Objectives: To explore the effect of intranasal administration of rh-bFGF on postoperative chronic rhinosinusitis with nasal polyps(CRSwNP) patients. Design: A prospective, randomized, controlled, double-blinded trial. Setting and Participants: 75 hospitalized patients who met the criteria of primary bilateral CRSwNP were enrolled from March 2020 to January 2021. Main outcome measures: Visual analogue scale, 22 item Sino-Nasal Outcome Test ,Lund-Kennedy system, and Scanning electron microscopy and Quantitative real-time PCR. Results: 75 patients with CRSwNP were randomly divided into three groups, and 72 patients completed the 1-month medication regimen and 1 year follow-up. Rh-bFGF nasal spray and drop application reduced general nasal VAS scores within two weeks after ESS compared to the control group. In contrast, only rh-bFGF nasal drops reduced SNOT-22 scores at 2 weeks and 1 year compared to the control group. A significant reduction in the endoscopic L-K score was observed in the rh-bFGF nasal spray and drop group compared to the control group. This is primarily because rh-bFGF promotes cilia growth in the nasal mucosal epithelium after the operation, as illustrated by scanning electron microscopy and expression of CP110, Tap73 and Foxj1 mRNA. For eosinophilic CRSwNP, the general VAS score of rh-bFGF nasal drops was more obviously reduced compared to the control group after ESS. A similar trend was observed for L-K score. Conclusions: Rh-bFGF nasal-drops and sprays can quickly and effectively relieve postoperative symptoms and improve long-term prognosis of patients with CRSwNP. Moreover, rh-bFGF nasal-drops are also an effective method for postoperative patients with eosinophilic CRSwNP.

Abstract Objectives: To assess the impact of risk factors on the disease control among CRS patients, following 1 year of functional endoscopic sinus surgery (FESS), and combining the risk factors to formulate a convenient, visualized prediction model. Design: A retrospective and nonconcurrent cohort study Setting and Participants: A total of 325 patients with Chronic rhinosinusitis (CRS) from June 2018 to July 2020 at the First Affiliated Hospital, the Third Affiliated Hospital, and the Seventh Affiliated Hospital of Sun Yat-sen University. Main Outcomes Measures: Outcomes were time to event measures: the disease control of CRS after surgery 1 year. The presence of nasal polyps, smoking habits, allergic rhinitis (AR), the ratio of tissue eosinophil (TER), and peripheral blood eosinophil count (PBEC)and asthma was assessed. The logistic regression models were used to conduct multivariate and univariate analyses. Asthma, TER, AR, PBEC were also included in the nomogram. The calibration curve and AUC (Area Under Curve) were used to evaluate the forecast performance of the model. Results: In univariate analyses, most of the covariates had significant associations with the endpoints, except for age, gender, and smoking. The nomogram showed the highest accuracy with an AUC of 0.760 (95% CI, 0.688-0.830) in the training cohort. Conclusions: In this cohort study that included the asthma, AR, TER, PBEC had significantly affected the disease control of CRS after surgery. The model provided relatively accurate prediction in the disease control of CRS after FESS and served as a visualized reference for daily diagnosis and treatment.