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Purpose: The purpose was to review relevant clinical data and formulate recommendations supporting the use of saline as a simple rinse for an early reassuring intervention to reduce the occurrence of re-positive COVID-19 patients. Methods: We conducted a single-centre retrospective cohort study, which enrolled patients with confirmed re-testing positive COVID-19 during 7-60 days after discharge from Third People's Hospital of Shenzhen. By one-to-two propensity score matching for age and sex, the control group of those not re-testing positive during the same period served as matched control. Results: A total of 223 patients were included in our study, 94 in re-positive group and 129 in non-re-positive group. The result shows that the rates of nasal douche treatment in the non-re-positive group were considerably higher than that of the re-positive group. And the Ct value of nasal douche group increased faster than that of non-nasal douche group after the Ct value reaching ≥35. Further analysis revealed that the higher the Ct value at the time of readmission, the shorter the time of average Ct values to reach ≥35. Conclusion: These findings suggest that nasal douche is beneficial to shorten the time of virus nucleic acid turning negative, thereby reducing the incidence of re-positive. The prevention and control of epidemics focuses on re-positive patients with Ct values <35.

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Functional endoscopic sinus surgery (FESS) is the gold standard treatment for medically refractive chronic rhinosinusitis, aimed at removing diseased tissue and improving natural sinus drainage and aeration. Irrigation of the sinuses has been known to improve sinus mucosal health and is an essential adjunct to surgery. There are a number of methods, devices, and solutions available which are used for nasal irrigation. Neti Pot, squeeze bottle, syringe, rubber bulb and commercially available nasal sprays are some of the simpler used devices used for douching. Electric devices like flosser, Hydropulse and the Navage nasal irrigation systems are available but it's not clear if they provide any advantage over the other methods. We use and propose a gravitational pressure-pulsed device which provides adequate volume and force without the need for external pressure. Salt with sodium bicarbonate is the most used solution base. Hypertonic saline has been described to be more efficacious compared to isotonic saline. Additives such as sodium hypochlorite, antibiotics, corticosteroids, manuka honey and xylitol have proven to be beneficial. Large volume positive pressure irrigations have proven to be beneficial. Optimal position for irrigation varies for low or high-volume irrigation systems. Patient education regarding precautions and disinfection of the device is a must.

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Hyaluronic Acid (HA) plays many roles in wound healing in general, through different mechanisms. Several authors reported the effectiveness of hyaluronic acid in promoting mucosal healing and reducing discomfort for patients after endoscopic sinus surgery (ESS). Different methods for HA nasal administration have been reported. The aim of our study has been to evaluate the efficacy of the administration of nebulized HA through a nasal douche compared with its administration through a nasal spray with patients undergoing ESS for chronic rhinosinusitis. From January 2013 to January 2019 a prospective clinical trial was carried out in our hospital with 163 patients who had undergone ESS for chronic rhinosinusitis. The sample was divided into three groups according to the method of administration of HA. Our study confirm the efficacy of the administration of nebulized HA through nasal douche in post-operative care (6.5% vs 4.5%). The most relevant data regards the nasal dryness sign: the data revealed an unexpected percentage of worsening of that sign at time T3 (p = 0.049) particularly evident in the patients treated with HA through nasal douche compared to whom the nasal spray device was prescribed (4% vs 1%). Further studies are needed to identify the best means of administration of HA, which would satisfy the requirements for efficacy in terms of the results and, at the same time, patient compliance.

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Objective:To investigate the effectiveness and safety of nasal lavage with hydrogen-rich saline in the treatment of moderate to severe allergic rhinitis.Method:Twenty patients with moderate to severe persistent allergic rhinitis were treated with normal saline and hydrogen-rich saline lavage the nasal cavity. The study was randomized doubl-blind self-control study. The symptoms and signs score, treatment index and total effective rate were evaluated before and after treatment, and the nasal conjunctivitis related quality of life questionnaire (BQLQ) was used to evaluate the life quality of patients.Result:There were significant differences of the symptoms, signs scores, the treatment index, the total efficiency and BQLQ between the two kinds of lavage fluid used for patients before and after treatment(P<0.05). No significant adverse reactions occurred during follow-up.Conclusion:Hydrogen-enriched saline is safe and effective for allergic rhinitis.

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Objective Allergic rhinitis (AR) is studied extensively while nonallergic rhinitis (NAR) insufficiently in the recent years .The aim of this study is to describe the inflammation characteristics of different types of NAR . Methods Using the skin prick test , we investigated the characteristics , nasal cytokine levels , serum cytokine levels , and the proportion of peripheral blood Treg cells in 12 cases of AR, 10 cases of NAR with eosinophilia (EOS) syndrome (NARES), 12 cases of NAR without ES (NAR), and 11 control adults . Results The NARES patients had a signifi-cantly higher level of IFN-γ(28.89 [10.97-127.07] pg/mL) than the control (8.98 [7.88-14.90] pg/mL) and the NAR patients (7.92 [7.67-45.85] pg/mL) ( P<0.05) but a lower level of nasal IL-10 than the control ([3.97±0.68] vs [4.80±1.32] pg/mL, P<0.05) .The contents of nasal IL-4, serum IL-4, nasal IL-17 and ser-um IL-17 were all markedly higher in the AR and NARES groups than in the control (P<0.05).The proportion of CD4+CD25+FOXP3+Treg cells in the CD4+T cells in the peripheral blood was (4.5±1.3)%in the AR group and (4.0±1.8) %in the NARES group, both significantly lower than (6.5±1.0) %in the control group (P<0.05) and (6.5±1.0) %in the NAR group (P<0.05). Conclusion NAR was classified according to the EOS level into NARES and NAR without EOS, which had different mechanisms and manifestations of inflammation and similar inflammatory manifestations of Th 2 and Th17.The classification of rhinitis by the level of EOS has more practical significance .

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Objective Nonallergic rhinitis with eosinophilia syndrome (NARES) is associated with such diseases as bronchial asthma , nasal polyps , and aspirin intolerance , but there is a lack of studies on its inflammatory conditions .The aim of this study is to describe the inflammation characteristics of NARES . Methods This study included 101 cases of allergic rhinitis ( AR) , 39 cases of NARES, and 162 adult controls .We analyzed the inflammation char-acteristics of the patients using skin prick test ( SPT) , nasal douche , fractional exhaled nitric oxide ( FeNO ) measurement , serum eosino-phil (EOS) counting, serum total IgE (tIgE) determination, induced sputum detection, and nasal and bronchial provocation tests . Results Compared with the controls , the NARES and AR groups showed significant increases in the positive rate of nasal provocation (32.1%vs 69.2%and 75.2%, P<0.05), positive rate of bronchial provocation (1.2%vs 10.3%and 14.9%, P<0.05), and FeNO level ([15.70 ±5.20] ppb vs [37.25 ±22.95] and [39.00 ±24.29] ppb, P<0.05), as well as in the serum EOS and tIgE levels, EOS count, and ratio of EOS in the induced sputum (P<0.05).However, the level of serum tIgE was significantly lower in the NARES than in the AR group (53.3 [23.3-186.0] kU/L vs 197.0 [62.6-391.0] kU/L, P<0.05). Conclusion NARES is a syndrome with nasal, lower airway, and systematic inflammation, similar to AR in inflammatory intensity.Therefore, for patients with NARES, attention should be paid not only to upper airway but also to lower airway and systemic inflammation .

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The study aims to investigate nasal and lower airway inflammation in patients with non-allergic rhinitis (NAR), and to discuss a method of NAR classification based on inflammatory characteristics and its clinical significance. A total of 117 NAR patients admitted to our hospital from June 2010 to June 2011 were enrolled in this study, 162 healthy participants were employed as healthy controls. Nasal and lower airway inflammation were evaluated using the skin prick test, nasal and pulmonary visual analogue scale scoring, cell blood count, nasal douche, induced sputum assay, nasal provocation test, and bronchial provocation test. Compared to the healthy controls, NAR patients have significant higher levels of nasal douche eosinophils, more induced sputum eosinophils as well as blood eosinophils, and higher rates of nasal and bronchial provocation. Patient with high level of eosinophil in nasal douch tended to be with higher concentrations of eosinophils in induced sputum. Scores on the nasal and bronchial provocation tests are also correlated to each other. Among all NAR patients, 28 cases (23.9%) were with no abnormality detectable by eosinophil measurement or a provocation test, 39 cases (33.3%) were with elevated levels of eosinophils, and 50 cases (42.7%) exhibited a nasal provocation response. Based on this, all studied NAR cases were classified into 3 groups: non-specific type (group A, 28/117), increased eosinophil type (group B, 39/117), and hyper-reactive type (group C, 50/117). Some NAR cases may be considered as systemic inflammatory disease characterized by increased nasal eosinophil and nasal hyperreactivity.

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BACKGROUND: The use of nasal irrigation in the management of postoperative endoscopic sinus surgery (ESS) patients is commonplace; however, the potential contamination of these bottles is concerning. The Sinugator® cordless pulsating nasal wash (NeilMed Pharmaceuticals, Inc., Santa Rosa, CA) is a battery-operated, positive pressure, pulsatile pump with a unidirectional flow. The principal aim of this study was to determine the incidence of cross-contamination using the pulsating nasal irrigation device and compare it with the traditional squeeze bottle. METHODS: Eleven post-ESS patients were given a NeilMed Sinugator nasal wash to use 3 times per day. A sterile nasal swab was obtained at the initial and second postoperative visits. A swab of the plastic irrigation reservoir was collected at the second visit. RESULTS: The overall contamination rate of bottles was found to be 45%. During the study several different organisms were cultured in the nose and bottles. The most commonly isolated organisms were coliforms and Staphylococcus aureus. We did not observe concomitant organisms in the nasal cultures and bottles in any subject. CONCLUSION: Despite using a motorized irrigation device, patients and their bottles grew positive cultures. However, no cross-contamination between the patients and bottles was identified, which can be attributed to a design that minimizes backwash.

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Objective To observe the clinical effect of nasal douche washing and nasal cleaning under the endoscope treatment for sinusitis after nasopharyngeal carcinoma radiotherapy.Methods Thirtyeighty cases of sinusitis after nasopharyngeal carcinoma radiotherapy was treated by nasal douche washing and nasal cleaning under the endoscope.The course of treatment were for 6 months.The clinical effect were evaluated with the chronic sinusitis visual analogue scale(VAS)and Lund-Mackey nasal sinuses CT image mark system before and after treatment.Results After treatment for 6 months,the VAS scores and LundMackey nasal sinuses CT image mark system scores significantly decreased compared with before treatment [(8.21 ± 1.57)scores vs.(3.01 ± 1.16)scores,(7.37 ± 1.44)scores vs.(3.23 ± 1.07)scores](P ＜ 0.05).Conclusions The nasal douche washing and nasal cleaning under the endoscope treatment for sinusitis after nasopharyngeal carcinoma radiotherapy has positive clinical effect,which is a better treatment method.

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BACKGROUND AND OBJECTIVES: A recently proposed apparatus for the treatment of nasal inflammatory affections is the atomized nasal douche. The aim of the paper was to assess the efficacy of the atomized nasal douche in patients affected by acute or chronic rhinopathy. MATERIALS AND METHODS: We selected 60 adult patients: They were subdivided into two groups and each group consisted of 15 patients suffering from vasomotor rhinitis and 15 patients affected by acute rhinitis. The former underwent atomized nasal douche and the latter underwent nasal lavages with saline solution. We performed bacterial cultures of the nasal swab and the secretions drawn from the nasal cavity, a rhinomanometric test, an assessment of the symptomatologic score before and after the treatment in all the patients. RESULTS: At the end of treatment, there was a reduction or complete disappearance of the bacterial colonies in 23 of the 30 patients treated with the atomized nasal douche, while in the control group the same result occurred in only 10 of the 30 patients. CONCLUSION: Our results confirm that the atomized nasal douche performs an efficacious lavage of the nasal cavity, representing a good support for the treatment of inflammatory processes of the nose.

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BACKGROUND AND OBJECTIVES: A recently proposed apparatus for the treatment of nasal inflammatory affections is the atomized nasal douche. The aim of the paper was to assess the efficacy of the atomized nasal douche in patients affected by acute or chronic rhinopathy. MATERIALS AND METHODS: We selected 60 adult patients: They were subdivided into two groups and each group consisted of 15 patients suffering from vasomotor rhinitis and 15 patients affected by acute rhinitis. The former underwent atomized nasal douche and the latter underwent nasal lavages with saline solution. We performed bacterial cultures of the nasal swab and the secretions drawn from the nasal cavity, a rhinomanometric test, an assessment of the symptomatologic score before and after the treatment in all the patients. RESULTS: At the end of treatment, there was a reduction or complete disappearance of the bacterial colonies in 23 of the 30 patients treated with the atomized nasal douche, while in the control group the same result occurred in only 10 of the 30 patients. CONCLUSION: Our results confirm that the atomized nasal douche performs an efficacious lavage of the nasal cavity, representing a good support for the treatment of inflammatory processes of the nose.

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