Associations of lifestyle and diet with the risk of nasopharyngeal carcinoma in Singapore:a case–control study

Background: Nasopharyngeal carcinoma(NPC) is a commonly diagnosed cancer in Southeast Asia. Many studies have examined the risk factors for NPC, yet the roles of some risk factors remain inconclusive. The purpose of this study was to examine associations between modifiable lifestyle factors and the risk of NPC in the Singaporean population.Methods: We conducted a case–control study in Singapore with 300 patients and 310 controls who were recruited between 2008 and 2012. Each control was selected and individually matched to each patient based on sex, ethnicity, and age(±5 years). A total of 290 pairs of cases and controls were matched successfully. We examined lifestyle factors such as tobacco smoking, alcohol drinking, various salted and preserved food consumption, and weaning practices.Results: After adjusting for covariates, multivariate analysis showed that those participants who were current smokers and had ever smoked tobacco had a higher risk of NPC than participants who had never smoked, with odds ratios(ORs) of 4.50(95% confidence interval [CI] 2.58–7.86; P < 0.001) and 2.52(95% CI 1.54–4.12; P < 0.001), respectively. Those who consumed salted vegetables at least once a week also showed a significantly increased risk of NPC than those who never or rarely consumed salted vegetables, with an OR of 4.18(95% CI 1.69–10.38; P = 0.002).Conclusion: Smoking(currently and ever-smoked) and consuming salted vegetables once a week or more were lifestyle risk factors for NPC, and changes of these factors for the better may reduce the risk of NPC.

Case Control Study of Impulsivity,Aggression,Pesticide Exposure and Suicide Attempts Using Pesticides among Farmers

A case-control study was conducted to investigate associations between organophosphate pesticide（OP）exposure,aggression,impulsivity,and attempted suicide.Questionnaires were used to collect information;impulsivity and aggression were measured by the Barratt Impulsivity Scale（BIS）and the Aggression Inventory（AI）.

A Case-Control Study on Leisure Time Physical Activity (LTPA) during the Last Three Months of Pregnancy and Foetal Outcomes in Italy

The association between Leisure Time Physical Activity (LTPA) during pregnancy and foetal outcomes has been extensively investigated. However, epidemiological studies specifically referred to LPTA in the last months of pregnancy are scarce. We evaluated the association between LPTA and the risk of both preterm delivery and small for gestational age (SGA) during the last three months of pregnancy in Italy. A nationwide case-control study was performed in nine Italian cities. A total of 299 preterm delivery, 364 SGA and 855 controls were enrolled in the study. A self-administered questionnaire was used to assess socio-demographic variables, medical and reproductive history, life-style habits and LTPA referred to the last three months of pregnancy. Univariate and multivariate regression analyses were performed in order to estimate Odds ratios and 95% CI. LTPA during the last three months of pregnancy decreases the risk of preterm delivery (adjusted OR = 0.56;95% CI 0.39 - 0.79). Among the different types of physical activity, walking, the most frequently referred activity, appears significantly protective against preterm delivery (adjusted OR = 0.53;95% CI 0.36 - 0.81). Moreover, a small protective effect of walking was evidenced against SGA (adjusted OR = 0.72;95% CI 0.51 - 1.00). In conclusion, a mild physical activity such as walking in the last three months of pregnancy seems to reduce the risk of preterm delivery and, at a lesser extent, of SGA, confirming the beneficial effects of physical activity along the whole pregnancy.

Nasopharyngeal colonization of otopathogens in South Indian children with acuteotitis media -- A case control pilot study

Background: Acute otitis media (AOM) is an inflammatory disease of the middle ear causing significantmorbidity in early childhood. A pilot study was undertaken to identify the role of various risk factorsSouth Indian children with AOM, especially the role of nasopharyngeal otopathogens.Methodology: A prospective case control pilot study was conducted in children aged below six years,presenting to a single tertiary care from 2018 to 2019. Fifty cases with AOM and 45 age and gendermatched controls were recruited. Two nasopharyngeal swabs were collected, one was processed forbacterial culture. The other swab was processed according to the CDC recommended broth enrichmentmethod to identify carriage of S. pneumoniae. Subsequent serotyping was done by Quellung method andconventional sequential multiplex PCR.Result: Otalgia was the major presentation seen in 92% of the children with AOM. None of the clinical anddemographic characteristics were found to be statistically significant between the cases and controls. Themost common otopathogen was S. pneumoniae (55%) followed by H. influenza (29%). The commonS. pneumoniae serotypes encountered were 11A and 19F.Nasopharyngeal colonization with S. pneumoniae[OR 6.57, p < 0.003] and H. influenzae [OR14.18, p < 0.003] were significant risk factors for AOM inchildren. The risk increased with co-colonization (OR 13.89,p < 0.003).Conclusion: This study strengthens the significant association between nasopharyngeal colonization ofotopathogens and AOM as a risk factor that is enhanced by co-colonization.S. pneumoniae was the mainotopathogen in this population, serotypes 11A and 19F being the most common.

A Case-control Study on High-risk Factors for Newborn Hearing Loss in Seven Cities of Shandong Province

To investigate the high-risk factors for newborn hearing loss and to provide information for preventing the development of hearing loss and delaying its progression, from May 2003 to June 2006, neonates who failed to pass the universal newborn hearing screening （UNHS） were referred to Jinan Newborn Hearing Screening and Rehabilitation Center from 7 newborn hearing screening centers in seven cities of Shandong province. One-to-one pair-matched case-control method was employed for statistical analysis of the basic features of definitely identified cases. High-risk factors relating to the bilateral hearing loss were evaluated by univariate and multivariate Logistic regression analysis. Our results revealed that 721 transferred newborns who didn＇t pass the heating screening received audiological and medical evaluation and 367 were confirmed to have hearing loss. Of them, 177 neonates with hearing loss who met the matching requirements were included in the study as subjects. Univariate analysis showed that high-risk factors related to hearing loss incuded age of father, education backgrounds of parents, parity, birth weight, gestational weeks, craniofacial deformity, history of receiving treatment in neonatal intensive care unit （NICU）, neonatal disease, family history of otopathy and family history of congenital hearing loss. Multivariate Logistic regression analysis revealed that 4 independent risk factors were related to bilateral hearing loss, including parity （OR=16.285, 95% CI 3.379--78,481）, neonatal disease （OR=34;968, 95% CI 2.720 449.534）, family history of congenital hearing loss （OR=69.488, 95% CI 4.417--1093.300） and birth weight （OR=0.241, 95% CI 0.090--0.648）. It is concluded that parity, neonatal disease and family history of heating loss are the promoting factors of bilateral hearing loss in neonates and appropriate intervention measures should be taken to deal with the risk factors.

Risk Factors for Birth Defects: A Conditional LogisticRegression Analysis of a Case-Control Study in Guang-dong Province of China

Information was obtained from the same questionnaire (23 risk factors listed) of cases and controls. We used a multivariate logistic model, which described variables significantly increased risk of birth defects. The risk factors included maternal educational levels, medicine taken during pregnancy and antenatal care. It was suggested to strengthen antenatal care was the main preventive measure against birth defects.

Serum Levels of Antioxidant Vitamins in Relation to Coronary Artery Disease: A Case Control Study of Koreans

With the changes in trends of disease pattern from infectious to chronic degenerative disease, cardiovascular disease has been considered as the major cause of death in Korea.Numerous studies have been done on the antioxidant effects of some vitamins in the prevention of chronic illness, but not many in relation to the cardiovascular disease.Therefore, the relation between antioxidant vitamins, mainly α-tocopherol (α-T) and B-carotene (B-C), and coronary artery disease (CAD) such as angina pectoris and myocardial infarction has been investigated in this study.The blood samples were obtained from the CAD patients who were angiographically diagnosed within a month (100 case group). Patients who had an experience of PTCA or CABG were excluded from the study. Control subjects were healthy adults who had normal EKG values, no chest pain and no past history of cardiac disease (100 control group). All subjects were free of serum lipid lowering drugs. Serum α-T and B-C were analysed using HPLC. In addition to antioxidant vitamins, serum lipids (total cholesterol, HDL, TG) were also measured. Each case and control was matched in terms of age and sex. And all the CAD risk factors such as blood pressure, smoking, alcohol, serum lipid profile and BMI were adjusted to determine pure effect(s) of α-T and B-C on the CAD.The concentrations of both α-T and B-C were significantly lower in the CAD group than those in control group (P<0.05); in CAD group, mean values of α-T and B-C were 11.9±7.2 (μg/ml), 35.8±3.1 (μg/dl) respectively. As for the levels of B-C, it shows inverse relation with age, but not for the α-T Ievels. Serum levels of both vitamins did not show any significant differences in terms of sex, but men have a tendency o higher levels of B-C,but lower levels of α-T

High Spicy Food Intake and Risk of Cancer： A Meta-analysis of Case-control Studies

Background：Studies on the association between spicy food intake and cancer risk have reported inconsistent results.We quantitatively assessed this association by conducting a meta-analysis based on evidence from case-control studies.Methods：PubMed,EMBASE,and the Cochrane Library were searched for eligible publications.Combined odds ratios （ORs） with their 95% confidence interval （CI） were calculated using a random-or fixed-effects model.The methodological quality of the included articles was assessed using the Newcastle-Ottawa scale （NOS）.All data were analyzed using STATA 1 1.0 software （version 11.0;StataCorp.,College Station,TX,USA）.Subgroup analyses were also performed with stratification by region,sex,number of cases,cancer subtype,source of the control group,and NOS score.Results：A total 39 studies from 28 articles fulfilled the inclusion criteria for the meta-analysis （7884 patients with cancer and 10,142 controls）.Comparison of the highest versus lowest exposure category in each study revealed a significant OR of 1.76 （95% CI =1.35-2.29） in spite of significant heterogeneity （P 〈 0.00l）.In the subgroup analyses,this positive correlation was still found for gastric cancer,different regions,different numbers of cases,different sources of the control group,and high-quality articles （NOS score of≥ 7）.However,no statistically significant association was observed for women,esophageal cancer,gallbladder cancer,or low-quality articles （NOS score of〈7）.No evidence of publication bias was found.Conclusions：Evidence from case-control studies suggested that a higher level of spicy food intake may be associated with an increased incidence of cancer despite significant heterogeneity.More studies are warranted to clarify our understanding of the association between high spicy food intake and the risk of cancer.

Executive function during transient ischemic attacks

BACKGROUND： Recent researches demonstrate that damage of executive function is an early manifestation of vascular cognitive disorder. OBJECTIVE： To investigate the executive functions of patients with transient ischemic attack （TIA）. DESIGN： Case control. SETTING： Department of Neurology, the First Affiliated Hospital of Xinxiang Medical College. PARTICIPANTS： A total of 83 TIA patients （46 males and 37 females, aged 32 - 74 years） were selected from Department of Neurology, the First Affiliated Hospital of Xinxiang Medical College from July 2005 to December 2006. The diagnosis of TIA was established by the criteria of cerebrovascular diseases made by the Fourth National Cerebrovascular Disease Meeting. In these cases, forty-five patients （54%） were involved in internal carotid artery, and thirty-eight patients （46%） were involved in vertebral basilar system. Fifty healthy adults （Control group： 28 males and 22 females, aged 32 - 74 years） were chosen from retiree in community and family of patients. All of them were right-handedness, without cerebrovascular disease, cerebral trauma, inborn oligophrenia, and heating and visual disorders; also they had no anxiety and depression nearly one week. In addition, all the subjects cooperated with examination. METHODS： After TIA diagnosis, all patients received neuropsychological examination, including attention and inhibition, working memory, flexibility, planning and diversion, based on Stroop tests （C and CW） and the Wisconsin card sorting tests （WCST）. ① WCST test： The edition revised by Nelson was used. We would take the times of sorting, incorrect response, persistent incorrect response, and randomly incorrect response as the index of evaluation.② Stroop tests： The edition revised by Trenarry was used and this test had two types： form color and form color-word. Their incorrect response and response time were recorded for data analysis in the end. MAIN OUTCOME MEASURES： Results of WCST test and Stroop tests. RESULTS： A total of 83 TIA patients and 50 healthy subjects were involved in the final analysis. Items of Stroop tests, including response time of Stroop-C test, incorrect response of Stroop-C test, response time of Stroop-CW test and incorrect response of Stroop-CW test, and items of WCST, including incorrect response, persistent incorrect response and random incorrect response, between internal carotid artery system and vertebral basilar artery system were （93.87±24.39） s, 3.16±3.97, （228.46±68.13） s, 12.91 ± 10.56, 55.42± 20.38, 26.58± 10.41, 28.62±11.22; （96.76±24.75） s, 3.89±4.77, （223.46±72.54） s, 18.71 ± 13.80, 52.47 ±22.25, 28.82± 16.20, 23.39±9.72, respectively; this was higher than those in the control group [（52.10± 12.18） s, 1.68± 1.97, （134.86±34.15） s, 4.22±4.21, 32.46± 17.97, 14.42±8.47, 18.24± 10.24, P 〈 0.05 - 0.01]. Times of sorting of WCST between internal carotid artery system and vertebral basilar artery system were obviously lower than those in the control group （8.27±2.73, 8.66±2.77, 11.22±2.41, P 〈 0.01）. However, there were no significant differences between internal carotid artery system and vertebral basilar artery system （P 〉 0.05）. CONCLUSION： Patients with TIA have executive dysfunctions, and the dysfunctions have no difference between internal carotid artery system and vertebral basilar artery system.

冗余包皮增大慢性前列腺炎／慢性骨盆区疼痛综合征的发病可能

Some published evidence has revealed that the dendritic cells can interact with pathogens that exist in the inner foreskin. This information provides a new vision that pathogens could play a role through the redundant prepuce; numerous studies have failed to find pathogens in prostates of patients who had chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）. However, no studies have reported an association between foreskin length and CP/CPPS. Hence, we conducted a retrospective case-control study of clinical data from 322 CP/CPPS patients （case group） and 341 nonCP/CPPS patients （control group）. Demographic characteristics, lifestyle factors, and foreskin lengths were collected and analyzed. Multivariate logistic regression was adopted to calculate the odds of foreskin length for CP/CPPS. According to the multivariate logistic regression results, when the foreskin length covered up more than half of the glans penis, the odds for CP/CPPS were higher with an increased foreskin （odds ratio （OR）： 1.66, 95% confidence interval （CI）： 1.04-2.66）. In comparison, when the glans penis was completely covered by the foreskin, the OR value increased to 1.86 （95% CI, 1.2-2.88）. The study results showed an association between foreskin length and the odds of CP/CPPS. When the foreskin length covered up more than half of the glans penis, there were greater odds for CP/CPPS. This possible mechanism might result from interaction between pathogens and DCs in the inner foreskin, consequently activating T-cells to mediate allergic inflammation in the prostate and producing the autoimmunizations causing CP/CPPS.

Closed patella fracture combined with cruciate ligament injury： a case control study

Background Patellar fracture and cruciate ligament injury are a common consequence of traumatic knee injury. Patellar fracture combined with cruciate ligament injury is rarely reported, although the mechanisms of two things are similar. This study aimed to evaluate the incidence of closed patella fracture combined with cruciate ligament injury.

Onchocerca volvulus as a risk factor for developing epilepsy in onchocerciasis endemic regions in the Democratic Republic of Congo:a case control study

Background:A high prevalence of epilepsy has been observed in onchocerciasis endemic areas in the Democratic Republic of Congo(DRC).With this study we aimed to investigate whether Onchocerca volvulus infection is a risk factor for developing epilepsy in onchocerciasis endemic regions in the DRC.Methods:Between October and December 2015,a multi-centre case control study was performed in onchocerciasis endemic health zones(HZ)in the DRC:one study site was situated in Tshopo Province in the HZ of Wanierukula(village of Salambongo)where there had been 13 annual community distributions of treatment with ivermectin(CDTI),a second was situated in Ituri Province in the HZ of Logo(village of Draju)where ivermectin had never been distributed and in the HZ of Rethy(village of Rassia)where there had been THREE CDTI annual campaigns before the study.Individuals with unprovoked convulsive epilepsy of unknown etiology were enrolled as cases(n=175).Randomly selected healthy members of families without epilepsy cases from the same village and age-groups and were recruited as controls(n=170).Results:Onchocerciasis associated symptoms(e.g.,itching and abnormal skin)were more often present in cases compared to controls(respectively,OR=2.63,95%CI:1.63-4.23,P<0.0001 and OR=3.23,95%CI:1.48-7.09,P=0.0034).A higher number of cases was found to present with microfilariae in skin snips and with O.volvulus IgG4 antibodies in the blood compared to controls.Moreover,the microfilariae load in skin snips was 3-10 times higher in cases than controls.Conclusions:This case control study confirms that O.volvulus is a risk factor for developing epilepsy in onchocerciasis endemic regions in the DRC.

Identification of COL3A1 variants associated with sporadic thoracic aortic dissection: a case-control study

Thoracic aortic dissection(TAD)without familial clustering or syndromic features is known as sporadic TAD(STAD).So far,the genetic basis of STAD remains unknown.Whole exome sequencing was performed in 223 STAD patients and 414 healthy controls from the Chinese Han population(N=637).After population structure and genetic relationship and ancestry analyses,we used the optimal sequence kernel association test to identify the candidate genes or variants of STAD.We found that COL3A1 was significantly relevant to STAD(P=7.35×10^(−6))after 10000 times permutation test(P=2.49×10^(−3)).Moreover,another independent cohort,including 423 cases and 734 non-STAD subjects(N=1157),replicated our results(P=0.021).Further bioinformatics analysis showed that COL3A1 was highly expressed in dissected aortic tissues,and its expression was related to the extracellular matrix(ECM)pathway.Our study identified a profile of known heritable TAD genes in the Chinese STAD population and found that COL3A1 could increase the risk of STAD through the ECM pathway.We wanted to expand the knowledge of the genetic basis and pathology of STAD,which may further help in providing better genetic counseling to the patients.

Case Control Study of Post-endoscopic Variceal Ligation Bleeding Ulcers in Severe Liver Disease: Outcomes and Management

Background and Aims:The management of post-endoscopic variceal ligation(EVL)bleeding ulcers(PEBUs)is currently based on local expertise and patients liver disease status.The present retrospective study investigated associations between the endoscopic morphology of PEBUs and patient outcomes.Methods:Patients underwent EVL(primary or secondary),from January 2015 to January 2018,in two tertiary care hospitals in India(ILBS New Delhi and Dharamshila Narayana New Delhi).Mortality rates were determined at post-EVL day five and week six.PEBUs were typified based on Jamwal&Sarin classification system as follows:A,ulcer with active spurting;B,ulcer with ooze;C,ulcer base with visible vessel or clot;and D,clean or pigmented base.Results:Of 3854 EVL procedures,141(3.6%)patients developed PEBU,and 46/141(32.6%)suffered mortality.Among the former,the PEBU types A,B,C,and D accounted for 17.7,26.2,36.3,and 19.8%,respectively.Of those who died,39.1,30.4,21.7,and 8.8%had PEBU types A,B,C,and D.Treatments included transjugular intrahepatic portosystemic shunts(TIPS),esophageal self-expandable metal stent(SEMS),glue and sclerosant injection,Sengstaken-Blakemore tube placement and liver transplant.On univariate analysis,no correlation with hepatic venous pressure gradient,TIPS placement,size of varices,or number of bands was found.The Model for EndStage Liver Disease(MELD)-sodium score correlated positively with outcome.After adjusting for MELD-sodium score,mortality was best predicted by type-A ulcer(p=0.024;OR 8.95,CI 1.34-59.72).Conclusions:PEBU occurred in 3.6%of a large EVL cohort.Stratifying patients based on PEBU type can help predict outcomes,independent of the MELD-sodium score.Classifying PEBUs by endoscopic morphology may inform treatment strategies,and warrants further validation.

Association between two polymorphisms of the bone morphogenetic protein-2 gene with genetic susceptibility to ossification of the posterior longitudinal ligament of the cervical spine and its severity

Background Ossification of the posterior longitudinal ligament （OPLL） has a strong genetic background. Previous studies have shown that bone morphogenetic protein-2 （BMP2） and BMP2 mRNA are expressed in ossifying matrix and chondrocytes adjacent to cartilaginous areas of OPLL tissues and mesenchymal cells with fibroblastic features in the immediate vicinity of the cartilaginous areas. It is suggested that BMP2 plays different roles in the different stages of development of OPLL. However, it remains unknown which factors induce ligament cells to produce BMP2. Methods OPLL patients （n=-192） and non-OPLL controls （n=304） were studied. Radiographs of the cervical spine were analyzed for extent of OPLL. We investigated whether single nucleotide polymorphisms of exons 3（-726） T/C and 3（-583） NG in the BMP2 gene are statistically associated with genetic susceptibility to OPLL in Chinese Han subjects. Results There was no statistical difference between the occurrence of exons 3（-726） T/C and 3（-583） NG and the occurrence of OPLL in the cervical spine. However, there was a significant association between occurrence of exon 3（-726） T/C polymorphism and occurrence of OPLL in males of cases and controls in the cervical spine. In addition, no significant association was found between the exons 3（-726） T/C and 3（-583） A/G with number of ossified cervical vertebrae in OPLL patients. Conclusions Exon 3（-583） A/G polymorphism in BMP2 gene is not associated with the occurrence and the extent of OPLL in the cervical spine. Chinese Han male patients with TC and CC genotypes in exon 3（-726） T/C have genetic susceptibility to OPLL but not to more extensive OPLL in the cervical spine.

T allele at site 6007 of bone morphogenetic protein-4 gene increases genetic susceptibility to ossification of the posterior longitudinal ligament in male Chinese Han population

Background Several candidate genes of ossification of the posterior longitudinal ligament （OPLL） susceptibility have been identified, but their polymorphisms account for only a small percent of the total variance. Bone morphogenetic protein-4 （BMP4） is a potent ectopic ossification inducing factor. BMP4 protein and mRNA are present in cells from OPLL patients, but not non-OPLL controls. A single nucleotide polymorphism of 6007C〉T（rs17563） of BMP4 has been reported to affect bone density in postmenopausal women. Thus, BMP4 may function in OPLL development. Appropriately, the relationship between BMP4 polymorphisms and OPLL was investigated. Methods A case-control association study investigated the genetic etiology in 179 OPLL patients and 298 non-OPLL controls. Extent of OPLL was analyzed by radiologic examinations. Whether single nucleotide polymorphism （SNP） of -5826G〉A（rs1957860） 5＇ of the transcription start site and 6007C〉T（rs17563） in exon 4 of the BMP4 gene were statistically associated with genetic susceptibility to OPLL in Chinese Han subjects was assessed. Results A significant statistical difference in genotype of 6007C〉T polymorphism between male OPLL patients and male controls was evident, and the frequency of ＂TT＂ genotype in male OPLL patients was significantly higher than in male controls （P=0.039）. The frequency of the ＂T＂ allele was also significantly higher in male OPLL subjects than in male controls （P=0.014, OR=1.57）. A significant difference was also observed between the 6007C〉T polymorphism and the number of ossified cervical vertebrae in OPLL patients, while no statistical difference was apparent between the -5826G〉A polymorphism and OPLL occurrence. Conclusions The T allele in the 6007C〉T polymorphism may be a risk factor for male Han Chinese with ossification of the posterior longitudinal ligament in the cervical spine. Chinese Han male patients with CT and TT 6007C〉T genotypes have a genetic susceptibility to OPLL and more extensive OPLL in the cervical spine.