Cheng-Ping Wang

Background: Postoperative urinary difficulty (POUD) is a common complication following surgery under general anesthesia. This study aims to evaluate the prevalence of and identify the risk factors associated with POUD in patients undergoing otolaryngology head and neck surgery. Methods: We retrospectively reviewed the medical records of consecutive patients who underwent otolaryngology head and neck surgery under general anesthesia between July 2020 and September 2020. Patients complaining of POUD were evaluated using an automatic portable bladder ultrasound scanner to assess bladder distension and urine volume. The prevalence and clinical characteristics of POUD were analyzed. Results: A total of 680 patients were enrolled (417 males, 61%; 263 females, 39%), with a mean age of 52 years. The overall prevalence of POUD was 14.1%, with a mean urine volume of 449 ml. Male gender was the independent risk factor of POUD, with males (18%) more common than females (8%). Age and operation time were also the independent risk factors of POUD. The prevalence of POUD increased significantly with age in males (p<0.001) but no significant association was observed in females (p=0.687). Notably, POUD occurred in 23% of males over 50 years old and 46% of those over 70. Patients with rocuronium plus neostigmine had the highest risk for POUD (43%). No patients with rocuronium plus sugammadex had POUD. Conclusions: POUD is common following otolaryngology head and neck surgery, particularly in older male patients and with prolonged operation time. It is essential to develop targeted interventional strategies to prevent and manage POUD in these high-risk groups.

Elevated Epstein-Barr virus (EBV) antibody levels are associated with risk of nasopharyngeal carcinoma (NPC) and risk scores based on these antibodies can predict NPC risk with high accuracy. The immune mechanisms underlying this association remain unclear. We evaluated whether individuals with elevated EBV-NPC antibody risk scores had a reduced T-cell response to EBV proteins within a NPC multiplex family study in Taiwan. In total, 79 cancer-free individuals from families with a history of NPC had blood tested for (i) EBV antibodies using a multiplex serology assay and (ii) T-cell responses to 7 EBV proteins (EBNA1, LMP1, LMP2, BZLF1, BRLF1, BARF1, gp350) using interferon-γ ELISPOT. Excluding individuals with low phytohemagglutinin proliferative responses, no statistically significant association was observed between lower EBV T-cell responses and higher EBV antibody-based NPC risk scores (P = 0.21). However, our findings did trend in the a-priori hypothesized direction, with lower EBV T-cell responses noted among those with higher EBV antibody-based NPC risk scores. Compared to individuals who responded to at least 3 EBV-specific T-cell peptide pools by ELISPOT, those who responded to 1–2 peptide pools had a 10% increased risk of having an EBV-NPC risk score above the median value (OR = 1.1; 95% CI = 0.3, 4.5) and those who responded to none had a 3-fold increased risk (OR = 3.0; 95% CI = 0.6, 17). Our study is the first to evaluate whether high EBV antibody responses observed among individuals at risk of NPC are associated with reduced T-cell responses to EBV. Our findings suggest such an association but require replication in larger studies. The online version contains supplementary material available at 10.1186/s13027-026-00743-w.

Supplementary Table S2 shows summary of participant characteristics

Supplementary Table S1 shows marker pathway allocation and corresponding citations

Supplementary Methods S1 expands upon data and statistical methods.

Supplementary Table S3 shows positivity rates of the 46 individual markers among cases and controls in each study

Background: Specific genetic variations of Epstein-Barr virus (EBV) have been linked to nasopharyngeal (NP) carcinoma (NPC). Because EBV is shed through saliva, saliva samples are commonly used for EBV genotyping in studies of EBV-associated diseases. However, it remains uncertain whether infection with the same EBV strains occurs across different tissues within a host and whether EBV detected in saliva accurately represents the strain in diseased tissues. Methods: We conducted whole-genome sequencing of EBV from paired biopsy tissues, saliva samples, and NP swab samples from 33 patients with newly diagnosed NPC to determine the genetic concordance of EBV strains across different tissue types within the same individual. Results: Phylogenetic and pairwise genetic distance analysis revealed a high degree of intrahost concordance, indicating infection with the same EBV strains among different samples within the host. Multiple EBV infections were identified in 6% of saliva samples, compared with 3% in tumor tissues. Notably, NPC tumor EBV strains were consistently detected in paired saliva and swab samples. For multiple infections in saliva and NP swab samples, EBV variants of the major strain showed higher genetic concordance with the variants detected in NPC tumors than with variants of the minor strain. Conclusions: Our study highlight the genetic consistency of EBV across tumor, NP swab, and saliva samples, supporting the use of saliva as a reliable source for EBV sequencing and genotyping in future epidemiological studies.