Guangxi Medical University China.
Yong Tan
Email: yongtan_navigation@outlook.com
Received : Jul 08, 2025 Accepted : Aug 14, 2025 Published : Aug 21, 2025 Archived : www.meddiscoveries.org
As a representation of Upper Respiratory Infection (URI, herein context refers to viral) COVID occasions us to study relevant subjects. Whereas disinfection with drawing on lower temperature for breach bio-barrier lining on nasal mucosa to exhibit virucides into epithelia thus an abroad-spectrum sterilization is there to motivate why a far-reaching clinical significance is well established. Besides curing COVID or Long COVID, even more interesting is a cohort who recovered from myriad idiopathic complaints they already suffered before epidemic 2019; therefore, a novel pathogenesis is acquired in exposure for abusing a traffic that spans nasal mucosa and Autonomic Nervous System (ANS). Neuropathological, the novel framework presents itself capable of a perfect compatibility of uptake myriad evidence from Laboratory, Radiology, and Semeiotics; the historical or present; or, longitudinal and across-section, particularly citing those hallmarks spotlighted due to specific trials in COVID or Long COVID between which anchoring their several clinical significances, there thus happens to so-called gaps yielding refers to undermining current Etiology from which postulations derive, which try to maintain the primary pathology currently recognized, but the outcome is long fully controversary due to arcane that URI a focal inflammation how does it disrupt systemic autoimmunity that can develop myriad illnesses, acute or chronic. In our pathogenesis, this autoimmune disorder is not more than a compromising sequence a cascading result from systemic hypometabolism that most often is reckoned in relation to Alzheimer’s or Parkinson’s disease or certain endocrine failure. This detriment of systems can be externalized with existing pathologically central ANS by its atrophy and thus dysfunction that all original to locally interstitial concentration of sugar pathologically escalating. This cascading interaction brings about a systematical disturbance other than ingrained conceptions in favor of postulation of viral direct invasion or aberrant autoimmunity incited up for historical lesion. Therefore, we spell out why URI is able to amplify its virulence through host body and its huge pernicious covering everywhere in body that can presents with myriad organs in morbid, yet, we have long been educated these chronic diseases are idiopathy. In this overview, we encompass this novel finding to profile our management, evidence, or arguments relevant to some challenges that have long puzzled people, of course including future envisage, too. From which, an interesting measurement is developed of Magnesium salt used to assess the nasal condition during which procedure, these cations delivered into cranium is observable, for which medication, a dream comes true of trafficking magnesium agent to relieve the neuropsychiatric stresses or involved chronic diseases.
Keywords: Upper respiratory infection; Upper respiratory infection treatment; COVID; Long COVID; Ruan YuHua syndrome; Neuropsychiatry; Neurologically systemic hypometabolism; Autonomic nervous system; Autonomic deficit or obstruction; Ruan Xin magnesium trial; Neurodegenerative disease; Type II diabetes mellitus.
Until 2019, URI as a sort of complaint that at least leaves to public a no bad impression with a comparatively lower either mortality burden or risk of exacerbating underlying diseases, and the severity commonly is not more than a running nose or congestion of airway within a week which, people are able to relieve or recovery from by disease-modifying drug.
To this nice figure, some researchers hold dissent; their study [1] indicates a statistical significance shapes the correlation of flu vaccination available for reducing the mortality burden of myocardial infarction; nevertheless, there appears to anything but understanding that two of pathological niche.
The world have been plagued by epidemic of COVID or lasting Long COVID since 2019 that recalls the 1918-1919 when Spanish flu overran likewise through the world, comparing to what mandated was “Wear A Mask or go to jail”, a bit of humor is what nowadays people reckon with appears so, although the modern biotechnology including advanced vaccinations and drugs today has taken a shape; against covid, in our expectation, both end up rendering their performance as a makeshift a shade of better than shiftless; even less, awkward to exuding a flavor of Sisyphean mission. The difficult or obstructions in management are gradually to emerge [2,3] if encapsulate these that failure may relate to segregate the pathogenetic strains withal, determine the share of pathological injury every pathogen contributes nay; therefore, further to pilot medication, the qualification setting for volunteers recruiting also is a challenge that absolutely can undermine the resultant credibility.
Alternatively, we have to agree that when babies were born, they have to combat with URI in which, these culprits had been conferred with facility of air-born by harbored in aerosol or droplets billion years ago. Their transmission even more happens within our community among members who are daily sharing their several pathogens, even including animals living with coronavirus or H5N1 for which vis-à-vis contagion, we ourselves unlikely always keep a safe distance off each other for prevention.
Treat of URI management, nasal rinsing protocol presents itself competent with four preponderances of niche: Swiftly subdue acute symptoms onset against pathogen’s inherent bio-behaviors in nasal lining. Second is wide-spectrum and cheap virucides applying for breach bio-barrier that faithfully defends nasal mucosa; moreover, the sterilization working mainly concentrates on the solid capsid of virus assembling or viral replication in endoplasm. Besides lower cost in favor of daily hygiene, safe with less side-effects can realize management with the largest coverage in demography contrasting with vaccination or drugs.
Washing nasal cavity to control acute infection onset may be presented without species or strain oriented. Whereas the in vitro [4] in which Delta and Omicron are observed, their infectious dynamic is acquired in exposure: Viral spreading in lining primary through drifting along with flowing snot for without self-motile rather than past worry or guess of trespass into host’s cellular neighbors through two clingy walls. Conversely, frequently egress from infectious cells and entry into healthy ones leaves a window of exposure in snot that also reveals viral surviving strategy to avoid being swept out for epithelial death in aged or premature death in viral replication and taken advantage of in washing them off body to prevent much more new in invasions from which, benefits patient is not only transiently and swiftly reducing the viral load in cavity equal to suppress inflammation in mucosa that likely violently impact patients’ physiology withal, viral shedding may into lower trachea which clinic significance is well established for possibly progression of viral pneumonia to which pernicious is developing cytokine storm.
Alternatively, coronavirus has already presented a constellation of URI viruses with analogue diseases. With rage the epidemic has overran for several years; maybe, credited to this reason, there has been a vast investment for stop this catastrophe. Many researchers however were rather optimistic: By the help of successfully subduing COVID people can clearly expand to resolve the involved pathology of URI [5].
Although with a nice idea, yet in practice, it is not easy. The first impediment is lack of a proper pathogenesis to characterize COIVD or Long COVID; conversely, for this aim, myriad established postulations meet with their several plausibility undermined by incompatible of myriad evidence, among which there are many gaps original to several clinic significances to negative each other. This failure, someone ascribes to existence of elusive evidence able to even the score. Actually, this implicates a novel finding other than current mainstream insists on.
For exogenous washing nasal lining, we immediately have to meet with two challenges. One is the safe threshold in volume correspondent to treating solutions; another, how to exhibit agents on mucosa by the way of rinsing. This way, it can be confirmed for any failed management which designers even yet considered the existence of nasal mucus.
A photograph seen in Ribbeck Lab [6] that displays a fibrous network without hue like cotton whereas, it is a snapshoot in nanometer resolution, of the mucus that also is bio-gel variety in which these interweaved fibers are monomer of glycated protein. Through this figure, the primary impression can refer to screening function; meanwhile enormous microbes perch on these twigs.
Mucus extensively distributes in many varieties of lining in body as film coating facing-milieu surface of lumen as an interface plays a vital role to cope with a variety of stresses for lumen exposure, externalizes a far-reaching significance to our survival. Within different organs, the task of mucus may be myriad. Such as in enteric lining [7] may be an ecological community with nutrients uptake or as being a rack to harbor particles including immune agents and benefited microbes; in contrast, without uptake anything, nasal cavity only leaves the feature of stronger protection which complex and tough.
In nasal lining, there are actually existing two types of mucus, one is watery the snot goblet cell excretes; another is sticky which molecules secreted by epithelia to cover about 95% surface of lumen. The rest 5% region is olfactory [8] at the top of nasal cavity without coating by gel barrier that has to adopt abondance of snot for washing as being defensive measurement.
The mucin monomer as essential component a vast amount interweaving thus can construct a big bio-shield among which, each likes a bottle brush [8] thus presents a porous structure to reject bigger agents. What is more, inside these pores an electrostatic field generated by chemical bonds between external cations and internal acid roots in place [9] to take advantage of electrostatic force to repulse anything that tries to approach. Thus, the film presents with double traits, hydrophobic and oleophobic; therefore, even to water, it cannot penetrate this barrier; moreover, the film serves for a bed to effortlessly bear the snot washing.
Certainly, understanding tough mucous defense can answer why viral invasion circumvents through cilia or villa rather than attempts to direct penetrate bio-barrier. Try to mimic viral capsid for exterior modification, some researchers intend to develop smart drug capsules [10] for deliver medication into nasal epithelium, but even now, we have learned still unsuccessful. Other than this way, we adopt low temperature (-3~0 degrees Celsius) via coldly hardening these molecules thus structurally centripetal collapse to yield a deal of cracks in film for prime delivering. Maybe, that conduce to restore molecular resilience or electrostatic institution when temperature return normal.
Consequently, we can understand that normal saline 0.9% NaCl (w/v) washing, the safe volume can be approaching to endless for salty concentration as same as in snot without injuring tissues. And, the above-mentioned knowledge over mucus provides a wide scope for design rinsing management.
Understanding how to breach mucous barrier can facilitate mucosal exhibition with many virucides. Such as sodium can accelerate infectious cells into apoptosis [11], well understood by the way, that virions inside died epithelia are removed off mucosa. To ethanol its instead of cholesterol inserted into viral capsid in assembling can give rise to defect pores yielding so that such ill virus will be inactivated [12] for its core RNA leaking while exposes it in snot where harbored trillion agents [13] meanwhile all those are ruthless predator, too.
Now, we recommend the solution comprising of 2.5-3% (w/v) NaCl and 5% (v/v) ethanol for cooling mucous barrier; to olfactory region, adopts in a relatively wide range--NaCl, 2-7%; moreover, keep warm saline in fever temperature (37-42 degrees Celsius) conduce to extort snot to enhance cleaning; carefully use ethanol in 0-5% that likely hurts neuroepithelial tissue though, well result in suppressing acute inflammation according to our practice. Of course, other parameters involved to operational time or additional washing or posture of head, these options, note that a mistake likely compromise treating efficacy a lot, over which, please refer in [14].
The interesting question is what decides salt parameter and why double that number rather than [12] explicitly demonstrates 1.2% obtained in 100% disinfection efficacy?
Note that, safe exhibiting these virucides comes likewise important in management since we found agent’s negative affection is absolutely able to exceed nasal cavity, interestingly.
However, a virtual clearance that between gel-barrier and mucosa becomes our subject where may be filled by saline-ethanol solution in URI management. The osmolality change affects the effect of management or safe exhibition will be certainly investigated. Herein, define isotonic as the baseline with NaCl 0.9% (w/v) that equal to the endoplasm.
When hyperosmotic doubles baseline or beyond thus yielding difference of osmotic pressure presented in transmembrane of nasal epithelium may drive the sodium transferred into endoplasm from clearance, against which, water outlet from endoplasm to dilute salty. Two inverse streams signal a physical mechanism activated in attempt to trade-off in/outside osmolality. Within clearance, fluid volume is inevitably increasing with which, the liquidous bulging pressure also varies; when reaches a critical and beyond; the bio-film intact cannot hold and thus torn up; through which breaches a physical force makes, ethanol is discharged into nasal lining thus epithelial uptake stops. That assumes hyperosmotic get more safer for exhibit ethanol.
Apparently, understand baseline without pressure difference to drain ethanol out of clearance thus entirely uptake, in our practice, patients thus with suspicious nuchal pain persisting for hours. An interesting lesson is absolute hypoosmolality for without salt in June 2024. With 50 ml liquor (5%) as cold solution, resulted in not only definitely nuchal persisting anguish but severity is motor obstruction—unable to walk straight at 12 hours that often signals cerebellum complaint—now, exposed to ethanol—fortunately, still with consciousness unlike alcoholism; nor manifested with signs for CNS (central nervous system) injured. Obviously, aseptically inflaming cells is primary factor to mediate ethanol into cerebellum. We call this neurological phenotype Ruan YuHua Syndrome (RS) that assumes a physiological pathway existing between nasal mucosa and, ventral brain and below (VBB); the latter, which anatomic region should cover from front lobe to infratentorial cerebellum and brain stem.
The interesting questions should involve that what is the solid tube to undertake this transcranial traffic, and what it transports, and what is the RS significance in clinic and its far-reaching impact for future research?
In anatomy, VBB which positions in cranium has implicated a relevance to a venous network in which double cavernous sinuses mark the portal of veins into cranium bottom and with falx and tentorium as basic rack to buttress the cranial travel that has long puzzled people, why it does so? Thus far, we know nothing but possibly brings thrombus for maxilla-facial inflammation. Is this vasculature the role of trafficking system in RS framework, thus far unknown.
Well, how to anatomize this novel finding? From Radiology, with dynamic scanning brain [16], the early study (2004, we can find) has noticed the pathological images over atrophy and hypometabolism concurs in VBB of patients who are diagnosed suspicious encephalitis with preponderance of clinical manifestations. These cases inconsistent with Etiology is cerebrospinal fluid testing which hallmarks still negative any pathogens contacting with CNS.
The same oxymoron reoccurs in today study on COVID although during last several years adopts the new-brand imaging modalities including MRI (magnetic resonance imaging), SPECT (single-photon emission computed tomography), and PET (positron emission tomography). Report from [17], among those cases the most mentioned morbid region is VBB still with hypometabolism and atrophy presenting a constellation of URI.
These gaps among myriad evidence in clinic seems to express virus can play magic. However, understand what is RS function and what it transports, can remove these gaps. The first we postulate RS serves for a physiological trafficking to deliver glucose for ANS behind which the truth is the mechanism of employing glucose metabolism in neurons is extreme complex but vital to nervous system. A better corroboration is reporting high sugar in cerebrospinal fluid that is rather common for seen among COIVD patients even more capable of discriminator applied in clinical severity classification [15]; whereas in Etiology, this hallmark most often is presented in diabetes or cranial infection brain thus into hypermetabolism.
But why the creator places such machine in our body? The up side is obvious that this fashion of glucose delivery to VBB is more efficient than depend on circulatory system. Since there is such requirement of regulating metabolism on viscera in order to coordinate body condition altering or quick response in presence of varieties of stresses, the frequent demand of energy supply in time from ANS that as the headquarter of autonomic system to control viscera by its transcranial broadcasting, thus generates. From another perspective, the down side is salient that equal to expose VBB to external milieu; on contrary, that explains why the bio-barrier defense is so hard for nothing uptake unlike enteric.
Consequently, no magic, merely is abusing RS to pathologically transfer overplus glucose that negatives the current postulations about neuropsychiatry in URI that is yielded on the ground of two main premises including viral entry into cranium or ever staying available to incite autoimmunity work up its aberrant response [18]. Therefore, there most often happens to an awkward called gap in our etiology that conclusive evidence always springs out to defend viral innocence in presence of the preponderations from other myriad evidence.
In one word, there is a pathologically cascading interaction, we denote this phenotype by Autonomic Deficit or Obstruction (ADoO), setting out from nasal inflammation, via abusing RS the physiological pathway to enforce ANS as a pathological portal to amplify pathological factors and then impact whole body. The detriment of ANS is induced by high interstitial sugar thus which neurons presents physiological or pathological dysfunction leading to themselves atrophic and hypometabolic; further ANS attenuated in its neurodegenerative progression, myriad diseases can thus be developed in body.
When we discuss URI and involved problems, we may focus on two aspects that one is within respiratory tract and, another relates to URI’s pernicious over neuropathology.
Well, the first is nasal rinsing which clinical significance is well established for easily being operated as a home remedy in favor of daily nasal disinfection—when acute URI onset at home, according to researchers’ caveat that severity relevant to the viral load in nasal cavity; motivated to clean nasal cavity aims to subdue inflammation furthers to hold back its progression from into lower ones takes more significant than does against time in waiting for a variety of medicine examinations ahead of prescription or hospitalized admission; presently, medical procedure always rules you so. While apply such a simply self-rescue extensively among outpatients, it is believable that absolutely rescues many more emergencies who have been living with URI.
Whereas definition of Rs or ADoO, the far-reaching significance is understanding any factor including the iatrogenic may make up ADoO so as long it able to incite nasal mucosa into inflammation; that means myriad pathogens residing in our nasal cavity can together share AdoO to contribute a wholesale pathology thus gives rise to a challenge in clinic how to precisely determine the share anyone contributes, as though SARS-CoV-2 and its mutating strains, however we believe, should responsible for the biggest one for stronger virulence.
Therefore, looking back COVID epidemic which progression is sure to feature with a lower age tendency of prevalent of Long COVID or chronic diseases involved, even including both mortality burden for autoimmunity getting a bigger compromising. To corroborate this assertion, California wherein patients the 18-49 age-group assumes occupying 53.1% into all deaths in diagnosed Long COVID [19]. Additionally, other epidemics caused by other genus should present of more serious than past years did before 2019 by COVID underlying. In sum, two sequences are the havoc to our civilization.
To shed light on neuropsychiatry in URI for neuropathological injury, the common cases are the detriment of medulla oblongata in VBB, meanwhile is the cranial portal of nervous communication of a/efference between central neurons and peripheral ganglia. This portal in disorder can lead to distort these bio-electronic signals in transmission that is well explains the myalgia encephalomyelitis is actual hallucination with pseudo-distal-lesions; for discover the putative infectious foe in medulla, people have spent half centuries to ferret about.
Certainly, VBB in disturbance is absolutely serious for its anatomic region covering the axis of pituitary-and-hypothalamus that rules systematical hormone regulation, and the vagus nerve releasing bioelectric impulse for manage viscera activation. So, of two in pathological disturbance, it can lead to a neurologically systemically hypometabolic is well known. Consequently, if peruse reports [20,21] over Long COIVD syndromes, which complications or comorbidities, including chronic exertional fatigue or “brain fog” or even to cardiovascular diseases, almost able to be uniformly externalized to a constellation of metabolic diseases, according to current Etiology.
As a result of systemic metabolic problem yielded by URI, autoimmune component thus would compromise and as a big bonus rewards pathology viruses contribute at ADoO. That signals a deficiency of a variety of metabolizable stuffs that can lead to glucose metabolism attenuated in CNS. In molecular level, a pathological cascading reaction may be established: The discrepancy on quantity of energic supply is likely responsible for a qualitative alteration of incapacity of normal deposal of toxic peptide normal function generates; now deposited in cells instead of dissolved and then discharged; as a result of aggradation, it triggers neurons injured or into morbid apoptosis [22], besides malfunction. To such a variety of neurodegenerative diseases like Alzheimer’s and Parkinson’s disease; Amyotrophic Lateral Sclerosis; which differences are presented in lesion.
Anyway, interesting are people who generally believe neuroinflammation is the main instigator to bring such aberrant hypometabolism for which, nevertheless, still exists of unable to identify which pathogen should be responsible.
From now, our etiology should be not only to concern the impact yielded to hypoxia [23] respiratory infection brings; conversely, the ADoO, either acute or chronic, its pernicious is still distracting people onto other diseases. On the other hand, it assumes URI responsible for human senescence rather than spontaneously pathological injury in genome.
Eventually, based this novel pathway accessing to VBB, we innovated a clinic trial called Ruan Xin Magnesium Trial (RXMT) aiming to assess the nose condition. We can take advantage of Magnesium Sulphate which cation is often reckoned of good for nervous system anything but no evidence to indicate its viral disinfection. We use 0.3-1.0 g Magnesium salt to coat nose including bridge and two flares within 1 hour.
Accordingly, there relates to two effects: One is nasal deep tissues relieves inflammation by transdermal uptake Magnesium salt; with either acute or chronic, however, this antiphlogistic avails to inhabit ADoO; on contrary, the inflammation may accelerate Magnesium cation transferred into cranium as same as glucose circumvents circulatory system. Therefore, we can have 24 hours to observe objects when they will go into drowsiness after Magnesium coating. The number of clock time can be used to measure the nasal condition.
The severe case can be 10 minutes with extra comfortable or relax into drowsiness and likely simultaneously relieve the neuropsychiatric complaints including malaise, myalgia, numbness, anxiety, depressed, and so on, consistent with these reports in [24] for applying Magnesium medication; besides the neuropsychiatric melioration of which, the dermatological red rash as peripherally nervous comorbidity, recedes off face; moreover, in second day, coating contributes a well bowel movement.
Systemic hypometabolism
With doubtless, people concern is what happens of relieving systemic hypometabolism from URI. Among clinical melioration, the most remarkable is Dermatology readily felt and recognized and its improvement encourages patients to insist on their URI management: Body odor diminishes and, ever chloasma or erythema or pimple all that previously manifested now recede; and appendage, hair began to recover bare region towards initial, and nails also became more softy.
Besides appearance getting younger and musculoskeletal restoring in stronger or stamina may take a par with youth level, between all, indicate energic metabolism restoring that as well prompts catabolism elevated able to massively dissolve trashes in serum.
The neuropsychiatric aspect, besides limbs paresthesia diminishes, to these senior citizens, chronic fatigue improvement is manifested for they waking up from before anxiety or depression complaints involved to their fatigue or malaise that ever made them without appetite for outdoor; or off social interaction due to living with testy or indifferent.
The interesting is a sort of systemic hypometabolism attributed to complication of some systemic diseases, such as type II diabetes mellitus (insulin resistance): Two can be segregated.
There is a representative case at our hand. The subject who is female with her age up to 83 in 2024 and with more than two decades of diabetes and more than 18 years history of applying hypodermic insulin. Since April 2024, she accepted nasal disinfection as being personal hygiene 1 times per day against COVID.
Out of our expectations is her albuminuria the diabetic nephritis hallmark reversed from previous positive persisting at 1.5 years when she into August for her health check. The ensuing event is bold to stop her insulin but keeps oral medications the tablets of Acarbose and Gliclazide. Under monitoring in hospitalizing period, she did successfully to get rid of both body odor and insulin.
Till now, the encouragement is we designed for her of adding an olfactory rinsing in her disinfection process and altered the rinsing times for twice per day in April 2025, her bloody sugar which prestation is closed to normal except susceptible to high sugar/fat diet.
The important is her waking up from “brain fog” in contrast to before as in Long COVID that can be estimated with 10 years aged [20].
The current Etiology regards systemic hypometabolism as a result from hyperglycemia which yielding homeostasis imbalance by hyperosmolality to attenuate myriad organs over time. As a result of metabolic failure yielding premature death, the mortality is estimated over 2 million per year in the world according to WHO [24]; whereas our case seems to provide a counterexample for URI which should be responsible for this sequence; conversely, hyperglycemia looks more like a pathological compensation. The insulin resistance seems never existing or extremely trivial not that we think so.
We eventually have to concede URI actually is a ruthless and cunning killer to their master strategy that secretly downregulates host autoimmunity. On the other hand, these viruses lose the motivation to develop more stronger bio-structures for a more extensive invasion in host body that puzzles people why a focal infection is so powerful. Therefore, we have an opportunity to wash them out of nasal cavity since they must have a window of exploration for fresh host cells.
We define a novel pathway and a cascading interaction conduce to describe the dynamic of URI in wreaking a variety of neuropsychiatry or metabolic diseases. Eventually, we use a case with diabetes to show a complicated pathogenesis in which, the correlation between hyperglycemia and systemic hypometabolism actually is so weak but still able to compose a vicious cycle to undermine human wellbeing although how hypometabolism triggers or prompts hyperglycemia is unknown.
Funding: Not funding institution for declare.
Conflicts of interest disclosure: No conflicts of interest.
Acknowledgement: Thank my darling Xin Ruan who is brave to experience RXMT and reported what she felt though, until then, we have nothing about the hazard. About 15 minutes after coating, she drowsed. Fortunately, she only just experienced a medicine trial which comfortable possibly is the most among all past or current ones, without adverse affection.
