Winter haze is frequent, the flu (H7N9) rampant, a serious threat to our health, the nose as the body’s first contact with the outside air, the first to bear the brunt of the attack. Can your nose hold up? In the face of the severe haze and the rampant flu virus, we suggest that you might want to give your nose a bath more often. First, let’s understand how our nose works? In addition to breathing, our nose also has protective functions such as moisturizing, heating and dust removal. In normal people, the epidermal mucous membrane cells in the nasal cavity and sinuses continuously secrete clear liquid, and then through the regular and coordinated movement of tens of thousands of cilia on top of the mucous membrane cells, these secretions flow from the sinuses, through the nasal cavity to the nasopharyngeal cavity, throat and then swallowed into the esophagus and stomach before being broken down. This is called the “mucus-cilia defense system”, which includes the cilia that transport mucus and the cells that secrete mucus, both of which are important for protecting the health of the respiratory tract. When this mechanism works well, it can remove the invading pollutants and harmful germs in a timely and effective manner, and you will be in a healthy state. When our health condition decreases or inhalants damage or overload the “mucus-cilia defense system”, it may cause disease, for example, due to the massive invasion of viruses and bacteria, or the strong stimulation of allergens and pollutants, resulting in inflammation of the nasal mucosa, which turns clear mucus secretion into pus, or the loss of coordinated cilia movement with regularity, both of which produce pusy nasal discharge. Both of them can produce pusy nasal discharge or nasal backflow, which can cause sinusitis or various rhinitis diseases. At this time, giving proper nasal rinsing can help our “mucus-cilia defense system” and restore its optimal defense status, which can not only prevent but also cure the disease. Next, let’s understand what is haze and flu? Haze is the collective name of fog and haze, the composition is very complex, the most important is sulfur dioxide, nitrogen oxides and respirable particulate matter, the first two are gaseous pollutants, the last particulate matter, mainly including dust, sulfuric acid, nitric acid, organic hydrocarbons and other particles, is the culprit to aggravate the haze weather pollution. Harmful to health is mainly particulate matter less than 10 microns in diameter, such as mineral particles, sea salt, sulfate, nitrate, organic aerosol particles, fuel and automobile exhaust, etc. It is characterized by the ability to directly enter and adhere to the mucous membranes of the upper and lower respiratory tracts of the human body, and is not easily discharged. In hazy weather, bacteria, viruses and allergens in the air are attached to pollutant particles, which will affect the movement and self-cleaning function of cilia after inhalation, often exceeding the load of the “mucus-cilia defense system”, resulting in the deposition of nasal mucosa and cilia dirt, easily causing upper respiratory tract infections, irritation and allergy symptoms This can lead to allergic rhinitis, sinusitis, tonsillitis, adenoid hypertrophy, bronchitis, asthma or pneumonia, or aggravate chronic obstructive pulmonary disease (emphysema, pulmonary heart disease). Patients with allergic rhinitis are most affected by hazy weather, and children are more sensitive to haze pollution, which can promote and induce various allergy symptoms such as asthma when particulate matter is inhaled into the body. The nose is used for inhalation and is the first line of defense against the invasion of haze into the body, so we recommend that after returning home from a serious haze day, in addition to washing your face, you should also wash your overburdened nose to restore his best defense and reduce the retention time of harmful substances in the nasal cavity. It is well known that cold and flu viruses invade the body first through the nose. Studies by the Centers for Disease Control and Prevention show that viruses can lurk in nasal secretions for 24 hours to 4 days, so in order to control the infection and spread of viruses in the population, we should pay more attention to the nose. Washing hands alone is not enough, because virus infection and transmission is mainly through the respiratory route and rarely through the mouth, so washing the nose is much more useful than washing hands. Timely removal of viruses from the nasal passages can greatly reduce the risk of getting a cold or flu. We believe that nasal rinsing is a simple, safe, economical and effective way to fight a cold or flu. Its effectiveness has been confirmed by the latest clinical studies: daily nasal rinses are not only effective in preventing colds in adults and children, but also in relieving symptoms and shortening the duration of illness in cold and flu patients, and some studies have shown that nasal rinses after a cold can reduce the use of antibiotics and decongestants in children. Rinsing the virus out of the nasal passages protects both yourself and those around you. Why do nasal rinses reduce the spread of viruses? Quite simply, by rinsing out the virus, the amount of virus in the droplets when people sneeze or cough is greatly reduced. Again, let’s understand how nasal rinsing works. Nasal flushing can do the following: 1) mechanically flush out disease-causing microorganisms from the nasal cavity; 2) mechanically flush out pollen, dust and other airborne pollutants from the nasal cavity; 3) soften and flush out mucous or purulent secretions formed in the nasal cavity; 3) dilute, reduce and remove inflammatory mediators from the nasal cavity; 4) promote the formation of a thin protective liquid film on the surface of the nasal mucosa The nasal cavity mucous membrane can be restored, promoted or activated to enhance the self-cleaning and protective effects of the nasal cavity and sinuses; 6, promote or restore the normal biological microenvironment of the nasal cavity and sinuses, so that the self-healing of the disease can be promoted by inhibiting the growth of pathogenic microorganisms; 7, relieve nasal congestion in a non-surgical manner. In conclusion, nasal irrigation can help our “mucus-cilia defense system” during the high season of influenza and haze, and can play an important role in the prevention and treatment of respiratory diseases. Finally, let’s understand who needs nasal rinsing and how to do it? Like brushing the teeth, nasal rinsing can reduce the incidence of respiratory diseases such as nasal and/or sinus disease by removing pathogens from the nasal cavity before they cause disease. Currently, there are also opinions that healthy people should not wash their nose, but we believe that nasal rinsing is like washing your hands. If your hands are clean, you can certainly do without it, but when they are dirty or during a cold and flu epidemic, it is best to wash your hands regularly, and when your nose is fine, you can certainly do without it, but when it is uncomfortable or during a cold and flu season or in a polluted air environment, it is best to wash to help your health. Of course, the advantages of nasal rinses are more suitable for patients with rhinitis, including: allergic rhinitis, acute and chronic sinusitis, acute and chronic rhinitis, colds and flu, post-nasal drip, post-sinus surgery, pregnant women with rhinitis, post-nasal radiation therapy, and dry syndrome that exhibits dry rhinitis. About the timing and frequency of nasal rinses: As a daily care, nasal rinses can be performed at any time of the day. Nasal rinses can be performed when you feel you have been exposed to pathogens, especially after close contact with someone who coughs or sneezes. In general, nasal rinsing is most convenient at night, when there is no time pressure and your nasal passages can stay clean all night before going out and being exposed to dirty air again. As for the frequency of nasal rinsing: you can wash your nose any time you feel you have been exposed to pathogens. If used as a nose care purpose, we believe that 2 to 3 times a week is sufficient, while patients with rhinitis and other diseases are recommended to wash their nose once a day, and the frequency can be increased when there is a lot of secretion. From the professional point of view of otolaryngologists, we do not recommend rinsing the nose with water alone. Because water is a hypotonic solution compared to the tissue fluid of the nasal mucosa, it will prompt some ions in the nasal solution to leave the nasal mucosa cells, and water will enter the nasal mucosa cells, making the nasal mucosa more swollen and thus destroying the nasal mucosa, so you should not use a lot of water to rinse the nose. Moreover, when using water alone to rinse the nose, the nasal cavity will feel quite tingling and uncomfortable. We advocate the use of warm salt water to wash the nose, that is, 35℃-38℃, too hot or too cold is not suitable. The salt used for rinsing can be purchased in the form of salt packets, or you can mix it yourself at home by adding 3 grams of refined salt (preferably iodine-free table salt) to 300 ml of warm water, or 2 grams of refined salt and 1 gram of baking soda to 300 ml of warm water. There are many kinds of nasal rinsers, and if you buy one, you should choose a rinse that is easy to operate and produced by a regular manufacturer, either manual or electric pulse. Most of the manual rinses are made by tilting the upper body forward, tilting the head slightly to one side, opening the mouth slightly, breathing calmly through the mouth, inserting the olive head of the rinse into the nostril on the high side, holding the olive head with the right hand when washing the right side, and using the left hand when washing the left side. Gently squeeze the soft bottle and wash the rinse fluid from one nostril into the nasal cavity and sinuses, then flow out from the other nasal cavity or mouth via the nasopharynx, alternately washing both nostrils. The liquid remaining in the nasal cavity can be allowed to flow off naturally. Do not pinch and blow your nose in an attempt to drain the liquid in the nasal cavity to avoid causing earache and otitis media. Special attention should be paid to not breathing through the nose when rinsing and not swallowing to avoid choking and coughing. However, nasal rinsing is also limited by age. Children under 6 years old are not suitable for nasal rinsing because of poor cooperation and poor sinus and ear development, which can increase the risk of sinusitis and otitis media. If you cannot do nasal rinsing, you can also use commercial physiological seawater nebulized nasal spray instead, which is hypertonic and contains microelements such as bactericidal (silver, zinc), anti-inflammatory (copper) and anti-allergic (manganese), etc. Safety and comfort are its most important features, and the nozzle design is suitable for both young and old, but the disadvantage is that it is more expensive. Common causes of uncomfortable nasal rinses and ways to improve them: (Tips) The main causes of discomfort are (1) the temperature of the water: use warm water, not cold water; (2) the concentration of salt water: a higher concentration of salt water will sting a little, using clear water without adding the right amount of salt, the quality of salt will also have an impact, some impurities in the water or salt irritation, etc.. So it is better to use high grade refined salt and add baking accompaniment with baking soda; (3) the water speed should not be too strong when rinsing, remember to rinse slowly; (4) when nasal rinsing, must remember not to swallow saliva, spit, or speak. This is because in nasal warm saline therapy, the water enters from one side of the nose, passes around the nasopharynx, and then flows out from the other side of the nose. If you swallow saliva at this time, the Eustachian tube may open up and the water in the nasopharynx may flow through the Eustachian tube toward the middle ear cavity, and you may feel pain in the ear or feel water flowing into the ear, and you may not hear the sound clearly. (2) Do not blow your nose hard when you have just finished flushing. If you blow your nose hard, the water or snot in the nasal cavity may hit the middle ear cavity through the Eustachian tube. In summary, we believe that nasal rinsing is a simple, safe, economical and effective method of health care and adjunctive therapy for nasal diseases.