| Objective:The ciliary structure,pathological morphology,number of eosinophils,number of CD4+T cells,CD8+T cells,and TH2 cytokines were observed before reboot operation and after reboot operation in patients with type 2 CRSw NP.To explore the clinical value and significance of reboot in patients with type 2 CRSw NP.Methods:1.The experimental group included patients diagnosed with type 2 CRSw NP who were admitted to our department from June 2021 to August 2022 and underwent reboot surgery;2.The mucosa of ethmoid region was taken during reboot operation and 1,3,and 6 months after reboot operation;3.Patients with type 2 CRSw NP were given nasal symptom score,endoscopic nasal polyps score,and sinus CT scan score before reboot operation and 1,3,and 6months after operation;4.HE staining was used to detect the histopathological changes and eosinophil infiltration of ethmoid mucosa before reboot operation and 1,3,and 6 months after operation;5.The changes of CD4+T and CD8+T cells in ethmoidal mucosa before and after reboot operation were detected by immunohistochemistry;6.The concentrations and changes of type 2 cytokines(IL-4,IL-5,IL-9,IL-13,IL-25,and IL-33)in ethmoidal mucosa of patients before and after reboot operation were measured by ELISA;7.The changes in the ciliary structure of ethmoidal mucosa were observed under transmission electron microscope and scanning electron microscope before reboot operation and 1,3,and 6 months after operation;Result:1.The VAS score,SNOT-22 score,Lund-Kennedy nasal endoscopy score,and Lund-Mackay sinus CT score of patients with type 2 CRSw NP after reboot operation were significantly lower than those before operation;2.After reboot operation,the histopathological morphology of ethmoid mucosa was significantly improved compared with that before operation,and the number of eosinophils was reduced compared with that before operation;3.Compared with before operation,the number of CD4+T and CD8+T cells in ethmoid mucosa decreased significantly after reboot operation;4.The concentration of type 2 cytokines(IL-4,IL-5,IL-9,IL-13,IL-25,and IL-33)in the ethmoid mucosa of patients after reboot operation decreased gradually compared with that before operation;5.The cilia structure and morphology of ethmoid mucosa in patients were gradually improved 1,3,and 6 months after reboot operation.Conclusion:1.The number of type 2 cytokines IL-4 and IL-5,eosinophils,CD4+T cells,and CD8+T cells in the regenerated ethmoid mucosa of patients with type 1 and type 2CRSw NP after reboot surgery decreased compared with that before surgery,and the decrease was more obvious at 6 months.2.The number,shedding,disorder,mucus attachment,and pathological injury of the regenerated ethmoid mucosa were improved compared with those of the diseased ethmoid mucosa before operation,and were significantly improved at 6months of follow-up,but did not return to the normal nasal mucosa. |
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