This study aimed to comprehensively examine the association of gallstones, cholecystectomy, and cancer risk. Multivariable logistic regressions were performed to estimate the observational associations of gallstones and cholecystectomy with cancer risk, using data from a nationwide cohort involving 239 799 participants. General and gender-specific two-sample Mendelian randomization (MR) analysis was further conducted to assess the causalities of the observed associations. Observationally, a history of gallstones without cholecystectomy was associated with a high risk of stomach cancer (adjusted odds ratio (aOR)=2.54, 95% confidence interval (CI) 1.50-4.28), liver and bile duct cancer (aOR=2.46, 95% CI 1.17-5.16), kidney cancer (aOR=2.04, 95% CI 1.05-3.94), and bladder cancer (aOR=2.23, 95% CI 1.01-5.13) in the general population, as well as cervical cancer (aOR=1.69, 95% CI 1.12-2.56) in women. Moreover, cholecystectomy was associated with high odds of stomach cancer (aOR=2.41, 95% CI 1.29-4.49), colorectal cancer (aOR=1.83, 95% CI 1.18-2.85), and cancer of liver and bile duct (aOR=2.58, 95% CI 1.11-6.02). MR analysis only supported the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer. This study added evidence to the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer, highlighting the importance of cancer screening in individuals with gallstones.
Humans ; Mendelian Randomization Analysis ; Gallstones/complications* ; Female ; Male ; Cholecystectomy/statistics & numerical data* ; Middle Aged ; Risk Factors ; Aged ; Adult ; Neoplasms/etiology* ; Stomach Neoplasms/epidemiology*

Objective To explore the diagnostic value of micropure imaging(MI)combined with strain elastography(SE)in correcting artificial intelligence(AI)S-Detect technology for benign and malignant breast complex cystic and solid masses.Methods The S-Detect diagnosis results were corrected based on the manifestations of MI and SE of the 145 breast complex cystic and solid masses.Postoperative pathological results were used as the gold standard to calculate the diagnostic sensitivity,specificity,and accuracy before and after correction.Additionally,receiver operating characteristic(ROC)curves were drawn for both groups,and the areas under the curves were compared.Results There were 80 benign and 65 malignant pathological results.After the correction of S-Detect,the diagnostic sensitivity,specificity,and accuracy,as well as the areas under the ROC curves,were all improved compared to before the correction.Conclusion Combining MI and SE to correct the diagnostic results of S-Detect can help improve the diagnostic efficacy of breast complex cystic and solid masses.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

Objective To investigate the clinicopathological and ultrasonic characteristics of dif-ferent molecular types of breast cancer with maximum diameter ≤2 cm,and analyze the diagnostic val-ue of conventional ultrasound.Methods A total of 174 breast cancer patients with diameter ≤2 cm were selected as the study objects.According to the immunohistochemical results,they were divided in-to LA group(Luminal A,n=46),LB group(Luminal B,n=71),HER-2 group(HER-2 overexpres-sion type,n=11)and triple-negative group(triple-negative,n=46).The clinicopathology,ultrasonic characteristics and the accuracy of conventional ultrasonic diagnosis were analyzed.Results There were significant differences in breast cancer size,pathological grade and pathological type among four groups(P＜0.05).Among the ultrasonic characteristics,there were statistically significant differ-ences in shape,edge,aspect ratio,calcification and rear echo among the four groups(P＜0.05).Breast Imaging Reporting and Data System(BI-RADS)grading and accuracy of conventional ultra-sound diagnosis among the four groups showed statistically significant differences(P＜0.05).Conclusion The clinicopathological features,ultrasound features and BI-RADS grading of different molecular types of breast cancer with maximum diameter ≤2 cm are different.Routine ultrasound has certain diagnostic value,which can provide important reference for molecular classification diagnosis,individualized treatment and prognosis evaluation of early breast cancer.

Objective To investigate the clinicopathological and ultrasonic characteristics of dif-ferent molecular types of breast cancer with maximum diameter ≤2 cm,and analyze the diagnostic val-ue of conventional ultrasound.Methods A total of 174 breast cancer patients with diameter ≤2 cm were selected as the study objects.According to the immunohistochemical results,they were divided in-to LA group(Luminal A,n=46),LB group(Luminal B,n=71),HER-2 group(HER-2 overexpres-sion type,n=11)and triple-negative group(triple-negative,n=46).The clinicopathology,ultrasonic characteristics and the accuracy of conventional ultrasonic diagnosis were analyzed.Results There were significant differences in breast cancer size,pathological grade and pathological type among four groups(P＜0.05).Among the ultrasonic characteristics,there were statistically significant differ-ences in shape,edge,aspect ratio,calcification and rear echo among the four groups(P＜0.05).Breast Imaging Reporting and Data System(BI-RADS)grading and accuracy of conventional ultra-sound diagnosis among the four groups showed statistically significant differences(P＜0.05).Conclusion The clinicopathological features,ultrasound features and BI-RADS grading of different molecular types of breast cancer with maximum diameter ≤2 cm are different.Routine ultrasound has certain diagnostic value,which can provide important reference for molecular classification diagnosis,individualized treatment and prognosis evaluation of early breast cancer.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.