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Hong HY, Chen TY, Yang QT, Sun YQ, Chen FH, Lou HF, Wang HT, Yu RL, An YF, Liu F, Wang TS, Lu MP, Qiu QH, Wang XD, Chen JJ, Meng CD, Xie ZH, Meng J, Zeng M, Xu CL, Wang Y, Yang YC, Zhang WT, Tang J, Yang YL, Xu R, Yu GD, Shi ZH, Wei X, Ye HP, Sun YN, Yu SQ, Zhang TH, Yong J, Hang W, Xu YT, Xu Y, Tan GL, Sun N, Yang G, Li YJ, Ye J, Zuo KJ, Zhang LQ, Wang XY, Yang AN, Xu YX, Liao W, Fan YP, Li HB. Chinese Expert Consensus on the Use of Biologics in Patients with Chronic Rhinosinusitis (2022, Zhuhai). ORL J Otorhinolaryngol Relat Spec 2023:1-13. [PMID: 37019094 DOI: 10.1159/000529918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/22/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a common inflammatory disease in otolaryngology, mainly manifested as nasal congestion, nasal discharge, facial pain/pressure, and smell disorder. CRS with nasal polyps (CRSwNP), an important phenotype of CRS, has a high recurrence rate even after receiving corticosteroids and/or functional endoscopic sinus surgery. In recent years, clinicians have focused on the application of biological agents in CRSwNP. However, it has not reached a consensus on the timing and selection of biologics for the treatment of CRS so far. SUMMARY We reviewed the previous studies of biologics in CRS and summarized the indications, contraindications, efficacy assessment, prognosis, and adverse effects of biologics. Also, we evaluated the treatment response and adverse reactions of dupilumab, omalizumab, and mepolizumab in the management of CRS and made recommendations. KEY MESSAGES Dupilumab, omalizumab, and mepolizumab have been approved for the treatment of CRSwNP by the US Food and Drug Administration. Type 2 and eosinophilic inflammation, need for systemic steroids or contraindication to systemic steroids, significantly impaired quality of life, anosmia, and comorbid asthma are required for the use of biologics. Based on current evidence, dupilumab has the prominent advantage in improving quality of life and reducing the risk of comorbid asthma in CRSwNP among the approved monoclonal antibodies. Most patients tolerate biological agents well in general with few major or severe adverse effects. Biologics have provided more options for severe uncontrolled CRSwNP patients or patients who refuse to have surgery. In the future, more novel biologics will be assessed in high-quality clinical trials and applied clinically.
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Affiliation(s)
- Hai-Yu Hong
- Allergy Center, Department of Otolaryngology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Teng-Yu Chen
- Allergy Center, Department of Otolaryngology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China,
| | - Qin-Tai Yang
- Department of Otolaryngology, Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Allergy, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yue-Qi Sun
- Department of Otolaryngology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Feng-Hong Chen
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hong-Fei Lou
- Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, China
| | - Hong-Tian Wang
- Department Allergy and Center of Allergy, Beijing Shijitan Hospital of Capital Medical University, Beijing, China
| | - Rui-Li Yu
- Department Allergy and Center of Allergy, Beijing Shijitan Hospital of Capital Medical University, Beijing, China
| | - Yun-Fang An
- Department of Otolaryngology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Feng Liu
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Tian-Sheng Wang
- Department of Otolaryngology, Head and Neck Surgery, Third Xiangya Hospital of Central South University, Changsha, China
| | - Mei-Ping Lu
- Department of Otolaryngology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qian-Hui Qiu
- Department of Otolaryngology, Head and Neck Surgery, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Xiang-Dong Wang
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital of Capital Medical University, Beijing, China
| | - Jian-Jun Chen
- Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cui-da Meng
- Department of Otolaryngology, Head and Neck Surgery, China Japan Friendship Hospital of Jilin University, Changchun, China
| | - Zhi-Hai Xie
- Department of Otolaryngology, Head and Neck Surgery, Xiangya Hospital of Central South University, Changsha, China
| | - Juan Meng
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Ming Zeng
- Department of Otolaryngology, Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cheng-Li Xu
- Department of Otolaryngology, Head and Neck Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Ying Wang
- Department of Rhinology, The First Hospital of Zhengzhou University, Zhengzhou, China
| | - Yu-Cheng Yang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei-Tian Zhang
- Department of Otolaryngology, Head and Neck Surgery, Sixth People's Hospital of Shanghai Jiaotong University, Shanghai, China
| | - Jun Tang
- Department of Rhinology, The First People's Hospital of Foshan, Sun Yat-Sen University, Foshan, China
| | - Yan-Li Yang
- Department of First Otolaryngology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Rui Xu
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Guo-Dong Yu
- Department of Otolaryngology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Zhao-Hui Shi
- Department of Otolaryngology, The ENT Hospital of Shenzhen Longgang District, Shenzhen, China
| | - Xin Wei
- Department of Otolaryngology, Head and Neck Surgery, Hainan People's Hospital, Haikou, China
| | - Hui-Ping Ye
- Department of Otolaryngology, Guizhou Province Hospital, Guiyang, China
| | - Ya-Nan Sun
- Department of Otolaryngology, Head and Neck Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Shao-Qing Yu
- Department of Otolaryngology, Head and Neck Surgery, Tongji Hospital Affiliated to Tongji University, Shanghai, China
| | - Tian-Hong Zhang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jun Yong
- Department of Otolaryngology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Wei Hang
- Department of Otolaryngology, Head and Neck Surgery, Huanhu Hospital of Tianjin City, Tianjin, China
| | - Yuan-Teng Xu
- Department of Otolaryngology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yu Xu
- Department of Otolaryngology, Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Guo-Lin Tan
- Department of Otolaryngology, Head and Neck Surgery, Third Xiangya Hospital of Central South University, Changsha, China
| | - Na Sun
- Department of Otolaryngology, Huadong Hospital of Fudan University, Shanghai, China
| | - Gui Yang
- Department of Otolaryngology, The Central Hospital of Shenzhen Longgang District, Shenzhen, China
| | - You-Jin Li
- Department of Otolaryngology, Shanghai Children's Medical Center of Shanghai Jiaotong University, Shanghai, China
| | - Jing Ye
- Department of Otolaryngology, Head and Neck Surgery, The First Hospital Affiliated to Nanchang University, Nanchang, China
| | - Ke-Jun Zuo
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Li-Qiang Zhang
- Department of Otolaryngology, Qilu Hospital of Shandong University, Jinan, China
| | - Xue-Yan Wang
- Department Allergy and Center of Allergy, Beijing Shijitan Hospital of Capital Medical University, Beijing, China
| | - An-Ni Yang
- Allergy Center, Department of Otolaryngology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Ying-Xiang Xu
- Allergy Center, Department of Otolaryngology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Wei Liao
- Allergy Center, Department of Otolaryngology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Yun-Ping Fan
- Department of Otolaryngology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Hua-Bin Li
- Department of Otolaryngology, Eye and ENT Hospital of Fudan University, Shanghai, China
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Lai YY, Lin TJ, Jiang LJ, Deng J, Zuo KJ, Zhang Y, Shi JB. [New system combining Hyams grading system and modified Kadish stage to evaluate the progress of esthesioneuroblastoma]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 33:599-602. [PMID: 31327194 DOI: 10.13201/j.issn.1001-1781.2019.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Indexed: 11/12/2022]
Abstract
Objective:Esthesioneuroblastoma(ENB) is a sinonasal rare tumor, and the assessment on the prognosis have not been used with on consensus, our study aims to set an accuracy indicator to predict the outcomes of ENB.Method:A retrospective review was performed on 31 ENB patients. We collected 31 patients with ENB and reviewed the clinical data and pathological slides; modified Kadish stages were evaluated by otolaryngologist and imaging specialist; Hyams grading system were confirmed by two pathologists, who reviewed and paid attention to the pathological characteristics of Hyams grading system. Finally, the relation among the clinical data, pathological features and clinical outcome of these 31 ENB were analyzed by Kaplan-Meier method.Result: The Hyams grading system and modified Kadish stage were considered together seemed to evaluate the prognosis of ENB more accurately, when the scores over 6 points, the patients had the poor prognosis with the mean median survival months of 24.67±32.22, compared with the scores under 6 and the final scores reached at 4, 5, 6, 7, 8, the tumor metastasis rates were 14.3%, 16.7%, 33.3%, 50.0%, 100.0% respectively.Conclusion:Taking the Hyams grading system and modified Kadish stage into consideration, which may evaluate the prognosis of ENB more accurately.
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Affiliation(s)
- Y Y Lai
- Department of Otolaryngology, Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yatsen University, Guangzhou, 510800, China
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Zhou M, Guan WJ, Zuo KJ, Xu ZF, Shi JB, Lai YY. Powder Cellulose in Allergic Rhinitis Management: Relevance of in vitro Findings to Real-Life Safety - Author's Reply. Int Arch Allergy Immunol 2019; 179:19-20. [PMID: 30982045 DOI: 10.1159/000497116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 11/19/2022] Open
Affiliation(s)
- Min Zhou
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Ke-Jun Zuo
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Zhao-Feng Xu
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Jian-Bo Shi
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Yin-Yan Lai
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China,
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Jiang LJ, Zhou M, Deng J, Zuo KJ, Shi JB, Lai YY. [Study on the relationship between 11β-hydroxysteroid dehydrogenase and glucocorticoid response in nasal polyps]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 54:198-202. [PMID: 30909340 DOI: 10.3760/cma.j.issn.1673-0860.2019.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the expression of 11β-hydroxysteroid dehydrogenase (11β-HSD) in polyps of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and its correlation with glucocorticoid sensitivity. Methods: The prospective study method was applied. Forty-three adult CRSwNP patients from Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University between April 2016 and June 2017 were enrolled in this study. There were 19 males and 24 females with the age of (37.44±7.42) years old. The endoscopic scores by nasal Polyps Grading System before and after one-week prednisone treatment (0.5 mg/(kg·d)) were evaluated. The response of glucocorticoid by the total endoscopic scores was estimated. According to the patient's reduced nasal polyp endoscopic score, patients were devided into nasal polyps insensitive to glucocorticoids treatment group (insensitive group) and nasal polyp sensitive to glucocorticoids treatment group (sensitive group). The expression of 11β-HSD1, 11β-HSD2 in nasal polyps were measured by Real-time PCR (RT-PCR), Western Blot and immunohistochemisty. According to the clinical data, the Logistic regression models and receiver operation characteristics (ROC) curves were used to explore the predictor for glucocorticoid response in CRSwNP. Results: The expression of 11β-HSD1 and 11β-HSD1/11β-HSD2 was higher in sensitive group than that of insensitive group, while the expression of 11β-HSD2 was lower (rank average was 26.08 vs 16.33, 27.24 vs 14.72, 18.66 vs 26.64, Z value was -2.511, 0.323, -2.059, respectively, all P<0.05). The endoscopic scores in CRSwNP group declined whereas the expression of 11β-HSD1/11β-HSD2 increased (r=0.528, P=0.001), while the cutoff value of the ratio of 11β-HSD1/11β-HSD2 was 2.290 (sensitivity was 79.17%, specificity was 88.89%). Conclusions: There is a positive correlation between the response of glucocorticoid and the ratio of 11β-HSD1/11β-HSD2, which could be used as a marker in predicting the level of tissue response to glucocorticoid therapy in CRSwNP.
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Affiliation(s)
- L J Jiang
- Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510800, China; Guangzhou Women and Children's Medical Central, Guangzhou 510800, China
| | - M Zhou
- Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510800, China
| | - J Deng
- Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510800, China
| | - K J Zuo
- Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510800, China
| | - J B Shi
- Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510800, China
| | - Y Y Lai
- Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510800, China
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Wang ZX, Lai YY, Chen FH, Shi JB, Zuo KJ. [Clinical features, diagnosis and treatment of silent sinus syndrome]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 53:820-824. [PMID: 30453400 DOI: 10.3760/cma.j.issn.1673-0860.2018.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the clinical features, diagnostic methods and therapeutic strategy of silent sinus syndrome (SSS). Methods: A retrospective study was made on eight SSS patients treated during 2013-2016 in Longgang ENT Hospital and Otorhinolaryngology Hospital of the First Affiliated Hospital of SUN Yat-sen University. The following clinical data, including demographic data, symptoms, history of trauma and surgery, signs, imaging examination, endoscopic surgery and postoperative outcomes, were analyzed to summarize the diagnosis and treatment experiences. Results: Eight SSS patients showed the following clinical features: the proportions of both sexes and sinus sides were 4 to 4; seven cases (7/8) were adult, with an average of (48.1±11.8)y; seven cases (7/8) had long history of trauma or surgery, with an average of (17.9±10.5)y; seven cases (7/8) cannot recall the exact course of SSS; six cases (6/8) had no nasal symptoms; eight cases (8/8) had unilateral ocular discomforts; eight cases (8/8) had signs of unilateral enophthalmos (2-5 mm), accompanied with hypoglobus; and by CT and MRI scanning, eight cases (8/8) showed the unilateral maxillary sinus outlet obstruction, sinus full opacification, sinus wall bony rarefaction, sinus wall contraction, sinus volume loss, and the ipsilateral orbital floor bowing descent and orbital volume increase. After treated by endoscopic sinus surgery and followed-up for one year, four cases were cured, and the other four improved; no intra- or post-operative complications occurred; and no individual need a two-stage orbital plastic reconstruction. Conclusions: SSS often develops in the unilateral maxillary sinus of adult patient with long history of trauma or surgery, but the nasal symptoms and signs are silent. Diagnostic for SSS depends on characteristic ocular sign and sinus CT imaging. Endoscopic sinus surgery helps to improve ocular and nasal signs and promote orbital self-reconstruction.
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Affiliation(s)
- Z X Wang
- Shenzhen Key Laboratory of ENT, Institute of ENT & Longgang ENT Hospital, Shenzhen 518172, China
| | - Y Y Lai
- Otorhinolaryngology Hospital and Institute of the First Affiliated Hospital of SUN Yat-sen University, Guangzhou Key Laboratory of Otorhinolarygology, Guangzhou 510080, China
| | - F H Chen
- Otorhinolaryngology Hospital and Institute of the First Affiliated Hospital of SUN Yat-sen University, Guangzhou Key Laboratory of Otorhinolarygology, Guangzhou 510080, China
| | - J B Shi
- Otorhinolaryngology Hospital and Institute of the First Affiliated Hospital of SUN Yat-sen University, Guangzhou Key Laboratory of Otorhinolarygology, Guangzhou 510080, China
| | - K J Zuo
- Otorhinolaryngology Hospital and Institute of the First Affiliated Hospital of SUN Yat-sen University, Guangzhou Key Laboratory of Otorhinolarygology, Guangzhou 510080, China
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Zhou M, Zuo KJ, Xu ZF, Guan WJ, Jiang LJ, Luo X, Zheng R, Wang D, Cao YJ, Chen Y, Yang F, Liu C, Shi JB, Lai YY. Effect of Cellulose Powder on Human Nasal Epithelial Cell Activity and Ciliary Beat Frequency. Int Arch Allergy Immunol 2018; 178:229-237. [PMID: 30408809 DOI: 10.1159/000493582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 09/10/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cellulose powder (CP) has been reported as a safe and effective complementary treatment for allergic rhinitis (AR). Currently, CP has gained increasing application for clinical management worldwide, particularly in China. However, studies focusing on the effect of CP on normal human nasal epithelial cells (hNECs) and ciliary function are lacking. Here, we aimed to explore the adverse effects of CP on the activity and ciliary function of hNECs. METHODS We biopsied ethmoid sinus or middle turbinate tissues during surgical resection from control subjects who underwent endoscopic sinus surgery for diseases other than AR. Cells were isolated and passaged, followed by differentiation in an air-liquid interface (ALI). Flow cytometry and cell viability test (cell counting kit-8) were performed to detect the cytotoxicity of CP (effects on cell proliferation) on normal hNECs. By using the ALI culture model, we investigated the effects of CP on ciliary beat frequency (CBF). RESULTS There was a significant reduction in hNEC count at high concentrations of CP (2.5 mg/mL) at days 3 and 7 (both p < 0.05). As the concentration increased, cell death increased progressively from day 3 to day 7. However, these effects were not evident at low concentrations (0.25 mg/mL, p > 0.05). High-dose CP (2.5 mg) significantly reduced the CBF (p < 0.05). At lower concentrations (0.25-2.5 mg/mL), CP initially increased but subsequently reduced the CBF of hNECs compared with control group. CONCLUSIONS Cytotoxicity and the suppression of ciliary beat at high concentrations justify more prudent use of CP for the management of AR.
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Affiliation(s)
- Min Zhou
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Ke-Jun Zuo
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Zhao-Feng Xu
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Li-Jie Jiang
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Xin Luo
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Rui Zheng
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Dang Wang
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Yu-Jie Cao
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Yang Chen
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Fei Yang
- Otolaryngology Laboratory, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Chen Liu
- Otolaryngology Laboratory, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Jian-Bo Shi
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China
| | - Yin-Yan Lai
- Department of Otolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Sun Yat-sen University, Guangzhou, China,
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Chen FH, Zuo KJ, Guo YB, Li ZP, Xu G, Xu R, Shi JB. Long-term results of endoscopic sinus surgery-oriented treatment for chronic rhinosinusitis with asthma. Laryngoscope 2013; 124:24-8. [PMID: 23686815 DOI: 10.1002/lary.24196] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 03/17/2013] [Accepted: 04/19/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS The aims of this study were to evaluate the efficacy of functional endoscopic sinus surgery (FESS)-oriented multimodality treatment in chronic rhinosinusitis (CRS) patients with asthma and its impact on asthma. STUDY DESIGN Prospective, nonrandomized cohort. METHODS Twenty-seven CRS patients with asthma who underwent FESS with postoperative topical corticosteroid spray were evaluated preoperatively; 25 of them were evaluated 1 year and 3 years postoperatively. CRS was evaluated by visual analogue scale, clinical control of CRS, and objective measurement endoscopy Lund-Kennedy scores. Asthma was assessed by subjective asthma control test and asthma control level, also by objective antiasthma medication use and pulmonary function tests. RESULTS VAS scores of general symptoms (8.09 ± 0.87 preoperatively) were significantly improved at 1 year (2.94 ± 2.21) and 3 years (3.77 ± 2.16) postoperation (P = .000). No difference in these items was found between 1 year and 3 years (P = .463). Endoscopy Lund-Kennedy scores at 1 year (4.34 ± 3.09) and 3 years (5.80 ± 3.38) postoperatively were significantly better (9.33 ± 2.03 preoperatively, P = .000), and there was no difference between 1 year and 3 years of follow-up (P > .05). Significantly, asthma control level improved postoperatively (P = .025). However, antiasthma drug and pulmonary function showed no significant change postoperatively (P > .05). CONCLUSIONS FESS-oriented multimodality treatment improves CRS with asthma significantly and persistently. Asthma control level improved. Antiasthma medication use and pulmonary function remained stable.
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Affiliation(s)
- Feng-Hong Chen
- Department of Otolaryngology Hospital and Otolaryngology Institute, Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China
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Xu G, Zhang L, Wang DY, Xu R, Liu Z, Han DM, Wang XD, Zuo KJ, Li HB. Opposing roles of IL-17A and IL-25 in the regulation of TSLP production in human nasal epithelial cells. Allergy 2010; 65:581-9. [PMID: 19968632 DOI: 10.1111/j.1398-9995.2009.02252.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The importance of IL-17A, IL-17F, and IL-25 in allergic rhinitis (AR), as well as their possible role in regulation on thymic stromal lymphopoietin (TSLP) production in nasal epithelial cells, is not well understood. OBJECTIVE To determine the possible regulation of IL-17A, IL-17F, and IL-25 on TSLP production in the initiation of allergic responses. METHODS The levels of IL-17A, IL-17F, IL-25, and TSLP in nasal lavages of patients with AR were measured using an enzyme-linked immunosorbent assay (ELISA) and compared with that in normal controls. Then, primary human nasal epithelial cells (HNECs) were stimulated with dsRNA (0-75 microg/ml), as well as IL-17A (100 ng/ml), IL-17F (100 ng/ml), and IL-25(100 ng/ml). The mRNA expression of IL-17A, IL-17F, IL-25, TSLP, as well as the chemokines CCL20, IL-8, and eotaxin was analyzed using quantitative real-time PCR, and their protein levels in the supernatants of cultured HNECs were determined by ELISA. RESULTS Both TSLP and IL-17 cytokines are significantly elevated in patients with AR. dsRNA was found to increase the production of IL-17F, IL-25, TSLP, CCL20, and IL-8 in HNECs. Furthermore, IL-25 significantly enhanced dsRNA-induced TSLP production in primary HNECs and was dominant to the inhibitory effect of IL-17A on TSLP regulation. CONCLUSIONS Our study provides the first evidence that both IL-17F and IL-25 can be induced by dsRNA in HNECs. Despite of the opposing effects of IL-17A and IL-25 on TSLP regulation in HNECs, IL-25 was dominant to IL-17A, providing a plausible explanation for the simultaneous upregulation of IL-17 cytokines and TSLP in patients with AR.
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Affiliation(s)
- G Xu
- Otorhinolaryngology Hospital of the First Affiliated Hospital of Sun Yat-sen University, Otorhinolaryngology Institute of Sun Yat-sen University, Guangzhou, China
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Ji J, Xie QM, Chen CY, Bai SW, Zou LS, Zuo KJ, Cao YC, Xue CY, Ma JY, Bi YZ. Molecular detection of Muscovy duck parvovirus by loop-mediated isothermal amplification assay. Poult Sci 2010; 89:477-83. [PMID: 20181863 DOI: 10.3382/ps.2009-00527] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Muscovy duck parvovirus (MDPV) usually causes high morbidity and mortality in 1- to 3-wk-old Muscovy ducklings due to serious infections, which is an imminent threat to the commercial duck industry in China. The objectives of this study were to develop and evaluate a simple, rapid, and inexpensive loop-mediated isothermal amplification (LAMP) method for specific detection of MDPV and to compare it with the PCR method in rapidity, sensitivity, and accuracy. The novel LAMP assay used a set of 4 specific primers to recognize 6 distinct genomic sequences of capsid protein (VP3) from MDPV, which could be completed within 50 min at 63 degrees C in a simple water bath. The diagnostic results demonstrated that the LAMP assay detected all 7 preserved MDPV isolates, had no cross-reactivity with other duck pathogens (i.e., goose parvovirus, duck plague virus, H9N2 avian influenza virus, duck hepatitis type virus I, and Muscovy duck reovirus). The LAMP assay was at least 10-fold more sensitive than the routine PCR assay and obtained more sensitivity in 61 clinical samples. Therefore, the newly developed LAMP assay provides a specific and sensitive means for detecting MDPV and can be simply applied both in field conditions and in laboratory operations in a cost-effective manner with primary care facilities.
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Affiliation(s)
- J Ji
- College of Animal Science, South China Agricultural University, Guangzhou 510642, People's Republic of China
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Xu G, Xia JH, Zhou H, Yu CZ, Zhang Y, Zuo KJ, Shi JB, Li HB. Interleukin-6 is essential for Staphylococcal exotoxin B-induced T regulatory cell insufficiency in nasal polyps. Clin Exp Allergy 2009; 39:829-37. [PMID: 19260868 DOI: 10.1111/j.1365-2222.2009.03218.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND The pathogenesis of nasal polyps is still unclear. There is increasing evidence indicating that Staphylococcal aureus (S. aureus) is associated with the formation of nasal polyps, but the mechanism has not been well documented to date. METHODS We stimulated cultured nasal polyps and turbinate tissues with Staphylococcal exotoxin B (SEB), detected the expression of pro-inflammatory cytokines (IL-2, IL-6, and IL-8) and T cell cytokines (IFN-gamma, IL-4, IL-5, IL-10, and IL-17) in the supernatants, and evaluated mRNA expression (T-bet, GATA-3, Foxp3, and RORgammat) and frequencies of CD4+CD25+ T regulatory cells (Tregs) in nasal tissues. We also evaluated the effects of blocking IL-6 with monoclonal antibodies to T cell profiles in cultured nasal tissues stimulated by SEB. RESULTS Levels of IL-6, IFN-gamma and IL-4 increased significantly in SEB-stimulated nasal polyps. Meanwhile, mRNA expressions of T-bet and GATA-3 were significantly up-regulated, while Foxp3 was inhibited and the frequencies of CD4+CD25+ Tregs were decreased after SEB stimulation. After blocking IL-6, the levels of IL-10 and Foxp3 mRNA, as well as the frequencies of CD4+CD25+ Tregs, were significantly increased, while IFN-gamma and IL-4 production and the mRNA expression of T-bet and GATA-3 were significantly inhibited. CONCLUSIONS SEB is able to modulate pro-inflammatory factors, T-helper type 1/Th2 profiles and suppress Treg activity in cultured nasal polyps, which were rescued by blocking IL-6 activity. Therefore, IL-6 is essential for SEB-induced Treg insufficiency in nasal polyps.
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Affiliation(s)
- G Xu
- Allergy and Cancer Center, Otorhinolaryngology Hospital of the First Affiliated Hospital of Sun Yat-sen University, and Otorhinolaryngology Institute of Sun Yat-sen University, Guangzhou, China
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Zuo KJ, Shi JB, Wen WP, Chen HX, Zhang XM, Xu G. [Transnasal endoscopic optic nerve decompression for traumatic optic neuropathy: analysis of 155 cases]. Zhonghua Yi Xue Za Zhi 2009; 89:389-392. [PMID: 19567116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To explore the outcome of transnasal endoscopic optic nerve decompression (TEOND) for traumatic optic neuropathy (TON). METHODS The clinical data of 155 consecutive patients with TON treated with TEOND after failure of mega-dose steroid therapy were retrospectively analyzed, their outcomes were summarized after follow-up, and then Logistic regression was used to analyze the prognosis-related information to explore the factors influencing prognosis. RESULTS Patients were followed up for 3 - 60 months. The total effective rate of the 155 patients was 44.5%. The effective rate of the patients with light perception or better vision was 87.5%, much higher than that of the patients without light perception (29.6%). Eyesight was improved, mostly occurring 1 - 5 days after operation and lasting for 1 - 3 months, in 69 patients. Residual vision degree after trauma (OR = 0.04) and the interval between injury and surgery (OR = 4.62) were significant prognostic factors of the general effect (P < 0.01), and the gradual or immediate visual loss history (OR = 0.22) and the interval between injury and surgery (OR = 6.34) were significant to the outcomes of the patients with no light perception (P < 0.05). Sex, age, duration of coma after trauma, pre- and post-operative duration of steroid treatment, operators, fracture site of optic canal, and nerve sheath incision were not correlated to the outcomes of patients (all P > 0.05). Intraoperative cerebrospinal fluid rhinorrhea and postoperative transient visual loss occurred in one and the other two cases, respectively, but these conditions were resolved successfully. CONCLUSION TEOND is effective and safe for TON patients, but the visual outcome is poor for the immediate blindness cases. The surgery is indicated for the patients with some residual vision or with a gradual visual loss and is suggested to perform early within seven days after injury.
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Affiliation(s)
- Ke-Jun Zuo
- Otorhinolaryngology Hospital of the First Affiliated Hospital of Sun Yat-sen University, Institute of Otorhinolaryngology of Sun Yat-sen University, Guangzhou 510080, China
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Xu CL, Zuo KJ, Xu G. [Impact of draining mode of enlarged maxillary ostium on mucociliary transportation system]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2008; 43:259-262. [PMID: 18666690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the proper site for enlarging maxillary natural ostium during ESS, and to compare the draining mode of mucociliary transportation system. METHODS Three groups were designed to observe the differences of tracer agent transported from maxillary sinus to nasal cavity. Normal control group: 30 cases; Trial group A:30 cases, the maxillary natural ostium were radically enlarged by all sides; Trial group B: 30 cases, the maxillary natural ostium were enlarged by reservation of whole inferior edge and cut away anterior and/or posterior edge. The patients in two trial groups were after nasal endoscopic sinus surgery for more than 12 months and the maxillary ostium were well open. RESULTS Tracer agent was drained from maxillary sinus to nasal cavity by inferior edge (s) of natural ostium in control group. The core area was posterior part of inferior edge. In trial group A, tracer agent was drained out by inferior edge in 4 cases (13.3%), tracer agent drained out by posterior and/or superior edge(s) and then dispersed to ethmoid sinus in 17 cases (56.7%),tracer agent stacked and/or circularly flowed in the maxillary sinus, and could not be transported out in 9 cases (30.0%). In trial group B,tracer agent drained out by inferior edge to middle meatal in all subjects (30/30,100%), and there was no redirection of the mucociliary transportation. CONCLUSIONS The inferior edge of natural ostium is the main passage of mucociliary transportation system of maxillary sinus. If the inferior edge of maxillary natural ostium reserved, the post-operative drainage of maxillary sinus would be the same as normal ones. Radical removal of all edges of maxillary natural ostium could lead to redirection of mucociliary transportation, only few cases could drain out by inferior edge, most cases drained out by posterior and/or superior edge and then dispersed to ethmoid sinus. In some cases, tracer agent often stacked in the maxillary sinus and could not be drained out. When there was a need to enlarge the maxillary natural ostium in ESS, it should be done in the anterior and/or posterior edge of natural ostium, the inferior edge should not be damaged so as not to interfere the passage of mucociliary transportation system of the maxillary sinus.
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Affiliation(s)
- Cheng-Li Xu
- Otorhinolaryngology Hospital, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
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Zuo KJ, Xu G, Xu R, Shi JB, Wen WP, Chen HX, Hu LJ, Liu LQ. [Quality of life outcome of patients with chronic rhinosinusitis and nasal polyposis after endoscopic sinus surgery and its influencing factors]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2008; 43:192-197. [PMID: 18630281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To explore the quality of life (QOL) outcome of patients with chronic rhinosinusitis (CRS) after endoscopic sinus surgery (ESS) and its influencing factors. METHODS prospective trial was conducted to survey the QOL status of 120 CRS patients undergoing ESS, in contrast that of 200 healthy individuals passing health examination, at the baseline and at 12-months after operation by Medical Outcomes Study Short Form-36 (SF-36) and Sino-Nasal Outcome Test-20 (SNOT-20). QOL changes and its influencing factors were analyzed statistically. RESULTS (1) By the assessment of SF-36, the scores of 6 domains were less than that of healthy individuals preoperatively (P < 0.01). After 6 months, the scores of these domains resumed normal level and the proportion of scores also restored normally (P > 0.05). (2) By the assessment of SNOT-20, the total scores of 20 items and 5 most important items of patients were more than that of healthy objects (P < 0.01). After 9 and 12 months, the former and latter returned to normal, respectively (P > 0.05). In 12 months setting, the proportion of scores also restored normally (P > 0.05). (3) According to the survey of SNOT-20, we concluded the following equation: convalescent time (months) = 39--(normal scores/preoperative scores) x 50, by which the time of coming back to normal QOL status can be computed. (4) By analysis of Logistic Regression, residence in city or country, course of disease, extension of diseased sinus, and coexistence of nasal polyposis or not were correlated to the preoperative QOL scores; working environments, surgical extension, and preoperative scores of QOL were correlated to the score difference between pre and post operation. CONCLUSIONS CRS patients undergoing ESS could obtain entirely normal QOL status at 12 months postoperatively, so we suggest that the essential follow-up period should last at least one year. The risk factors influencing patients QOL status preoperatively includes residence in country, longer course of disease, more extension of diseased sinus, and coexistence of nasal polyposis. The risk factors hindering the improvement of QOL status postoperatively includes exposure to indoor working environments, insufficient surgical extension, and lower preoperative QOL scores.
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Affiliation(s)
- Ke-Jun Zuo
- Otorhinolaryngology Hospital and Institute of the First Affiliated Hospital of SUN Yat-sen University, Guangzhou 510080, China
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Fan YP, Xu G, Zuo KJ, Xu R, Jiang HY, Lin ZB, Shi JB. [Detection of specific IgE of anti-Staphylococcus aureus enterotoxins in nasal polyps and analysis theoretically about the superantigen hypothesis]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2006; 41:825-9. [PMID: 17283535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To search the evidence for the presence of superantigen of Staphylococcus aureus enterotoxin (SE) in the pathogenesis of nasal polyposis. METHODS In a cohort of population composed of 42 cases who belonged to three groups: nasal polyposis, simple chronic rhinosinusitis (CRS), and control group without any rhinopathy, detecting the specific IgE against SE-A and B (SEA and SEB), total IgE (TIgE), eosinophilic cationic protein (ECP) of the local mucosa by means of FRAST (UniCAP system), as well as the serum TIgE, and serum anti-SEA and SEB SIgE (only in 8 cases); meanwhile the secretion culture was performed for aerobic bacteria from the middle meatus. RESULTS There was no evidence to support that SE played as a superantigen in all mucosa samples (42 cases) and 8 cases serum samples out of the 42 patients. The range of TIgE in mucosa was 4.59 -70.21 kIU/2 mg tissue protein, the mean was (17.85 +/- 14.31) kIU/2 mg tissue protein; in serum the total IgE was 7.44 - 344.00 kIU/L, the mean was (88.65 +/- 80.03) kIU/L The positive culture of Staphylococcus aureus was obtained from only 3 cases from secretion of middle meatus (1 from nasal polyps, 2 from CRS). There was no significance statistically among the three groups on the tissue fluorescence value of SIgE for SE, the means of tissue TIgE and ECP. CONCLUSIONS No evidence was found to support the role of SE acting as a superantigen among our cases who did not have persistent asthma. It is suggested that further study and investigation is required to prove the superantigen Hypothesis in the pathogenesis of NPs.
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Affiliation(s)
- Yun-Ping Fan
- Hospital of Otorhinolaryngology, First Affiliated Hospital of Sun Yat-Sen University, Otorhinolaryngology Institute of Sun Yat-Sen University, Guangzhou 510080, China
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Zuo KJ, Sun JZ, Zhang JF, Nie YC, Liu JL. Genetic diversity evaluation of some Chinese elite cotton varieties with RAPD markers. Yi Chuan Xue Bao 2001; 27:817-23. [PMID: 11132498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
RAPDs analysis was used to assess the genetic diversity of some elite cotton varieties. 17 cotton varieties or breeding lines were screened with 200 arbitrary primers to generate 113 polymorphic bands. Cluster analysis and UPGMA showed that 17 varieties could be put into 3 clusters corresponding to genome difference. The genetic similarity among them ranged from 0.2000 to 0.8451. Three elite varieties Ejing-1, Sumian-3 and Zhongmiansuo-12 are highly similar in genetic base. 7581, an offspring from Gossypium hirsutum x G. hirsutum race Latifolium, is distinct from other upland cotton varieties. A trend in germplasm usage in the same research center was also shown in the study. To sustain progress in genetic improvement, we suggest that some good gene from other species should be considered in the upland cotton breeding procedure.
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Affiliation(s)
- K J Zuo
- National Key Lab of Crop Genetic Improvement, Huazhong Agricultural University, Wuhan 430070, China
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