Autonomic dysfunction as an independent risk factor for uncontrolled inflammation in chronic rhinosinusitis following functional endoscopic sinus surgery.

BACKGROUND: Chronic rhinosinusitis (CRS) is a multi-factorial disorder that causes systemic symptoms beyond rhinologic symptoms alone. A possible association between autonomic nervous system (ANS) dysfunction and CRS has been identified; however, few studies have confirmed this observation. In this study, we prospectively measured changes in ANS dysfunction symptoms following functional endoscopic sinus surgery (FESS) and explored the impact of ANS dysfunction on surgical outcomes of CRS. METHODOLOGY: Patients diagnosed with CRS who consented to surgical intervention were included prospectively. All patients completed the Sino-nasal Outcome Test-22 (SNOT-22) and the 31-item Composite Autonomic Symptom Score (COMPASS 31) questionnaires before the operation and during the follow-up period. Clinical demographic data, Lund-Mackay, and modified Lund-Kennedy scores were recorded and measured. RESULTS: A total of 102 patients were enrolled. The median SNOT-22 and COMPASS 31 scores significantly improved following FESS from 43.0 to 14.0 and 21.0 to 11.2 (all P less than 0.001), respectively. FESS led to a significant reduction in the prevalence of various ANS dysfunction symptoms. In multivariate analyses, revision surgeries (odds ratio [OR] 5.012, 95% confidence interval [CI] 1.52416.489; P=0.008), CRS with nasal polyps (OR 4.071, 95% CI 1.454-11.40; P=0.008), and higher Pre-FESS COMPASS 31 scores (OR 1.043, 95% CI 1.003-1.084; P=0.036) were independent risk factors for uncontrolled inflammation following FESS. CONCLUSIONS: ANS dysfunction symptoms are prevalent in CRS and higher preoperative COMPASS 31 scores correspond with poor surgical outcomes. Following FESS, the majority of ANS dysfunction symptoms can be alleviated. Further investigations are required to explore the possible mechanism of how ANS is involved in the pathogenesis of CRS.

The symptom burden of autonomic dysfunction is positively associated with chronic rhinosinusitis status.

BACKGROUND: Dysregulation of the autonomic system can affect sinonasal physiological function and may exacerbate the symptom burden associated with rhinosinusitis. However, the association between autonomic dysfunction and chronic rhinosinusitis (CRS) has seldom been studied. Here, we investigated the relationship between autonomic dysfunction and CRS. METHODS: Patients with CRS who failed medical treatment were prospectively enrolled. All patients underwent pre-operative examinations and completed questionnaires, including the reflux symptom index (RSI) and the Sino-nasal Outcome Test-22 (SNOT-22). Autonomic dysfunction was scored using the 31-item Composite Autonomic Symptom Score (COMPASS 31), a validated simple instrument used to evaluate dysautonomia. RESULTS: We prospectively enrolled a total of 89 CRS patients, including 37 with polyps (CRSwNP) and 52 without polyps (CRSsNP). The most common dysautonomic symptoms were dry eye, dry mouth, postural dizziness, and a sensation of excessive fullness after meals. Significant positive correlations were evident between COMPASS 31 and SNOT-22 scores in CRSwNP patients. CRS-associated symptoms, including cough, post-nasal drip, sleep, and psychological dysfunction, were correlated with the level of autonomic dysfunction. CONCLUSIONS: We found a positive correlation between the symptom burdens of autonomic dysfunction and CRSwNP. The relationship between autonomic dysfunction and CRS is highly complex; further work is needed.

Unilateral sudden hearing loss as the first presenting symptom of moyamoya disease.

OBJECTIVE: We describe a rare case of sudden onset of unilateral sensorineural hearing loss occurring as the first symptom of moyamoya disease, which is characterised by progressive stenosis of the intracranial internal carotid arteries and their proximal anterior cerebral arteries and middle cerebral arteries. METHOD: Case report and review of the world literature regarding moyamoya disease with hearing loss. RESULTS: The reported patient had moyamoya disease that initially presented as sudden, unilateral sensorineural hearing loss. Magnetic resonance imaging showed occlusion of the anterior cerebral, middle cerebral and distal internal carotid arteries bilaterally. The possible mechanism of this patient's sudden sensorineural hearing loss may have been vascular occlusion resulting from thrombotic narrowing or blockage by plaque. CONCLUSION: The described patient represents the first reported case of sudden onset, unilateral sensorineural hearing loss occurring as the first symptom of moyamoya disease. The possibility of a vascular lesion such as moyamoya disease should be considered in patients with sudden sensorineural hearing loss, especially children, young adults and Asian patients. Due to this disease's poor outcome, early diagnosis and treatment are important to prevent stroke.

Calibration of temperature measurement by infrared pyrometry in microwave heating of powder materials: an exothermic reaction based approach.

Accurate temperature measurement remains a challenge for microwave heating of powder materials. We propose a temperature calibration method based on exothermic reactions and the resultant thermal runaway that occurs during microwave heating. The approach was demonstrated on microwave heating of four titanium alloys. Differential scanning calorimetry was used to determine the threshold reaction temperature for each selected titanium alloy. This served as a standard for the microwave heating of these titanium alloys. Infrared pyrometric temperature measurements were then calibrated by comparing the starting temperature of each thermal runaway event with the threshold reaction temperature.

Periodic ZnO nanorod arrays defined by polystyrene microsphere self-assembled monolayers.

We demonstrate a low-cost and effective method to fabricate hexagonally patterned, vertically aligned ZnO nanorod arrays. Selective wet-etching is used to develop the catalyzing gold particle hexagonal pattern with the aid of a polystyrene microsphere self-assembled monolayer. The gold particles have tunable sizes independent of the polystyrene microsphere's diameter and are inherently round in shape. Each ZnO rod is grown individually from a catalyzing site via catalyst-initiated epitaxy, and the original hexagonal periodicity is well-preserved. The rods have flat ends, and the diameters of the rods can be controlled well by the amount of source materials. This method provides a promising way to create ZnO one-dimensional nanostructures for applications as two-dimensional photonic crystal, sensor arrays, nanolaser arrays, and optoelectronic devices.

Triterpenes from Tripterygium wilfordii Hook.

Two new friedelane-type triterpenes, tripterfrielanons A (1) and B (2), along with six known triterpenoids, friedelin (3), canophyllal (4), canophyllalic acid (5), 3-oxo-29-hydroxyfriedelane (6), wilforlide A (7), wilforlide B (8), have been isolated from the EtOH extract of the roots of Tripterygiumwilfordii Hook.f. Compounds 4, 5, 6 were isolated for the first time from this plant. The new triterpenes 1 and 2 exhibited mild cytotoxic activity against human Hela cell lines in vitro. The assay showed the IC50 of 1 and 2 were 8.5 and 25 microg/mL, respectively.

Triterpenoid glycoside from Cimicifuga racemosa.

One new triterpene glycoside, cimiracemoside , and 14 known triterpene glycosides have been isolated from the rhizome extracts of black cohosh (Cimicifuga racemosa). On the basis of spectral and chemical evidence, the structure of the new compound was elucidated to be 12beta-acetoxycimigenol-3-O-beta-D-xylopranoside, and the known compounds were identified to be 25-acetylcimigenol xyloside, cimigenol-3-O-beta-D-xylopyranoside, acetin, 27-deoxyacetin, cimicifugoside H-1, 23-O-acetylshengmanol 3-O-beta-D-xylopranoside, foetidinol-3-O-beta-xyloside, cimicifugoside H-2, 25-O-methylcimigenol xyloside, 21-hydroxycimigenol-3-O-beta-D-xylopyranoside, 24-epi-7,8-didehydrocimigenol-3-xyloside, cimidahurinine, cimidahurine and cimifugin. The compounds, , and showed weak antibacterial activities in the agar diffusion assay.

[Constituents of Liguliria vellerea (Franch.) Hand-Mazz].

OBJECTIVE: To study the chemical constituents of Ligularia vellerea. METHOD: The compounds were isolated by column chromatography, and the structures were identified by NMR spectral data and other methods. RESULT AND CONCLUSION: Seven compounds were isolated and identified as 4-hydroxyacetophenone, 8 alpha-hydroxy-7(11)-eremophilen-12, 8 beta-olide, umbelliferone, tiglic acid, 6 beta-hydroxy-7(11)-eremophilen-12, 8 alpha-olide, daucosterin, beta-sitosterol and stigmasterol. All the compounds were isolated for the first time from this plant.

[Determination of rufloxacin in human plasma by high performance liquid chromatography].

A high performance liquid chromatographic method has been developed for the determination of rufloxacin in human plasma. Rufloxacin was extracted from plasma with dichloromethane for three times. It was chromatographed on an Ultrasphere ODS column with Pefloxacin as internal standard with a mobile phase consisting of methanol-tetrabutylammonium bromide-triethanolamine (32:68:0.5, V/V) adjusted to pH 2.8 with orthophosphoric acid. The flow rate was 1.2 mL/min and the monitoring wavelength was 295 nm. The calibration curve was linear from 0.1 to 10 mg/L of plasma. The detection limit of rufloxacin was 0.05 mg/L for plasma and the recovery was (97.7 +/- 2.1)%. The intra-day RSD and inter-day RSD were 2.33% and 3.38% respectively. The method is simple, rapid, accurate and can be used to determine the rufloxacin concentration in plasma and for pharmacokinetic study.

[Stability of liensinine injection].

The stability of liensinine injection was studied by accelarating test with classical isothermal method. Results of the study showed that the decomposition of the injection was found to be a first-order reaction. The activation energy was 75030 J.mol-1. The shelf life at 10 degrees C and 25 degrees C was predicted to be about 15 months and 3 months respectively. This experiment provides a reference for the storage of the injection.

[Quantitative determination of liensinine in the embryo Nelumbinis (Nelumbo nucifera Gaertn.) by TLC-scanning].

The content of liensinine in the green seed embryo of Nelumbo nucifera was determined by dual-wavelength TLC-scanning. The crude drug was extracted with two different method of impregnating and refluxing. The content of liensinine was determined to be 0.853% and 0.939% and the average recovery was 97.9% and 100.9% respectively.