We investigated the mechanisms underlying the therapeutic effects of Yiqi Jiemin decoction (YJD), a traditional Chinese medicine (TCM), in the ovalbumin (OVA)-induced allergic rhinitis (AR) model in guinea pigs. YJD significantly decreased infiltration of mast cells and eosinophils into the nasal mucosa of AR model guinea pigs. YJD also increased expression of TGF-β in the nasal mucosa, restored the balance of Th1/Th2 immune cell responses, and decreased serum levels of various pro-inflammatory mediators, including histamine (HA), neuropeptide Y (NPY), acetylcholine (ACH), norepinephrine and immunoglobulin E (IgE). Metabolic analyses using liquid chromatography coupled with high-resolution mass spectrometry revealed that YJD improved cellular metabolism in AR model guinea pigs and increased serum levels of glycocholic acid while decreasing levels 1-palmitoyl lysophosphatidic acid. RNA-sequencing analysis identified BPIFB2 as a potential diagnostic biomarker and therapeutic target for AR. Functional enrichment analyses showed that YJD significantly inhibited cytokine secretion pathways in AR model guinea pigs. These findings demonstrate that YJD protects against OVA-induced AR in guinea pigs by suppressing inflammation in the nasal mucosa, restoring Th1/Th2 balance, and improving cellular metabolism.

Background: Acupuncture is used to treat allergic rhinitis (AR) in traditional Chinese medicine, and the ST2 and ST36 acupoints are generally selected in clinical practice. We report a new intranasal acupuncture method at the Neiyingxiang (EX-HN9) and Biqiu points for the treatment of persistent AR (PAR). Here, the efficacy and safety of this method were evaluated. Methods: A total of 120 patients diagnosed with PAR were randomly allocated (2:1 ratio) to intranasal acupuncture or Western medicine groups, the basic principle of random grouping is SAS random grouping method. The applicator held a nasal endoscope and a 0.30 × 75 mm filiform needle in their left and right hands, respectively. When aiming at the Neiyingxiang or Biqiu point, the applicator quickly inserted the needle to a 20-mm depth as parallel as possible to the inferior turbinate or middle turbinate, without special reinforcing and reducing techniques (the needle remained for 20 min). The intranasal acupuncture groups received acupuncture treatment three times per week for 2 weeks. The Western medicine group was treated with budesonide nasal spray (two sprays/nostril, twice/day) and loratadine (one tablet/night) for 2 weeks. Visual analog scale (VAS) scores were the primary outcome. Quality of life, medication dosages and adverse events were secondary outcomes measured using the Rhinoconjunctivitis Quality-of-Life Questionnaire (RQLQ). Confidence assessments were performed to evaluate data from the treatment and follow-up periods. Results: The results were as follows: (1) VAS and RQLQ scores were significantly lower in the intranasal acupuncture group than in the Western medicine group on day 1 (i.e., first treatment) (P < 0.05; 95% CI − 13.1 to − 9.6 VAS points) (P < 0.05; 95% CI − 20.27 to − 12.28 RQLQ points). Overall symptoms (95% CI − 2.86 to − 1.86 points), nasal obstruction (95% CI − 6.33 to − 5.36 points), olfactory function (95% CI − 2.91 to − 1.75 points), sleep (95% CI − 5.05 to − 3.57 points), actual problems (95% CI − 2.03 to − 0.06 points), nasal symptoms (95% CI − 6.62 to − 4.5 points), and emotional problems (95% CI − 5.05 to − 3.5 points) were significantly improved. (2) VAS and RQLQ scores in the two groups were significantly improved at week 2; however, there were no significant group differences in the VAS (P > 0.05; 95% CI − 1.21 to − 1.38 points) and RQLQ (P > 0.05; 95% CI − 0.33 to − 3.46 points) scores. Olfactory function symptoms were significantly improved (95% CI − 1.58 to − 0.21 points). (3) During the follow-up period, there was a significant difference between the two groups (P < 0.05) with higher RQLQ and VAS scores in the intranasal acupuncture group than in the Western medicine group. VAS scores on rhinobyon symptoms, nasal itch, rhinorrhea and olfactory function and RQLQ scores for activities, non-nasal/eye symptoms, actual problems, nasal symptoms, and eye symptoms were significantly improved. (4) No adverse events were observed in either group during treatment. Conclusions: Intranasal acupuncture has good efficacy and safety in the treatment of PAR. Moreover, VAS and RQLQ scores were much lower in the intranasal acupuncture group than in the Western medicine group, and acupuncture had an immediate impact, especially for improving nasal congestion, olfactory function and sleep.

Post-viral olfactory dysfunction (PVOD) is the common symptoms of long COVID, lacking of effective treatments. Traditional Chinese medicine (TCM) is claimed to be effective in treating olfactory dysfunction, but the evidence has not yet been critically appraised. We conducted a systematic review to evaluate the effectiveness and safety of TCM for PVOD. We searched eight databases to identified clinical controlled studies about TCM for PVOD. The Cochrane risk of bias tools and GRADE were used to evaluate the quality of evidence. Risk ratio (RR), mean differences (MD), and 95 % confidence interval (CI), were used for effect estimation and RevMan 5.4.1 was used for data analysis. Six randomized controlled trials (RCTs) (545 participants), two non-randomized controlled trials (non-RCTs) (112 participants), and one retrospective cohort study (30 participants) were included. The overall quality of included studies was low. Acupuncture (n = 8) and acupoint injection (n = 3) were the mainly used TCM therapies. Five RCTs showed a better effect in TCM group. Four trials used acupuncture, and three trials used acupoint injection. The results of two non-RCTs and one cohort study were not statistically significant. Two trials reported mild to moderate adverse events (pain and brief syncope caused by acupuncture or acupoint injection). Limited evidence focus on acupuncture and acupoint injection for PVOD and suggests that acupuncture and acupoint injection may be effective in improving PVOD. More well-designed trials should focus on acupuncture to confirm the benefit. The protocol of this review was registered at PROSPERO: CRD42022366776.

Bacterial meningitis is a rare event in children with cochlear implants. A 7-year-old child who underwent cochlear implantation (CI) for the right ear 6 years ago was admitted to our hospital with the chief complaint of intermittent fever and headache for 6 months. Cochlear implant infection was suspected. The right cochlear implant removal and middle ear exploration were performed. Postoperatively, the bacterial cultures of cerebrospinal fluid (CSF), cochlear implant and inserting electrodes all suggested Pseudomonas aeruginosa. The body temperature of the child was controlled within 2 weeks after the operation by using meropenem, and other symptoms like headache and abdominal pain disappeared. During 20-month follow-up visit, the child did not suffer any discomforts. In conclusion, we reported a child who developed Pseudomonas aeruginosa meningitis following head injury after CI. This case should serve as a reminder for clinical doctors.

Allergic rhinitis (AR) is a prevalent allergic condition affecting the nasal mucosa. Intranasal acupuncture therapy (IAT), an innovative therapy that involves the precise insertion of acupuncture needles into specific nasal acupoints, has demonstrated potential effects in managing AR. The aim of this study was to evaluate the effectiveness and safety of IAT in the management of AR. Nine databases were systematically searched for randomized controlled trials (RCTs) from their inception to September 2024. We included participants who were diagnosed with AR and who received IAT alone or as add-on treatment to conventional treatment. The Cochrane risk of bias 2.0 tool and the GRADE approach were used to assess the quality of the studies. A meta-analysis was performed via RevMan 5.4.1 software. Twenty-one RCTs with 1889 participants were included. The certainty of evidence was generally low or moderate. Compared with sham acupuncture, the IAT significantly reduced the total nasal symptom score (MD −2.65, 95% CI −4.01 to −1.29, 1 RCT, 30 participants, moderate evidence). Compared to an antihistamine, IAT was associated with a lower total nasal non-symptom score (MD −0.44, 95% CI −0.64 to −0.25, 5 RCTs, 295 participants, moderate evidence) and a better quality of life measured by the rhinoconjunctivitis quality of life questionnaire (MD −13.72, 95% CI −18.01 to −9.43, 4 RCTs, 255 participants, moderate evidence). No serious adverse events were reported. The IAT may be beneficial for improving AR-related symptoms and quality of life. However, the safety of the IAT remains unclear due to inadequate reporting. Further high-quality, rigorously designed, and well-reported trials are needed. PROSPERO, CRD42024526357.