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*

In the current process of talent cultivation in biology majors,some challenges like teaching content that lags behind the forefront of scientific research,instructional models that deviate from the principles of effective knowledge transmission,and evaluation systems that lack dimensions reflecting scientific innovation.As a strategy of tackling challenges,the Genetic Engineering teaching team,drawing on theoretical analysis and extensive teaching practice,has explored a reform of the instructional model from the perspective of integrating theory with practice.This effort led to the development of a research-oriented teaching model characterized by four iterative stages:knowledge instruction,thinking exercises,practical operation,and feedback evaluation.This model is ground-ed in five core elements of scientific thinking:criticality,coherence,simplicity,logic,and integrity.Imple-mentation follows the four-step framework,emphasizing structured knowledge delivery,cultivation of analytical thinking,hands-on experimentation,and comprehensive feedback.After one semester of application,it was found that through reconstructed knowledge systems,immersive simulations of research contexts,realistic problem-solving of technical bottlenecks and all-round feedback,this teaching model effectively fosters scientific thinking among both instructors and students,significantly enhances students'scientific research ca-pabilities and improves overall teaching effectiveness.

Objective To observe the incidence of vascular calcification in patients with chronic renal failure(CRF)undergoing maintenance hemodialysis and analyze the related influencing factors.Methods A total of 110 CRF patients undergoing maintenance hemodialysis at Xingtai Central Hos-pital in Hebei Province were selected.Vascular calcification was determined through hip,abdominal,and bilateral hand X-ray examinations,and patients were divided into calcification group(n=59,with mild,moderate,and severe calcification)and non-calcification group(n=51,without calcifica-tion)based on the calcification results.General information and laboratory indicators[white blood cell(WBC)count,hemoglobin(Hb),total cholesterol(TC),triglycerides(TG),high-density lip-oprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),albumin(LB),serum potassium(K),serum calcium(Ca),serum phosphorus(P),serum creatinine(SCr),urea nitro-gen(BUN),uric acid(UA),intact parathyroid hormone(iPTH),high-sensitivity C-reactive pro-tein(hs-CRP),interleukin-13(IL-13),fibroblast growth factor 23(FGF23),sclerostin(SOST)]were compared between the two groups,and Logistic regression analysis was performed to screen in-fluencing factors of vascular calcification.Results There were no statistically significant differences in gender,body mass index,smoking history,and primary renal diseases between the calcification and non-calcification groups(P＞0.05).The mean age and dialysis duration were higher in the calcification group compared to the non-calcification group(P＜0.05).There were no statistically significant differences in WBC,Hb,TC,TG,HDL-C,LDL-C,K,Ca,and BUN levels between the two groups(P＞0.05).Compared with the non-calcification group,the calcification group had lower ALB and UA levels and higher P,SCr,iPTH,hs-CRP,IL-13,FGF23,and SOST levels(P＜0.05).Multivariate Logistic regression analysis showed that age,dialysis duration,and levels of P,iPTH,IL-13,FGF23,and SOST were influencing factors for vascular calcification in patients(P＜0.05).The receiver operating characteristic curve indicated that IL-13,FGF23,and SOST had cer-tain diagnostic value for vascular calcification in patients[area under the curve(AUC)＞0.7],and the diagnostic efficacy of combined IL-13,FGF23,and SOST was higher than that of each indi-cator alone(AUC=0.911,P＜0.05).Conclusion Vascular calcification is common in CRF pa-tients undergoing maintenance hemodialysis,and age,dialysis duration,P,IL-13,FGF23,and SOST are influencing factors for vascular calcification.

Pregnant women will encounter various physiological and psychological problems during pregnancy and childbirth, which seriously affect the health of mothers and children. Progressive muscle relaxation training is widely used in nursing as a simple and side-effect-free complementary alternative therapy. This article reviewed the overview of progressive muscle relaxation training and its application in pregnant women. The current problems were analyzed and suggestions were put forward in order to provide a valuable reference for better promoting maternal and child health.

Objective:To investigate the influence of celastrol(CEL)on the inflammatory response of rats with endometritis by regulating high mobility group box B1(HMGB1)/receptor for advanced glycation end products(RAGE).Methods:Seventy-two SPF SD female rats were randomly grouped into normal control group(Control group),sham operation group(Sham group),Model group,low-dose CEL group(CEL-L group,CEL 20 mg/kg),high-dose CEL group(CEL-H group,CEL 40 mg/kg)and HMGB1 in-hibitor glycyrrhizic acid group(GA group,GA 2 mg/kg),12 rats in each group.A rat model of endometritis was established by intra-uterine injection of phenol mucilage.Histopathological changes of rat uterus were observed by HE staining;the levels of superoxide dismutase(SOD),malondialdehyde(MDA),nitric oxide(NO)and prostaglandin E2(PEG2)in rat serum,and the levels of TNF-α and IL-1β in rat uterus tissue were measured by ELISA;the levels of MMP-2 and MMP-9 in rat uterus tissue were detected by immuno-histochemistry;the mRNA expression levels of HMGB1 and RAGE in rat uterus tissue were detected by RT-qPCR;the protein expres-sions of HMGB1 and RAGE in rat uterus were detected by Western blot.Results:Compared with the Sham group,the uterine tissue of the Model group was severely damaged,and the level of serum SOD and the levels of MMP-2 and MMP-9 in the uterine tissue were ob-viously decreased(P<0.05);the level of serum MDA,NO,PEG2,TNF-α and IL-1β,the expressions of HMGB1 and RAGE mRNA and protein in uterine tissue were obviously increased(P<0.05).Compared with the rats in the Model group,the changes of each in-dex of the rats in the CEL-L and CEL-H groups were opposite to the above(P<0.05).There was no obvious difference in the corre-sponding indexes between the CEL-H group and the GA group(P>0.05).Conclusion:Celastrol may reduce the inflammatory response in rats with endometritis by down-regulating the HMGB1/RAGE signaling pathway.

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 explore the impact of PM 2.5 concentration in Shanghai on the incidence of allergic rhinitis（AR） in the population, and provide strategies for early warning and prevention of AR. Methods:Collect daily average concentrations of atmospheric pollutants monitored in Shanghai from January 1, 2017 to December 31, 2019, and clinical data of AR patients from five hospitals in Shanghai during the same period. We used a time-series analysis additive Poisson regression model to analyze the correlation between PM 2.5 levels and outpatient attendance for AR patients. Results:During the study period, a total of 56 500 AR patients were included, and the daily average concentration of PM 2.5 was（35.28±23.07）μg/m³. There is a correlation between the concentration of PM 2.5 and the number of outpatient attendance for AR cases. There is a positive correlation between the daily average number of outpatient for AR and levels of PM 2.5 air pollution（（P<0.05）） . We found that every 10 μg/m³ increase in PM 2.5, the impact of on the number of AR visits was statistically significant on the same day, the first day behind, and the second day behind, with the strongest impact being the exposure on the same day. Every 10 μg/m³ increases in PM 2.5, the number of outpatient visits increased by 0.526% on the same day（95%CI 1.000 50-1.010 04）. Conclusion:The atmospheric PM 2.5 concentration in Shanghai is positively correlated with the number of outpatient for AR, and PM 2.5 exposure is an independent factor in the onset of AR. This provides an important theoretical basis for AR.
Humans ; Particulate Matter/analysis* ; Air Pollutants/adverse effects* ; Incidence ; China/epidemiology* ; Air Pollution/adverse effects* ; Rhinitis, Allergic/etiology*

Background: and Purpose We investigated the causal relationships between the gut microbiota (GM), stroke, and potential metabolite mediators using Mendelian randomization (MR). Methods: We leveraged the summary statistics of GM (n=18,340 in the MiBioGen consortium), blood metabolites (n=115,078 in the UK Biobank), and stroke (cases n=60,176 and controls n=1,310,725 in the Global Biobank Meta-Analysis Initiative) from the largest genome-wide association studies to date. We performed bidirectional MR analyses to explore the causal relationships between the GM and stroke, and two mediation analyses, two-step MR and multivariable MR, to discover potential mediating metabolites. Results: Ten taxa were causally associated with stroke, and stroke led to changes in 27 taxa. In the two-step MR, Bifidobacteriales order, Bifidobacteriaceae family, Desulfovibrio genus, apolipoprotein A1 (ApoA1), phospholipids in high-density lipoprotein (HDL_PL), and the ratio of apolipoprotein B to ApoA1 (ApoB/ApoA1) were causally associated with stroke (all P<0.044). The causal associations between Bifidobacteriales order, Bifidobacteriaceae family and stroke were validated using the weighted median method in an independent cohort. The three GM taxa were all positively associated with ApoA1 and HDL_PL, whereas Desulfovibrio genus was negatively associated with ApoB/ApoA1 (all P<0.010). Additionally, the causal associations between the three GM taxa and ApoA1 remained significant after correcting for the false discovery rate (all q-values <0.027). Multivariable MR showed that the associations between Bifidobacteriales order, Bifidobacteriaceae family and stroke were mediated by ApoA1 and HDL_PL, each accounting for 6.5% (P=0.028) and 4.6% (P=0.033); the association between Desulfovibrio genus and stroke was mediated by ApoA1, HDL_PL, and ApoB/ApoA1, with mediated proportions of 7.6% (P=0.019), 4.2% (P=0.035), and 9.1% (P=0.013), respectively. Conclusion The current MR study provides evidence supporting the causal relationships between several specific GM taxa and stroke and potential mediating metabolites.

Objective: To examine the safety and effectiveness of a new stent graft system for endovascular repair of abdominal aortic aneurysm(AAA). Methods: This is a prospective,multi-center,single-arm clinical trial. The patients with AAA treated with a new stent graft system were enrolled at 21 centers from September 2018 to September 2019 in China. Follow-up was performed before discharge, and at 30, 180, 360 days after operation, respectively. The primary safety endpoint was the incidence of major adverse events(MAE) within 30 days. The primary efficacy endpoint was the success rate of AAA treatment at 360 days. Secondary safety endpoints were the incidence of perioperative access complications and acute lower limb ischemia,all-cause mortality, AAA related mortality and incidence of serious adverse events (SAE) at 180 and 360 days. Secondary efficacy endpoints were the incidence of type Ⅰ or Ⅲ endoleak,stent displacement,and conversion to open surgery or re-intervention at 180 and 360 days. Results: One hundred and fifty-six patients were enrolled,including 137 males and 19 females. The age was (68.9±6.9) years (range:48.2 to 84.6 years).Maximum aneurysm diameter was (50.8±11.2) mm (range:25.0 to 85.0 mm),diameter of proximal landing zone was (21.2±2.5) mm (range:17.0 to 29.5 mm),and length of proximal landing zone was (31.4±13.0) mm (range:11.0 to 75.0 mm).The incidence of MAE was 1.3% (2/156) at 30 days,both were all-cause death cases. The success rate of AAA treatment was 88.5% (138/156) at 360 days. No perioperative access complication and acute lower limb ischemia occurred. All-cause mortality was 2.0% (3/154) at 180 days and 2.6% (4/153) at 360 days,and there was no AAA related death. The incidence of SAE was 23.0%(35/152) at 180 days and 30.5%(46/151) at 360 days, and no device-related SAE occurred. The incidence of type Ⅰor Ⅲ endoleak was 3.4% (5/147) at 180 days and 3.5% (5/144) at 360 days. Conclusion: The new stent graft system is easy to operate,and early-term safety and effectiveness results are expected.
Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Prospective Studies ; China ; Ischemia ; Aortic Aneurysm, Abdominal/surgery*