Periodontitis is a highly prevalent oral microbial biofilm-driven chronic inflammatory disease. If unmanaged, periodontitis leads to progressive destruction of the ligamentous attachments of teeth to the alveolar bone and resorption of the alveolar bone. It eventually leads to tooth hypermobility and loss. Periodontitis commonly causes overlying maxillary sinus inflammation (mucositis), reflected on radiographic imaging as maxillary sinus mucosal thickening. While uncommon, advanced periodontitis (stage III/IV) or chronic perio-endo lesions can lead to purulent odontogenic sinusitis (ODS). This article describes periodontitis pathophysiology, diagnostic features, and its potential to cause ODS. Clinical practice guideline conform therapy is very successful in managing periodontitis and enabling long-term tooth retention. Localized tooth extration is reserved to end-stage disease.

UNASSIGNED: Yujiang Paidu Decoction (YJPD) has demonstrated clinical efficacy in the treatment of chronic rhinosinusitis. However, the effects and mechanisms of the YJPD on chronic rhinosinusitis with nasal polyps (CRSwNP) remain unclear.
UNASSIGNED: This study aimed to elucidate the potential mechanism of action of YJPD in the treatment of CRSwNP based on network pharmacology, transcriptomics and experiments.
UNASSIGNED: A CRSwNP mouse model was established using ovalbumin (OVA) and staphylococcus aureus enterotoxin B (SEB) for 12 weeks and the human nasal epithelial cell (HNEpC) model was induced with IL-13 in vitro. Behavioral tests, scanning electron microscopy (SEM), micro-CT and pathological change of nasal tissues were observed to investigate the therapeutic effects of YJPD. Network pharmacology and transcriptomics were launched to explore the pharmacological mechanisms of YJPD in CRSwNP treatment. Finally, an ELISA, immunofluorescence, RT-qPCR, Western blotting and Tunel were performed for validation.
UNASSIGNED: Different doses of YJPD intervention effectively alleviated rubbing and sneezing symptoms in CRSwNP mice. Additionally, YJPD significantly reduced abnormal serological markers, structural damage of the nasal mucosa, inflammatory cell infiltration, goblet cell increases, and inhibited OVA-specific IgE levels and the secretion of Th2 cytokines such as IL-4, IL-5, and IL-13. Moreover, transcriptomics and network pharmacology analyses indicated that YJPD may exert anti-inflammatory and anti-apoptotic effects by inhibiting the MAPK/AP-1 signaling pathway. The experimental findings supported this conclusion, which was further corroborated by similar results observed in IL13-induced HNEpCs in vitro.
UNASSIGNED: YJPD could alleviate inflammatory status and epithelial apoptosis by inhibiting aberrant activation of MAPK/AP-1 signaling pathway. This finding provides a strong basis for using YJPD as a potential treatment in CRSwNP.

BACKGROUND: Rhinosinusitis and intracranial hemorrhage are prevalent conditions within their respective medical specialties. While rhinosinusitis is predominantly an inflammatory disease confined to the paranasal sinuses, it can, in exceedingly rare circumstances, lead to intracranial hemorrhage with potentially fatal outcomes. Despite the gravity of this rare association, the literature remains sparse regarding its pathophysiological mechanisms, natural history, management principles, and clinical outcomes.
METHODS: We present a systematic literature review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and a case illustration of epitural hematoma arising from rhinosinusitis.
RESULTS: A systematic review of the literature identified 20 published cases of intracranial hemorrhage induced by rhinosinusitis, plus the case presented herein, the total number of cases is 21. Nineteen epidural hematomas (EDH) and 2 subdural hematomas(SDH) were identified. The frontal region (14/19, 74%) was the most prevalent location for EDH corresponding to sinusitis related to the frontal sinus (12/14, 86%). Common symptoms included headache (n=18, 86%), fever and impaired consciousness (n=13, 62%), and periorbital swelling/pain (n=8, 38%). Interventions included hematoma removal/drainage, rhinosinus surgery, and antibiotic therapies. One fatality and three residual neurological impairments occurred. Multiple hypotheses exist regarding the mechanisms of intracranial hemorrhage in rhinosinusitis.
CONCLUSIONS: Intracranial hemorrhagic complications, primarily EDH and SDH, are rare and potentially fatal consequences of rhinosinusitis. It should be cognizant of the potential existence of such a possibility during clinical practice.

Rhinosinusitis is a common inflammatory disease of the sinonasal mucosa and paranasal sinuses. The pathogenesis of rhinosinusitis involves a variety of factors, including genetics, nasal microbiota status, infection, and environmental influences. Pathogenic microorganisms, including viruses, bacteria, and fungi, have been proven to target the cilia and/or epithelial cells of ciliated airways, which results in the impairment of mucociliary clearance, leading to epithelial cell apoptosis and the loss of epithelial barrier integrity and immune dysregulation, thereby facilitating infection. However, the mechanisms employed by pathogenic microorganisms in rhinosinusitis remain unclear. Therefore, this review describes the types of common pathogenic microorganisms that cause rhinosinusitis, including human rhinovirus, respiratory syncytial virus, Staphylococcus aureus, Pseudomonas aeruginosa, Aspergillus species, etc. The damage of mucosal cilium clearance and epithelial barrier caused by surface proteins or secreted virulence factors are summarized in detail. In addition, the specific inflammatory response, mainly Type 1 immune responses (Th1) and Type 2 immune responses (Th2), induced by the entry of pathogens into the body is discussed. The conventional treatment of infectious sinusitis and emerging treatment methods including nanotechnology are also discussed in order to improve the current understanding of the types of microorganisms that cause rhinosinusitis and to help effectively select surgical and/or therapeutic interventions for precise and personalized treatment.

慢性鼻窦炎（CRS）是一种常见的慢性炎性疾病，由于其存在高度异质性，早期准确的临床诊断和治疗对控制CRS的病情至关重要。多种组学技术可以全面系统地分析CRS患者DNA、RNA、蛋白质的差异表达及生物学功能，有利于深入研究CRS内在机制，为实现CRS的精准诊疗提供了可能。本文分别概述基因组学、表观基因组学、转录组学、蛋白质组学和代谢组学等各类组学方法在CRS中的研究进展，对既往研究数据进行归纳整合和分析，阐明多组学技术在推动CRS精准诊疗中的重要作用，并为CRS的精准诊疗提供新的方向。.

Neutrophil infiltration plays a key role in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). However, pertinent mechanisms remain poorly elucidated. Here, we obtained the data from gene expression omnibus (GEO) and gene set enrichment analysis (GSEA) to identify and validate neutrophil-associated hub genes in CRSwNP. We found that four neutrophil-associated hub genes, namely ICAM1, IL-1β, TYROBP, and BCL2A1, were markedly upregulated and positively correlated with neutrophil infiltration levels in patients with CRSwNP. Subsequently, this was confirmed by real-time quantitative PCR. In conclusion, we identified the role of neutrophil infiltration in the pathophysiology of CRSwNP, which may be the potential targets for the diagnosis and treatment of CRSwNP.

To evaluate whether radiomics models based on unenhanced paranasal sinuses CT images could be a useful tool for differentiating inverted papilloma (IP) from chronic rhinosinusitis with polyps (CRSwNP). This retrospective study recruited 240 patients with CRSwNP and 106 patients with IP from three centers. 253 patients from Qilu Hospital were randomly divided into the training set (n = 151) and the internal validation set (n = 102) with a ratio of 6:4. 93 patients from the other two centers were used as the external validation set. The patients with the unilateral disease (n = 115) from Qilu Hospital were selected to further develop a subgroup analysis. Lesion segmentation was manually delineated in CT images. Least absolute shrinkage and selection operator algorithm was performed for feature reduction and selection. Decision tree, support vector machine, random forest, and adaptive boosting regressor were employed to establish the differential diagnosis models. 43 radiomic features were selected for modeling. Among the models, RF achieved the best results, with an AUC of 0.998, 0.943, and 0.934 in the training set, the internal validation set, and the external validation set, respectively. In the subgroup analysis, RF achieved an AUC of 0.999 in the training set and 0.963 in the internal validation set. The proposed radiomics models offered a non-invasion and accurate differential approach between IP and CRSwNP and has some significance in guiding clinicians determining the best treatment plans, as well as predicting the prognosis.

Objective:The purpose of this study is to explore the expression of prostacyclin receptor（IP） in patients with chronic rhinosinusitis（CRS） and its possible association with type 2 inflammation. Methods:HE staining was used to observe the morphological changes of nasal mucosa, qRT-PCR was used to detect the expression of IP in polyps and nasal mucosa, and IHC was used to detect the expression of IP, IL-4, IL-5 and IL-13 in polyps and nasal mucosa. Results:Compared with the control group, the nasal mucosa of patients with various types of CRS was obviously thickened, accompanied by inflammatory cell infiltration and gland hyperplasia. The statistical results of IHC showed that the expression levels of IL-4, IL-5 and IL-13 in CRS group were significantly higher than those in control group（P<0.05）, and the IP expression in control group was significantly higher than that in ECRS group and non-ECRS group（P<0.05）. The IP expression in ECRS group was negatively correlated with IL-4, IL-5 and IL-13. The results of qRT-PCR showed that the expression of IP mRNA in control group was significantly higher than that in ECRS group and non-ECRS group（P<0.05）. Conclusion:IL-4, IL-5 and IL-13 are highly expressed in the nasal mucosa of CRS patients, while IP is poorly expressed in the nasal mucosa of CRS patients, and IP is negatively correlated with IL-4, IL-5 and IL-13, suggesting that IP is related to the occurrence and development of type 2 inflammation and may be a potential therapeutic target for CRS patients.
目的：本研究旨在探索慢性鼻窦炎（CRS）患者前列环素受体（IP）的表达及其与2型炎症之间可能存在的关联。 方法：采用苏木精-伊红染色对鼻黏膜组织形态改变进行观察，qRT-PCR用于检测息肉与鼻黏膜组织IP表达，免疫组织化学染色用于检测息肉与鼻黏膜组织IP、IL-4、IL-5和IL-13表达情况。以取自鼻中隔偏曲、垂体瘤、脑脊液鼻漏且无CRS患者的中鼻甲黏膜为对照组。 结果：与对照组比较，各型CRS患者鼻黏膜组织明显增厚，并伴随着炎症细胞浸润及腺体增生。免疫组织化学染色的统计结果显示，ECRS组和non-ECRS组的IL-4、IL-5和IL-13表达水平均明显高于对照组（P<0.05），对照组IP表达量均显著高于ECRS组和non-ECRS组（P<0.05），ECRS组中IP表达量与IL-4、IL-5和IL-13呈负相关。qRT-PCR结果显示，对照组IP mRNA表达量均明显高于ECRS组和non-ECRS组（P<0.05）。 结论：IL-4、IL-5和IL-13在CRS患者鼻黏膜中高表达，IP在CRS患者鼻黏膜中呈低表达，且IP与IL-4、IL-5和IL-13具有负相关性，提示IP与2型炎症的发生发展有关，可能是CRS患者潜在的治疗靶点。.

Observational studies have linked autoimmune diseases (ADs) with rhinosinusitis (RS) manifestations. To establish a causal relationship between ADs and RS, and to explore the potential mediating role of inflammatory mediators between ADs and RS, we utilized Mendelian randomization (MR) analysis. Using a two-sample MR methodology, we examined the causality between multiple sclerosis (MS), rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriasis (PsO), type 1 diabetes (T1D), Sjogren\'s syndrome (SS), celiac disease (CeD), Crohn\'s disease (CD), hypothyroidism (HT), Graves\' disease (GD), and Hashimoto\'s thyroiditis and their association with chronic and acute rhinosinusitis (CRS and ARS, respectively).To achieve this, we employed three distinct MR techniques: inverse variance weighting (IVW), MR-Egger, and the weighted median method. Our analysis also included a variety of sensitivity assessments, such as Cochran\'s Q test, leave-one-out analysis, MR-Egger intercept, and MR-PRESSO, to ensure the robustness of our findings. Additionally, the study explored the role of inflammation proteins as a mediator in these relationships through a comprehensive two-step MR analysis. Among the ADs, MS, RA, T1D, CeD, and HT were determined as risk factors for CRS. Only CeD exhibited a causal relationship with ARS. Subsequent analyses identified interleukin-10 (IL-10) as a potential mediator for the association of MS, RA and HT with CRS, respectively., while C-X-C motif chemokine 10 levels (CXCL10) and T-cell surface glycoprotein CD6 isoform levels (CD6) were found to influence HT\'s effect on CRS. Our findings demonstrate a causative link between specific autoimmune diseases and rhinosinusitis, highlighting IL-10, CXCL10, and CD6 as potential mediators in this association.

Aims/Background Patients with chronic rhinosinusitis often have a higher incidence of anxiety and depression. Nevertheless, the impact of specific chronic rhinosinusitis types (chronic anterior/posterior/anterior and posterior rhinosinusitis) on anxiety and depression remains unexplored. Methods From January 2022 to July 2023, we employed various assessment scales to gauge the severity of chronic rhinosinusitis and anxiety and depression among Chinese patients with chronic rhinosinusitis. Statistical analysis involved non-parametric tests and binary logistic regression. Results In total, 123 patients with chronic rhinosinusitis were enrolled. The number of patients with anxiety and depression in the chronic posterior rhinosinusitis and chronic anterior and posterior rhinosinusitis groups (p=0.022), the nasal symptom subdomain scores of the chronic anterior rhinosinusitis and chronic anterior and posterior rhinosinusitis (p=0.011) groups and the chronic posterior rhinosinusitis and chronic anterior and posterior rhinosinusitis (p=0.008) groups, and the Lund-Kennedy score of the three groups (all p < 0.05) were significantly different. Binary logistic regression analysis revealed that chronic rhinosinusitis type (p=0.035) was a risk factor for anxiety and depression. Conclusion Anatomical chronic rhinosinusitis type was a risk factor for anxiety and depression in patients with chronic rhinosinusitis.