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 glymphatic system is a recently discovered essential waste-clearance pathway in the central nervous system that plays a pivotal role in maintaining brain homeostasis.Growing evidence suggests that dysfunction of this system is closely associated with the pathogenesis of various neurodegenerative disorders;however,its precise mechanistic involvement in Parkinson's disease is poorly understood.This review systematically summarizes the structural and functional characteristics of the glymphatic system,provides an in-depth exploration of its potential role in Parkinson's disease pathophysiology,and synthesizes current research evidence on glymphatic system-targeted therapeutic strategies,with the aim of establishing a theoretical foundation for advancing the understanding of PD pathogenesis and developing novel diagnostic and therapeutic approaches.

Parkinson's disease(PD)is a common progressive neurodegenerative disease mainly affecting the motor system.Various genetic factors and cellular mechanisms underlying PD have recently been discovered.Emerging evidence suggests that epigenetic modifications play a very important role in the pathogenesis,prevention,and treatment of PD.Epigenetic modification mediates genetic and environmental interactions mainly through complex interactions of DNA methylation,histone modification,and non-coding RNA,thereby affecting expression in the absence of changes in DNA sequence.In this review,we summarize the epigenetic modification mechanisms involved in the pathogenesis of Parkinson's disease.In this review,we summarize the epigenetic modification mechanisms involved in the pathogenesis of Parkinson's disease.Recent studies have found that traditional Chinese medicine can participate in the regulation of abnormal epigenetic modifications in the treatment of PD.Traditional Chinese medicine benefits from its multi-level and multi-target regulatory effects,and various traditional Chinese medicine monomers,compound prescriptions,and techniques have been evaluated,confirming that this is a promising approach for improving symptoms in PD.This review summarizes the mechanisms by which epigenetic modifications contribute to P D,explores the role of traditional Chinese medicine,and provides new ideas for clinical treatment and drug development in PD through epigenetic intervention.

The glymphatic system is a recently discovered essential waste-clearance pathway in the central nervous system that plays a pivotal role in maintaining brain homeostasis.Growing evidence suggests that dysfunction of this system is closely associated with the pathogenesis of various neurodegenerative disorders;however,its precise mechanistic involvement in Parkinson's disease is poorly understood.This review systematically summarizes the structural and functional characteristics of the glymphatic system,provides an in-depth exploration of its potential role in Parkinson's disease pathophysiology,and synthesizes current research evidence on glymphatic system-targeted therapeutic strategies,with the aim of establishing a theoretical foundation for advancing the understanding of PD pathogenesis and developing novel diagnostic and therapeutic approaches.

Parkinson's disease(PD)is a common progressive neurodegenerative disease mainly affecting the motor system.Various genetic factors and cellular mechanisms underlying PD have recently been discovered.Emerging evidence suggests that epigenetic modifications play a very important role in the pathogenesis,prevention,and treatment of PD.Epigenetic modification mediates genetic and environmental interactions mainly through complex interactions of DNA methylation,histone modification,and non-coding RNA,thereby affecting expression in the absence of changes in DNA sequence.In this review,we summarize the epigenetic modification mechanisms involved in the pathogenesis of Parkinson's disease.In this review,we summarize the epigenetic modification mechanisms involved in the pathogenesis of Parkinson's disease.Recent studies have found that traditional Chinese medicine can participate in the regulation of abnormal epigenetic modifications in the treatment of PD.Traditional Chinese medicine benefits from its multi-level and multi-target regulatory effects,and various traditional Chinese medicine monomers,compound prescriptions,and techniques have been evaluated,confirming that this is a promising approach for improving symptoms in PD.This review summarizes the mechanisms by which epigenetic modifications contribute to P D,explores the role of traditional Chinese medicine,and provides new ideas for clinical treatment and drug development in PD through epigenetic intervention.

Parkinson's disease is a neurodegenerative disease associated with abnormal copper metabolism in the brain,which leads to misfolding and aggregation of α-synuclein-copper complexes,which is an important pathological sign of Parkinson's disease.Copper metabolism,i.e.,cellular metabolic processes involving copper ions,is closely related to the pathogenesis of α-synuclein aggregation,dopamine metabolism,mitochondrial dysfunction,oxidative stress,and ferroptosis in Parkinson's disease.In this review,we summarize the molecular metabolic mechanism of copper toxicity by studying the pathological role of copper metabolism in Parkinson's disease,to support our further understanding of the mechanism of action and drug development.

Objective:To explore the value of coronary computed tomography angiography(CCTA)in assessing the relationship between the fat volume around coronary plaque and the abnormal coronary hemodynamics.Methods:A total of 218 hospitalized patients admitted to Cangzhou People's Hospital from June 2022 to September 2023 were selected.In these patients,108 patients without coronary heart disease(CHD)were included in the control group,and 110 CHD patients were included in the observation group.All patients underwent CCTA examination to compare the CT imaging values(FFRCT)of the fat volume around heart and blood flow reserve fraction between the two groups.Receiver operating characteristic(ROC)curve was performed to analyze the efficacy of the fat volume around heart and FFRCT values in predicting coronary artery plaques.Additionally,Pearson's method was used to analyze the correlation between fat volume around heart and FFRCT.Results:The fat volume around heart in the observation group was(168.70±38.16)cm3,which was significantly higher than(98.75±21.19)cm3 in the control group,and the FFRCT value(0.78±0.11)of the observation group was lower than(0.89±0.10)in the control group,with statistically significant differences(t=16.688,8.041,P<0.05),respectively.In the observation group,89 patients occurred plaque,and 21 patients did not occur plaque.In the observation group,the fat volume around heart in patients with plaques was(176.63±34.15)cm3,which was significantly higher than(133.52±36.85)cm3 in patients without plaques,and the FFRCT value in patients with plaques was(0.76±0.10),which was significantly lower than(0.85±0.11)in patients without plaques,with statistically significant differences(t=4.945,3.815,P<0.05),respectively.According to Pearson's analysis,there was a negative correlation between the fat volume around heart and FFRCT value.According to Spearman's analysis,with or without plaques appeared positive correlation with the fat volume around heart in CHD patients,and they appeared negative correlation with FFRct value.According to ROC curve analysis,the area under curve(AUC)values of fat volume around heart,FFRCT,and the combination of them were respectively 0.777,0.726 and 0.930 in predicting the plaques of CHD patients.Conclusion:Hemodynamics and fat volume around heart that is measured by CCTA can predict coronary plaque,and there is a certain of relationship between coronary hemodynamics and the fat volume around coronary artery plaques,which appears negative correlation.

Objective:To analyze the clinical effects of intraoperative transesophageal echocardio-graphy(TEE)in different surgical methods for nephrectomy combined with Mayo Ⅲ-Ⅳ inferior vena cave(IVC)tumor thrombectomy.Methods:In the study,28 patients who did surgery of nephrectomy and Mayo Ⅲ-Ⅳ IVC thrombectomys in Peking University Third Hospital from 2022 January to 2024 February were included.Of the 28 patients,16 patients did robotic surgery,2 patients did laparoscopic surgery,and 10 patients did open surgery.All patients'clinical data were collected.Results:Intra-operative TEE was used in 9 robotic surgeries,of which 7 cases showed image changes compared with preoperative image results.Intraoperative TEE indicated that tumor thrombus entered the right atrium in 2 cases,showed that tumor thrombus grade rose from Mayo Ⅲ to Mayo Ⅳ in 2 cases,and indicated that tumor thrombus adhered to IC wall in 3 cases.All of these surgical plans were timely adjusted.Intra-operative TEE was used in 6 cases of open surgery,and 4 cases of them showed Mayo grade changes com-pared with preoperative image results.Intraoperative TEE indicated that tumor thrombus adhered to the IVC wall in 3 cases,and tumor thrombus adhered to the IVC wall with thrombus in one case.The surgi-cal plans were adjusted,and the tumor thrombus was left or segmentally removed.Laparoscopic surgery did not use intraoperative TEE.The effects of intraoperative TEE included:the combination of explora-tion and TEE monitoring was used in open surgery,and tumor thrombus removal process was fully moni-tored by intraoperative TEE in the robotic surgery.Intraoperative TEE real-time monitored circulatory sta-tus and cardiac function changes.Conclusion:In different surgical methods for nephrectomy com-bined with Mayo Ⅲ-Ⅳ tumor thrombectomy,intraoperative TEE can re-determine the tumor thrombus grade and degree of tumor thrombus adhered to IVC,track the tumor thrombus removal process in real-time,and monitor circulatory status and cardiac function changes.Intraoperative TEE plays an important role in different surgical methods,but its clinical application is still insufficient.Intraoperative TEE is recommended to such type of surgeries.

Objective:To investigate the levels of microRNA (miR) -106b-5p and miR-760 in the serum of early lung cancer patients, and the clinical value of the combination of them and low-dose spiral CT in the diagnosis of early lung cancer.Methods:Ninety early lung cancer patients (lung cancer group) who underwent treatment in Cangzhou People's Hospital of Hebei Province from January 2022 to March 2023 were collected as research subjects, meantime, 90 patients with benign pulmonary lesions (benign pulmonary nodules) diagnosed by pathology were selected as the control group. The levels of miR-106b-5p and miR-760 in the serum of two groups were compared, the results of low-dose spiral CT examination were analyzed; receiver operating characteristic curve was drawn to determine the optimal cut-off values of serum miR-106b-5p and miR-760; four grid table method was applied to analyze the diagnostic efficacy of serum miR-106b-5p, miR-760 combined with low-dose spiral CT for early lung cancer.Results:The level of miR-106b-5p in lung cancer group was higher than that in control group (1.39±0.31 vs. 1.04±0.30), serum miR-760 level was lower than that in control group (0.75±0.24 vs. 1.02±0.26), with statistically significant differences ( t=7.70, P<0.001; t=7.24, P<0.001). The area under curve (AUC) of miR-106b-5p, miR-760 and low-dose spiral CT in the diagnosis of early lung cancer was 0.83, 0.81 and 0.82, the accuracy was 76.67%, 77.22% and 81.67%, the sensitivity was 84.44%, 81.11% and 76.67%, and the specificity was 68.89%, 73.33% and 86.67%, respectively. The AUC, accuracy, sensitivity, and specificity of serum miR-106b-5p, miR-760 combined with low-dose spiral CT in diagnosing early lung cancer were 0.96, 90.00%, 94.44%, and 85.56%, respectively. The accuracy of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p, miR-760 and low-dose spiral CT ( χ2=11.52, P=0.001; χ2=10.72, P=0.001; χ2=5.14, P=0.023), the sensitivity of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p, miR-760 and low-dose spiral CT ( χ2=4.77, P=0.029; χ2=7.46, P=0.006; χ2=11.51, P=0.001), the specificity of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p, miR-760 ( χ2=7.11, P=0.008; χ2=4.12, P=0.042) . Conclusion:The serum level of miR-106b-5p is significantly increased in early lung cancer patients, while the serum level of miR-760 is significantly reduced. The combination of miR-106b-5p, miR-760 and low-dose spiral CT has high diagnostic value for early lung cancer.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.