[Incidence and prognosis of olfactory and gustatory dysfunctions related to infection of SARS-CoV-2 Omicron strain: a national multi-center survey of 35 566 population]

Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.

[Experimental study on the effect of olfactory training on olfactory function in mice with olfactory dysfunction]

Objective: To observe the effect of olfactory training on mice with olfactory dysfunction induced by 3-methylindole (3-MI). Methods: Thirty-one male BALB/c mice were randomly divided into 3 groups by random digits table: control group (group A, n=10), olfactory dysfunction group (group B, n=10) and olfactory dysfunction+olfactory training group (group C, n=11). Mice in group B and group C were intraperitoneally injected with 150 mg/kg 3-MI to induce olfactory dysfunction model, while mice in group A were intraperitoneally injected with corn oil of the same volume. From the first day after injection, mice in group C were treated with 4 kinds of odors by inhalation, while mice in group B were treated with distilled water by inhalation, with 2 times/d, 30 min/time/kind of odor, and continuous training for 28 d. Group A was not treated. Buried food pellet tests were conducted before injection and at 7, 14, 21 and 28 days after injection, respectively. The olfactory epithelium was harvested for observation of the number of olfactory marker protein (OMP) and the thickness of olfactory epithelium on the 28th day after injection. SPSS 23.0 software was used for statistical analysis. Results: Before injection, all mice in each group had no olfactory dysfunction. At the 7th, 14th, 21st and 28th days after injection, the food finding time of mice in group C was shorter than that in group B, and the difference was statistically significant ((175.88±100.50) s vs (266.73±46.83) s, (132.00±84.62) s vs (264.10±48.50) s, (103.57±77.43) s vs (197.43±69.78) s, (67.79±32.54) s vs (176.63±61.06) s, all P<0.05), but food finding time of mice in group B and C was longer than that in group A (the food finding time of group A at the 7th, 14th, 21st and 28th days after injection was (27.13±5.36) s, (25.83±7.28) s, (23.13±2.72) s, (26.63±7.60) s, respectively, all P<0.05). At the 28th day after olfactory training, the number of OMP positive cells in group B and C were fewer than that in group A, and the difference was statistically significant ((108.00±28.19)/HP vs (288.22±84.06)/HP, (199.33±58.55)/HP vs (288.22±84.06)/HP, all P<0.05). The number of OMP positive cells in group C were higher than that in group B (P<0.05). The number of OMP positive cells had negative correlation with food finding time (r=-0.886, P<0.01). As for the thickness of the olfactory epithelium, the thickness of group B was thinner than that in group A and C, and the difference was statistically significant ((59.57±31.27) μm vs (114.55±40.70)μm vs (90.54±37.72) μm, all P<0.05). Conclusion: Olfactory training can accelerate the recovery of olfactory function in 3-MI-induced olfactory impaired mice.

[The application of Chinese version of anterior skull base questionnaire (ASBQ) in patients with anterior and middle skull base tumors]

Objective: To develop the Chinese version of anterior skull base questionnaire(ASBQ) and to verify its application in patients with anterior and middle skull base tumors. Methods: The following steps were finished including getting the permission from the author of the original English scale, translating and back-translating, tentative test, discussing the consequence and cultural debugging. From October 2016 to December 2018, 51 patients with skull base tumors from Xuanwu Hospital and China-Japan Friendship Hospital were enrolled as an experimental group, aged from 24 to 70 years old, with 19 males and 32 females, which included 27 patients with anterior skull base tumor and 24 patients with middle skull base tumor. From December 2016 to January 2018, 46 healthy volunteers were selected as a control group, aged from 18 to 36 years old, including 26 females and 20 males. The subjects in the test group and the control group were rigorously tested with official manuscripts and judged whether the manuscript was applicable. The SPSS 22.0 statistical software was used to analyze the data of the test group, the anterior skull base group, the middle skull base group and the control group to evaluate the performance of the scale. Results: Both the rate of the recovery and efficiency in experimental group, anterior skull base group and middle skull base group were 100%, with the average time of completion of (8.7±3.2), (11.2±4.0) and (7.3±2.1) min, respectively in each group. The r value of test-retest reliability was 0.96, 0.99 and 0.97 in experimental group, anterior skull base group and middle skull base group, with the split-half reliability coefficient of 0.91, 0.90 and 0.96, with the entire scale Cronbach's coefficient of 0.91, 0.95 and 0.93, respectively. The content validity and the construct validity of the scale were good enough, and the criteria validity was-0.483,-0.509 and -0.489 in experimental group, anterior skull base group and middle skull base group. The scale could well distinguish the difference of the quality of life between the preoperative and postoperative patients in experimental group and the middle skull base group. The difference of the quality of life in anterior skull base group was not found between preoperative and postoperative patients. Conclusion: The Chinese version of ASBQ has good reliability and validity, which is suitable for a wide range of Chinese patients with anterior and middle skull base tumors to assess their quality of life.

[Ganglioneuroma in poststyloid space removed under endoscope through transoral approach: a case report]

Parapharyngeal space refers to the potential space under skull base between masticatory muscles and pharyngeal muscles, ranging from skull base at the top to hyoid bone at the bottom. The outer lateral wall consists of medial pterygoid muscle, deep parotid lobe and lower jawbone, lateral pharyngeal wall, medial pterygoid, deep lobe of parotid gland and mandible constitute the lateral wall, lateral pharyngeal wall forms medial wall, and prevertebral fascia constitutes the posterior wall, generally forming an inverted pyramid lacuna. Parapharyngeal space is divided into prestyloid space and poststyloid space by stylopharygeal fascia. Prestyloid space is relatively small and contains levator veli palatinetensor veli palatine, branches of maxillary artery, mandibular nerve and its branches. Poststyloid space is relatively large. It includes internal jugular vein, internal carotid artery, posterior cranial nerves, etc. Poststyloid space tumors are relatively rare. In this report, a case of ganglioneuroma wrapping right internal carotid artery is described, which is resected through oral approach.

[The bacteriologic features of recurrent acute rhinosinusitis]

Objective:To investigate the bacteriologic characteristics of recurrent acute rhinosinusitis(RAR).Method:Twenty-nine patients (29 with RAR) from outpatient clinic in our hospital between June 2010 and May 2016 were enrolled in the study. Specimens of the middle meatus or olfactory cleft area using the sinus endoscopy through were transported to the laboratory for bacterial culture.Result:Twenty-five specimens out of 29 were bacterial culture positive (culture positive rate was 86.2%).A total of 32 isolates (25 aerobic or facultative and 7 anaerobic) were recovered from the 29 cases of RAR. The predominant aerobic or facultative bacteria were Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus. The predominant anaerobic bacteria were Bacteroides fragilis and Propionibacterium. Antibiotic susceptibility tests showed that the resistance rate of these aerobic or facultative bacteria to Macrolides (Erythromycin and Azithromycin) and quinolones (Levofloxacin) was 88% and 92%, respectively. Similarly, the resistance rate of bacteria to β-lactamase antibiotics (penicillin, ampicillin, and cefazolin) was also greater than 90% (100%, 92%, and 92%, respectively). But the drug resistance of these bacteria to the thirdgeneration cephalosporin combined with beta lactamase inhibitors (Cefoperazone/sulbactam) was 20%. Among the 7 strains of anaerobic bacteria, 6 strains were sensitive to ornidazole.Conclusion:The major pathogens of RAR are the aerobic and facultative bacteria Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus, most of which are resistant to commonly used antibiotics.

Altered myelopoiesis and the development of acute myeloid leukemia in transgenic mice overexpressing cyclin A1

A mammalian A-type cyclin, cyclin A1, is highly expressed in testes of both human and mouse and targeted mutagenesis in the mouse has revealed the unique requirement for cyclin A1 in the progression of male germ cells through the meiotic cell cycle. While very low levels of cyclin A1 have been reported in the human hematopoietic system and brain, the sites of elevated levels of expression of human cyclin A1 were several leukemia cell lines and blood samples from patients with hematopoietic malignances, notably acute myeloid leukemia. To evaluate whether cyclin A1 is directly involved with the development of myeloid leukemia, mouse cyclin A1 protein was overexpressed in the myeloid lineage of transgenic mice under the direction of the human cathepsin G (hCG) promoter. The resulting transgenic mice exhibited an increased proportion of immature myeloid cells in the peripheral blood, bone marrow, and spleen. The abnormal myelopoiesis developed within the first few months after birth and progressed to overt acute myeloid leukemia at a low frequency ( approximately 15%) over the course of 7-14 months. Both the abnormalities in myelopoiesis and the leukemic state could be transplanted to irradiated SCID (severe combined immunodeficient) mice. The observations suggest that cyclin A1 overexpression results in abnormal myelopoiesis and is necessary, but not sufficient in the cooperative events inducing the transformed phenotype. The data further support an important role of cyclin A1 in hematopoiesis and the etiology of myeloid leukemia.