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*

The endometrial thickness is a crucial indicator for pregnancy success. Thin endometrium is typically related to low clinical pregnancy and live birth rate. Current research indicates that granulocyte colony-stimulating factor (G-CSF) is a glycoprotein that recognized as a cytokine and growth factor, which may support the establishment of endometrial receptivity during embryo implantation through promoting angiogenesis, embryo adhesion, and trophoblast invasion, thus increasing the endometrial thickness and clinical pregnancy rate. However, there are still conflicts about the efficacy of G-CSF. Therefore, identifying the pathological mechanism of thin endometrium and how G-CSF promotes endometrial thickness and receptivity has clinical significance. This article will review the progress on clinical research and molecular mechanism of G-CSF in treating thin endometrium.

The endometrial thickness is a crucial indicator for pregnancy success. Thin endometrium is typically related to low clinical pregnancy and live birth rate. Current research indicates that granulocyte colony-stimulating factor (G-CSF) is a glycoprotein that recognized as a cytokine and growth factor, which may support the establishment of endometrial receptivity during embryo implantation through promoting angiogenesis, embryo adhesion, and trophoblast invasion, thus increasing the endometrial thickness and clinical pregnancy rate. However, there are still conflicts about the efficacy of G-CSF. Therefore, identifying the pathological mechanism of thin endometrium and how G-CSF promotes endometrial thickness and receptivity has clinical significance. This article will review the progress on clinical research and molecular mechanism of G-CSF in treating thin endometrium.

In recent years,significant progress has been made in the study of endometrial epitheli-al organoids in the field of reproduction.Traditional two-dimensional cell culture models and animal ex-periments fail to accurately replicate the three-di-mensional structure and physiological functions of the endometrium,limiting the in-depth exploration of its normal physiological mechanisms and related disease mechanisms.Emerging organoid technolo-gies have provided new avenues for research.These organoids,formed by self-organization of stem cells or progenitor cells in a three-dimensional culture system,faithfully recapitulate the character-istics of endometrial glands in situ.Not only can these organoid models mimic the changes in the endometrium at different stages of the menstrual cycle,but they can also simulate the interaction be-tween the fertilized embryo and the endometrium.Moreover,organoid systems have become essential tools for fundamental research in the field of repro-duction and for disease research,including studies related to reproductive biology,drug screening and development,disease mechanism exploration,drug action mechanisms,drug combination therapies,and targeted therapies.These studies have provid-ed novel insights and methods for a deeper under-standing of the biological properties of the endome-trium,its disease mechanisms,and the develop-ment of therapeutic strategies for related disorders.

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 surgical treatment strategy of acute type A aortic dissection (ATAAD) complicated with Neri type C coronary artery involvement on the basis of detailed classification.Methods Clinical data of 21 cases of ATAAD complicated with Neri type C coronary artery involvement in our hospital from November 2020 to February 2024 were retrospectively analyzed.The dissection involved the coronary artery,and the onset time was less than 1 week.Total aortic arch replacement,descending aorta stent and elephant trunk artificial vessel placement,ascending aorta replacement,and coronary artery management were performed.The treatment of detailed classification and coronary artery was as follows.Seven cases with type C1 ( local damage and rupture of coronary artery opening,partial connection with pseudolumen,and no proximal coronary involvement) were repaired with artificial material"copper coin sample";3 cases with type C2 ( severe avulsion of coronary artery opening,complete connection with pseudolumen,slight proximal involvement of coronary artery,and no sleeve formation) were replaced with 8 mm artificial vessels;11 cases with type C3 ( severe avulsion of coronary artery opening,complete connection with pseudolumen,severe proximal involvement of coronary artery,and sleeve formation) were transplanted by great saphenous vein bypass.Results Two patients died in hospital (all type C3),all of whom had difficulty in cardioversion and were given extracorporeal membrane oxygenation (ECMO) assisted circulation,and passed away on the same day and the second day after surgery,respectively.Aortic and coronary CTA were re-examined in the remaining 19 patients before discharge,and no coronary artery opening stenosis or bridge stenosis was found.Aortic and coronary CTA were re-examined at 6,12,and 18 months after surgery,respectively.The 19 patients were followed up for 6-36 months ( mean,21 months),and there were no cases of coronary artery opening stenosis or bridge stenosis.According to the New York Heart Association (NYHA) functional classification,there were 15 patients with grade Ⅰ and 4 patients with grade Ⅱ.Conclusion The detailed classification of ATAAD combined with Neri type C coronary artery involvement has guiding significance for surgical precision treatment.

Objective To explore the surgical treatment strategy of acute type A aortic dissection (ATAAD) complicated with Neri type C coronary artery involvement on the basis of detailed classification.Methods Clinical data of 21 cases of ATAAD complicated with Neri type C coronary artery involvement in our hospital from November 2020 to February 2024 were retrospectively analyzed.The dissection involved the coronary artery,and the onset time was less than 1 week.Total aortic arch replacement,descending aorta stent and elephant trunk artificial vessel placement,ascending aorta replacement,and coronary artery management were performed.The treatment of detailed classification and coronary artery was as follows.Seven cases with type C1 ( local damage and rupture of coronary artery opening,partial connection with pseudolumen,and no proximal coronary involvement) were repaired with artificial material"copper coin sample";3 cases with type C2 ( severe avulsion of coronary artery opening,complete connection with pseudolumen,slight proximal involvement of coronary artery,and no sleeve formation) were replaced with 8 mm artificial vessels;11 cases with type C3 ( severe avulsion of coronary artery opening,complete connection with pseudolumen,severe proximal involvement of coronary artery,and sleeve formation) were transplanted by great saphenous vein bypass.Results Two patients died in hospital (all type C3),all of whom had difficulty in cardioversion and were given extracorporeal membrane oxygenation (ECMO) assisted circulation,and passed away on the same day and the second day after surgery,respectively.Aortic and coronary CTA were re-examined in the remaining 19 patients before discharge,and no coronary artery opening stenosis or bridge stenosis was found.Aortic and coronary CTA were re-examined at 6,12,and 18 months after surgery,respectively.The 19 patients were followed up for 6-36 months ( mean,21 months),and there were no cases of coronary artery opening stenosis or bridge stenosis.According to the New York Heart Association (NYHA) functional classification,there were 15 patients with grade Ⅰ and 4 patients with grade Ⅱ.Conclusion The detailed classification of ATAAD combined with Neri type C coronary artery involvement has guiding significance for surgical precision treatment.

ObjectiveTo develop a high-quality rehabilitation major curriculum using the World Health Organization rehabilitation competency framework (RCF), to improve the level of traditional Chinese medicine (TCM) rehabilitation major, to meet the requirements of competency-based education development. MethodsThe competence requirements of rehabilitation professionals of higher traditional TCM colleges and universities were analyzed using the theory and method of RCF. ResultsThe competency structure of TCM rehabilitation talents based on RCF was built, and the curriculum setting of TCM rehabilitation based on RCF was proposed. According to the characteristics of the educational environment of colleges and universities, a competency model suitable for undergraduate-level TCM rehabilitation major was established. ConclusionThe theory and methods of RCF are of great significance for the construction of competency-based education system of TCM rehabilitation major. Based on RCF, this study constructs the basic and practical curriculum system of TCM rehabilitation at the undergraduate level to promote the training of applied talents in TCM rehabilitation.

Objective:To evaluate the influence of 25-hydroxyvitamin D[25(OH)D]on dyslipidemia in elderly female patients with type 2 diabetes(T2DM)mellitus aged 60 or over.Methods:We retrospectively reviewed the clinical records of 175 type 2 diabetic older women meeting the inclusion criteria, admitted to the Department of Endocrinology, Beijing Chuiyangliu Hospital, between January and December 2020, with an average age of 66(63, 70)years.According to the diagnostic criteria of dyslipidemia(cholesterol ≥6.2 mmol/L, high density lipoprotein cholesterol <1.0 mmol/L, low-density lipoprotein cholesterol ≥4.1 mmol/L or triglycerides ≥2.3 mmol/L), 110 participants(62.9%)were divided into a dyslipidemia group and 65 participants(37.1%)were assigned into a normal blood lipid group.Logistic regression was employed to investigate factors influencing dyslipidemia.Spearman correlation analysis was employed to analyze the correlation between serum 25(OH)D and blood lipid indexes.Results:The median serum 25(OH)D level of the 175 subjects was 10.92(8.1, 15.2)μg/L.For the dyslipidemia group, it was 9.1(5.8, 12.9)μg/L, lower than 11.9(8.4, 22.6)μg/L in the normal blood lipid group.The proportion of people with hypertension in the dyslipidemia group was higher than in the normal blood lipid group.The dyslipidemia group also had higher BMI, waist circumference and homocysteine levels( P<0.05). Results of multivariate logistic regression analysis demonstrated that hypertension, waist circumference, and homocysteine were significant risk factors for dyslipidemia in elderly women with T2DM, whereas serum 25(OH)D was a protective factor( P<0.05). Correlation analysis results identified that cholesterol and low density lipoprotein cholesterol were inversely correlated to 25(OH)D while high density lipoprotein cholesterol was positively correlated to it( P<0.05). Conclusions:There is a serious deficiency of serum 25(OH)D in older women with T2DM.25(OH)D is protective factor in elderly T2DM women against dyslipidemia.Clinicians should pay attention to vitamin D deficiency in patients during diagnosis and treatment and correct the deficiency.