ObjectiveTo investigate the associations of multiple glycolipid metabolic indicators and their cumulative abnormality burden with incident colorectal cancer risk in a general population-based prospective cohort, and to examine the mediating role of glycolipid metabolic abnormalities in the relationships between smoking, alcohol consumption, physical activity, and colorectal cancer incidence. MethodsA total of 17 897 eligible participants recruited from the Taizhou Cohort between 2011 and 2014 were included. Cox proportional hazards regression models were used to assess the associations of conventional and derived glycolipid indicators, as well as a glycolipid abnormality index constructed from total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting plasma glucose, and insulin, with incident colorectal cancer risk. Restricted cubic spline models were applied to evaluate dose-response relationships for major indicators. Receiver operating characteristic curves were generated to compare predictive performance across indicators. Mediation analyses were conducted to assess the mediating effects of the glycolipid abnormality index on the associations of smoking, alcohol consumption, and physical activity with colorectal cancer incidence. ResultsDuring a median follow-up of 11.2 years, 102 incident colorectal cancer cases were identified, with an incidence density of 51.2 per 100 000 person-years. After adjustment for potential confounders, Cox proportional hazards regression analyses showed that decreased high-density lipoprotein cholesterol was associated with a 1.74-fold higher risk of colorectal cancer (HR=1.74, 95%CI: 1.03‒2.95), elevated low-density lipoprotein cholesterol was associated with a 1.78-fold higher risk (HR=1.78, 95%CI: 1.05‒3.02), and abnormal fasting plasma glucose was associated with a 1.86-fold higher risk (HR=1.86, 95%CI: 1.15‒3.02). Triglycerides and fasting plasma glucose showed an approximately linear increasing association with colorectal cancer risk in multivariable restricted cubic spline models. The glycolipid abnormality index showed a clear gradient association with colorectal cancer risk; participants with three or more abnormal indicators had a 3.08-fold higher risk than those without abnormalities (HR=3.08, 95%CI: 1.60‒5.92). The area under the curve was 0.795, higher than that of individual glycolipid indicators and other combined indices, and gender-stratified analyses showed generally consistent patterns. Glycolipid metabolic abnormalities partially mediated the associations of smoking, alcohol consumption, and physical activity with colorectal cancer incidence, with mediation proportions of 8.33%, 9.45%, and 9.04%, respectively. ConclusionGlycolipid metabolic abnormalities are associated with an increased risk of incident colorectal cancer. The glycolipid abnormality index shows an increasing relationship with colorectal cancer risk and demonstrates better discrimination, and it partially mediates the associations of smoking, alcohol consumption, and physical activity with colorectal cancer incidence in the overall population.

Objective To explore the effect of single port laparoscopic traceless technology for child contralateral latent hernia.Methods Three hundred and twelve children cases of unilateral indirect inguinal hernia in Mianyang 404 Hospital from June 2013 to June 2016 were retrospectively analyzed.Among them,170 cases receivedsingle port laparoscopic traceless technology and 142 cases underwent common open surgery.The gender,age,recurrent rate,onset site of unilateral side,cases number of postoperative contralateral asynchrony hernia occurrence,cases number of contralateral vaginal process deformity found by laparoscopy and onset time of postoperative asynchrony hernia were compared between the two kinds of surgery.Results Among the 142 cases of common open surgery,male accounted for 97.8％ and female accounted for 2.2％,and the average age was (2.45±2.18) years old;the postoperative contralateral asynchrony hernia occurred in 5 cases (3.5％),in which 1 case (0.7％) was in the right side and 4 cases in the left side,the difference between them was statistically significant (x2 =5.30,P=0.01),the asynchrony hernia occurred in postoperative 8,14,18,20,24 months.Three cases (2.1 ％) had hernia relapse.The laparoscopic surgery had 170 cases,including 145 male cases (85.3％) and 25 female cases (14.7％),the average age was (2.44±2.15) years old.The intraoperation found 86 cases (50.6 ％) of latent hernia of contralateral vaginal process deformity,while the asynchrony inguinal indirect hernia was not found,1 case had the relapse in postoperative 18 months,the difference was statistically significant compared with the patients with open surgery (x2=10.12,P=0.01).Conclusion Single port laparoscopic surgery for treating child unilateral inguinal indirect hernia can accurately judge whether having contralateral latent hernia and simultaneously conducts the operation compared with the common open operation,its postoperative relapse rate and asynchrony hernia occurrence rate are significantly decreased.