[One-stage tympanic cavity ventilation tube placement in canal wall down tympanomastoidectomy].

Objective:To research the clinical application of tympanic cavity ventilation tube placement in canal wall down tympanomastoidectomy. Method:There were 52 patients with otitis media received canal wall down tympanomastoidectomy. We placed ventilation tube in posterior hypotympanum during the surgery. After surgery, all patients were followed up in 12 days, 1 month, 2 months, 6 months, and 1 year. The ventilation tubes were withdrew 6 months later, and then the hearing level and tympanic cavity status was evaluated after another half year. Result:All cases were followed up at least 1 year after surgery. Forty-four patients' tubes were removed 6 months later, but other 8 tubes had been extruded within 1 to 3 months. After 1 year, all 52 cases of ears were dry; 39 patients' tympanic membranes were stable, the postoperative complications included tympanic membrane retraction in 7 cases, middle ear effusion in 4 cases, and tympanic membrane perforation at anterior-inferior quadrant in 2 cases; CT examination indicated that 39 patients' aeration between tympanic cavity and Eustachian tube bony portion was normal, 9 patients' tympanic cavity aeration was smaller, and 4 patients' cavity was obstructed; 52 patients' average air conduction thresholds were 12.5 dB lower than that of preoperation. Conclusion:One-stage tympanic cavity ventilation tube placement is a simple, safe and effective method in canal wall down tympanomastoidectomy for middle ear diseases with Eustachian tube severe stenosis or obstruction in bony portion.

Review and pooled analysis of studies on MTHFR C677T polymorphism and esophageal cancer.

Esophageal cancer has been associated with tobacco and alcohol consumption, gastric reflux, exposure to nitrosamines from food or other environmental sources, and diets lacking folate. Susceptibility to esophageal cancer may be modified by functional polymorphisms in genes along the folate metabolic pathway, such as methylenetetrahydrofolate reductase (MTHFR). The C677T polymorphism is the most common functional variant, leading to a reduction in enzyme activity. We report a pooled analysis of 5 studies on the association of MTHFR C677T polymorphism and esophageal cancer, including 725 cases and 1531 controls. A significant association between the MTHFR 677 TT genotype and esophageal cancer was observed (OR=2.63, 95% CI: 1.75-3.94), although there was significant heterogeneity between studies. A sensitivity analysis excluded one study; the association between TT genotype and esophageal cancer was still present, although of reduced magnitude (OR=1.57, 95% CI: 0.96-2.56). A significant interaction between smoking and TT genotype on esophageal cancer risk was observed, while no interaction was observed between alcohol consumption and genotype.

Dietary protective and risk factors for esophageal and stomach cancers in a low-epidemic area for stomach cancer in Jiangsu Province, China: comparison with those in a high-epidemic area.

Comparative epidemiological studies with ecological and case-control approaches in high- and low-epidemic areas of China have provided us with much evidence with regard to risk and benefit in the environment. To clarify how dietary factors are involved in esophageal and stomach cancer development, we performed a case-control study in a low-epidemic area, and compared the findings with those obtained earlier for a high-epidemic area for stomach cancer in the same Jiangsu Province, China. We recruited 199 and 187 cases with esophageal and stomach cancers, respectively, and 333 population-based common controls. Odds ratios (ORs) for esophageal and stomach cancers were calculated with adjustment for potential confounding factors, using an unconditional logistic model. Current and former smoking elevated the OR for esophageal cancer, along with high intake of pickled vegetables and broiled meat, while decreased ORs were observed for frequently consumed raw vegetables and garlic. With regard to stomach cancer, ORs were increased with frequent consumption of salty fish, leftover gruel, and broiled meat, and lowered by snap bean consumption. The present risk factors were common to the previously obtained results in the high-epidemic area, and similarly distributed in each general population. While more protective factors were observed in the high-epidemic area, their penetrance was much greater in the low-epidemic area. The present study thus suggests that frequent vegetable and garlic consumption contributes to low mortality rates for esophageal and stomach cancers in a low-epidemic area, counteracting similar exposure levels for risk factors as in the high-epidemic area.

Protective effect of allium vegetables against both esophageal and stomach cancer: a simultaneous case-referent study of a high-epidemic area in Jiangsu Province, China.

To study the relation between allium vegetable intake and cancer of the esophagus (EC) and stomach (SC) in Yangzhong city, which is one of the highest-risk areas for these cancers in Jiangsu province, China, a simultaneous case-referent study was conducted using histopathologically confirmed cases (EC: n = 81, SC: n = 153) and population-based referents (n = 234). A questionnaire was used to collect information on the general status of subjects, their dietary habits, frequency intake of allium vegetables and other foods, tea consumption, smoking and alcohol drinking. The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by a multiple logistic regression model. The results showed that frequent intake of allium vegetables (including garlic, onion, Welsh onion and Chinese chives), raw vegetables, tomatoes and snap beans, and tea consumption were inversely associated with the risk for EC and SC. In the highest consumption category (> or = 1 time/week) of garlic, onion, Welsh onion and Chinese chives, the adjusted ORs compared with the lowest category (< 1 time/month) were 0.30 (CI = 0.19-0.47), 0.25 (CI = 0.11-0.54), 0.15 (CI = 0.08-0.26), and 0.57 (CI = 0.23-1.42) for EC, and 0.31 (CI = 0.22-0.44), 0.17 (CI = 0.08-0.36), 0.22 (CI = 0.15-0.31) and 0.40 (CI = 0.17-0.94) for SC, respectively. The main results in the present study suggested that allium vegetables, like raw vegetables, may have an important protecting effect against not only stomach cancer, but also esophageal cancer.

Comparative study of lifestyles of residents in high and low risk areas for gastric cancer in Jiangsu Province, China; with special reference to allium vegetables.

There is a low risk area for gastric cancer in Jiangsu Province, China, where people frequently consume raw allium vegetables. As a first step epidemiological study to clarify the factors involved in the low incidence of gastric cancer, we conducted a comparative study of the ecological factors in a high risk area (HRA), Yangzhong, and a low risk area (LRA), Pizhou, using a questionnaire. Subjects were selected from the general population according to age and sex, and comprised 414 residents of the HRA and 425 residents of the LRA. Ecological factors were compared for the two areas by Cochran-Mantel-Haenszel method, age-adjusted. Smoking and drinking habits were found to be more common in the LRA. On the other hand, allium vegetables were consumed in the LRA much more frequently, with high consumption of raw vegetables fruit, tomatoes, kidney beans and soybean products. People who consumed garlic en masse 3 times or more per week were 82% of men and 75% of women in the LRA, and 1% of men and women in the HRA. The results of the survey suggest that frequent consumption of allium vegetables, in addition to other anticancer foods, may be a factor in low mortality for gastric cancer.

Life-style and subsite of gastric cancer--joint effect of smoking and drinking habits.

To clarify the effects of life-style on gastric cancer by subsite focusing on the proximal part (cardia and fundus) and the distal part (pyloric antrum), a case-control study was conducted at the Aichi Cancer Center in Nagoya, Japan from 1988-1991. This study compared 668 histologically confirmed gastric cancer cases [123 cardia, 218 middle (body), 256 antrum, and 71 unclassified] with 668 controls using a common questionnaire about life-styles as related to smoking, drinking, dietary habits and frequency of food intake. Controls were selected from among outpatients of the same hospital. Controls free of cancer and other specific diseases were matched with cases for sex, age (within 2 years), and time of hospital visit (within 2 months). A Western-style breakfast decreased the risk of antrum cancer, while consumption of greasy food increased the risk of cardia cancer. Fresh vegetables decreased the risk of cancer in both cardia and antrum. Habitual smoking is associated with increased risk of gastric cancer and it is more prominent in cardia cancer, especially in those who are drinkers. Results obtained from this study suggest that risk factors and relative risks of gastric cancer varied by subsite to a considerable degree. Furthermore, the joint effect of smoking and drinking may play an important role in the development of gastric cancer, especially of cardia cancer.

Protective effects of raw vegetables and fruit against lung cancer among smokers and ex-smokers: a case-control study in the Tokai area of Japan.

In a hospital-based case control study, the protecting effects of fruit, raw and green vegetables against lung cancer risk among male smokers were studied in 282 cases and the same number of controls. The current smokers showed a 6.61-fold increased risk of lung cancer. The odds ratio (OR) declined markedly with starting age of smoking habit and increased markedly with number of cigarettes smoked per day. The ex-smokers showed a 3.56-fold increased risk of lung cancer. The ORs gradually decreased with years passed since cessation of smoking. In the single factor analysis, significant protective effects of fruit, raw vegetables, green vegetables, lettuce and cabbage against lung cancer were found. The risk for all lung cancer decreased to 0.45 (95% confidence intervals (CI) 0.30-0.67), 0.64 (95% CI 0.43-0.97) and 0.44 (95% CI 0.26-0.73) with increment of intake frequency of fruit, raw and green vegetables respectively. The OR for lung cancer decreased to 0.41 (95% CI 0.24-0.72) and 0.56 (95% CI 0.32-0.99) with increasing intake frequency of fruit and raw vegetables among current smoking males. Lettuce and cabbage showed protective effects against lung cancer, and the OR for risk of lung cancer decreased to one-half among the high intake frequency group. The risk of lung cancer among current smokers declined markedly with increasing intake of lettuce and cabbage. A similar effect was observed among ex-smokers and non-smokers, but there was no statistical significance. In the multivariate analysis, fruit and raw vegetables showed the strongest protective effects against lung cancer among current smokers (P = 0.01). Among ex-smokers, the protective effect of fruit is also statistically significant (P = 0.03). These results suggest that fruit and raw vegetables may play an important role in protecting smokers from lung cancer.

[An epidemiological evaluation of the efficacy of mass screening for uterine cancer in Japan. The relationship between coverage rate of mass screening and reduction in death rate from uterine cancer].

To evaluate the efficacy of mass screening for uterine cancer, the relationship between the coverage rate of mass screening and the reduction in mortality rate from uterine cancer was analyzed. The percent change in the AADR (Age-adjusted death rate) from 1979-1983 to 1984-1988 were compared between the high coverage rate areas and the control areas with relatively lower coverage rates, and among the high coverage rate areas with varied coverage rates. The main results were: (a) the decreases of AADR from uterine cancer were greater in three groups of high coverage rate areas than in control areas with low coverage rates. (b) Among three groups of high coverage rate areas with variation in coverage rates (> or = 20%, > or = 30%, > or = 40%), the higher the coverage rate was, the greater was the percent reduction (-45.9%, -52.3%, -63.5%) of AADR. These results suggest that systematic mass screening may be effective in reducing mortality from uterine cancer.