Risk factors and psychological condition of pruritus in type 2 diabetes mellitus: a retrospective, propensity score-matched study.

OBJECTIVE: Our aim is to characterize patients with pruritus in type 2 diabetes, determine independent risk factors and explore the impact of the psychological condition of these patients. MATERIALS AND METHODS: This is a retrospective study. From October 1, 2020, to September 30, 2021, 944 individuals with T2DM who had medical treatment were identified from the database. Electronic medical record information including patient characteristics, complications, laboratory data, and medication usage was obtained from the database. Propensity score matching, univariate analysis and a multivariable logistic regression model were used in this study. Based on observation, we discussed the psychological impact of pruritus on these patients. RESULTS: There were 97 patients with T2DM who suffered from pruritus. After propensity score matching based on age, gender, and family history of diabetes etc., 97 pairs of subjects were matched. 97 patients were categorized as the Pruritus group and 97 patients as the Non-pruritus group. In univariate analysis, there were 5 variables significantly related to pruritus, including BMI, absolute eosinophils, percentage of eosinophils, diabetic kidney disease, diabetic retinopathy. After multivariable logistic regression, BMI (OR 1.094, 95%CI 1.010-1.185) and diabetic retinopathy (OR 2.440, 95%CI 1.229-4.847) were considered significant. Patients with pruritus in T2DM suffer greatly in psychological condition in many ways. CONCLUSIONS: For patients with pruritus complicated by T2DM, BMI and diabetic retinopathy may be independent risk factors. Mental health problems such as anxiety and depression might exacerbate by pruritus. The intimate partner relationship was also challenged due to the restless sleep caused by their partner. Frequent monitoring of BMI and diabetic retinopathy and psychological assessment may be warranted in these patients.

[Advances in prevention of pharyngocutaneous fistula after total laryngectomy].

Summary Total laryngectomy is a common method for the treatment of malignant tumors of the pharynx and larynx in China, but pharyngocutaneous fistula often happens after surgery, which burdens patients and affects postoperative recovery. At present, there are many measures to prevent pharyngocutaneous fistula, including strengthening nutrition pre-operative and post-operative, testing related indicators, controlling comorbidities, rational use of drugs, regular oral care, optimal selection of incision closure, and using of flaps and special materials during operation, etc. However, the choice of specific program needs to take care of the patient's condition, surgeon's skills and hospital conditions, and often requires multiple programs to be used together throughout the perioperative period. This article will provide a brief review of some strategies for preventing pharyngocutaneous fistula after total laryngectomy.

[Clinical characteristics of allergic rhinitis allergen spectrum in Gannan area].

Objective:To study the clinical features of common allergens in patients with allergic rhinitis in Gannan area and provide reference for the prevention，diagnosis and treatment of allergic rhinitis with regional character.MethodThe clinical data of 363 patients who were newly diagnosed with allergic rhinitis and given allergen skin prick test（skin prick test，SPT）at our department from August 2012 to May 2016 were analyzed retrospectively.SPSS 180 was used to ananlyze the data.Result:Two hundred and fifty-two cases of allergen skin prick test were positive.The positive rates of allergens were 86.90% of house dust mites，86.11% of dust mites，51.19% of cockroach，14.29% of hair fungus，4.76% of crab meat and 3.17% of shrimp.The positive rate of various allergens in the children group was 93.24% for dust mites，91.89% for house dust mites，44.59% for cockroach，8.11% for crab meat，6.76% for shrimp，and 1.35% for hair fungus.The difference in positive rate of allergens among different age groups was statistically significant（P<0.01），among which the highest was 2 to 14 years old，which was 90.24%；the lowest was ＞44 to 74 years old，which was 31.70%.The difference in positive rates of allergens among different occupations was statistically significant（P<0.01），among which the highest was 86.45% for students，and the lowest was 45.24% for those without employment.There was no significant difference in the positive rate of allergens between different seasons.ConclusionThe most common allergens in Gangnan area are house dust mites，dust mites cockroache and scrab meat.Patients with allergic rhinitis are more common with multiple allergens.Age and occupation are also factors affecting the positive rate of allergens.

[Mechanism research progress of miRNA in laryngeal carcinoma].

MiRNA(miR) is a non-coding small RNA of 18 to 24 nucleotides in length.By pairing with 3'UTR of its target mRNA molecule, miRNA regulateS the target mRNA molecule in the translation level or directly lead to its degradation. Each miRNA may target several to several hundred mRNAs, of which 30% of the mRNA is regulated by miRNAs. Some studies have shown that miRNA expression disorders play an important role in the development and progression of various tumors and may be the ideal target for tumor therapy. It has been shown that abnormal expression of RNA (miRNA) plays an important role in the occurrence and development of laryngeal cancer. Wang Ping found 47 kinds of miRNA expression abnormalities in laryngeal cancer tissue with microarray chip detection, that of which high expression were 23 kinds and low expression were 24 kinds. MiRNAs that are abnormally expressed in laryngeal squamous cell carcinoma are expected to be a new marker for early diagnosis of laryngeal cancer. In this review, we summarized the progress in recent three years on the association of miRNA and the biological behaviors of laryngeal cancer.

[Current treatment of pharyngocutaneous fistula after total laryngectomy].

Pharyngocutaneous fistula is a common and serious complication after total laryngectomy, and it will seriously affect patients' postoperative recovery. The treatment of pharyngeal fistula mainly include conservative and surgery therapy. The use of negative-pressure wound therapy and endoscopic technique to treat post laryngectomy pharyngocutaneous fistula also acquire good result in recent years. However, specific therapy options should be choose according to the type and size of the fistula, the patient's overall health condition and preoperative chemoradiotherapy etc. This article will give a review on the status of treatment of pharyngocutaneous fistula after total laryngectomy.

Genetic variations of EBV-LMP1 from nasopharyngeal carcinoma biopsies: potential loss of T cell epitopes.

To find Epstein-Barr virus (EBV) strains with genetic variations of EBV latent membrane protein 1 (EBV-LMP1) from nasopharyngeal carcinoma (NPC), the full-length DNA of LMP1 genes from 21 NPC biopsies obtained in Hunan province in southern China was amplified and sequenced. Our sequences were compared to those previously reported by the Clustal V method. Results showed that all 21 sequences displayed two amino acid changes most frequently in LMP1 of CD4+ T cell epitopes at codons 144 (F-->I, 21/21) and 212 (G-->S, 19/21) or (G-->N, 2/21). We also show that type A EBV strain is prevalent in the cases of NPC from Hunan province with a 30-bp 18/21 deletion, and we highlight that this deletion resulted in loss of one of the CD4+ T cell-restricted epitopes. The other 3 sequences without this deletion all had a change at codon 344 (G-->D). Furthermore, in the major epitope sequence of CD8+ T cells restricted by HLA-A2, all 21 sequences showed changes at codons 126 (L-->F) and 129 (M-->I). Our study discovered that one of the 21 sequence variations harbored a new change at codon 131 (W-->C), and 5/21 specimens showed another novel change at codon 115 (G-->A) in the major epitope sequence of CD8+ T cells restricted by HLA-A2. Our study suggests that these sequence variations of NPC-derived LMP1 may lead to a potential escape from host cell immune recognition, protecting latent EBV infection and causing an increase in tumorigenicity.

Genetic variations of EBV-LMP1 from nasopharyngeal carcinoma biopsies: potential loss of T cell epitopes

To find Epstein-Barr virus (EBV) strains with genetic variations of EBV latent membrane protein 1 (EBV-LMP1) from nasopharyngeal carcinoma (NPC), the full-length DNA of LMP1 genes from 21 NPC biopsies obtained in Hunan province in southern China was amplified and sequenced. Our sequences were compared to those previously reported by the Clustal V method. Results showed that all 21 sequences displayed two amino acid changes most frequently in LMP1 of CD4+ T cell epitopes at codons 144 (F arrow right I, 21/21) and 212 (G arrow right S, 19/21) or (G arrow right N, 2/21). We also show that type A EBV strain is prevalent in the cases of NPC from Hunan province with a 30-bp 18/21 deletion, and we highlight that this deletion resulted in loss of one of the CD4+ T cell-restricted epitopes. The other 3 sequences without this deletion all had a change at codon 344 (G arrow right D). Furthermore, in the major epitope sequence of CD8+ T cells restricted by HLA-A2, all 21 sequences showed changes at codons 126 (L arrow right F) and 129 (M arrow right I). Our study discovered that one of the 21 sequence variations harbored a new change at codon 131 (W arrow right C), and 5/21 specimens showed another novel change at codon 115 (G arrow right A) in the major epitope sequence of CD8+ T cells restricted by HLA-A2. Our study suggests that these sequence variations of NPC-derived LMP1 may lead to a potential escape from host cell immune recognition, protecting latent EBV infection and causing an increase in tumorigenicity.