively. The integral incidence of RVH after vitrectomy was 5.6%, 5.6% and 12.5% respectively (P = 0.602). There was no early RVH in VA or TA group, whereas 3 early RVHs were identified in BSS group, however there was no significant difference (P = 0.171). Every group had one late RVH case. In all groups, final BCVA showed significant improvement compared to baseline. BCVA at any postoperative visit showed no significant differences among 3 groups. Mean IOP was higher 1 week after surgery in VA group compared with the other groups; however, in other times the differences were not significant. No cataract formation and other complication was noted in 3 groups. Conclusion Intravitreal injection of VA or TA at the end of vitrectomy for PDR patients with unabsorbed VH tend to reduce the incidence of early RVH after vitrectomy similarly. As VA was preferred to applicate in the eyes that were prone to bleed, intravitreal injection of VA at the end of vitrectomy might be a promising method for preventing RVH in PDR patients.

Chronic rhinosinusitis (CRS) has brought a huge socioeconomic burden. However, its mechanism is still elusive, which may involve genetic, environmental and some other factors. Epigenetic analyses have been conducted to explore the mechanisms underlying CRS. Here, we reviewed the fruits in the epigenetic studies on DNA methylation, histone modification, and non-coding RNA regulation. We concluded that the epigenetic research on CRS has made great breakthroughs, especially in the past 5 years and the field of microRNAs. “Epigenetic therapies” are expected to be designed to treat CRS in the future.

Abstract Background Inconsistencies remain regarding the effectiveness and safety of leukotriene receptor antagonists (LTRAs) and selective H1-antihistamines (SAHs) for allergic rhinitis (AR). A meta-analysis of randomized controlled trials (RCTs) was conducted to compare the medications. Methods Relevant head-to-head comparative RCTs were retrieved by searching the PubMed, Embase, and Cochrane’s Library databases from inception to April 20, 2020. A random-effects model was applied to pool the results. Subgroup analyses were performed for seasonal and perennial AR. Results Fourteen RCTs comprising 4458 patients were included. LTRAs were inferior to SAHs in terms of the daytime nasal symptoms score (mean difference [MD]: 0.05, 95% confidence interval [CI] 0.02 to 0.08, p = 0.003, I 2 = 89%) and daytime eye symptoms score (MD: 0.05, 95% CI 0.01 to 0.08, p = 0.009, I 2 = 89%), but were superior in terms of the nighttime symptoms score (MD: − 0.04, 95% CI − 0.06 to − 0.02, p

Abstract Background As a novel high magnification module (HMM) combining with OCT (OCT-HMM) is able to detect the microstructure of retina, we apply it to explore the ultrastructure of the macula after closure of the idiopathic macular hole (IMH) by surgery. Methods This is an observational case series study in which patients with full-thickness IMHs who had undergone successful macular closure by vitrectomy and internal limiting membrane peeling and healthy subjects were recruited. After comprehensive ophthalmic examinations, the images of macular area were obtained and collected by professional operators using OCT-HMM. Then images were independently analyzed by 4 masked vitreoretinal specialists. Results A total of 24 IMH eyes and 42 healthy eyes were examined. HMM images were obtained in 10 IMH eyes. Among them, 4 eyes whose macula closed completely with recovery of photoreceptor layer presented a dark arc nasal to the fovea, oriented to the optic, and the notch of arc faced temporally. Six eyes in which the macula closed incompletely with photoreceptor cells loss revealed a dark ring with uneven bright spots inside. The other 14 eyes failed to obtain clear images by OCT-HMM. The contra lateral eyes of the patients and the healthy subjects’ eyes succeeded to obtain the HMM images which displayed evenly grey background thickly covered with tiny bright dots that was in similar size and evenly and widely distributed and there no dark arc or ring. OCT B-scan and IR images could be acquired in all of the IMH and healthy eyes. Conclusion The preliminary application of HMM has supplied us a brand-new insight into the microstructure of closed IMH. A dark arc sign could be detected with OCT-HMM in the macula which was functionally closed after surgery that was probably the healing mark on a microstructure photoreceptors level. Its existence and shape indicated that the functional closure followed by a retinal displacement mainly horizontally from temporal side to nasal side but not symmetric centripetally.

Background: A higher compliance with clinical guidelines helps improve treatment outcomes. But the clinical practice of otolaryngologists is not always consistent with guidelines. Objective: To describe otolaryngologists’ compliance with guidelines about allergic rhinitis (AR) management and identify factors responsible for the discordance between clinical practice and guideline recommendations in China. Methods: A cross-sectional nationwide survey was designed and conducted via an online platform. Recruitment was done by emailing otolaryngologists registered in the Chinese Society of Otorhinolaryngology-Head and Neck Surgery or by inviting otolaryngologists to scan a Quick Respond (QR) code that linked to the questionnaire at various academic meetings. Results: A total of 2142 otolaryngologists were eligible and completed the survey. Of them, 64.7% had over 10 years work experience and 97.4% had a bachelor's degree or higher. About 18.3% of the participants strictly copied the guideline in clinical practice, while 73.7% used the guideline that had been adjusted according to their clinical experience. Otolaryngologists were most concerned about the efficacy, safety, and minimum age of AR medications, and least concerned about patient preferences. Regarding the use of intranasal steroids (INS), leukotriene receptor antagonists (LTRA), and H1-antihistamines, 86.8%, 55.7% and 51.2% of otolaryngologists complied with the guideline recommendations, respectively. Educational background was a factor affecting the compliance with guidelines and acceptance of INS. Conclusion: A vast majority of Chinese otolaryngologists complied with the current Chinese AR guidelines. A difference still existed between the otolaryngologists' real-world and guideline-recommended management. The otolaryngologists should pay more attention to patient preferences. A higher education could improve otolaryngologists’ adherence to the guidelines.

Background: Circular RNAs (circRNAs) are involved in inflammation; however, their role in allergic rhinitis (AR) remains unclear. In this study, we analyzed circRNA expression and identified a circRNA-miRNA-mRNA network through which circRNAs regulate AR pathogenesis. Methods: We analyzed circRNA, miRNA, and mRNA expression profiles in the nasal mucosa by high-throughput sequencing (HTS), using a fold-change >1.5 and p-value

AIM: To study the relationship between optical coherence tomography angiography(OCTA)and eye axis in adolescents.METHODS: Prospective non-randomized clinical study. The clinical data of 33 cases(66 eyes)were collected and analyzed. All the subjects underwent naked vision, diopter, corrected visual acuity, axial measurement and OCT examination. SPSS 19.0 software was used to analyze the relationship between the results of OCTA and the eye axis.RESULTS: The mean axial length was(24.46±1.50)mm, the mean vascular density in macular area was(47.88±2.56)%, and the mean thickness of nerve fiber layer in macular area was(278.61±15.08)μm. The mean perioptic vessel density was(57.79±2.99)%, and the mean capillary density was(53.08±3.49)%. There was a negative correlation between the length of the eye axis and the thickness of the nerve fiber layer in the macular area(P=0.006), but there was no correlation between the axial length and the other results.CONCLUSION: There was a negative correlation between the thickness of nerve fiber layer in macular area and the eye axis, but there was no correlation between the blood vessel density and the eye axis in the detection of fundus OCTA in adolescents.

AIM: To evaluate the ocular parameter changes following scleral buckling(SB)for rhegmatogenous retinal detachment(RRD). METHODS: This retrospective, non-randomized case-control study included 46 eyes of 23 patients who underwent SB for RRD. Best corrected visual acuity(BCVA), diopter, intraocular pressure(IOP), anterior chamber depth(ACD), the number of corneal endothelial cells, axial length and the degree of exophthalmos were evaluated in the operated eyes and the follow eyes postoperatively at 3mo. RESULTS: After SB surgery, retina reattachment was achieved without any obvious complications or adverse reactions in all follow-up patients. Among all parameters, the significant decrease in BCVA of 0.15(LogMAR BCVA, P=0.007), in anterior chamber depth(ACD)of 0.29mm(P=0.011)and increase in the degree of exophthalmos of 0.54mm(P=0.047)were observed; the surgery-induced changes for other parameters, including diopter, IOP, counts of endothelial cells and axial length, were not significantly different(P>0.05). CONCLUSION: SB is a good technique for repairing RRD. It brings SB-induced changes in ACD and the degree of exophthalmos.

AIM: To evaluate the effect of long-term weightlessness on retina and optic nerve in tail-suspension (TS) rats. METHODS: A stimulated weightlessness model was established by suspending rats’ tail. After 12wk, the ultrastructure and the number of optic nerve axons were observed by transmission electron microscope. The number of survival retinal ganglion cells (RGCs) was calculated by fluorescent gold retrograde labeling. Retina cells apoptosis was detected by TUNEL staining. The function of optic nerve and retina was evaluated by the visual evoked potential (VEP) and oscillatory potentials (Ops). RESULTS: The optic nerve axons were swollen and sparsely aligned, and the lamellar separation and myelin disintegration occurred after 12wk in TS rats. The density of optic nerve axons was 32.23±3.92 (vs 37.43±4.13, P=0.0145), the RGCs density was 1645±46 cells/mm2 (vs 1867±54 cells/mm2 P=0.0000), the incidence rate of retinal cells apoptosis was 5.38%±0.53% (vs 4.75%±0.54%, P=0.0238), the amplitude of VEP-P100 was 15.43±2.14 µV (vs 17.67±2.17 µV, P=0.0424), the latency of VEP-P100 was 69.05±5.34ms (vs 62.43±4.87ms P=0.0143) and the sum amplitude of Ops was 81.05±8.34 µV (vs 91.67±10.21 µV, P=0.0280) in TS group and the control group, respectively. CONCLUSION: Long-term weightlessness can induce the ultrastructural changes and functional depress of the optic nerve, as well as retinal cell damages in TS rats.

AIM:To research blood pressure and blood glucose variability during peroperative period for patients with secondary neovasular glaucoma(NVG)after silicone oil removed in proliferative diabetic retinaopathy(PDR).METHODS: Totally, 271 patients(271 eyes)undergone surgery of vitrectomy and silicon-oil tamponade combined with cataract were respective analyzed. Fourteen patients(14 eyes)with secondary NVG after silicon oil removed and randomly controlled group of no NVG according with ages, operation method in the same time were studied. The blood pressure and blood glucose variability during peroperative period was analyzed, and did comparison after excluded contralateral eye. The complications of 271 patients were surveyed in following-up period 1～12mo. The incidence of NVG, the time, blood pressure, blood glucose and glycated hemoglobin(Hbc%)variability during peroperative period was statisticed and compared by software of SPSS 11.0.RESULTS: Fourteen eyes(5.2%)of 271 cases was with secondary NVG(female: 4 eyes, 28.6%; male: 10 eyes, 71.4%), average ages was 57.07 years(49～68 years). NVG presented in the 107～ 135d after vitrectomy and 7～45d(average 31.78d)after silicon-oil removed. Diabetes mellitus was 10～15(average 13.2)a. In NVG group, the variability of blood glucose was 4.0～10.2mmol/L(mean 8.52±3.24mmol/L), variable coefficient was 0.48. In NNVG group, the variability of blood glucose was 5.0～8.2mmol/L(mean 7.22±0.24mmol/L), variable coefficient was 0.43. It was significantly difference in comparison in variable coefficient(PPPPCONCLUSION: There are significant variability on fasting blood glucose, daytime SBP and night DBP during perioperative in PDR patients with secondary NVG. It might be occurred 1wk after silicone oil removal surgery.